Reflex Sympathetic Dystrophy Syndrome (RSDS)
Medical Author: William C.
Shiel Jr., MD, FACP, FACR
What is reflex sympathetic dystrophy?
Reflex sympathetic dystrophy syndrome (RSDS) is a condition that features a
group of typical 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.
What causes reflex sympathetic dystrophy?
RSDS is also referred to as "the shoulder-hand syndrome," "causalgia," and "Sudeck's
atrophy." The exact mechanism of how RSDS develops is poorly understood. The
theories include irritation and abnormal excitation of nervous tissue,
leading to abnormal impulses along nerves that affect blood vessels and
skin. A variety of events can trigger the condition, including
trauma, surgery, heart
disease, degenerative
arthritis of the neck,
stroke or other brain diseases, nerve irritation by entrapment (such as
carpal tunnel syndrome) or
shingles, shoulder problems,
breast cancer, and drugs for
tuberculosis and barbiturates. There is no associated event in one-third
of patients.
What are the symptoms of reflex sympathetic
dystrophy?
The onset of the RSDS symptoms may be rapid on gradual. The condition may
not display all features. It has been bilateral in up to half of the
patients. There are several stages:
- Acute: (three to six months) burning, flushing, blanching, sweating, swelling,
pain, and tenderness. This stage can show early x- ray changes of patchy
bone thinning.
- Dystrophic: (three to six months) early skin changes of shiny, thickened skin
and contracture with persistent pain, but diminished swelling and
flushing.
- Atrophic: (may be long-standing) loss of motion and function of the
involved hand or foot with contracture (flexed scarring process),
thinning of the fatty layers under the skin.
X-ray can show significant
osteoporosis.
Next: How is reflex sympathetic dystrophy diagnosed? »
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