Does my patient have CRPS?

CRPS is diagnosed by using the “Budapest Criteria“.

Note: Early after trauma it may not be possible to diagnose CRPS, because features in the limb which are typical early after trauma can look like CRPS (such as swelling, warmth, pain). If CRPS is not present, then these features will quickly resolve. The good news is that even if you’re not sure whether what you see is normal after trauma, or whether it is CRPS, the initial treatment remains the same.

How much can I rely on symptoms only?

Some patients do not have a sufficient number of signs to qualify for the Budapest criteria, but they report symptoms. For example, they may report frequent limb swelling, but you cannot see this on your examination. Pragmatically, having excluded differentials one should treat these patients as if they had CRPS, however there is not much published evidence advising about the best management of this patient group and therefore there is more uncertainty than in Budapest CRPS.