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Recurrent spontaneous hemarthrosis associated with reflex sympathetic dystrophy
D L Braverman1, H B Kern, W Nagler
1Department of Rehabilitation Medicine, The New York Hospital-Cornell Medical Center, New York, USA.
Archives of Physical Medicine and Rehabilitation
|April 2, 1998
Summary
Reflex sympathetic dystrophy (RSD) can manifest as spontaneous hemarthrosis after knee replacement. Lumbar sympathetic blocks provided relief in a unique case of recurrent atraumatic hemarthrosis.
Area of Science:
- Orthopedics
- Pain Management
- Neurology
Background:
- Reflex sympathetic dystrophy (RSD) presents diagnostic and therapeutic challenges due to unclear pathogenesis.
- Diagnosis relies on clinical signs of pain and vasomotor dysfunction.
Observation:
- A 75-year-old woman developed recurrent spontaneous hemarthrosis post-total knee replacement.
- Symptoms included extremity edema, discoloration, hyperesthesia, and limited range of motion.
Findings:
- Standard imaging (radiographs, bone scan) was inconclusive for hemarthrosis.
- Clinical suspicion of RSD led to a lumbar sympathetic block.
- The patient experienced significant symptom improvement following the sympathetic block.
Implications:
- This case highlights a potential association between atraumatic hemarthrosis and RSD.
- It suggests lumbar sympathetic blocks may be effective for managing this rare presentation.
- Further research into RSD pathogenesis and treatment is warranted.