Prognosis

Childhood CRPS presents with a wide clinical spectrum that ranges from a mild self-limited course to severe pain and disability. In contrast to adult CRPS, the time course of illness in childhood CRPS is shorter and the prognosis is favorable in most children.44[V], 45[V], 58[V], 62[V], 63 [II], 88[V] Early treatment may shorten the course of the illness and disability, and may prevent osseous growth deformities.89[V], 90[V] In three retrospective pediatric trials, aggressive therapy of active mobilization, analgesics and/or psychological therapy yielded functional improvement ranging from 60, 69, and 92 percent, respectively.45 [V], 62[V], 91[V] A long-term follow-up study of 70 children with CRPS reported the presence of some degree of residual pain and dysfunction in 54 percent of children at a median follow-up interval of three years and 50 percent of those children who were engaged in competitive sport before treatment were unable to return to sports because of residual pain.44[V] A recent controlled trial of pediatric CRPS showed a response rate of 89 percent to conservative therapy, including resolution of musculoskeletal signs, improvement in function, and return to school. Although recurrent episodes were frequent, most patients continued to respond to conservative therapy more readily than with the initial therapy after onset of the CRPS.63[II]

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