Diagnosis of Reflex Sympathetic Dystrophy (RSD)

Diagnosis of RSD

Diagnosis of Reflex Sympathetic Dystrophy (RSD)

I’m Ed Smith, an RSD Attorney in Sacramento. Reflex Sympathetic Dystrophy, also known as Complex Regional Pain Syndrome, is a devastating disease that impacts many people all over the world. For those who may not know, this syndrome can lead to significant, chronic pain that could prevent people from engaging in the activities that they enjoy. Commonly impacting an arm or a leg, many different causes could lead to this serious disease. Sometimes, individuals can present a variety of RSD symptoms that could leave medical professionals confused. Therefore, there are a handful of steps that a medical professional may take to make a diagnosis. It is important for affected individuals to understand these tests before they are performed.

Steps in Diagnosis: History First

As with many medical conditions, a diagnosis requires an accurate history first. The physician is going to ask several questions about the type of symptoms, their severity, and their timing picture decide whether or not laboratory testing or imaging should present. Some of the questions about the symptoms could include:

  • Is the pain continuous?
  • Is the pain located in an arm or leg?
  • Is there swelling of the affected area?
  • Does the impacted extremity feel hot or cold to touch?
  • Have there been changes in the growth of nails or hair in the area?
  • Do the joints feel stiff?
  • Have there been any muscle spasms, limb tremors, or loss of muscle strength?
  • Is it difficult to move that part of the body?

Because there are so many symptoms that could indicate the presence of RSD, it can be a challenge to differentiate Reflex Sympathetic Dystrophy from other diseases that could impact the arms and legs. If an individual answers “yes” to many of the questions above, there are several tests that the physician could run to gather more information.

Diagnosis of RSD: Tests and Imaging

There are various tests that a physician could order to collect more information about the affected limb or extremity. Individuals need to know how these tests work, the risks, and the benefits before agreeing to them. Some of the tests include:

Bone Scan: In a bone scan, a radiolabeled isotope is injected into the bloodstream. In essence, a contrast agent that readily shows up on imaging is placed in the bloodstream. This contrast agent is chosen carefully to ensure it has a tendency to pool in the bone. A couple of hours after the agent is injected, imaging is used to obtain a closer look at the bones. Because this is a radioisotope, it shows up well on the imaging scans. If it pools in the bones, the bones show up on the scan. There are specific patterns that the radiologist will look for on the imaging scan that could indicate the presence of RSD.

Tests of the Sympathetic Nervous System: Sometimes, those who have RSD may have disturbances in the perception of pain, pressure, and temperature in an affected area. If this is the case, this could indicate damage to some of the sensory nerves in the region. Tests can be run on the sympathetic nervous system to tell whether or not damage has been done to the nerves. If the tests indicate an anomaly with the nerves, this could support a diagnosis of RSD.

X-Rays: An x-ray is one of the oldest imaging tests used by medical professionals. In an x-ray, an image is generated based on differences in density. Dense material, such as bone, will show up white. Light material, such as air, will show up dark. An x-ray can be taken of the affected limb, and those who have RSD sometimes have erosions of the bone that can be seen on an x-ray. While this cannot definitively diagnose RSD, it can be used to support diagnosis in a clinical setting.

MRI Scan: An MRI is one of the newer scans used by physicians. This test can take a long time to run; however, it also produces a stunning level of detail that few other scans can produce. In an MRI, a magnet used and an image is generated based on the differences of how molecules respond to this magnet. This can provide a detailed image of the bones, muscles, tendons, ligaments, and nerves. In someone who has RSD, problems can be detected in the muscles (if they have spasms), nerves (if they have shooting pain), or bones (if they have fractures or erosions). It is important to note that someone cannot have an MRI if they have pieces of metal in their bodies, such as old tattoos, implants, or pacemakers. The magnet could suck these metallic materials right out of someone’s body.

These are only a few of the different tests that a physician could order to help make a diagnosis of RSD. Please ask questions to make sure that all of the information regarding these tests is explained before the procedure.

The Final Diagnosis of RSD

After gathering all of the information from the history, the physical exam, and the tests described above, the physician may make a diagnosis of RSD or CRPS. It is important for everyone to understand that the diagnosis of RSD cannot be definitively made with the tests above. The doctor cannot “see” RSD on the images. The physician will use the test results in combination with the history of the symptoms to make a diagnosis. If the physician believes that the individual does have RSD, they will begin treatment and see if the symptoms improve. Many times, an improvement in the severity of the symptoms can be diagnostic as well. If the individual gets better, the final diagnosis can is made. It can be frustrating for individuals to have to wait to hear their diagnosis; however, everyone should keep in mind that this disease can take time to diagnose. It is important to make this diagnosis properly. This will improve the patient prognosis and ensure that the right diagnosis is made.

Contact an Experienced RSD Attorney in Sacramento

I’m Ed Smith, an RSD Attorney in Sacramento. If you or a family member has been diagnosed with Reflex Sympathetic Dystrophy, please give me a call at (916) 382-0693. I would be happy to share free, friendly advice to anyone who asks.

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