[Sudeck disease]

In 1900, the Hamburg surgeon P.H.M. Sudeck was the first to describe the clinical and radiological symptomatology of the disorder to which he later lent his name. He devoted his scientific career to this disorder, "acute inflammatory atrophy" of bone and soft-tissue as he called it. He elaborated the histology of the disorder with his students and advocated the pathogenic peripheral humoral theory. In later years seven further attempts to explain the pathogenesis were published. The present paper notes that this disorder, which can be divided into three distinct stages, is diagnosed mainly on the basis of clinical factors, above all in the early stage, and that x-rays in the early stages are difficult to differentiate from those of immobilisation osteoporosis since both disorders can manifest as patchy rare fraction and fibrous osteolysis in subchondral bone and old growth plates. Moreover, the author also notes that 10% of all Sudeck cases are not preceded by trauma; these must be understood as spontaneous Sudeck or as Sudeck after distant disturbances. A few sources also refer to Sudeck's dystrophy in the presence of lymphatic congestion. Another, special form of Sudeck's atrophy, is the shoulder-hand syndrome which, however, cannot always be differentiated precisely from rheumatic disorders or dystrophic contractures.