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Advised to see rheumatologist. Diagnosed with Reflex Sympathetic Dystrophy Syndrome. Done with blood test. Advice?

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General & Family Physician
Practicing since : 2009
Answered : 3094 Questions
Hello dr.Luchuo Engelbert Bain
I hope you remember me i contact you in the past caplevtimes with question regarding may health you advice me to go to reumatologist and i did i pick up his letters to may gp yesterday she is awey it is long latter only what is there new it is that he suspect that i devlop RSD-syndrom and that may doctor should sent me to neurologist .(he told me at appoitment i have big time carpel tunel syndrom i told him frst neurologist said no he said not possible and i told him i am tired of going back and foward ).He masuare may hand gripp and hands movment or exstention.
Grip strenght is barely 40 millimetres of Mercury in the right hand and 150 millimeters of Mercury in the left hand with widespread tenderness.
Right shoulderaducts abaut 60 with60 of XXXXXXX and external rotation.
Fingertip-floor dystance is27cm with Schober's test normal at 6cm.
Can you please explein me this mesurments and what is this rsd-syndrome and may gp told me she refer me to neurologist bat yesterday her secretary told me she don't see any refferal to same .
May blood test for automne desiase is:
Esr. 10
Reumatoid factor. <. 20
hs-Crp. 6.8. A
Cut points for cardiac risk assissment are:
Low risk level < 1.0 Mg/L
Avrige risk level 1.0-3.0 mg/l
High risk level 3.0 mg/l
Values> 8.0 MG/L indicate inflammatory conditions and may not predict cardiac risk.
HLA. B 27. Negative

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Can you also read me may blood test also reumatologist said he will get me back if this show (blood picture) any nead for that all depend of blood picturess may gp is awey i don't no haw to read this i ques you can help me with same.
Thank you dr.Luchuo E.B.
Posted Sat, 17 Aug 2013 in Medicines and Side Effects
Answered by Dr. Luchuo Engelbert Bain 3 hours later
Hi and thanks for the update,

RSD is the reflex sympathetic syndrome, other wise called algodystrophy, characterized by pain of from nervous origin, of a given part of the nervous system called the sympathetic nervous system. Its usually due to compression, an autoimmune condition of metabolic disease. Other locompotor system measures including a normal Schober's test is reassuring. Schober's test is designed to check the mobility and movement of the vertebral column. Reduced movements is characterized by abnormal values with the Schober's measure which is not the case with you. Its reassuring.When generally its less than 5, its a problem.

The blood tests done by the rheumatologist are within normal limits with no signs of chronic inflammation. With a negative HLA 27, its further reassuring. This sets the ground to work with a better direction in the diagnostic possibilities.

I think the opinion of the neurologist now is capital in this case. Reevaluating for Reflex Sympathetic dystrophy, and also bearing carpel tunnel syndrome in mind. Get the neurologist's consultation and reevaluation first. I hope to share my own final opinion when you get back from the neurologist. I am beginning to think of including physiotherapy, mineral replacement therapy, specific diet recommendations and reducing the number of drugs you do take. But , see you neurologist first.

Thanks and waiting to hear from you when you see him. Kind regards.

Bain LE, MD.
Above answer was peer-reviewed by
Follow-up: Advised to see rheumatologist. Diagnosed with Reflex Sympathetic Dystrophy Syndrome. Done with blood test. Advice? 3 hours later
Thank you for answering to me,
Can you jast lead me what should i ask neurologist wich question will benefit me with may all situation ??
I will have neurologist posibole jast one more time in months and months waiting.
Thank you !
Answered by Dr. Luchuo Engelbert Bain 6 minutes later
Thanks for the query,

1. To screen for any electrolyte abnormalities (Calcium, Potassium, Magnesium and Sodium).

2. Detailed evaluation for Carpal Tunnel syndrome

3. In case he confirms Algodystrophy or RSD, the place of Calcitonine injections in the treatment process.

I think with a proper neurological review and in depth evaluation of these issues, this should be able to at least help in improving your health and quality of life. Thanks and kind regards as I wish you the best of health. Feel very asking any further questions in case of need.

Bain LE, MD.
Above answer was peer-reviewed by
Follow-up: Advised to see rheumatologist. Diagnosed with Reflex Sympathetic Dystrophy Syndrome. Done with blood test. Advice? 3 hours later
Thank you doctorand can you please explein me that mesure on may frst question hand gripp,shoulder exstention and finger what is normal and where i am?
Also he ask mi to tach may toes with may hands bay stending i did tray and jast could go on half with hands in eir could not go with may hands any close to toe of may leg may tip of fingers are uper of may knee of legs then there is secund question whay i could not go further ? I wos shock bay that forgot to ask him?
Please dont forget may mesurments of hands to explein me.
Thank you and after you answer me i will not bother you untill i go to neurologist i hope so .
You are the best
Answered by Dr. Luchuo Engelbert Bain 1 hour later
Hi and thanks for the query,

The measures and Schober's test are to determine whether you have restricted movements, a reduction in the range of movements and an appreciation of movement generated pain. In your case, this was not a major problem.The Schober's test was normal, but there was a slight decrease (mild abnormality) or restricted movement in your finger - toe manouvre.This to me should not be a major issue considering the normality of the rheumatologic tests.

Thanks and hope this helps. A clinical decision shall be made only a a proper clinical evaluation by your neurologist. You really need not bother much for now. I think after the neurologist's evaluation, treatment options shall be discussed and might contribute my bit to improve your quality of life if offered the opprotunity. Wishing you the best of health and hoping to hear from you soon. Wishing you good health and kind regards.

Bain LE, MD.
Above answer was peer-reviewed by
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