{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:39:21Z","timestamp":1777927161003,"version":"3.51.4"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Nucl Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Complex regional pain syndrome (CRPS) is a chronic pain disorder with complex pathophysiology involving neurogenic inflammation and autonomic dysfunction. While CRPS is typically associated with trauma or surgery, its occurrence following a snakebite is extremely rare. We report the case of a 47-year-old man who developed persistent pain, swelling, and hypersensitivity in the left foot after a snakebite to the dorsum. Despite prompt administration antivenom and admission to the intensive care unit, the symptoms progressed without systemic infection. Magnetic resonance imaging (MRI) revealed evolving soft tissue inflammation, fat necrosis, and periostitis. Triple-phase bone scintigraphy with single-photon emission computed tomography\/computed tomography (SPECT\/CT) demonstrated increased perfusion and periarticular tracer uptake consistent with CRPS, while effectively excluding osteomyelitis and abscess. The diagnosis was established using the Budapest criteria, supported by clinical assessment and multimodal imaging, including evidence of evolving periostitis without cortical bone destruction. This case underscores the diagnostic challenge of CRPS in the absence of infection or trauma and highlights the crucial role of MRI and triple-phase bone scintigraphy with SPECT\/CT in detecting early osseous involvement and guiding appropriate management.<\/jats:p>","DOI":"10.1055\/s-0045-1812054","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T22:30:17Z","timestamp":1759617017000},"page":"051-055","source":"Crossref","is-referenced-by-count":0,"title":["Complex Regional Pain Syndrome Triggered by Snake Bite: Diagnostic Utility of Triple-Phase Single-Photon Emission Computed Tomography-Computed Tomography Bone Scan\u2014Case Report"],"prefix":"10.1055","volume":"25","author":[{"given":"Osama","family":"Ragab","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Al-Adan Hospital, Ministry of Health, Hadiya, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haneen","family":"Alqattan","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Al-Adan Hospital, Ministry of Health, Hadiya, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7930-9268","authenticated-orcid":false,"given":"Manar","family":"Al Daas","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Al-Adan Hospital, Ministry of Health, Hadiya, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hany M.","family":"A. Elrahman","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Al-Adan Hospital, Ministry of Health, Hadiya, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,10,4]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1007\/s40122-021-00279-4","article-title":"Complex regional pain syndrome: a comprehensive review","volume":"10","author":"S S Taylor","year":"2021","journal-title":"Pain Ther"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/S1474-4422(11)70106-5","article-title":"Clinical features and pathophysiology of complex regional pain syndrome","volume":"10","author":"J Marinus","year":"2011","journal-title":"Lancet Neurol"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1111\/j.1468-1331.2010.02947.x","article-title":"Complex regional pain syndromes: new pathophysiological concepts and therapies","volume":"17","author":"C Maih\u00f6fner","year":"2010","journal-title":"Eur J Neurol"},{"key":"ref5","first-page":"69","article-title":"Complex regional pain syndrome caused by snake bite: a case report","volume":"58","author":"S A Ergan","year":"2012","journal-title":"Turk J Phys Med Rehabil"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/j.1533-2500.2009.00262.x","article-title":"Current understandings on complex regional pain syndrome","volume":"9","author":"M de Mos","year":"2009","journal-title":"Pain Pract"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"68","DOI":"10.3344\/kjp.2014.27.1.68","article-title":"Development of complex regional pain syndrome after a snake bite: a case report","volume":"27","author":"Y H Seo","year":"2014","journal-title":"Korean J Pain"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.avsg.2007.10.006","article-title":"Complex regional pain syndrome: a review","volume":"22","author":"R Albazaz","year":"2008","journal-title":"Ann Vasc Surg"},{"issue":"08","key":"ref9","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1111\/j.1526-4637.2010.00909.x","article-title":"Objectification of the diagnostic criteria for CRPS","volume":"11","author":"R N Harden","year":"2010","journal-title":"Pain Med"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1097\/01.rlu.0000162605.14734.11","article-title":"The role of nuclear medicine in the evaluation of complex regional pain syndrome type I","volume":"30","author":"C M Intenzo","year":"2005","journal-title":"Clin Nucl Med"},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1002\/j.1532-2149.2012.00137.x","article-title":"Concordance of qualitative bone scintigraphy results with presence of clinical complex regional pain syndrome 1: meta-analysis of test accuracy studies","volume":"16","author":"R Ringer","year":"2012","journal-title":"Eur J Pain"},{"issue":"09","key":"ref12","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1007\/s00259-016-3415-4","article-title":"The EANM practice guidelines for bone scintigraphy","volume":"43","author":"T Van den Wyngaert","year":"2016","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"115","DOI":"10.5603\/NMR.2014.0029","article-title":"Complex regional pain syndrome type I with atypical scintigraphic pattern\u2013diagnosis and evaluation of the entity with three phase bone scintigraphy. A case report","volume":"17","author":"M Pachowicz","year":"2014","journal-title":"Nucl Med Rev Cent East Eur"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.pain.2008.07.003","article-title":"Long-term skin temperature measurements - a practical diagnostic tool in complex regional pain syndrome","volume":"140","author":"E K Krumova","year":"2008","journal-title":"Pain"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1097\/j.pain.0000000000002146","article-title":"Screening and diagnostic tools for complex regional pain syndrome: a systematic review","volume":"162","author":"G Mesaroli","year":"2021","journal-title":"Pain"}],"container-title":["World Journal of Nuclear Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1812054.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:36:33Z","timestamp":1777674993000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1812054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,4]]},"references-count":14,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,5,1]]},"published-print":{"date-parts":[[2026,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0045-1812054","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1450-1147","1607-3312"],"issn-type":[{"value":"1450-1147","type":"print"},{"value":"1607-3312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,4]]}}}