The Budapest criteria are a set of diagnostic criteria used for identifying Complex Regional Pain Syndrome (CRPS). They were developed to improve the reliability and validity of CRPS diagnosis, replacing earlier, less precise criteria.
Understanding the Budapest Criteria
The Budapest criteria focus on both clinical signs and symptoms. To meet the criteria, a patient must report at least one symptom in three out of four categories, and a clinician must observe at least one sign in two out of four categories. The four categories are:
- Sensory: Includes hyperalgesia (increased sensitivity to pain) and allodynia (pain from a stimulus that usually doesn't cause pain).
- Vasomotor: Relates to changes in skin temperature and/or color.
- Sudomotor/Edema: Involves changes in sweating and/or the presence of swelling (edema).
- Motor/Trophic: Concerns motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (changes in hair, nails, or skin).
The Specific Criteria
The diagnostic criteria require the following to be met:
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Continuing pain disproportionate to any inciting event.
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Must report at least ONE symptom in THREE of the following FOUR categories:
- Sensory:
- Hyperesthesia (increased sensitivity to stimulation)
- Allodynia (pain due to a stimulus that does not normally provoke pain)
- Vasomotor:
- Temperature asymmetry
- Skin color changes/asymmetry
- Sudomotor/Edema:
- Edema
- Sweating changes/asymmetry
- Motor/Trophic:
- Decreased range of motion
- Motor dysfunction (weakness, tremor, dystonia)
- Trophic changes (hair, nail, skin)
- Sensory:
-
Must display at least ONE sign at the time of evaluation in TWO of the following FOUR categories:
- Sensory:
- Evidence of hyperalgesia (to pinprick)
- Evidence of allodynia (to light touch, deep somatic pressure, joint movement)
- Vasomotor:
- Temperature asymmetry
- Skin color changes/asymmetry
- Sudomotor/Edema:
- Edema
- Sweating changes/asymmetry
- Motor/Trophic:
- Decreased range of motion
- Motor dysfunction (weakness, tremor, dystonia)
- Trophic changes (hair, nail, skin)
- Sensory:
-
There is no other diagnosis that better explains the signs and symptoms.
Significance of the Budapest Criteria
The Budapest criteria are more sensitive and specific than previous diagnostic criteria for CRPS. This means they are better at correctly identifying individuals with CRPS and reducing the number of false positives. The implementation of these criteria helps in early diagnosis and intervention, which can improve patient outcomes.
In summary, the Budapest criteria are a standardized and validated set of diagnostic criteria used to diagnose CRPS, based on a combination of reported symptoms and observed clinical signs across sensory, vasomotor, sudomotor/edema, and motor/trophic categories.
