What is Sudeck’s atrophic syndrome?
Sudeck’s atrophic syndrome, also known as Complex Regional Pain Syndrome or Reflex Sympathetic Dystrophy, has been defined in many different ways, due to its great complexity.
What are its main symptoms?
Currently, a series of polymorphous clinical forms are included under this denomination, in which functional impotence, trophic alterations and the presence of pain stand out. It mainly affects the extremities and may affect several joints.
Although its most common cause is trauma, it can be caused by metabolic alterations, tumors (benign and malignant) or even idiopathic causes.
As for the mechanisms of production, there are several theories being the Sympathetic-Reflex of Leriche the one that has more followers. This account is due to an alteration of the vegetative innervation, which causes alterations at the microcirculation level. The abnormal action of the sympathetic nervous system causes disorders in the nervous trophism of the tissues and vasomotor disorders. At night, pain may appear spontaneously.
The causes of pain may be in this case:
- Edemas
- Hyperemia
- Hyperpressure
Are there subtypes of this disorder?
In order to facilitate its differential diagnosis with other types of chronic pain, Complex Regional Pain Syndrome has two forms:
- CRPS 1 or Sudeck’s atrophy: a chronic neurological disorder occurring in the arms or legs after a minor injury.
- CRPS 2: caused by a nerve injury, formerly known as causalgia.
How is this pathology diagnosed?
The main problem of this syndrome is its identification and diagnosis, since its symptoms are complex and difficult to identify.
Its evolution can be divided into three stages:
- Acute: first stage that can last up to one trimester. It begins with burning or pain on physical contact. In any case, inflammation and stiffness in the joints of the body are present.
- Dystrophic: stage that can last 3 to 12 months. It is when the swelling and the affected limb increases. In addition, the skin temperature gradually becomes cooler, as well as the sensitivity to touch and the nails tend to break.
- Atrophic: final stage that occurs after one year after the disease has affected the person. The skin in the affected area becomes pale, tightens and dries out. Generally, it is concluded that there is little hope of recovering movement in the affected area. For this reason, the pain decreases and the syndrome continues to spread to another part of the body.
However, this clinical course does not always occur. Its evolution is generally good and leaves no sequelae in most patients. However, sometimes it persists in the form of functional limitation, which will end in capsulo-ligamentous retractions and atrophies.