Q. - An elderly lady presents with severe pain and disability in full use of his whole affected extremity after sustaining distal radius fracture and a course of plaster for six weeks. Fracture has healed and the recent radiograph is given below. What possibly can be cause of pain and discomfort ?
1. reaction to plaster material
2. nerve damage following fracture
3. CRPS
4. late compartment syndrome
Answer
The radiograph showing patchy , spotty osteoporosis following the aforementioned complaint after sustaining a trauma, apperas to be a case of CRPS (complex regional pain syndrome). Previously it was also known as Sudeck's sympathetic osteodystrophy, causalgia, allodynia etc. The involvement of problem in whole extremity may be due to affected shoulder and adjacent joints i.e. Shoulder -hand syndrome.
Other options are excluded as the nerve damage would lead to clinical affectation of the distribution of nerve as motor or sensory complaints and not global problem of the entire extremity.
Reaction to plaster material would have presented earlier and full course of immobilisation would not have been possible.
late compartment syndrome would have associated muscle atrophy and contractures and out of proportion pain would have been presented at earlier stages.
1. reaction to plaster material
2. nerve damage following fracture
3. CRPS
4. late compartment syndrome
Answer
The radiograph showing patchy , spotty osteoporosis following the aforementioned complaint after sustaining a trauma, apperas to be a case of CRPS (complex regional pain syndrome). Previously it was also known as Sudeck's sympathetic osteodystrophy, causalgia, allodynia etc. The involvement of problem in whole extremity may be due to affected shoulder and adjacent joints i.e. Shoulder -hand syndrome.
Other options are excluded as the nerve damage would lead to clinical affectation of the distribution of nerve as motor or sensory complaints and not global problem of the entire extremity.
Reaction to plaster material would have presented earlier and full course of immobilisation would not have been possible.
late compartment syndrome would have associated muscle atrophy and contractures and out of proportion pain would have been presented at earlier stages.
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