title: Scoring system in the assessment of the clinical severity of reflex sympathetic dystrophy of the hand.
abstract: A scoring classification for assessment of the clinical severity of reflex sympathetic dystrophy (RSD) and rating the presence and clinical expression of each feature is proposed. The following were included: pain, reduction of finger flexion, swelling, temperature changes, discoloration, sensory disturbances, shoulder pain and loss of movement, increased sweating, and hair/nail growth changes. For most of these features one point was assigned for strong expression, half a point for moderate expression, and zero points if the feature was absent. A score of four points was assumed, empirically, to indicate a minimal degree of RSD, and the maximum score of 10.5 to indicate fully symptomatic condition. One hundred forty-six patients with RSD of the hand were classified according to those criteria. Seventy-four patients (51%) had a score of 4-6, 51 patients (35%) of 6.5-8, and 21 patients (14%) of 8.5-10. This classification was then used to investigate the influence of clinical severity of RSD on the intensity of uptake of the tracer in three-phase bone scintigraphy. No correlation between RSD score values and intensity of fixation of the radionuclide was found.
authors.affiliation: Department of General and Hand Surgery, Ul. Unii Lubelskiej, 1 71-252, Szczecin, Poland. azyluk@hotmail.com
authors.forename: Andrzej
authors.initials: A
authors.lastname: Zyluk
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D011877:Radionuclide Imaging; D012019:Reflex Sympathetic Dystrophy / Q000145:classification* / Q000000981:diagnostic imaging / Q000503:physiopathology; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric