title: Steroid atrophy scarring treated with fat grafting in a patient with complex regional pain syndrome: A case report.
abstract: Subcutaneous atrophy is a known complication of steroid injections. Excellent results with fat grafting for the treatment of steroid atrophy have been documented. However, the benefit of treating steroid-induced subcutaneous atrophy in an extremity diagnosed with complex regional pain syndrome (CRPS) has not been described. CRPS, known formerly as reflex sympathetic dystrophy or RSD, causalgia, or reflex neurovascular dystrophy, is a severe, progressive musculoskeletal pain syndrome characterized by pain which is disproportionate to the severity of the inciting event, edema, or skin changes. Common treatment modalities include pharmacotherapy, physical therapy, and nerve blocks-each therapy producing varying results. We present a literature review of CRPS and the case of a 15-year-old female who developed CRPS of the left lower leg after arthroscopic debridement with retrograde drilling of an osteochondral lesion. Steroid atrophy of the involved area following a saphenous nerve block complicated the patient's treatment course. The area of atrophy was treated with autologous fat grafting. Following the adipose injection procedure, the patient experienced almost complete resolution of her CPRS-associated pain symptoms, along with improved cosmetic appearance of the area.
authors.affiliation: a Medicine, University of Alabama School of Medicine , Birmingham , AL , USA.
authors.forename: Leah R
authors.initials: LR
authors.lastname: Strickland
authors.affiliation: b Plastic Surgery, University of Alabama at Birmingham , Birmingham , AL , USA.
authors.forename: Sherry S
authors.initials: SS
authors.lastname: Collawn
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D001284:Atrophy / Q000139:chemically induced / Q000628:therapy*; D002422:Causalgia / Q000139:chemically induced / Q000628:therapy*; D002921:Cicatrix / Q000139:chemically induced / Q000628:therapy*; D005260:Female; D006801:Humans; D010525:Peripheral Nerves / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Complex regional pain syndrome; fat grafting; reflex sympathetic dystrophy; steroid atrophy