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Related Experiment Videos

[Reflex sympathetic dystrophy: still a poorly defined entity].

Paul Ornetti1, Jean-Francis Maillefert

  • 1Service d'immuno-rhumatologie, Hôpital qénéral, et Inserm ERIT-M 0207, BP 1519, 21033 Dijon. paul.ornetti@club-internet.fr

La Revue Du Praticien
|April 17, 2004
PubMed
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Reflex sympathetic dystrophy, or algodystrophy, involves limb pain and vasomotor symptoms. Recent research suggests polymodal afferent nerves play a key role in its pathophysiology.

Area of Science:

  • Pain management
  • Neurology
  • Rheumatology

Background:

  • Reflex sympathetic dystrophy (algodystrophy) is characterized by segmental limb pain and vasomotor symptoms following various pathologies.
  • Traditionally attributed to sympathetic nervous system dysregulation, recent research emphasizes the role of polymodal afferent nerves.
  • The condition presents clinically in two phases: a warm phase with pain and stiffness, followed by a cold phase with fibrosis and trophic symptoms.

Purpose of the Study:

  • To review the pathophysiology, diagnosis, and treatment of reflex sympathetic dystrophy (algodystrophy).
  • To highlight the evolving understanding of the disease, incorporating recent findings on neurogenic mechanisms.
  • To outline current diagnostic criteria and therapeutic strategies, including pharmacological and non-pharmacological interventions.

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Main Methods:

  • Clinical diagnosis based on characteristic symptoms and phases.
  • Paraclinical investigations including bone scintigraphy and MRI to confirm diagnosis.
  • Review of current treatment modalities, including medications, regional blocks, and supportive care.

Main Results:

  • Diagnosis is primarily clinical, supported by paraclinical findings like specific bone scintigraphy or MRI signal abnormalities.
  • Absence of a biological inflammatory syndrome is noted.
  • X-rays may reveal late, non-homogenous demineralization.

Conclusions:

  • Reflex sympathetic dystrophy (algodystrophy) is a complex condition with evolving etiological theories.
  • Early diagnosis and comprehensive management, including rehabilitation and psychological support, are crucial.
  • Treatment remains poorly codified, with calcitonins as first-line therapy in some regions, and other interventions for resistant cases.