Affiliations: [a] Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Akdeniz University, Antalya, Turkey | [b] Department of Nuclear medicine, Faculty of Medicine, Akdeniz University, Antalya, Turkey | [c] Department of Orthopedics and Traumatology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
Correspondence:
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Address for correspondence: Dr. Ilhan Sezer, Department of Physical Medicine and Rehabilitation, School of Medicine, Akdeniz Universitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Romatoloji Bilim Dalı, Antalya, Turkey. Tel.: +90 242 2496000; Fax: +90 242 2274490; E-mail: drilhans@gmail.com
Abstract: Objective:The aim of the present study was to evaluate and compare the role of dual energy X-ray absorptiometry and three-phase bone scintigraphy in the diagnosis of complex regional pain syndrome type I of upper extremity. Methods:Five male and nineteen female patients diagnosed with complex regional pain syndrome type I (CRPSI) were included in this study. Three-phase bone scintigraphy (TPBS), bone mineral density (BMD) and bone mineral content (BMC) of wrist, metacarpophalangeal joint (MCP) and proximal interphalangeal (PIP) area in the affected and unaffected hands of patients were measured simultaneously using dual energy X-ray absorptiometry (DEXA). The time passed between the precipitating event and clinical onset of CRPSI was also recorded. Results:TPBS findings were in agreement with CRPSI diagnosis in 96% of the patients (23 of 24 patients). Periarticular BMD and BMC values in wrist, MCP, and PIP joints were statistically lower in affected hands than in unaffected hands for all three regions. Moreover, we found no correlation between BMD or BMC values with the sex, age, dominant hand, and the duration between the clinical onset of CRPSI and its precipitating event. Conclusion:The present study suggests that beside TPBS, a valuable tool in the early diagnosis of CRPSI, DEXA can also be used in the determination of early demineralization of bones in CRPSI patients. DEXA is an accurate, noninvasive, rapid, and safe device for quantitative assessment of unilateral bone loss caused by upper limb CRPSI.
Keywords: Complex regional pain syndrome, densitometry, three-phase bone scintigraphy
