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Results for “Reflex Sympathetic Dystrophy”

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PubMed1982

The reflex dystrophy syndrome response to treatment with systemic corticosteroids.

Twenty-three patients with reflex dystrophy syndrome were randomly allocated to medication with oral prednisone, 10 mg thrice daily, or placebo, previous reports having indicated effect of systemic corticosteroids. The medication was continued until clinical remission, maximally 12 weeks. The diagnosis was based on fulfillment of at least four of seven criteria which included clinical, radiological and circulatory changes. All 13 patients in the prednisone-treated group showed more than 75% clinical improvement within the twelve-week period. Of the ten patients who received placebo, only two reported improvement. Prednisone appears to be superior to other treatment in reflex dystrophy syndrome, although the mode of action is not known.

Administration, Oral↗
PubMed1982

[Algodystrophy: predisposition and pathogenic factors. Results of a multicentric survey concerning 765 cases].

The authors analyze the results of a cooperative and retrospective survey of seven hundred and sixty five cases of reflex dystrophies of all localizations. Most of the etiologies usually described were present. As for predisposing factors, some, such as psychic or vascular factors and alcoholism, seem to have been overestimated. Others, such as diabetes or hypertriglyceridemia, are confirmed as predisposing factors. Recurrent forms, the summation of trigger actions or predisposing factors are relatively rare. These findings can mean that the "reflex dystrophic ground", if it exists, remains largely to be discovered. Among the various possible localizations of reflex dystrophy, only the hip a real etiopathogenic individuality.

Adolescent↗
PubMed1984

Localized Sudeck's dystrophy and distal interphalangeal osteoarthritis of a finger: anatomicoradiologic study.

After an injury to the right ring finger, a 44-year-old woman experienced pain in the distal interphalangeal joint. A subcutaneous mucoid cyst was noted near the joint. The x-ray films revealed no fracture but a narrowing of the joint space and a well-defined radiolucent area in the ulnar condyle of the middle phalanx. The biopsy specimen of this area excluded infection or tumor and revealed active osteogenic remodelling. These elements permitted a diagnosis of distal interphalangeal osteoarthritis that was associated with highly localized Sudeck's dystrophy (also called " parcellar algodystrophy"). This unusual case suggests the possibility that this dystrophy might be favored by an "osteoarthritic terrain" and might also play a role in the evolution of the osteoarthritis.

Adult↗
PubMedDate not supplied

[The mineralocorticoid receptor apparatus of the kidneys in rats with reflex dystrophy of the organ against a background of simultaneous denervation or blockade of the body beta-adrenoreceptors by propranolol].

Interaction of labeled aldosterone with rat kidney mineral corticoid cytoplasm receptors and duct cell nuclei at different dysfunctions of nervous-trophic organ supply. Dysfunction of vagus innervation leads to breakage of cytoplasm receptor apparatus and duct cell nuclei that performs aldosterone reception. Organ denervation and introduction of beta-adrenoblocking agent prevents development of kidney neurogenous dystrophy.

Aldosterone↗
PubMed1994

Compartment pressure in the carpal tunnel in distal fractures of the radius. A prospective study.

In a prospective controlled study, carpal tunnel tissue pressures were determined in a group of 56 patients with distal dislocated fractures of the radius at initial presentation, immediately prior to and after reduction, and 1, 2, 4, 12, and 24 h after reduction. Depending on the severity of the trauma and delay to presentation at the hospital, initial measurements revealed raised pressure averaging 23 mm Hg, which further increased during reduction to 44 mm Hg. After 4 h the average pressure was 37 mm Hg, and it then dropped to 26 mm Hg after 12 h. For anatomical reasons the median nerve is quite vulnerable in the region of the wrist joint. Chronic pressure here may cause carpal tunnel syndrome. Acute pressure in the carpal tunnel, which according to our investigations represents a distinct compartment, results in an overt compartment syndrome. The possibility of a direct relationship between markedly elevated tunnel pressure and the development of Sudeck's dystrophy is discussed.

Adolescent↗
PubMed1986

Reflex neurovascular dystrophy in children.

Six children with reflex neurovascular dystrophy are described. The clinical characteristics are discussed, and the contrasting features between the adult and childhood syndrome are considered. The importance of early diagnosis and appropriate therapy is stressed.

Adolescent↗
PubMed2002

[Tuberculosis of the talus: a rare localization of Koch's bacillus].

A 66-year-old woman complained of pain in the left rear foot and malleoli. Standard x-ray and magnetic resonance imaging as well as laboratory tests were non-contributive. Pathology study of a bone biopsy led to the diagnosis of talar tuberculosis. A 12-month regimen combining rifampicin, isoniazid and pyrazinamide was given. Clinical improvement was achieved although the patient developed significant reflex dystrophy. The risk of degeneration compromises the functional future of the ankle joint.

Antitubercular Agents↗
PubMed1988

Skin microvascular circulation in the sympathetic dystrophies evaluated by videophotometric capillaroscopy and laser Doppler fluxmetry.

