Bone scintigraphy in post-traumatic reflex dystrophy

Twenty-five patients presenting consecutively with persistent pain and tenderness, edema, and vasomotor instability in an extremity following trauma to the same extremity were clinically diagnosed as having early post-traumatic reflex dystrophy (PRD). All underwent scintigraphy with 99mTechnetium methylene diphosphonate before institution of prednisolone treatment. The time lag between the occurrence of the initial trauma and scintigraphic imaging averaged 11.5 weeks. Of 25 scintigrams, 24 showed multiple periarticular accentuation in the affected extremity. Scintigraphy is a useful clinical aid to establish the diagnosis of early PRD.