Navil Sethna1, SungJun Son1, Christine Sieberg1
1) United States
Background and Aims: Complex Regional Pain Syndrome (CRPS) is a debilitating chronic pain condition that often affects one of the extremities, the upper extremity in particular. Currently, there is a lack of pediatric-focused diagnostic criteria. The specific aims of the study are two-fold: 1) evaluate the sensitivity and specificity of the Budapest CRPS diagnostic criteria in the pediatric population—along with positive and negative likelihood ratios—and compare it with those of the adults. 2) Assess whether pediatric CRPS patients report a decrease in Budapest signs and symptoms scores from the course of admission to the Pediatric Pain Rehabilitation Center (PPRC) to their discharge.
Methods: The Budapest Criteria was administered to a total of 218 patients at admission. Sensitivity, specificity, and positive and negative likelihood ratios of the Budapest Criteria were calculated using the SPSS data collected at the PPRC. The clinical diagnostic decision rule for CRPS was utilized: for a clinical diagnosis, a patient must have at least 2 or more signs and 3 or more symptoms. A repeated measures ANOVA was also performed using the Budapest reports of 94 CRPS patients.
Results: The sensitivity was 0.56, whereas the specificity was 0.95. The positive likelihood ratio was 10.39 and the negative likelihood ratio was 0.47. Moreover, there was a significant decrease in the Budapest signs and symptoms scores amongst the CRPS patients admitted to the PPRC (p < 0.001).
Conclusions: Although the specificity was high in pediatric CRPS patients, this data does not support the hypothesis that the Budapest Criteria will show both high sensitivity and specificity when administered to the pediatric population. However, the Budapest signs score and symptoms score demonstrated a significant decrease over time, from when they were admitted to the PPRC to their discharge. This result corroborated the efficacy of an interdisciplinary approach in managing pediatric CRPS.
