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At least 19 recordsLinked to original sources
PubMed1993

A functional and psychosocial assessment of patients with post-Sudeck atrophy amputation.

Twelve patients with reflex sympathetic dystrophy were referred to a comprehensive orthopaedic rehabilitation center after failure of conservative management. Ten underwent amputation of the affected limb and, although functional improvement occurred in the patients undergoing lower limb amputation, psychosocial dysfunction persisted. All the patients required psychological support. In cases of post-Sudeck amputation, early orthopaedic diagnosis and referral to a comprehensive treatment center are recommended. In the 12 cases described here, apart from the obvious limb pathology, severe psychological inadequacies were found to be present.

Activities of Daily Living↗
PubMed1992

Carpal collapse and Sudeck's atrophy.

Acute posttraumatic (Sudeck's) atrophy of the upper extremity is well known. The symptoms and signs are out of proportion to what is to be expected from the inciting event. Typically, bone atrophy is characterized by a focal, patchy, periarticular demineralization pattern, which is usually transient. Remineralization occurs after successful treatment. This report describes a typical case of the clinical syndrome after a wrist sprain but with carpal dissolution and collapse before remineralization.

Adult↗
PubMed1979

Articular changes due to disuse in Sudeck's atrophy.

Two cases of Sudeck's atrophy of the foot occurring 16 months and 17 years after infected fractures of the leg were studied radiologically and pathologically. Various cartilaginous changes were observed, the nature and severity of which depended on the joint involved. They included superficial pannus, deep erosion, fibrous ankylosis and, at times, bony ankylosis. These changes are similar to those observed in nine cases studied by Rutishauser et al. Comparison of the pathological changes in human and experimental joint immobilization suggests that these changes are due mainly to decreased mobility of the joints of the foot in Sudeck's atrophy. These observations also suggest that physiotherapeutic mobilization in Sudeck's atrophy is important for the joints as well as for bone. From a more general point of view, they demonstrate that a condition which is nosologically different from the chronic rheumatic diseases can nevertheless cause lesions that are a fundamental part of the pathological changes in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.

Adult↗
PubMed1981

Sudeck's atrophy: a review of the literature.

Sudeck's atrophy, initiated by local irritation, proceeds from a mild form of neurovascular and osseous changes to a stage of increasing or intractable pain and trophic changes. Differential diagnosis is important as a number of conditions may produce a similar clinical picture. At any stage, the disease may improve spontaneously or from therapy, or it may result in varying degrees of permanent disability.

Atrophy↗
PubMedDate not supplied

[The hemodynamic disorders in Sudeck's atrophy and the effect on them of interference therapy].

Interferential currents applied to the forearm fracture region of 80 patients with Sudeck atrophy eliminated hemodynamic changes in the affected limb as shown by capillaroscopy, rheovasography. The effect of the treatment is attributed to recovery of normal blood flow and microcirculation in the region of bone atrophy as well as analgetic action of pulse current.

Adult↗
PubMed2002

[Sudeck's atrophy: pathophysiology and treatment of a complex pain syndrome].

UNLABELLED: Sudeck's atrophy: pathophysiology and treatment of a complex pain syndrome. SUMMARY: The "Morbus Sudeck" or Complex Regional Pain Syndrome (CRPS) forms a typical triad of motor, sensory and autonomic symptoms. It is clinically characterized by spontaneous pain and hyperalgesia not limited to a single nerve territory and disproportionate to the inciting event. An underlying pathophysiology which could explain the whole symptomatology of CRPS is still unknown. Therefore, nowadays therapy is still symptomatic. However, recent research led to a better understanding of the disease and to the beginning of a pathophysiologically orientated therapy.

Afferent Pathways↗
PubMed1987

Carbocalcitonin treatment in Sudeck's atrophy.

The efficacy of new calcitonin, the amino analog of eel calcitonin (carboCT) on Sudeck's atrophy of the foot was investigated in 14 patients. CarboCT was administered at the dose of 40 Medical Research Council (MRC) units per day, and the duration of treatment was two to ten months. No adverse effects were noted. Bone pain and local edema decreased associated with improvement of motility. CarboCT induced a slight decrease in plasma calcium, plasma phosphate, and 24-hour urinary calcium excretion. An increase in cAMP/Cr ratio, an index of parathyroid function, was also observed (probably a manifestation of the hypocalcemic effect of calcitonin and secondary parathyroid stimulation). The whole body retention of 99mTc-MDP represents a valuable index of bone turnover, it decreased progressively and significantly on treatment. A dynamic study of local bone uptake of 99mTC-MDP was performed in eight patients. After carboCT therapy, statistically significant decreases in local blood flow, early uptake, and delayed uptake were appreciated in the involved foot. These findings lead to the conclusion that carboCT is effective in the treatment of Sudeck's atrophy.

