Failure of MR imaging to detect reflex sympathetic dystrophy of the extremities.

Abstract

Reflex sympathetic dystrophy of the extremities is a disease with a wide spectrum of clinical manifestations.it is characterized by pain, hyperthermia, and cutaneous changes and has been linked to an abnormality of regional blood flow. The disease is associated with previous injury or trauma including surgery, but also has been found in association with myocardial infarctions and tumors. The final diagnosis can be made only on the basis of the clinical course, which is characterized either by regression without sequel or the appearance of aponeurotic and tendinous retractions including bony sclerosis in the affected region occurring over many months to years. The literature and our own results show that MR imaging has high sensitivity for diagnosing transient osteoporosis of the hip, which is generally thought to be a form of reflex sympathetic dystrophy. Therefore we investigated the usefulness of MR imaging for diagnosing sympathetic dystrophy of the extremities. Twenty-five patients underwent

Type I complex regional pain syndrome: MRI may be misleading

“…There appears to be a significant proportion of cases where routine MRI sequences are Type I complex regional pain syndrome normal. 8 Our two cases demonstrated a variety of the reported features including bone marrow changes, skin and subcutaneous thickening, synovial thickening and enhancement. The marginal bone erosions seen in the second case have not been previously reported but they presumably occur as a result of synovitis.…”

Skeletal Muscle MRI in Complex Regional Pain Syndrome

“…The area of T2WI signal changes was reduced in some muscles (Table 1), and there was no enhancement by gadolinium dimeglumine (Fig. 1F) (3)(4)(5), and the other one shows abnormal muscular metabolism of high-energy phosphate by 31 P NMR spectroscopy (2 …”

Ultrasound Appearance of Forearm Muscles in 18 Patients With Complex Regional Pain Syndrome 1 of the Upper Extremity

“…Magnetic resonance imaging (MRI) findings in patients with CRPS‐1 have been equivocal. A recent report showed discernible muscle changes in the acute phase, 27 but other MRI‐based studies have not corroborated these findings 28,29 . The bone demineralization seen on radiographs may not always be present in patients with CRPS‐1, particularly in the initial stages of disease 12 .…”