Document Detail

The "kick-off" position: a new sign for early diagnosis of complex regional pain syndrome in the leg.
MedLine Citation:
PMID:  17257546     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Complex regional pain syndrome (CRPS) is a clinical entity that develops after a precipitating injury. It involves dysfunction of the sensory, autonomic, and motor systems and frequently is missed on initial presentation. The purpose of this report was to describe a simple clinical sign that can aid in its diagnosis.
METHODS: A retrospective review was conducted of 39 consecutive patients with CRPS type I or II seen in a foot and ankle clinic between October, 2001, and May, 2005. The diagnosis was based on clinical findings.
RESULTS: Twenty-six patients had type I (67%) and 13 patients had type II (33%) CRPS. The most common nerve involved in type II was the superficial peroneal nerve. Each patient, while sitting on the exam table, held the affected extremity with the knee extended against gravity. When the leg was pushed back to a relaxed and suspended position, the patient eventually involuntarily resumed the extended position. This position in which the patients held their legs was termed the "kick-off" position sign. Nine patients were seen at the foot and ankle clinic within 6 weeks of the initial inciting event and had an established "kick-off" position sign within 3 months from the time of injury. The disappearance of this sign correlated with the subsidence of pain.
CONCLUSIONS: Patients with CRPS have variable clinical presentations. The awareness of this simple observation in the right clinical setting should raise the index of suspicion of CRPS in the differential diagnosis. Early treatment of this syndrome is associated with better outcome.
Saul G Trevino; Vinod K Panchbhavi; Oscar Castro-Aragon; Margaret Rowell; Jeannie Jo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Foot & ankle international     Volume:  28     ISSN:  1071-1007     ISO Abbreviation:  Foot Ankle Int     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-04-19     Revised Date:  2014-08-27    
Medline Journal Info:
Nlm Unique ID:  9433869     Medline TA:  Foot Ankle Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  92-5     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Ankle Injuries / complications
Complex Regional Pain Syndromes / diagnosis*
Early Diagnosis
Foot Injuries / complications
Middle Aged
Retrospective Studies
Erratum In:
Foot Ankle Int. 2007 Mar;28(3):vi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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