technetium-tc-99m-medronate and Causalgia

The authors describe a complex regional pain syndrome (CRPS) and discuss its type according to the presence or absence of nerve injury. A patient underwent thromboendarterectomy of the right popliteal artery. Subsequently, right lower limb reflex sympathetic dystrophy developed, which was confirmed by scintigraphy and responded well to calcitonin treatment. Typing according to the new classification of CRPS type I or II with possible nerve injury is discussed, and a short review of the literature is included.

Topics: Aged; Causalgia; Complex Regional Pain Syndromes; Diagnosis, Differential; Endarterectomy; Foot; Humans; Male; Popliteal Artery; Radionuclide Imaging; Radiopharmaceuticals; Reflex Sympathetic Dystrophy; Technetium Tc 99m Medronate; Vascular Diseases; Whole-Body Counting

Reflex sympathetic dystrophy (RSD or causalgia) has been rarely reported in children. We now report a 10-year-old boy with RSD in whom we performed extensive ancillary investigations including thermography, bone scintigraphy and dermo-echography. The clinical, laboratory and ancillary studies reported here highlight the profound focal acquired autonomic disturbance in this disorder. The patient presented a compression of the deep peroneal nerve at the inferior extensor retinaculum in the affected limb. Surgical decompression lead to rapid improvement of the patient's condition. Peripheral nerve decompression should be considered as a possible treatment of RSD in children, particularly those that are refractory to conservative maneuvers.

Topics: Causalgia; Child; Humans; Male; Nerve Compression Syndromes; Peroneal Nerve; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate