Painless complex regional pain syndrome: a case report/Agrisiz seyreden kompleks bolgesel agri sendromu: olgu sunumu

A 57-years old female patient who had been treated by immobilization in a cast for six weeks after a distal radius fracture was evaluated for physical therapy and rehabilitation at the end of the immobilization period. She had complaints such as swelling, hyperhidrosis, and tremor in her affected hand and wrist, and restriction of finger and wrist movements. She had no pain. On examination, the hand and wrist were swollen and hot; range of motion was restricted at the wrist and fingers. Hyperhidrosis and tremor were also determined. There was no allodynia and hyperalgesia. The patient was diagnosed as complex regional pain syndrome Type I according to Zyluk scoring system. The patient's signs and symptoms markedly improved after the physical therapy program and she did not report any pain at the control visits. This case is presented since she had no pain although she had marked vasomotor, sudomotor, and motor signs and sypmtoms which are typical for complex regional pain syndrome and few cases like this have been reported in the literature. Key Words: Pain, complex regional pain syndrome, immobilization Radius distal uc kirigi gelisen 57 yasinda kadin hasta alti hafta immobilizasyon sonrasinda fizik tedavi ve rehabilitasyon amaciyla degerlendirildi. Etkilenen el bilegi ve elinde sislik, terleme, el bilegi ve parmak hareketlerinde kisitlilik ve tremor yakinmalari vardi. Agri yakinmasi yoktu. Fizik muayenede aktif ve pasif el bilegi ve parmak hareketlerinde belirgin kisitlilik, el bilegi ve elde sislik, isi artisi, terleme artisi ve tremor tespit edildi. Allodini ve hiperaljezisi yoktu. Hastaya Zyluk skorlama sistemi kullanilarak kompleks bolgesel agri sendromu (KBAS) Tip I tanisi konuldu. Fizik tedavi programi sonrasinda yakinmalari belirgin olarak azaldi ve hastanin izlemi suresince agri yakinmasi olmadi. Bu olgu immobilizasyon donemi sonrasinda kompleks bolgesel agri sendromu icin tipik olan sudomotor, vazomotor ve motor semptom ve bulgularin belirgin olmasina ragmen agrisiz olmasi ve literaturde boyle olgulara az rastlanmasi nedeniyle sunulmustur. Anahtar Kelimeler: Agri, kompleks bolgesel agri sendromu, immobilizasyon