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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(1):24-30.
Reflex Sympathetic Dystrophy in Cervical Cord Injured Patients.
Kim, Seong Woo , Park, Chang Il , Park, Eun Sook , Kim, You Chul , Shin, Ji Cheol , Kim, Seong Won , Cho, Sung Rae
1Department of Rehabilitation Medicine, Yonsei University College of Medicine.
2Institute of Rehabilitation Medicine, Yonsei University College of Medicine.
3Department of Rehabilitation Medicine, Chungang University College of Medicine.
경수손상 환자에서의 반사성 교감신경성 디스트로피
김성우, 박창일, 박은숙, 김유철, 신지철, 김성원1, 조성래
연세대학교 의과대학 재활의학교실 및 재활의학연구소, 1중앙대학교 의과대학 재활의학교실

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.

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.

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.

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.

Key Words: Reflex sympathetic dystrophy, Cervical cord injury, Bone scintigraphy, Digital infrared thermographic imaging


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