Recognition of Atypical Reflex Sympathetic Dystrophy

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Abstract
Previous reports of radionuclide imaging have emphasized the hyperemic response and increased rate of bone metabolism in patients with reflex sympathetic dystrophy syndrome (RSD). The atypical presentation to the nuclear medicine physician of this clinical entity occurs when there is decreased rather than increased perfusion to the effected extremity. This clinical presentation may be more commonly seen as patients attempt to continue to exercise on a painful extremity. The cases in this paper emphasize the vasospastic abnormalities that occasionally may be predominant and the importance of early diagnosis of the disorder. The peripheral perfusion may be improved with interventional therapy to decrease sympathetic vasoconstrictive effect.