J Korean Acad Rehabil Med.  1999 Feb;23(1):24-30.

Reflex Sympathetic Dystrophy in Cervical Cord Injured Patients

• Kim SW
• Park CI
• Park ES
• Kim YC
• Shin JC
• Kim SW
• Cho SR

Abstract

OBJECTIVE
Reflex sympathetic dystrophy (RSD) is a syndrome of post-traumatic neuropathic pain in association with dystrophic changes and signs of sympathetic overactivity. Pain following spinal cord injury occurs frequently, but RSD is not usually considered as one of the common sources of pain. There have only been a few reports of RSD in spinal cord injured patients, although this condition is well-known in the painful upper extremity of hemiplegia due to stroke. The purpose of this study was to investigate the rate of occurrence, characteristic clinical features and more objective evaluation tools for the diagnosis of RSD in cervical cord injured patients. METHOD: Thirty-two cervical cord injured patients were evaluated for hand pain, swelling, vasomotor changes and dystrophic skin or nail changes. The patients were evaluated with studies such as three phase bone scintigrathy, digital infrared thermographic imaging (DITI) and plain roentgenograms of the hands.
RESULTS
Eighteen patients (56.3%) were diagnosed as RSD based on the clinical symptoms and findings of three phase bone scintigraphy. Characteristic symptoms were hand pain, edema and dystrophic skin or nail changes, in the order of frequency. In patients with spasticity of the upper extremity, the incidence of RSD was higher than in patients without spasticity.
CONCLUSION
We should consider RSD as a cause of upper extremity pain in cervical cord injured patients. This will lead to early diagnosis and treatment of the condition and it will be helpful in preventing various complications.

Keyword

Reflex sympathetic dystrophy; Cervical cord injury; Bone scintigraphy; Digital infrared thermographic imaging

MeSH Terms

Diagnosis
Early Diagnosis
Edema
Hand
Hemiplegia
Humans
Incidence
Muscle Spasticity
Neuralgia
Radionuclide Imaging
Reflex Sympathetic Dystrophy*
Reflex*
Skin
Spinal Cord
Spinal Cord Injuries
Stroke
Upper Extremity