Pain: complex regional pain syndrome: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Pain: complex regional pain syndrome

Sample item

Six weeks after a wrist fracture and cast removal, a woman has burning pain out of proportion to the injury, a swollen shiny hand with temperature change and allodynia. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Complex regional pain syndrome type I

Complex regional pain syndrome follows trauma or immobilisation and presents with disproportionate pain, allodynia, oedema, skin and temperature changes, sweating and later stiffness. Treatment is multimodal with early physiotherapy, neuropathic pain drugs, bisphosphonates and sometimes sympathetic blocks or spinal cord stimulation. Diagnosis uses the Budapest criteria.

Option by option

  • A. Carpal tunnel syndrome

    Carpal tunnel syndrome causes median nerve paraesthesia without these skin changes.

  • B. Postherpetic neuralgia

    Postherpetic neuralgia follows a herpes zoster rash.

  • C. Volkmann ischaemic contracture

    Volkmann contracture is due to compartment ischaemia and presents with fixed flexion deformity.

  • D. Complex regional pain syndrome type I (correct)

    Correct. Disproportionate pain with autonomic and trophic changes after fracture is typical.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Complex regional pain syndrome type I. Complex regional pain syndrome follows trauma or immobilisation and presents with disproportionate pain, allodynia, oedema, skin and temperature changes, sweating and later stiffness.

Why is "Carpal tunnel syndrome" not the answer?

Carpal tunnel syndrome causes median nerve paraesthesia without these skin changes.

Why is "Postherpetic neuralgia" not the answer?

Postherpetic neuralgia follows a herpes zoster rash.

Why is "Volkmann ischaemic contracture" not the answer?

Volkmann contracture is due to compartment ischaemia and presents with fixed flexion deformity.

What concept does this question test?

It tests Pain: complex regional pain syndrome in Anaesthesia. Treatment is multimodal with early physiotherapy, neuropathic pain drugs, bisphosphonates and sometimes sympathetic blocks or spinal cord stimulation. Diagnosis uses the Budapest criteria.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pain: complex regional pain syndrome?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.