Validation of proposed diagnostic criteria (the "budapest Criteria") for Complex Regional Pain Syndrome

Robert N Harden, Stephen Bruehl, Roberto S.G.M. Perez, Frank Birklein, Johan Marinus, Christian Maihofner, Timothy Lubenow, Asokumar Buvanendran, Sean MacKey, Joseph Graciosa, Mila Mogilevski, Christopher Ramsden, Melissa Chont, Jean Jacques Vatine

Research output: Contribution to journalArticlepeer-review

820 Scopus citations


Current IASP diagnostic criteria for CRPS have low specificity, potentially leading to overdiagnosis. This validation study compared current IASP diagnostic criteria for CRPS to proposed new diagnostic criteria (the "Budapest Criteria") regarding diagnostic accuracy. Structured evaluations of CRPS-related signs and symptoms were conducted in 113 CRPS-I and 47 non-CRPS neuropathic pain patients. Discriminating between diagnostic groups based on presence of signs or symptoms meeting IASP criteria showed high diagnostic sensitivity (1.00), but poor specificity (0.41), replicating prior work. In comparison, the Budapest clinical criteria retained the exceptional sensitivity of the IASP criteria (0.99), but greatly improved upon the specificity (0.68). As designed, the Budapest research criteria resulted in the highest specificity (0.79), again replicating prior work. Analyses indicated that inclusion of four distinct CRPS components in the Budapest Criteria contributed to enhanced specificity. Overall, results corroborate the validity of the Budapest Criteria and suggest they improve upon existing IASP diagnostic criteria for CRPS.

Original languageEnglish (US)
Pages (from-to)268-274
Number of pages7
Issue number2
StatePublished - Aug 2010


  • CRPS
  • Complex Regional Pain Syndrome
  • Diagnosis
  • RSD
  • Reflex sympathetic dystrophy
  • Validation

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Anesthesiology and Pain Medicine


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