Reflex Sympathetic Dystrophy Syndrome (cont.)
How is reflex sympathetic dystrophy diagnosed?
RSDS is diagnosed based on the clinical features described above. Blood
testing is not abnormal because of RSDS but may be with one of its
associated conditions as described above. X-rays can show patchy thinning or
significant osteoporosis. Nuclear bone scanning can demonstrate
characteristic uptake patterns.
What is the treatment for reflex sympathetic
dystrophy?
Response to treatment is greater in earlier stages than later stages. Cool,
moist applications can provide some relief of burning symptoms. Gradual
exercising can prevent contracture. Medications for pain and inflammation
can also reduce symptoms. For persisting symptoms, high doses of
prednisone (cortisone) are used for periods of weeks, depending on
response, then gradually reduced. Occasionally, a
nerve block with anesthetic injected
into a specialized area of the involuntary nervous system (stellate
ganglion blockade) can help. Sometimes a series of these blocks is
tried.
Other treatments include surgically interrupting the nerves (the
sympathetic nerves) of the involuntary nervous system (surgical
sympathectomy), pain drug pumps implanted into the spinal canal (intrathecal
drug pumps), and spinal cord
stimulation devices.
- RSDS is characterized by a group of symptoms, including pain (often
"burning" type), tenderness, and swelling of an extremity associated
with varying degrees of sweating, warmth and/or coolness, flushing,
discoloration, and shiny skin.
- How RSDS occurs is not known, but there can be trigger events.
- Symptoms of RSDS often occur in three stages: acute, dystrophic, atrophic.
- Diagnosis of RSDS is based on clinical findings, supported by
radiological tests.
- Treatment of RSDS is most effective in earlier stages.
Last Editorial Review: 11/6/2007
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