Quantitative sensory testing

Results of computer-driven quantitative sensory testing (QST) are sparse because there are few clinical laboratories with this capability. However, it is essential to test for the function of large and small peripheral sensory fibers with the usual bedside modalities. Light touch, pinprick/von Frey, cold/heat, vibration, and propriocep-tion should be recorded. In addition, a qualitative estimate should be made of allodynia and hyperesthesia to pinprick, light touch, deep pressure, and temperature, comparing the affected and unaffected limbs. Painful joint movement should also be noted.17 Unfortunately, changes are not specific for CRPS.

Table 27.2 Incidence of sensory symptoms in CRPS I and II.

Spontaneous pain

75-S1

Hyperalgesia

S3-S6

Cold

32-61a

Allodynia

Brush

26

Quality

Tearing

25-30

Burning

16-26

Stinging

17-22

Squeezing

S-12

Location

Deep

63-65

Superficial

30

Dysesthesia

28-52a

Distribution

Stocking/glove

30-37

Palms/soles

30-52

Pinprick

Hypoalgesia

42-60

Hyperalgesia

22-3S

No change

13-1S

Touch

Hypoesthesia

50-70

Hyperesthesia

S-18

No change

22-32

CRPS, complex regional pain syndrome. aSignificantly higher in CRPS II.

Adapted from Oaklander AL, Birklein F. Factor I: sensory changes -pathophysiology and measurement. CRPS: current diagnosis and therapy. In: Wilson PR, Stanton-Hicks M, Harden RN (eds). Progress in Pain Research and Management. Seattle: IASP Press, 2005: 59-79.

CRPS, complex regional pain syndrome. aSignificantly higher in CRPS II.

Adapted from Oaklander AL, Birklein F. Factor I: sensory changes -pathophysiology and measurement. CRPS: current diagnosis and therapy. In: Wilson PR, Stanton-Hicks M, Harden RN (eds). Progress in Pain Research and Management. Seattle: IASP Press, 2005: 59-79.

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