SynthesisPloS one2017
Usefulness of bone scintigraphy for the diagnosis of Complex Regional Pain Syndrome 1: A systematic review and Bayesian meta-analysis.
Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Meta-Analysis and Meta-Regression of Frequency and Risk Factors for Poststroke Complex Regional Pain Syndrome.Medicina (Kaunas, Lithuania) · 2021Pooled it
- Diagnostic Criteria and Technical Evaluation of Complex Regional Pain Syndrome: A Narrative Review.Diagnostics (Basel, Switzerland) · 2025Review
- [Biomarkers in complex regional pain syndrome].Schmerz (Berlin, Germany) · 2025Review
- 10. Complex regional pain syndrome.Pain practice : the official journal of World Institute of Pain · 2025Review
- Diagnostic Performance of Infrared Thermography, Quantitative Sudomotor Axonal Reflex Testing, and 3-Phase Bone Scintigraphy for Complex Regional Pain Syndrome Diagnosis: A Retrospective Observational Study.Journal of pain research · 2025Article
- A brief review of complex regional pain syndrome and current management.Annals of medicine · 2024Review
- Bone metabolism in complex regional pain syndrome.Pain reports · 2024Article
- Complex Regional Pain Syndrome after Distal Radius Fracture-Case Report and Mini Literature Review.Journal of clinical medicine · 2024Article
- Modern Principles of Diagnosis and Treatment in Complex Regional Pain Syndrome.Deutsches Arzteblatt international · 2022Article
- Diagnosis, Treatment, and Management of Painful Scar: A Narrative Review.Journal of pain research · 2022Review
- [41/m-Where does the pain come from? : Preparation for the medical specialist examination: part 68].Der Unfallchirurg · 2021Article
- Senso-Immunologic Prospects for Complex Regional Pain Syndrome Treatment.Frontiers in immunology · 2021Review
- Intramuscular neridronate for the treatment of complex regional pain syndrome type 1: a randomized, double-blind, placebo-controlled study.Therapeutic advances in musculoskeletal disease · 2021Article
- Complex regional pain syndrome and bone marrow oedema syndrome: family ties potentially closer than expected.BMJ case reports · 2020Article
- Updates in the Treatment of Post-Stroke Pain.Current neurology and neuroscience reports · 2019Review
- Complex regional pain syndrome: a narrative review for the practising clinician.British journal of anaesthesia · 2019Review
- Complex Regional Pain Syndrome: An update.Mediterranean journal of rheumatology · 2019Review
- Bisphosphonates in the treatment of complex regional pain syndrome: is bone the main player at early stage of the disease?Rheumatology international · 2018Review
- [Complex regional pain syndrome].Der Unfallchirurg · 2018Article
- Bone scintigraphy in patients with pain.The Korean journal of pain · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince 2007, the Budapest criteria are recommended for the diagnosis of Complex Regional Pain Syndrome (CRPS) 1. The usefulness of bone scintigraphy (BS, index test) for the diagnosis of CRPS 1 remains controversial. Imperfect reference tests (RT) result in underestimation of the diagnostic accuracy of BS. Further, biased results can occur when a dependency between the RT and BS exists. The objective was to assess the impact of different RTs, specifically the Budapest criteria, and the assumed imperfect nature of the RT on the diagnostic accuracy of BS. Further, we analyzed the association between baseline characteristics and positive BS in patients with CRPS 1.
methodsSystematic literature review and Bayesian meta-analysis to assess the test accuracy of BS with and without accounting for the imperfect nature of the RT. We examined correlations (Spearman correlation coefficients / Wilcoxon tests) between baseline characteristics and the proportion of positive BS in patients with CRPS 1.
resultsThe pooled sensitivity was 0.804 (95% credible interval (CI) 0.225-1.0, 21 studies) and specificity 0.853 (95%CI 0.278-1.00). Sensitivity and specificity of BS increased when accounting for the imperfect nature of the RT. However, in studies using Budapest criteria as reference, the sensitivity decreased (0.551; 95% CI 0.046-1) and the specificity increased (0.935; 95% CI 0.306-1). Shorter disease duration and a higher proportion of males were associated with a higher proportion of positive BS (27 studies, disease duration <52 weeks Wilcoxon test p = 0.047, female proportion Spearman correlation -0.63, p = 0.009).
conclusionCompared to the accepted Budapest diagnostic criteria BS cannot be used to rule-in the diagnosis of CRPS 1. In patients with negative BS CRPS 1 is less likely the underlying illness. Studies using older or no diagnostic criteria should not be used to evaluate the diagnostic accuracy of BS in CRPS 1.
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