Diffuse reflex sympathetic dystrophy

Reflex sympathetic dystrophy represents a group of disorders that include causalgia, algodystrophy, Sudeck's atrophy, and shoulder-hand syndrome. Early symptoms include pain, hyperesthesia, swelling, vasomotor instability, and limited range of motion, which may progress to trophic skin changes and osteoporosis. Optimal treatment includes early mobilization and sympathetic blockade with a local anesthetic. The pathophysiology of reflex sympathetic dystrophy is thought to include excessive autonomic responses to various factors, including trauma (often seemingly trivial), arthritis, disc disease, myocardial infarction, herpes zoster, vasculitis, bone or joint infection, and tumor. Spread of symptoms to the opposite extremities has implicated central nervous system mediation of reflex sympathetic dystrophy. A case in which acute exacerbation of chronic reflex sympathetic dystrophy resulted in a unique case of total-body involvement is described.