Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reflex Sympathetic Dystrophy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed1998

Clinical criteria and treatment of segmental versus upper extremity reflex sympathetic dystrophy.

The effectiveness of a multimodal treatment protocol in the long-term management of upper extremity reflex sympathetic dystrophy (RSD), as well as of isolated finger involvement, was analyzed. In the present series, 62 patients diagnosed with RSD were treated and followed for a mean of 22.2 +/- 1.5 months. The findings in the present study indicate that: 1) RSD occurs predominantly in females (female:male, 3:1); 2) regional dystrophy is twice as common as segmental dystrophy; 3) segmental dystrophy is most often associated with minor traumatic dystrophy, whereas regional dystrophy is more evenly distributed among the various clinical types; 4) patients with regional dystrophy score their pain significantly higher; and 5) segmental and regional dystrophy respond with equal satisfaction to the multimodal treatment regimen. In conclusion, the weight of the available evidence strongly suggests that RSD is a complex multifaceted disease entity which responds well when managed with a multimodal treatment program aimed at the various interacting components of the disorder. Furthermore, the finding that segmental dystrophy did not behave differently from the treatment protocol compared to extensive upper extremity RSD, suggests that the anatomic location of the syndrome may not significantly alter the course of the disease during treatment.

Adolescent↗
PubMed1989

Scintigraphic patterns of the reflex sympathetic dystrophy syndrome of the lower extremities.

Thirty-two patients with clinical signs and symptoms of the reflex sympathetic dystrophy syndrome (RSDS) of the lower extremities underwent Tc-99m MDP bone scintigraphy. Twenty-three patients had abnormal scan findings consistent with RSDS, while the scans of the remaining nine patients were normal. Of the 23 patients with abnormal scans, 19 demonstrated increased periarticular activity on early and delayed images, while 4 patients demonstrated decreased activity in the affected limb.

Adolescent↗
PubMed1999

A case of reflex sympathetic dystrophy (complex regional pain syndrome, type I) resolved by cerebral contusion.

We present a case of refractory reflex sympathetic dystrophy (RSD) (complex regional pain syndrome, type I) whose symptoms (ongoing pain, allodynia, hyperhydrosis and temperature abnormalities) were resolved after the patient suffered a traumatic cerebral contusion in the left temporal lobe, which caused no neurological deficit. This case suggests that symptoms of some RSD patients may largely sustained by a complex network involving the brain.

Brain Concussion↗
PubMed1997

Clinical value of dynamic bone and vascular scintigraphy in diagnosing reflex sympathetic dystrophy of the upper extremity.

The role of planar dynamic scintigraphy in the diagnosis and staging of reflex sympathetic dystrophy (RSD) is presented. Bone and vascular tracers are used for this purpose. The bone scan assessment corresponded closely to the clinical diagnosis and appeared excellent to exclude RSD. Accurate staging is important for therapy decisions. Staging by the early phases of bone and vascular scans were concordant in about three quarters of patients, but vascular scintigraphy led to a restaging in the remaining quarter of patients. Both scintigraphic procedures (bone and vascular) are indicated in diagnosing and monitoring upper extremity RSD.

Adult↗
PubMed1983

Bone tissue in reflex sympathetic dystrophy syndrome--Sudeck's atrophy: structural and ultrastructural studies.

Light and electron microscopic examination of bone in reflex sympathetic dystrophy syndrome confirms that vascular disorders play an important role in the genesis of bone lesions. These vascular disorders lead to degeneration of osteocytes and demineralization of bone, with the disappearance of hydroxyapatite crystals. The neo-osteogenesis that follows resembles the different stages of fracture repair, with precocious elaboration of irregular, replacement woven bone, followed by osteoclastic resorption and the laying down of lamellar bone trabeculae. The bone lesions clearly appear to be a consequence of autonomic nervous system circulatory disorders.

