Reflex sympathetic dystrophy in the hands: clinical and scintigraphic criteria

In an attempt to establish specific scintigraphic criteria for the reflex sympathetic dystrophy syndrome (RSD) as defined by a group of specialized hand surgeons, 145 consecutive patients, 23 of whom had clinical RSD, underwent three phase radionuclide bone scanning (TPBS). Specific patterns for positive radionuclide angiogram, blood pool, and delayed images were established. The delayed images were sensitive (96%), specific (97%), and had a valuable negative predictive value (99%). We concluded that TPBS could provide an objective marker for RSD, and it could also be used to exclude RSD in patients who had less specific signs and symptoms.