Complex Regional Pain Syndrome — SCE Rheumatology MCQ

Correct answer: C — Symptoms in at least three categories and signs in at least two categories, after safety review

The best answer is “Symptoms in at least three categories and signs in at least two categories, after safety review”. The Budapest clinical criteria require continuing disproportionate pain, symptoms in at least three of four categories, signs in at least two categories at assessment, and no better diagnosis. The remaining choices—“Symptoms in one category and radiographic osteopenia, with clinical reassessment, within a rheumatology pathway, after specialist assessment”, “Signs in all four categories in the absence of continuing pain, within a rheumatology pathway”, “A positive bone scan plus one sensory symptom, after safety review, after specialist assessment, within a rheumatology pathway”, “Abnormal nerve conduction plus autonomic symptoms, after specialist assessment, with clinical reassessment, after safety review”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: NICE CKS chronic pain syndromes: https://cks.nice.org.uk/topics/chronic-pain-syndromes-assessment-management/