Adolescent↗
PubMed1997

Osteopenia, bone fragility and reflex sympathetic dystrophy syndrome in a man with ureterosigmoidostomy.

A 68-year-old man is presented with a reflex sympathetic dystrophy syndrome (RSDS) of the right ankle diagnosed by radiography, magnetic resonance imaging and bone scintiscan. Investigations, including blood tests and bone biopsy, revealed a diagnosis of metabolic acidosis and osteomalacia. These appeared to result from a ureterosigmoidostomy performed 9 years previously for a transitional carcinoma of the bladder. Correction of the metabolic acidosis coincided with improvement in ankle pain. RSDS may be the initial presentation of osteomalacia, which in turn may be caused by the metabolic acidosis resulting from a ureterosigmoidostomy.

Acidosis↗
PubMed1992

The effect of adding calcitonin to physical treatment on reflex sympathetic dystrophy.

The efficacy of intranasal salmon calcitonin was examined in a double-blind randomized study in reflex sympathetic dystrophy. Sixty-six patients were randomly divided in two groups receiving physiotherapy. In addition group I also received 3 x 100 U/day of salmon calcitonin by intranasal spray whereas group II received 3 sprays of placebo. The pain and the range of motion were improved by calcitonin administration. Similarly the patients' ability to work was also improved. The results confirmed that salmon calcitonin has an effect but that this effect was not equally observed on all parameters analyzed. It was most marked on pain (at rest and on movement) and on the ability to work.

Administration, Intranasal↗
PubMed2000

[Reflex sympathetic dystrophy vs. a factitious disorder].

Three women aged 18, 30 and 21, were admitted with complaints of reflex sympathetic dystrophy. These patients were caught at inducing their symptoms. Factitious disorders may be more common and serious than expected. It is suggested to include this diagnosis routinely in the differential diagnosis when dealing with inexplicable complaints, symptoms or therapy resistance. If factitious disorders are diagnosed it is advised to confront the patients. This is important in order to limit further iatrogenic damage to the patient. It also allows the physician to inform other doctors. After confrontation quite a few patients will stop inducing their symptoms. Most of them become angry, deny self-induction and refuse psychiatric help. Sometimes patients will withdraw from treatment. Despite these negative reactions patient confrontation is mandatory.

Adolescent↗
PubMed1998

The natural history of post-traumatic reflex sympathetic dystrophy.

The paper presents the results of a prospective trial to examine the natural history of early reflex sympathetic dystrophy (RSD). Thirty patients with post-traumatic RSD of the hand were observed without treatment. They were reassessed 1, 2 and 6 months after diagnosis with a final assessment at 10 to 18 months (average 13 months). Twenty-seven patients completed the study. Three were withdrawn during the study because of persistence of signs and symptoms of RSD and were given further treatment. Of the 27 patients who completed the study, only one showed sufficient features of the condition to warrant the diagnosis of mild RSD. In the remaining 26, most features of RSD had resolved spontaneously. Pain and swelling disappeared more quickly than other features of RSD. Although the signs and symptoms of RSD had largely gone at 13 months, the hands were still functionally impaired because of weaker grip strength.

Disease Progression↗
PubMed2000

Strain and psychological distress among informal supporters of reflex sympathetic dystrophy patients.

PURPOSE: A study to investigate strain and psychiatric morbidity in informal caregivers of patients with reflex sympathetic dystrophy (RSD). METHOD: Fifty one caregivers of RSD patients in the community, identified from a support group in Leeds or a conference in Eastbourne completed standardized questionnaire measures of strain, mood, adjustment, positive and negative affectivity and social support. RESULTS: Fifty seven percent of caregivers experienced significant strain and 53% had poor mood. Adjusting for age and gender, partial correlations showed that the experience of strain in caregivers was associated with poor mood, poor psychological adjustment to the patient's illness, high levels of negative affectivity, increased handicap and disability of the patient. CONCLUSIONS: A high proportion of caregivers of RSD patients experience poor mood and significant levels of strain. Caregivers who are poorly adjusted to the illness experience the most strain. These findings suggest a need for intervention to alleviate the negative impacts of caregiving and facilitate adjustment.

