tailieunhanh - Báo cáo y học: " Improvement of pain and regional osteoporotic changes in the foot and ankle by low-dose bisphosphonate therapy for complex regional pain syndrome type I: a case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Improvement of pain and regional osteoporotic changes in the foot and ankle by low-dose bisphosphonate therapy for complex regional pain syndrome type I: a case series. | Abe et al. Journal of Medical Case Reports 2011 5 349 http content 5 1 349 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Improvement of pain and regional osteoporotic changes in the foot and ankle by low-dose bisphosphonate therapy for complex regional pain syndrome type I a case series 11 2 1 1 Yasuhisa Abe Kousuke Iba Junichi Takada Takuro Wada and Toshihiko Yamashita Abstract Introduction Complex regional pain syndrome is characterized by pain allodynia hyperalgesia edema signs of vasomotor instability movement disorders joint stiffness and regional osteopenia. It is recognized to be difficult to treat despite various methods of treatment including physiotherapy calcitonin corticosteroids sympathetic blockade and nonsteroidal anti-inflammatory drugs. Pathophysiologically complex regional pain syndrome reveals enhanced regional bone resorption and high bone turnover and so bisphosphonates which have a potent inhibitory effect on bone resorption were proposed for the treatment of complex regional pain syndrome. Case presentation A 48-year-old Japanese man with complex regional pain syndrome type I had severe right ankle pain with a visual analog scale score of 59 out of 100 regardless of treatment with physiotherapy and nonsteroidal anti-inflammatory drugs for five months. Radiographs showed marked regional osteoporotic changes and bone scintigraphy revealed a marked increase in radioactivity in his ankle. One month after the start of oral administration of risedronate mg per day his bone pain had fallen from a VAS score of 59 out of 100 to 18 out of 100. Bone scintigraphy at 12 months showed a marked reduction in radioactivity to a level comparable to that in his normal left ankle. On the basis of these results the treatment was discontinued at 15 months. At 32 months our patient had almost no pain and radiographic findings revealed that the regional osteoporotic change had returned to normal. A second 48-year-old .