The role of bone scan in confirming the diagnosis of foot and ankle complex regional pain syndrome: a case series

Background: The pathophysiology of complex regional pain syndrome (CRPS) remains poorly understood and is usually diagnosed clinically. Magnetic resonance imaging (MRI) was initially thought as the most effective method of diagnosing CRPS, but new studies showed that there is no specific MRI feature that might differentiate CRPS patients from healthy individuals. Studies have shown mixed results of diagnostic reliability. Case Presentation: In this study four patients were presented who had a Tc-99m bone scintigraphy scan to confirm the diagnosis of CRPS. The application of this imaging method was demonstrated in clinical settings to reveal that these patients had CRPS. Each case had different difficulties; in three of four cases, a bone scan was able to establish the typical appearance of CRPS. Bone scans facilitated a timely diagnosis and guided subsequent management approaches. A bone scan was not able to confirm the diagnosis in one patient since she had cellulitis. Conclusion: The findings of this study underscore the significant role of bone scans in confirming the diagnosis of CRPS within the foot and ankle region.