Adult↗
PubMed1989

Evidence for spirochetal origin of Sudeck's atrophy (algodystrophy, reflex sympathetic dystrophy).

Four female patients with Sudeck's atrophy (SA) were evaluated at our department. Sera of all patients were investigated for antibodies against Borrelia burgdorferi. In all patients elevated IgG antibody titers and in one patient also elevated IgM titer were found. In one patient structures identical with B. burgdorferi could be detected on histological sections from the skin of the affected limb. Our data and those of other authors suggest that a spirochetal infection can be regarded as an important etiopathogenetic factor in the development of SA.

Adult↗
PubMed1994

[Sudeck's atrophy. 3 clinical cases].

Three patients fulfilling criteria for Sudeck's atrophy (reflex sympathetic dystrophy syndrome--RSDS) are described and etiological, pathogenetic and clinical features of the disease are reviewed. RSDS is associated with a wide variety of precipitating factors, each of whom, often in concomitance with metabolic diseases and psychiatric disturbances, may cause the same clinical syndrome, which continues in a "vicious circle" of feed-back mechanisms, correlated with sympathetic hyperactivity. The symptoms may begin gradually and the disorder progresses in stages lasting from weeks to months. The management has not yet been established. Generally, the earlier the syndrome is recognized, the better the results of treatment will be. Analgesics, salmon calcitonin and physiokinesitherapy are recommended. Psychological support is advisable. In more severe patients sympathetic blockade and surgical sympathectomy may be necessary. The effects of hyperbaric oxygen treatment must still be assessed.

Adult↗
PubMed1993

Scintigraphic evaluation of the effectiveness of intranasal calcitonin therapy in Sudeck's atrophy.

The aim of this study was to evaluate the efficacy of intranasal salmon calcitonin compared to a nonsteroidal anti-inflammatory drug (NSAID) in patients with Sudeck's atrophy by means of quantitative three-phase bone scanning. Included in the study were 14 patients with Sudeck's atrophy whose diagnoses were confirmed by clinical and radiological examinations. Seven patients were treated with intranasal salmon calcitonin (100 IU twice daily) and 1 g elementary calcium daily for 5 weeks. The other group of seven patients was treated with 75 mg indomethacin daily for 5 weeks. The effectiveness of both treatments was analysed by comparing quantitative three-phase bone scans which were performed before and after the treatment. Bone-to-soft tissue ratios were calculated from static (delayed) images and scintigraphic evaluations were done both visually and quantitatively. Patients who received the calcitonin/calcium regimen showed reduced bone/soft tissue indices after therapy whereas patients who received indomethacin showed no change or showed increased indices. In conclusion, the results show that intranasal salmon calcitonin and calcium treatment is more effective than NSAIDs in patients with Sudeck's atrophy.

Administration, Intranasal↗
PubMed1998

Usefulness of ultrasound in Sudeck's atrophy of the foot.

Quantitative ultrasound (QUS) of bone has been proposed as an inexpensive and radiation-free device method of assessing skeletal status. QUS has been widely used in the assessment of osteoporosis. Until now only few data are available on the usefulness of QUS in different disorders, such as Sudeck's atrophy. To evaluate the ability of QUS in the diagnosis and monitoring of regional osteoporosis, we investigated 19 patients (12 women and 7 men, age range 30-65 years) with osteoporosis of the foot (Sudeck's atrophy), as evidenced by X-ray study and Technetium-99 bone scan. In all patients we measured speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness of the calcaneus using Lunar Achilles Ultrasound, both in the affected and unaffected foot. Bone mineral density at the lumbar spine, by DXA (Hologic QDR 1000), was also performed. QUS was repeated after 3 and 6 months of treatment with salmon calcitonin (100 IU I.M. every second day). At baseline, SOS, BUA, and stiffness, expressed as T-score, were -1.9, -2.4, and -2.4 in unaffected feet and -2.9, -5.1, and -4.3, respectively, in affected feet. The difference between the unaffected and affected foot was significant for SOS, BUA, and stiffness (P < 0.001). No significant difference was found in QUS parameters in the unaffected foot during the study period. After 3 and 6 months of treatment, SOS increased in the affected foot by 0.2% and 0.3%, BUA increased by 6. 2% and 8.2%, and stiffness by 7.5% and 11.1%, respectively. In conclusion, BUA and stiffness seem to be influenced more than SOS by Sudeck's atrophy; QUS, namely, BUA and stiffness, significantly increase with calcitonin treatment. In conclusion, QUS is a sensitive tool in the diagnosis of Sudeck's atrophy of the foot and is adequate for measuring improvement in bone status following treatment.