Finger-skin microcirculation and its reactions to sympathetic stimuli were investigated in 12 patients with sympathetic dystrophies, secondary to trauma or other diseases. Nailfold-skin capillary blood cell velocity (CBV) was measured by videophotometric capillaroscopy. Laser Doppler fluxmetry was used to provide an index of skin circulation in vessels in addition to the superficial capillaries. Both CBV and laser Doppler flux (LDF) values were significantly lower in the patients, compared with the healthy controls (P less than 0.05), despite the fact that skin temperature was the same in both groups. During cooling of the contralateral hand, CBV and LDF decreased markedly (22-60%) in the control group but not in the patients (0-13%). The decrease in skin perfusion normally seen upon lowering of the hand was also impaired in the patient group (7%) compared with controls (42%) (P less than 0.05). These impaired vasomotor reflex responses are consistent with sympathetic dysfunction and may well explain some of the typical features of the syndrome, e.g. limb oedema.

Aged↗
PubMed1982

[Rehabilitation and algodystrophies].

Based on 20 years experience, and a personal series of 272 cases of reflex dystrophy (84 cases involving upper limbs, 188 cases involving lower limbs) admitted under a rheumatology unit equipped with all the available techniques of rehabilitative medicine, the authors stress the value of well conducted functional rehabilitation which, even alone, can obtain excellent results in the treatment of this disease, whatever the stage. The authors detail the modalities of this treatment. A local intra-articular or intra-canal injection of corticosteroids permits pain-free physiotherapy. The mobilisation of the lower limb is an urgent priority. Non-aggressive physiotherapeutic techniques should be adapted to the stage and the site of reflex dystrophy. Hydrokinesitherapy and the adaptation of craft techniques to occupational therapy also play an important part.

Exercise Therapy↗
PubMed1996

[Severe algoneurodystrophy of the right foot associated with prostatic cancer].

The authors report 1 case of particularly severe reflex neurovascular dystrophy whose clinical course was marked by the discovery of a carcinoma of the prostate. There was improvement in the reflex neurovascular dystrophy despite hormonal therapy of the cancer. Reflex neurovascular dystrophy cannot be considered as a form of a paraneoplastic syndrome.

Adenocarcinoma↗
PubMed1985

Technetium 99m-methylene diphosphonate bone scans in children with reflex neurovascular dystrophy.

Eleven children with reflex neurovascular dystrophy were investigated by technetium-labeled methylene diphosphonate bone scanning. Eight of 12 scans demonstrated abnormal findings, four showing diffusely decreased uptake and four diffusely increased uptake of the radionuclide in the affected site. Three scans showed normal findings initially, as did one previously abnormal scan when repeated in the asymptomatic patient 6 months later. Diffusely abnormal findings can be helpful in the diagnosis of childhood reflex neurovascular dystrophy, but a normal scan does not exclude the diagnosis.

Adolescent↗
PubMed1990

[Sudeck disease].

In 1900, the Hamburg surgeon P.H.M. Sudeck was the first to describe the clinical and radiological symptomatology of the disorder to which he later lent his name. He devoted his scientific career to this disorder, "acute inflammatory atrophy" of bone and soft-tissue as he called it. He elaborated the histology of the disorder with his students and advocated the pathogenic peripheral humoral theory. In later years seven further attempts to explain the pathogenesis were published. The present paper notes that this disorder, which can be divided into three distinct stages, is diagnosed mainly on the basis of clinical factors, above all in the early stage, and that x-rays in the early stages are difficult to differentiate from those of immobilisation osteoporosis since both disorders can manifest as patchy rare fraction and fibrous osteolysis in subchondral bone and old growth plates. Moreover, the author also notes that 10% of all Sudeck cases are not preceded by trauma; these must be understood as spontaneous Sudeck or as Sudeck after distant disturbances. A few sources also refer to Sudeck's dystrophy in the presence of lymphatic congestion. Another, special form of Sudeck's atrophy, is the shoulder-hand syndrome which, however, cannot always be differentiated precisely from rheumatic disorders or dystrophic contractures.

Adult↗
PubMed1978

Reflex neurovascular dystrophy in childhood.

Reflex neurovascular dystrophy has rarely been recognized in children. During the past eight years we have observed 24 instances of RND in 23 children. Lower extremity involvement was manifested in 20 of them and upper extremity in four. The major complaint was pain; swelling and vasomotor instability were prominent, and exquisite tenderness was characteristic. Chronic trophic changes were not observed. Antecedent illness or trauma could be related to the RND in less than half of the children, but personality factors appeared contributory to the development of RND in most children. Physical therapy was the principal form of treatment; therapy with a corticosteroid or by sympathetic blockade was not employed. Reduction in the evidences of disease, including improvement in function, were present in all children at the termination of therapy; improvement was maintained in all but one child after a mean period of 2.4 years. The excellent response to conservative therapy suggests that RND may be a more benign condition in children than in adults.

Adolescent↗
PubMed1988

Psychologic aspects of childhood reflex neurovascular dystrophy.

Psychosocial factors in 21 families with children affected by reflex neurovascular dystrophy were studied. Each family was interviewed and given a battery of standardized psychologic tests. Two distinct types of families were identified. Fifteen families showed high internal cohesion, expressiveness, and organization and low levels of conflict. Six families showed high overt conflict with low levels of family cohesion, expressiveness, and organization. In all families parental enmeshment with the patient was present. Marital discord was present in 12 families. Thirteen patients had significant school problems (ten had learning disabilities). Although most of the children were described as especially bright, only four had above average intelligence test scores. Four had a history of sexual abuse. The patients and their mothers perceived the health problem as significantly worse than did children with arthritis from whom similar scores had been obtained. Possible role models with similar symptoms were reported by ten patients. These data support the concept that childhood reflex neurovascular dystrophy is frequently a stress-related disease; the therapeutic approach to treating these children and their families must take these psychosocial factors into account.

Adolescent↗