ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
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Vazomotor ve Sudomotor Değişiklikler Olmaksızın Allodiniyle Seyreden KBAS Tip 2
Crps Type 2 Case Whom Was Presented with Allodynia and Without Vasomotor and Sudomotor Changes
Received Date : 07 May 2020
Accepted Date : 31 Aug 2020
Available Online : 18 Jan 2021
Doi: 10.31609/jpmrs.2020-76045 - Makale Dili: TR
J PMR Sci. 2021;24(1):71-5
ÖZET
Kompleks bölgesel ağrı sendromu (KBAS) genellikle zararlı bir stimulustan sonra gelişen, etkilenen ekstremitede şiddetli ağrı, ödem, deri kan akımı değişiklikleri, anormal sudomotor aktivite ve allodini ile karakterize bir klinik tablodur. Etiyopatogenezi tam olarak bilinmemekle birlikte travma, en önemli rolü oynamaktadır. Tanı, genellikle klinik ile konmaktadır. Fakat tanıyı doğrulamada, radyolojik incelemeler ve sintigrafiden yararlanılmaktadır. Ayak tabanından ateşli silah yaralanması sonrası gelişen, ağrı ve allodini dışında klinik belirti vermeyen, sintigrafi ile ayak bileği, diz ve kalça ekleminde KBAS tanısı konulan bir olguyu sunmayı amaçladık. Tedavide medikal olarak steroid, pregabalin, tramadol ve topikal kapsaisin; fizik tedavi ajanları olarak kontrast banyo, girdap banyosu, transkutanöz elektriksel sinir uyarımı, su içi ultrason, desensitizasyon ve eklem hareket açıklığı egzersizleri uygulamasıyla ağrıda azalma, eklem hareket açıklığı ve kas gücü artışı kaydedildi. Travma sonrası gelişen şiddetli ağrı ve allodinide sudomotor ve vazomotor değişiklikler olmasa bile ayırıcı tanıda KBAS düşünülmelidir.
ABSTRACT
Complex regional pain syndrome (CRPS) is a clinical feature which is occurred after harmful stimulus and also characterized by severe pain in affected extremities, edema, change in blood flow of skin, abnormal sudomotor activity and allodynia. Although, etiopathogenesis remains largely unknown; it is believed that trauma plays a role in etiopathogenesis. It is usually diagnosed with clinical features. However; radiologic examinations and scintigraphy are used to confirm the diagnose. We aimed to present a case with diagnosed CRPS in ankle, knee and hip joint by scintigraphy; whom had no symptoms except for pain and allodynia, that are observed after gunshot injury of sole. With steroids, pregabalin, tramadol and topical capsaicin as medical treatments; with contrast bath, whirlpool bath, transcutaneous electrical nerve stimulation, in-water ultrasound, desensitization and range of motion exercises as physical therapy agents, decreased pain, increased range of motion and increased muscle strength were detected. CRPS should be considered in the diagnosis severe pain after trauma and allodynia even in the absence of sudomotor and vasomotor changes.
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