Posttraumatic dystrophy, also known as CRPS, is a serious pain condition that often follows an injury. In Leiden, this term is still widely used in medical and legal contexts, especially in personal injury cases.
Definition and Terminology
The nomenclature of this condition has taken various forms over time.
Old and New Names
| Era | Term | Characteristics |
|---|---|---|
| 19th century | Causalgia | Related to nerve damage |
| 1900-1950 | Sudeck's atrophy | Often after fractures |
| 1950-1990 | Reflex Sympathetic Dystrophy (RSD) | Focus on the sympathetic nervous system |
| 1990-present | Posttraumatic dystrophy | Commonly used term in the Netherlands |
| 1994-present | CRPS (Complex Regional Pain Syndrome) | Globally recognized term |
Relation to CRPS
In the Netherlands, posttraumatic dystrophy is often equated with CRPS type I. Especially in legal cases and among older physicians, this term remains popular.
Common Characteristics
- Identical symptoms such as pain, swelling, and discoloration
- Similar causes, such as trauma or surgical interventions
- Comparable diagnostic methods
- Consistent treatment strategies
Developmental Stages
In the past, the condition was divided into three stages, although this model is now applied less strictly.
Traditional Stages
Stage I - Acute (0-3 months)
- Intense pain and sensitivity
- Swelling and red skin
- Increased temperature and perspiration
- Limited range of motion
Stage II - Dystrophic (3-6 months)
- Persistent pain complaints
- Cold, bluish skin
- Deterioration of skin and muscles
- Stiff joints
Stage III - Atrophic (> 6 months)
- Chronic pain
- Severe atrophy
- Contractures in joints
- Bone loss
Note: New research indicates that the stages do not always progress linearly. The condition can stabilize or improve at any time.
Risks and Causes
There are specific factors that increase the risk of posttraumatic dystrophy.
Important Risk Factors
| Factor | Influence |
|---|---|
| Wrist fracture | Common cause |
| Female gender | Higher prevalence |
| Age between 40-60 years | Most affected group |
| History of CRPS | Higher chance of recurrence |
| Prolonged immobilization | Worsens the condition |
Legal Context in Leiden
In personal injury cases in Leiden, posttraumatic dystrophy plays a crucial role, with specific points of attention.
Important Legal Aspects
- Causal link: The injury must be clearly linked to the accident
- Predisposition: An existing predisposition does not alter liability
- Diagnosis: Diagnosis must meet the Budapest criteria
- Burden of proof: Careful documentation of complaints and limitations
- Expert report: Engage a CRPS specialist for reporting
For legal support, you can go to the Juridisch Loket Leiden at Stationsweg 46, or submit cases to the Rechtbank Den Haag, Leiden location.
Course and Prognosis
The prospects for posttraumatic dystrophy vary greatly per individual.
Possible Outcomes
- Approximately 50% recover fully or nearly fully
- Around 30% retain mild complaints
- About 20% suffer from permanent, severe limitations
- Early intervention increases the chance of recovery
Practical Advice
- Watch for early symptoms and consult a doctor immediately
- Avoid prolonged inactivity after an injury
- Request referral to a pain clinic for persistent pain
- Be prepared for a possible chronic course
- Keep a detailed record of the complaints