45 years old Female, Foot Pain
Detail of Left Foot
Findings? DDx?
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Confirmatory Studies Findings on these images?
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More Studies, same disease Summary of findings and Final Dx?
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Answers
Reflex Sympathetic Dystrophy
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  • Initial images showed periarticular osteopenia, most striking around the left interphalangeal joints, with preservation of the joint space. The right foot is not visibly involved (minimal osteoarthriris)
  • DDx: Disuse Osteopenia, early Rheumatoid Arthritis (but more likely symmetric)
  • Bone scan confirms increased periarticular uptake, isolated to one extremity
  • RSD often has antecedent trauma (may be minimal); Clinically, associated with burning pain, swelling, dystrophic changes
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