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Fundamentals of Infrared Thermal Imaging
Published in U. Snekhalatha, K. Palani Thanaraj, Kurt Ammer, Artificial Intelligence-Based Infrared Thermal Image Processing and Its Applications, 2023
U. Snekhalatha, K. Palani Thanaraj, Kurt Ammer
Complex regional pain syndrome (CRPS) is a chronic pain syndrome which affects the upper and lower extremities following injuries, often of minor in nature, but surgery or in rare cases even heart infarction or a lung tumor may be the initial trigger. Early diagnosis and treatment of CRPS improve the functional prognosis. The International Association for the Study of Pain (IASP) classified CRPS into two types as follows: Type I, formerly known as “reflex sympathetic dystrophy,” in which a peripheral nerve injury is not observed, and type II, formerly known as “causalgia.” Diagnosis of CRPS is based on the “Budapest Criteria,” where a temperature difference of 1°C between affected and non-affected limb is required to evidence vasomotor disturbance. There are several non-invasive methods available to detect the components of CRPS. The skin temperature changes can be measured by a thermal camera and a GSR sensor may be used for sweating detection. Quantitative sensory testing identifies sensory deficits, trophic alterations, and edematous swellings found by inspection and palpation. Pain related information is captured in the patient’s history and quantified by a pain scale.
Complex regional pain syndrome type I
Published in Peter Houpt, Hand Injuries in the Emergency Department, 2023
The diagnosis is based on clinical symptoms. An acute CRPS is characterized by major symptoms: swelling, stiffness, pain, functio laesa and rubor. Autonomic dysregulation can express itself as increased sweating, discoloration, abnormal temperature and trophic disorders such as abnormal growth of hairs and nails.
Thermography by Specialty
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Thermographic studies have focused on CRPS1, algodystrophy. The neuropathic pain of CRPS1 is characterized by significant autonomic and inflammatory features.124 In general, CRPS patients initially exhibit the classic signs of inflammation, i.e., heat, pain, redness, and swelling.125
Signs and symptoms of pediatric complex regional pain syndrome - type 1: A retrospective cohort study
Published in Canadian Journal of Pain, 2023
Giulia Mesaroli, Logan McLennan, Yvonne Friedrich, Jennifer Stinson, Navil Sethna, Deirdre Logan
Differences in the prevalence rates of symptoms versus signs may be related several factors. First, clinical features of CRPS are episodic in nature, and patients may be able to self-report symptoms experienced in the prior days that are not present during the time of the physical examination. Perhaps some clinical features such as color changes, swelling, and temperature are more episodic—that is, dynamic regional autonomic nervous system dysregulation due to immobilization of the limb—than others (e.g., skin texture, nail and hair growth changes) due to chronic poor circulation to deliver nutrition over time, explaining this difference in prevalence rates across symptoms vs. signs. Second, patients may be able to report symptoms that have resolved and are not present on physical exam. Third, some symptoms may be difficult for patients to report because of persistent pain and immobilization of the affected limb (e.g., sweating changes, temperature changes, weakness) that may be more easily detected as a sign on physical exam using objective measures (e.g., skin thermometer, sweat test, manual muscle testing).
Bio-Electro-Magnetic-Energy-Regulation (BEMER) for the treatment of type I complex regional pain syndrome: A pilot study
Published in Physiotherapy Theory and Practice, 2020
Maria Grazia Benedetti, Lorenzo Cavazzuti, Massimiliano Mosca, Isabella Fusaro, Alessandro Zati
Complex regional pain syndrome (CRPS) is a painful condition, typically affecting the limbs, which arises usually after an injury or a fracture and is divided into two forms: (1) the classical one, type 1 (CRPS-I); and (2) type 2 (CRPS-II), resulting from nerve injury. CRPS-I is characterized by regional pain and edema, not proportional in time or degree with respect to the usual course of any known trauma or other lesion, and is usually associated with abnormal sensory, motor, sudomotor, vasomotor, and/or trophic findings, and bone structure abnormalities (Harden, Bruehl, Stanton-Hicks, and Wilson, 2007). The cause of CRPS-I is unknown. Local release of pro-inflammatory neuropeptides and some cytokines has been recently claimed as the event that triggers and maintains the first stages of illness while, in subsequent stages, disturbance of the microcirculation and micro-damage vascular appears to be the pathogenetic mechanisms responsible for the observable clinical evolution in most cases (Varenna and Zucchi, 2015). Treatment of CRPS-I requires an integrated interdisciplinary approach, based on pain relief, patient information, and education to support self-management, psychological interventions, and physical and vocational rehabilitation. In the earliest stages of the disease, physiotherapy is proposed with the aim to reduce local edema and improve functional limitation associated with an adequate pharmacological coverage of the pain symptoms (Goebel et al., 2012).
Utilization of manual therapy to the lumbar spine in conjunction with traditional conservative care for individuals with bilateral lower extremity complex regional pain syndrome: A case series
Published in Physiotherapy Theory and Practice, 2020
Zachary Walston, Luis Hernandez, Dale Yake
Conservative therapies for CRPS have traditionally focused on pain management in combination with strength and flexibility training and manual soft tissue techniques to the involved extremity (De Jong et al., 2005; Harden, 2001; Harden et al., 2013; Oerlemans, Goris, de Boo, and Oostendorp, 1999; Quisel, Gill, and Witherell, 2005; Sherry et al., 1999; Smith, 2005; Van de Meent et al., 2011). The focus of physical therapy (PT) is on reducing pain, improving mobility and strength, and restoring function. A variety of treatment strategies are used including desensitization therapy, progressive exercise, thermal modalities, transcutaneous electrical stimulation, manual therapy, and patient education (Harden, 2001; Oerlemans, Goris, de Boo, and Oostendorp, 1999; Rho, Brewer, Lamer, and Wilson, 2002; Sherry et al., 1999; Van de Meent et al., 2011). A review of the current literature suggests the treatments listed above have historically been the treatment choice and approach for most clinicians and are well-accepted for CRPS. However, the CRPS is a lack of high-quality evidence evaluating the effectiveness of PT for this patient population (Oerlemans, Goris, de Boo, and Oostendorp, 1999; Polard, 2013; Quisel, Gill, and Witherell, 2005). Current literature is focused on treating the distal extremity, where the subjective symptoms are primarily reported (Quisel, Gill, and Witherell, 2005). Simply treating the area of subjective complaint ignores other potential contributing factors and areas that allow for superior outcomes.