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How a Simple Ankle Sprain Turned Into Neuropathic Pain: Complex Reflex Sympathetic Dystrophy Versus Erythromelalgia.

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A rare pain disorder, primary erythromelalgia, was misdiagnosed as complex reflex sympathetic dystrophy following an ankle sprain. This case highlights the importance of accurate diagnosis for effective pain management.

Keywords:
complex sympathetic dystrophy complexerythromelalgiasmall fiber neuropathysympathectomyvoltage-gated sodium channel

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Area of Science:

  • Neurology
  • Pain Medicine
  • Orthopedics

Background:

  • Ankle sprains are common injuries.
  • Complex reflex sympathetic dystrophy (CRPS) is a chronic pain condition.
  • Primary erythromelalgia is a rare neurological disorder causing intense burning pain.

Observation:

  • A 36-year-old woman experienced intense burning pain and redness in her ankle and foot after a Grade 2 ankle sprain.
  • Initial diagnosis was CRPS, treated with medication and a nerve block, providing temporary relief.
  • Surgical sympathectomy was unsuccessful, prompting referral to a neurologist.

Findings:

  • The patient was ultimately diagnosed with primary erythromelalgia.
  • Primary erythromelalgia can mimic symptoms of CRPS, leading to misdiagnosis.
  • The rare nature of primary erythromelalgia contributes to diagnostic challenges.

Implications:

  • Accurate diagnosis is crucial for effective treatment of rare pain disorders.
  • Distinguishing between primary erythromelalgia and CRPS is vital for patient outcomes.
  • This case underscores the need for comprehensive neurological evaluation in persistent pain conditions.