Evaluation of bone microstructure in CRPS-affected upper limbs by HR-pQCT

TY - JOUR

T1 - Evaluation of bone microstructure in CRPS-affected upper limbs by HR-pQCT

AU - Mussawy, Haider

AU - Schmidt, Tobias

AU - Rolvien, Tim

AU - Rüther, Wolfgang

AU - Amling, Michael

PY - 2017/7/26

Y1 - 2017/7/26

N2 - INTRODUCTION: Complex regional pain syndrome (CRPS) is a major complication after trauma, surgery, and/or immobilization of an extremity. The disease often starts with clinical signs of local inflammation and develops into a prolonged phase that is characterized by trophic changes and local osteoporosis and sometimes results in functional impairment of the affected limb. While the pathophysiology of CRPS remains poorly understood, increased local bone resorption plays an undisputed pivotal role. The aim of this retrospective clinical study was to assess the bone microstructure in patients with CRPS.METHODS: Patients with CRPS type I of the upper limb whose affected and unaffected distal radii were analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT) were identified retrospectively. The osteology laboratory data and dual-energy X-ray absorptiometry (DXA) images of the left femoral neck and lumbar spine, which were obtained on the same day as HR-pQCT, were extracted from the medical records.RESULTS: Five patients were identified. The CRPS-affected upper limbs had significantly lower trabecular numbers and higher trabecular thicknesses than the unaffected upper limbs. However, the trabecular bone volume to total bone volume and cortical thickness values of the affected and unaffected sides were similar. Trabecular thickness tended to increase with time since disease diagnosis.DISCUSSION: CRPS associated with significant alterations in the bone microstructure of the affected upper limb that may amplify as the duration of disease increases.

AB - INTRODUCTION: Complex regional pain syndrome (CRPS) is a major complication after trauma, surgery, and/or immobilization of an extremity. The disease often starts with clinical signs of local inflammation and develops into a prolonged phase that is characterized by trophic changes and local osteoporosis and sometimes results in functional impairment of the affected limb. While the pathophysiology of CRPS remains poorly understood, increased local bone resorption plays an undisputed pivotal role. The aim of this retrospective clinical study was to assess the bone microstructure in patients with CRPS.METHODS: Patients with CRPS type I of the upper limb whose affected and unaffected distal radii were analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT) were identified retrospectively. The osteology laboratory data and dual-energy X-ray absorptiometry (DXA) images of the left femoral neck and lumbar spine, which were obtained on the same day as HR-pQCT, were extracted from the medical records.RESULTS: Five patients were identified. The CRPS-affected upper limbs had significantly lower trabecular numbers and higher trabecular thicknesses than the unaffected upper limbs. However, the trabecular bone volume to total bone volume and cortical thickness values of the affected and unaffected sides were similar. Trabecular thickness tended to increase with time since disease diagnosis.DISCUSSION: CRPS associated with significant alterations in the bone microstructure of the affected upper limb that may amplify as the duration of disease increases.

KW - Journal Article

U2 - 10.11138/ccmbm/2017.14.1.054

DO - 10.11138/ccmbm/2017.14.1.054

M3 - SCORING: Journal article

C2 - 28740526

VL - 14

SP - 54

EP - 59

JO - Clin Cases Miner Bone Metab

JF - Clin Cases Miner Bone Metab

SN - 1724-8914

IS - 1

ER -