Reflex sympathetic dystrophy true is?: (A) Osteoporosis, (B) Increased skin temp, (C) Common in athletes, (D) Vasoconstriction
Answer is A. Ans. is 'a' i.e., Osteoporosis RSD is a condition that features a group of typical symptoms, including pain (often burning type), tenderness, and swelling of an exterimity associated with varying degrees of sweating, warmth and/or shiny skin. It is an abnormal sympathetic response following trauma. This is commonly encountered in colle's fracture. However, RSD may be seen in other injuries also. Clinical manifestations of RSD The onset of the RSD symptoms may be rapid or gradual. There are several stages :- Stage 1 (Acute) :- Burning pain, flushing, sweating, swelling, erythema, increased heat, hyperesthesia, spotty osteoporosis. Stage 2 (dystrophic) :- Cyanotic extremity, thickened & shiny skin, Increased sweating (hyperhidrosis), contracture; but diminished swelling & flushing. There is diffuse osteoporosis. Stage 3 (Atrophic) :- Stiffness of joints, contracture of the involved hand or foot, Pale & cool extremity, skin is dry, tight skin, homogenous osteoporosis with thinned coices at the joint. Prognosis The prognosis varies from person to person. Spontaneous remission from symptoms occur in ceain people. Others can have unremitting and crippling, irreversible changes inspite of treatment. Treatment of RSD Physical therapy :- gradually increasing exercise program Psychotherapy Sympatholytic drugs :- Phentolamine (a. - blocker), Propranolol (13-blocker) Sympathetic nerve block :- Stellate ganglion block for upper extremity RSD and L2- L3 block for lower extremity. Medications : Topical analgesics, antidepressants, coicosteroids, opioids. Surgical sympathectomy.