Post-traumatic reflex sympathetic dystrophy in the ankle and foot: a study of 32 cases

The etiopathogenesis of reflex sympathetic dystrophy is still undefined, and diagnosis and treatment are difficult. It is the purpose of this study to propose precise diagnostic and therapeutic criteria for post-traumatic reflex sympathetic dystrophy of the ankle and foot. Diagnosis is pre-eminently clinical. Clinical progression of the disease occurs in three stages: acute, dystrophic, chronic. Radiographic examination cannot be used to classify the stage of the syndrome. Bone scan with Tc 99M methylendiphosphonate aids diagnosis, and helps establish the prognosis of the disease. Clinical symptoms and instrumental tests (x-ray, bone scan, CT scan, MRI) are discussed in relation to differential diagnosis with other pathologies of the ankle and foot. Furthermore, the effective use of drugs, physiokinesitherapy, and hyperbaric oxygen therapy is discussed. The authors present a study of 32 patients, paying close attention to early clinical signs of the disease. X-ray examination and bone scan were routinely carried out in established diagnostic protocols.