Reflex Sympathetic Dystrophy Workup
- Author: Don R Revis, Jr, MD; Chief Editor: Herbert S Diamond, MD more...
Laboratory studies are not useful for the diagnosis of reflex sympathetic dystrophy. Levels of acute-phase reactants (ie, erythrocyte sedimentation rate [ESR], C-reactive protein) are generally within the reference range.
Plain radiographs usually demonstrate pronounced demineralization in the underlying bony skeleton of the involved extremity (ie, Sudeck atrophy) that may become more severe with disease progression. No joint erosions are present. Demineralization begins at the ends of the bones and progresses to become homogeneous.
Findings on three-phase radionuclide bone scans are positive in 50-90% of patients with RSD, and this study is most useful in early disease. Findings on the delayed image (ie, third phase) are generally abnormal, with increased uptake in the articular and periarticular structures of the involved extremity. Of course, this finding is not specific for RSD) but is supportive of that diagnosis in the appropriate clinical situation. In chronic RSD, the bone scan findings may be normal, but the plain radiographs generally reveal profound demineralization of the affected extremity. For more information, see Reflex Sympathetic Dystrophy Imaging.
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