Adolescent↗
PubMed1998

Reflex sympathetic dystrophy: model of a severe regional inflammatory response syndrome.

The systemic inflammatory response syndrome (SIRS) and acute reflex sympathetic dystrophy syndrome (RSD) share clinical signs of severe inflammation, a protracted course, and a similar problem of impaired oxygen utilization. The difference is that SIRS patients have these signs and symptoms systemically and are severely ill in the intensive care unit (ICU), whereas acute RSD patients are in good health and their problems are limited to one extremity. Both conditions seem to be the result of an exaggerated inflammatory response. As RSD patients have a healthy contralateral extremity, they may be their own control in various flux studies. It is hypothesized that this situation is exquisitely suitable for studying the pathophysiology of severe inflammatory responses in humans. Only a few patients are required to perform studies of, for example, oxygen metabolism and cytokine or oxygen radical production. Assessment methods may be utilized, such as nuclear magnetic resonance spectroscopy, which cannot easily be performed in ICU patients.

Animals↗
PubMed2003

Magnetic resonance imaging in reflex sympathetic dystrophy syndrome of the foot.

OBJECTIVE: The purpose was to analyze magnetic resonance imaging (MRI) abnormalities in reflex sympathetic dystrophy syndrome (RSDS) of the foot, with the goal of helping to meet the difficult diagnostic challenges raised by this condition. METHODS: Retrospective study of 20 patients with RSDS of the foot, 15 at the warm phase and five at the dystrophic phase. RESULTS: Of the 15 patients at the warm phase, seven had evidence of bone edema (low signal on T1-weighted images and high signal on T2, T2 STIR, and fat saturation images) and five had occult fractures (linear band of low signal on T1 and T2 weighted images with no enhancement after contrast injection). Other abnormalities included soft tissue changes in three patients, joint effusion in five, and synovial hypertrophy in one. Of the five patients at the dystrophic phase, one had a fracture with a joint effusion, one had isolated joint edema, and three had normal MRI findings. CONCLUSION: Bone marrow edema is inconsistent at the warm phase of RSDS and is never present at the dystrophic phase. Thus, absence of bone edema does not rule out RSDS. Fractures may be visible by MRI in one-third of patients with RSDS and no clinical or plain radiography evidence of fracturing.

Adult↗
PubMed1999

Autonomic regulation of lymphatic flow in the lower extremity demonstrated on lymphoscintigraphy in patients with reflex sympathetic dystrophy.

PURPOSE: Nuclear medicine techniques were used to show that the peripheral lymphatics are under autonomic control in much the same way as the blood vessels that supply the same anatomic region. METHODS: Three patients with complex regional pain syndrome type 1 (reflex sympathetic dystrophy) involving a lower extremity were evaluated using three-phase bone scintigraphy and peripheral lymphoscintigraphy. Each patient was treated with ipsilateral chemical lumbar sympathectomy, and lymphoscintigraphy was repeated within several days of the procedure. RESULTS: All three patients had evidence of decreased flow (compared with the contralateral extremity) to normal flow after ipsilateral sympathectomy. Bone scintigraphy, before and after sympathectomy, was difficult to interpret because of the effects of altered weight bearing. Two patients who had unilateral peripheral edema showed marked improvement after sympathectomy and increased lymphatic flow. CONCLUSIONS: Peripheral lymphatic function is controlled by the autonomic nervous system. In reflex sympathetic dystrophy, peripheral edema may be caused by an increased sympathetic stimulus to the lymphatics. Further study of this phenomenon may show that nuclear medicine studies, such as bone scintigraphy and lymphoscintigraphy, can be used to distinguish patients who will benefit from sympathectomy from those who will not, thereby obviating invasive testing and unnecessary invasive treatment.

Adult↗