Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Reflex sympathetic dystrophy (RSD)Sudeck’s atrophyReflex neurovascular dystrophy (RND)AlgoneurodystrophyCausalgia ++ 337.21 Reflex sympathetic dystrophy of the upper limb337.22 Reflex sympathetic dystrophy of the lower limb ++ G90.519 Complex regional pain syndrome I of unspecified upper limbG90.529 Complex regional pain syndrome I of unspecified lower limb ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation +++ Description ++ Autonomic changesSevere pain, swelling, skin changes, inability to tolerate light touchInternational Association for the Study of Pain (IASP) classification2Type I: no nerve damageType II: nerve damage +++ Essentials of Diagnosis ++ Unknown causeElectromyography (EMG)Usually occurs near the site of injuryThree stages3Stage 1 (inflammatory phase): severe burning, spasm, stiffness, skin changes, non-focal pain, decreased ROM Stage 2 (vasomotor phase): symptoms of stage 1, plus muscle atrophy, osteoporosis, thickening of the dermis, cool skin temperature Stage 3 (end stage): symptoms of stages 1 and 2, plus irreversible changes in skin and bones, flexor tendon contracture, atrophic stage +++ General Considerations ++ Fatigue, swelling, pain, sensory changes can cause disabilityDeregulation of the autonomic system +++ Demographics ++ Usually following injury or surgeryThree times more likely in females than males4 +++ Signs and Symptoms ++ PainSweating in the areaInability to tolerate light touchDeregulation of the autonomic systemSkin-color changesSwellingNerve painCracked nailsOsteoporosisMuscle atrophyFlexor tendon contractureSkin-temperature changeSympathetic hyperactivityAssociated symptoms may include paresthesias, burning, tingling +++ Functional Implications ++ Pain and stiffness can limit ALDsUnable to use the extremityUnable to wear socksUnable to sleep due to pain from touching the sheets +++ Possible Contributing Causes ++ Unknown etiologySurgeryInjuryVascular diseaseSpinal cord injuryFractureFrostbiteAmputationPsychological componentsStressAnxiety +++ Differential Diagnosis ++ ErythromelalgiaMyasthenia gravisChronic fatigue syndromeHypothyroidismLyme diseaseFibromyalgiaPeripheral nerve injurySystemic lupus erythematosus Rheumatoid arthritisPolymyalgia rheumaticaDepressionChronic neck and back pain +++ Imaging ++ X-rayThermographyMRI +++ Diagnostic Procedures ++ Electromyography (EMG)Widespread Pain Index (WPI)Symptom severity scoreSympathetic blockSkin blood-flow test ++ X-ray and MRI negativeLaboratory tests negative +++ Medication ++ Sympathetic blockCortisone ++ To dietician/nutritionist for nutritional counselingTo pain clinic for pain management, counselingTo neurologist for neurologic assessmentTo cognitive-behavioral therapist, psychologist forCounselingSupport groupsBiofeedbackRelaxation techniques ++ Sleep deprivationLimited walking and movement secondary to pain and morning stiffness, which ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth