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Handchirurgie Scan 2023; 12(01): 57-79
DOI: 10.1055/a-1778-9786
CME-Fortbildung
Varia

Complex Regional Pain Syndrome (CRPS)

Diagnostik und Behandlungsmöglichkeiten
Ariane Asmus
,
Pattariya Jänsch
,
Sylvia-Sofia Pappa-Eisenschenk
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Das klinische Bild eines „Complex Regional Pain Syndrome“ (CRPS) ist der wesentliche diagnostische Pfeiler, das Syndrom als solches zu diagnostizieren. Dabei hilft es, die weniger bekannten Zeichen der Kategorien Sensorik, Vasomotorik, Sudomotorik und Motorik zu erkennen, um Hinweise auf die zu erwartende Prognose zu bekommen. Neu ist der CRPS Severity Score, der über die Erfassung klinischer Symptome helfen kann, Differenzialdiagnosen und insbesondere den neuropathischen Schmerz abzugrenzen sowie Tendenzen und Therapieerfolge zu beurteilen.
Kernaussagen

  • Patienten mit den Diagnosen CRPS-NOS und CRPS with Remission of some Features als Diagnosen berücksichtigen.

  • Erkennen und Therapieren anhaltender schmerzinduzierender Trigger ohne Sorge vor operativen Interventionen unter ausreichendem Schutz.

  • Checklisten und der CSS hilft, Symptome zu dokumentieren und Tendenzen zu erkennen.

  • Erfassen auch selten auftretender und wenig beachteter, vor allem motorischer Symptome.

  • Die eindeutige Zuordnung der verschieden Schmerzsyndrome hilft, Therapien besser einzuschätzen und Verläufe zu vergleichen.

  • Das Risiko einer Zweiterkrankung an CRPS ist nicht zu unterschätzen.

  • Interdisziplinäre Zusammenarbeit, aber einen koordinierenden Ansprechpartner für Patienten vereinbaren.

  • Suffiziente Schmerztherapie, aber auch funktionelle Therapien wie Handergotherapie und Krankengymnastik nutzen.

Schlüsselwörter

CRPS - Operation - klinische Zeichen - CRPS-NOS - neuropathischer Schmerz


Publication History

Received: 19 February 2022

Article published online:
09 March 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
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