Reflex sympathetic dystrophy in a teenaged girl

A patient had pain, a cold feeling, and absent pulses in the lower part of the right leg. Minimal change was present on Doppler artery examination. She was diagnosed as having reflex sympathetic dystrophy and was treated with nifedipine (Adalat, Procardia). Symptoms gradually diminished, and after three months the results of physical examination were normal, although she still had an occasional cool feeling in the right foot. Reflex sympathetic dystrophy seems to be a common condition, but it is not widely understood and is probably underdiagnosed. It may be seen by primary care physicians as well as by specialists. Treatment is fairly simple. When pain with vasospasm is the presenting manifestation, use of a calcium channel blocker or prazosin (Minipress) in addition to physical therapy should be considered.