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What is the cause and treatment for reflex sympathetic dystrophy(RSD)?

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General Surgeon
Practicing since : 2002
Answered : 3190 Questions
My mother dropped a piece of wood (for woodstove) on her shin, going on 2 years now. The skin on her shin is now permanently bruised looking, warm, and making her ankle swell. She has had x-rays and ultrasound but they haven't found DVT or even a break. But after this long of time, it's really concerning. The redness seems to be spreading and the doctors can't seem to find an answer.
Posted Sat, 1 Feb 2014 in General Health
Answered by Dr. Deepak Kishore Kaltari 1 hour later
Brief Answer: Condition more likely to be due to CRPS/RSD Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Dear XXXX Thanks for the clinical photograph and history of your mother. Based on the history you have provided and the clinical photograph, the condition appears to be more likely Reflex Sympathetic dystrophy (RSD) {New terminology for the same is Complex regional pain syndrome (CRPS)}. The lesion does not look like Cellulitis or DVT and hence diagnostic possibility of CRPS becomes much higher. The International Association for the Study of Pain (IASP) lists the diagnostic criteria for Complex Regional Pain Syndrome I (CRPS I) as follows: 1.The presence of an initiating noxious event or a cause of immobilization 2. Continuing pain, allodynia (perception of pain from non-painful stimulus), or hyperalgesia (an exaggerated sense of pain) disproportionate to the inciting event 3. Evidence at some time of edema, changes in skin blood flow, or abnormal Pseudo-motor activity in the area of pain 4. The diagnosis is excluded by the existence of any condition that would otherwise account for the degree of pain and dysfunction. The treatment is usually multi-modality and includes both Non-Pharmacological(without use of drugs) and Pharmacological including Surgical intervention which is based on clinical examination and investigations. I would suggest you to discuss this condition with the treating Physician as one of the differential diagnosis for redness and edema. Do not worry things can be definitely be taken care In case you need any further assistance, kindly get back to me. I would be glad to assist you. Take care Wish your mother good health Best Regards Dr Deepak Kishore Kaltari MBBS,MS,MCH Consultant Surgeon
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