National Library of Medicine MEDLINE Database TITL: Reflex sympathetic dystrophy in the foot: clinical and scintigraphic criteria. AUTH: Holder LE; Cole LA; Myerson MS ORGA: Department of Radiology and Nuclear Medicine, Baltimore, MD 21218-2895. CITE: Radiology 1992 Aug; 184 (2): 531-5 LANG: ENG; English ABST: To establish strict clinical criteria for reflex sympathetic dystrophy (RSD) of the foot and to characterize any associated scintigraphic pattern, the authors performed three-phase radionuclide bone scanning in 51 patients prospectively referred because RSD was a diagnostic consideration. To establish sensitivity and specificity data, the cases of an additional 100 consecutive patients referred for a variety of foot problems were retrospectively reviewed. The authors defined RSD of the foot as a pain syndrome characterized by diffuse nonanatomic, often unrelenting pain; autonomic-vasomotor signs including warm or cool skin temperatures and moist-sweaty or dry-scaly skin; and a positive response to a lumbar sympathetic block. Patients with RSD have a characteristic delayed bone-scan pattern consisting of diffuse increased tracer throughout the foot, with juxta-articular accentuation of tracer uptake. Overall, sensitivity in this study was 100%; specificity, 80%; positive predictive value, 54%; and negative predictive value, 100%. False-positive images were obtained in patients with infection, diabetes, and chronic pain. Specificity was 66% in the subgroup of patients who underwent sympathetic block, with a positive-predictive value of 88%. There were no differences in scan pattern related to duration of symptoms prior to imaging. (AUTHOR) MJTR: Foot Diseases RI. Reflex Sympathetic Dystrophy RI. MNTR: Adult. Aged. Bone and Bones RI. False Positive Reactions. Female. Foot Diseases EP. Human. Male. Middle Age. Prospective Studies. Radionuclide Angiography. Reflex Sympathetic Dystrophy EP. Retrospective Studies. Technetium Tc 99m Medronate DU. JOURNAL ARTICLE RNUM: 63347-66-0 (Technetium Tc 99m Medronate) GEOT: UNITED STATES IDEN: ISSN: 0033-8419. JOURNAL-CODE: QSH. ENTRY-DATE: 920806. JOURNAL-SUBSET: A M X. IM-DATE: 9210. ACCE: 92319966
National Library of Medicine MEDLINE Database TITL: Reflex sympathetic dystrophy involving the foot. AUTH: Van Wyngarden TM; Bleyaert AL ORGA: Podiatry Hospital of Pittsburgh, Pennsylvania. CITE: J Foot Surg 1992 Jan-Feb; 31 (1): 75-8 LANG: ENG; English ABST: Reflex sympathetic dystrophy often presents with the subjective chief symptom of pain. This paper demonstrates that careful study of the subtle and often cyclical objective signs can be used to assess the state of the disease. It may also evaluate progress of treatment. (AUTHOR) MJTR: Foot Diseases DI. Reflex Sympathetic Dystrophy DI. MNTR: Autonomic Nerve Block. Bupivacaine DU. Case Report. Female. Foot Diseases CO. Foot Diseases TH. Human. Middle Age. Pain ET. Pain TH. Reflex Sympathetic Dystrophy CO. Reflex Sympathetic Dystrophy TH. JOURNAL ARTICLE RNUM: 2180-92-9 (Bupivacaine) GEOT: UNITED STATES IDEN: ISSN: 0449-2544. JOURNAL-CODE: IAH. ENTRY-DATE: 920602. JOURNAL-SUBSET: M. IM-DATE: 9208. ACCE: 92242738
National Library of Medicine MEDLINE Database TITL: Bilateral burning foot pain: monitoring of pain, sensation, and autonomic function during successful treatment with sympathetic blockade. AUTH: Galer BS; Lipton RB; Kaplan R; Kaplan JG; Arezzo J; Portenoy RK CITE: J Pain Symptom Manage 1991 Feb; 6 (2): 92-7 LANG: ENG; English ABST: We describe a patient with burning pain in both feet associated with local autonomic disturbances following bilateral traumatic sciatic mononeuropathies. The diagnosis of a sympathetically maintained pain was confirmed through a prompt response to sympathetic blockade. Although a mild alcohol-nutritional neuropathy was found, the clinical findings strongly suggested a diagnosis of bilateral causalgia. Clinical evaluation and quantitative sensory testing were performed prior to and after successive unilateral lumbar sympathetic nerve blocks. After unilateral blockade, bilateral improvement was recorded in measures of pain, sudomotor function, and foot temperature. Other measures of autonomic function showed variable responses to sympathetic blockade. Quantitative sensory testing revealed a dramatic alteration in the contralateral limb's thermal sense following unilateral block. This case underscores the potential for bilateral causalgia and provides additional evidence for a central mechanism operating in this disorder. The relationship between bilateral causalgia and the "burning feet syndrome" in alcoholic neuropathy is discussed. (AUTHOR) MJTR: Alcoholism CO. Autonomic Nerve Block ST. Causalgia TH. Foot Diseases TH. Monitoring, Physiologic MT. Nerve Compression Syndromes CO. Sciatic Nerve. MNTR: Adult. Body Temperature. Case Report. Causalgia DI. Causalgia ET. Foot Diseases DI. Foot Diseases ET. Human. Male. Pain Measurement. Sensation. JOURNAL ARTICLE GEOT: UNITED STATES IDEN: ISSN: 0885-3924. JOURNAL-CODE: IJJ. ENTRY-DATE: 910501. SPECIAL-LIST: N. JOURNAL-SUBSET: N. IM-DATE: 9107. ACCE: 91178322
National Library of Medicine MEDLINE Database TITL: Reflex sympathetic dystrophy syndrome following trauma to the foot. AUTH: Malkin LH ORGA: Department of Orthopedic Surgery, Boston University School of Medicine, Mass. CITE: Orthopedics 1990 Aug; 13 (8): 851-8 LANG: ENG; English MJTR: Foot IN. Foot Injuries. Reflex Sympathetic Dystrophy ET. MNTR: Adolescence. Adult. Autonomic Nerve Block. Case Report. Female. Hallux Valgus SU. Human. Male. Physical Therapy. Postoperative Complications. Reflex Sympathetic Dystrophy DI. Reflex Sympathetic Dystrophy TH. Sympathectomy. Sympathetic Nervous System. JOURNAL ARTICLE GEOT: UNITED STATES IDEN: ISSN: 0147-7447. JOURNAL-CODE: PCM. ENTRY-DATE: 901011. JOURNAL-SUBSET: M. IM-DATE: 9012. ACCE: 90370674