Impact of three-phase bone scintigraphy on the diagnosis and treatment of complex regional pain syndrome type I or reflex sympathetic dystrophy.
OBJECTIVE
To determine the impact of three-phase bone scintigraphy (TPBS) on the diagnosis and management of complex regional pain syndrome type I (CRPSI) or reflex sympathetic dystrophy (RSD).


METHODS
Twenty consecutive patients with a recent clinical evidence of CRPSI were referred for TPBS as part of their routine management plan. All patients underwent neurological examinations with special attention to the evaluation of clinical features of vasomotor, sudomotor, motor and sensory dysfunction. Patients were followed prospectively. When both the clinical and TPBS results supported the diagnosis of CRPSI, patients were started on treatment.


RESULTS
Of the 20 patients, TPBS supported the diagnosis of RSD in 9 who were treated with steroids and physiotherapy. Complete follow-up was available for 7 of them and all had a satisfactory response to treatment. For the remaining 11 patients RSD was diagnosed clinically but not confirmed by TPBS. On follow-up there was no evidence that TPBS failed to identify RSD in these 11 patients.


CONCLUSIONS
The results indicate that TPBS confirmed the clinical diagnosis of RSD, and, more importantly, had a significant impact on its management.
Shehab
Dia
D
Department of Medicine, Faculty of Medicine, Kuwait University. diaa@hsc.edu.kw
Elgazzar
Abdelhamid
A
Collier
B David
BD
Naddaf
Sleiman
S
Al-Jarallah
Khalid
K
Omar
Abdelmoneim
A
Al-Mutairy
Moudi
M
D000328:Adult; D001847:Bone Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007730:Kuwait; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy
D019275:Radiopharmaceuticals