Adult↗
PubMed1992

Personality of patients with Sudeck's atrophy following tibial fracture.

Patients with reflex sympathetic dystrophy are often considered by physicians and allied health personnel as having a peculiar personality. In medical literature they are frequently described as anxious and depressive, emotional, nervous and irritable patients with neurovegetative instability. A review of the literature on psychological research in this field is not always illuminating. Hypochondria and hysteria, whether or not accompanied by depression, are frequently reported to be typical traits, whereas other findings point more in the direction of psychosis. Increased anxiety, emotional lability and lowered self-esteem are psychological entities that are regularly encountered. The present study includes 42 cases of severe reflex sympathetic dystrophy. Except for the 7 cases of Sudeck atrophy of the hand and wrist, the localization was always in the foot or ankle. The majority of patients had a history of fractures or orthopedic procedures on the lower limbs as a causative factor. In addition to an interview, two questionnaires and a projective test (Rorschach) were used in the personality assessment. While the Rorschach test did not reveal any findings that could be considered as typical of our study population, we did observe different frequency distributions for the personality traits "self-satisfaction", "rigidity" and "somatization".

Humans↗
PubMed1980

The treatment of Sudeck's atrophy in the upper limb by sympathetic blockade.

The incidence of Sudeck's atrophy as a sequel to injury in the upper limb has been estimated in relation to casualty attendances in a 3-year period. Seventeen patients were treated at varying intervals after the onset of the condition either by stellate ganglion block or by regional intravenous guanethidine. The results are compared and the advantages of each method are discussed.

Adult↗
PubMed1992

Spontaneous reflex sympathetic dystrophy (Sudeck's atrophy) syndrome associated with idiopathic thrombocytopenia.

A 37-year-old woman developed reflex sympathetic dystrophy (RSD) (Sudeck's atrophy) syndrome in the right foot. Simultaneously, she had idiopathic thrombocytopenia. There was no history of injury or bone fracture before onset of RSD. Spontaneous RSD associated with idiopathic thrombocytopenia has rarely been described. A possible relationship between the 2 conditions is discussed.

Adult↗
PubMed1984

Muscle spasms associated with Sudeck's atrophy after injury.

Four patients developed abnormal involuntary movements of a limb after injury. All subsequently developed sympathetic algodystrophy with Sudeck's atrophy and then abnormal muscle spasms or jerks of the affected limb, lasting years. Sympathetic block in three patients did not relieve the abnormal movements. Two patients obtained partial recovery spontaneously, but the other two required surgery for relief. The pathophysiology of this condition remains to be determined but the evidence suggests that it is a distinct, disabling clinical syndrome.

Adult↗
PubMedDate not supplied

Sudeck's atrophy in Lyme borreliosis.

A patient with disseminated Lyme borreliosis is reported. The patient suffered from erythema migrans and radicular pain. Serologic tests routinely performed (IFT, ELISA, Western blots with different strains and Borrelia-LTT) were negative. However, Borrelia burgdorferi (genotype Borrelia afzelii) was cultivated from a skin biopsy. Western blot with the patient's isolate and sera showed strong reactivity only with the 60 kDa protein. In spite of immediate diagnosis and intravenous antibiotic treatment according to current recommendations he developed pain in the right ankle, which was resistant to further antibiotic and anti-inflammatory therapy. Sudeck's atrophy was diagnosed by X-ray. Treatment with calcitonin brought immediate relief from pain and led to radiographically demonstrable recalcification.

Aged↗