Post-Stroke CRPS — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateNeurorehabilitationPost-Stroke CRPSSCE Neurology

A 65-year-old man with a right MCA stroke has persistent left arm pain with allodynia, colour changes, and swelling of the left hand and wrist. The hand is warm and oedematous. X-ray shows patchy osteoporosis of the hand bones. What is the diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Complex regional pain syndrome (CRPS) type 1 — a recognised post-stroke complication affecting the hemiplegic limb

CRPS type 1 (formerly reflex sympathetic dystrophy) is a recognised complication of stroke, affecting approximately 12–20% of hemiplegic patients. It presents with pain (disproportionate to any injury), allodynia/hyperalgesia, vasomotor changes (colour/temperature changes), sudomotor changes (oedema, sweating), and motor/trophic changes (weakness, tremor, dystonia, skin/nail/hair changes). X-ray may show patchy osteoporosis. Early recognition and treatment (physiotherapy, pain management, corticosteroids in early stages) are important. A: DVT does not cause allodynia or osteoporosis. C: Shoulder subluxation is a separate entity. D: Cellulitis has infection features. E: Gout has crystal-proven inflammation.

Reference: RCP Stroke Guidelines; Budapest CRPS Criteria