earticle

영어

Diagnosis and treatment of complex regional pain syndromes (CRPS) continue to generate controversy among clinicians and frustration and suffering for patients. As a result, the clinical features of pediatric CRPS remain poorly understood. We report a case of CRPS in a 15- year -old girl after minor trauma. She was consulted from pediatrics with right arm pain and edema that occurred 6 months ago. After blood test for school health checkup, a bruise appeared at the puncture site, followed by swelling and tenderness. She complained of a pain with a numerical rating scale (0 = no pain, 10 = worst pain imaginable) 5 when rest and 7 in motion. The MR angiography and ultrasound were performed, revealed swelling of subcutaneous layer of upper arm. She showed a temporary response to steroid therapy under suspicion of cellulitis or panniculitis, however, the lesion recurred. After a multidisciplinary evaluation, the possibility of other diagnosis was ruled out. CRPS type 1 was diagnosed. She received intermittent steroid therapy, and exercise for range of motion. Medications were not effective, except for combination of codeine, ibuprofen and acetaminophen. We will register her for bio-data genome testing and plan sympathetic block or intravenous infusion. CRPS in children and adolescents is still underdiagnosed. The management by an experienced multidisciplinary team is recommended.