Reflex Sympathetic Dystrophy: Bone Scans and Photos

TUUM EST

 
  1. Bone Scan Film:  February 8, 1999

  2. Georgena Sil

  3. Note:  The black dot is beside the right foot

  1. Bone Scan Film:  January 31, 2000

  2. Georgena Sil

  3. Note: The black dot is beside the right foot


During wartime, Reflex Sympathetic Dystrophy was known as Causalgia.

The modern term is:

Complex Regional Pain Syndrome

(CRPS, Type I or Type II)

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RSD Support Groups

RSDSA of America

RSD Canada

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RSD Overview

Complex Regional Pain Syndrome

CRPS Resources: MedLine

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Nuclear Medicine

Impact of Three-Phase Bone
Scintigraphy on the Diagnosis
and Treatment of CRPS

Med Princ Pract 2006

RSD:  Radiology and Imaging

eMedicine

CRPS: Review of Diagnostic Tools

RSDSA Review Digest

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Sympathetic Nerve Block

Interrupting the Sympathetic
Outflow in Causalgia and RSD

British Med J 1998

Local Anaesthetic Sympathetic
Blockade for CRPS / Review

Cochrane Library 2010

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RSD Gets Support in Law

Reflex Sympathetic Dystrophy
Syndrome Education Act

Illinois Bill HB0009

RSDS Education Act: Progress
through the Legislature

Illinois General Assembly

Bill to Improve Detection of
Reflex Sympathetic Dystrophy
Becomes Law

News Release (7 Jan 2008)

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Treatment Update

Off-Label Use of Neurontin:
Not effective for RSD

Reflex Sympathetic Dystrophy

A view of both limbs, for comparison:  RSD symptoms are prominent in the right foot, going up the calf to the knee.

© Georgena Sil

Reflex Sympathetic Dystrophy

Close-up: The right foot and ankle are grossly swollen. The color up to the knee is a uniform dark, dusky red. The ankle is fiery.

© Georgena Sil

Reflex Sympathetic Dystrophy

Close-up of right ankle: The angry red flare blazing across the inner ankle points out the inflammatory component of RSD.

© Georgena Sil

Reflex Sympathetic Dystrophy

The two-inch scar from the bone biopsy is visible atop the right foot. That surgical procedure in Sept 1999 caused the immediate onset of RSD.

© Georgena Sil

Reflex Sympathetic Dystrophy

The right foot is swollen and stiff. To bend the ankle is a work project. Other symptoms: Nails are brittle;  sweating in that limb is abnormal.

© Georgena Sil

Reflex Sympathetic Dystrophy

Specialists in Pain Management say that RSD measures at 42 out of 50 on the McGill Pain Scale. RSD is the most painful chronic disease known.

© Georgena Sil

RSD Right Foot

Georgena Sil


I developed Reflex Sympathetic Dystrophy in my right foot in 1999, as a surgical complication of a bone biopsy. Within hours of the biopsy, there was clear evidence of a complication.  Before I left the OR recovery room, my right foot was morbidly swollen; it was blue in color from my toes up past my ankle; and my foot needed constant elevation to relieve pain that was almost incomprehensible. Despite those signs, and despite my repeated visits to his office, my orthopedist Dr. Jeff McKerrell did not diagnose my RSD until three months later.


Reflex Sympathetic Dystrophy is uncommon, with little medical expertise available in small cities, including the prairie city of Saskatoon.  In 2000, after a year of no improvement in my foot, I asked for a referral out-of-province to see rheumatologist Dr. Milton Baker in Victoria B.C.  Previously I had consulted Dr. Baker for my Lupus, and although he could not cure it, he achieved results far superior to anything Saskatoon attained in twenty years.


Dr. Baker does clinical research; his knowledge is up to date; and he takes the physical findings and diagnostic reports seriously. To prepare for the new referral, I needed documentation of my RSD, an outline of its progression through stages. RSD goes through three separate stages, and the traits at each stage help differentiate whether the patient’s case is inflammatory, or mediated through the central nervous system.  By the time Dr. Baker saw my foot, it would be in Stage III, and that would not inform him about Stages I and II.


Thus, before I traveled, I requested an ‘RSD Summary’ from my orthopedist Dr. McKerrell, but he refused; he could not grasp the reason.  Next I asked my family doctor, but he became belligerent and set an exorbitant price ($300 for just over a page) which he knew I could not afford on my disability pension. Finally I made an application through the Saskatchewan Freedom of Information Act, and I obtained the summary which was so necessary.


The photos on this webpage, along with the Bone Scan films, depict the RSD in my right foot. The Bone Scans bracket the onset of this condition (one scan was taken before, and one after). The dates are:


Photos: November-December 2003
Bone Scan (after RSD): January 2000
Bone Biopsy (onset of RSD): September 1999
Bone Scan (before RSD): February 1999

McGill Pain Index

With Academic Citations

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