© 2009 American Academy of Pain Medicine, Pain Medicine
Published Online: 9 Dec 2009
Rick Kennedy, FRCA,* Joan Hester, FRCA, MSc, FFPMRCA,* and Dominic W. N. Simon, FRCS (Tr & Orth), BSc †
*Department of Pain Relief, King's College Hospital, London; † Basingstoke and North Hampshire Hospital, Basingstoke, Hampshire, UK
Correspondence to Rick Kennedy, FRCA
Anaesthetic Department, St Thomas' Hospital
Lambeth Palace Road, London SE1 7EH, UK
Tel: 44-7986360997; Fax: 00-61893463481
E-mail: rcpkennedy@hotmail.com.
Sources of support: None was received.
ABSTRACT
A synovial sarcoma presented in the knee of a young woman 20 years after the onset of pain which was attributed to complex regional pain syndrome (CRPS). Was this a chance occurrence, or could there be any link between the two conditions? Did the pain itself and the persistent inflammatory and immunological response to pain contribute to the development of malignancy, or could the malignancy have been present subclinically for many years and have contributed to the ongoing pain syndrome? This case report looks into the diagnosis of synovial sarcoma and CRPS and the relationship between the neurogenic inflammation seen in CRPS and that seen in malignancies. The diagnosis of CRPS is a diagnosis of exclusion. Constant vigilance of patients with this unpleasant condition is necessary.
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