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.
Reflex Sympathetic Dystrophy Syndrome At A Glance
- 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.
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