Hello, I am a physiotherapist working in the french countryside with a patient list similar to an outpatient setting so I see a lot of backs, knees and shoulders etc!

I have recently taken on an 8yo girl who 2 months ago sprained her ankle (no swelling or bruising after) and has developed an algodystrophy in her ankle and foot.

She is non-WB, mobilising with 2xEC and has been since the accident. Diagnosis of cold stage algodysptrophy by Scintigraphie (is it the same word in english?!). There is slight sswelling of the foot and ankle and can have discolouration but no abnormal sweating or hair growth.

Assessment of pain is quite tricky to get an accurate idea, but sole of the foot and toes are extremely painful to light touch/tissue(10!) with heel/ankle and top of foot slightly less painful. She does tolerate wearing a sock and has been wearing a medial/lateral splint since the sprain. She is able to tolerate tepid water baths and apparently has been to the swimming pool with the injury.

ROM is pretty poor but again difficult to accurately assess due to pain on touch. Minimal AROM in IP jt of big toe and some PROM DF/PF at the ankle, some reflex movement in toes and ankle when stroked across sole of foot.

I have very little experience with CRPS let alone in children so if anybody has any bright ideas or treatment options I would be extremely grateful! I have also posted this in the general section but thought here might be good for any pediatric ideas!

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