X-ray bone densitometry in the diagnosis and followup of reflex sympathetic dystrophy syndrome.

Abstract

To establish bone involvement in reflex sympathetic dystrophy syndrome (RSDS). Bone mineral density (BMD g/cm2) and bone mineral content (BMC g) were measured by dual X-ray absorptiometry. We studied 12 patients with phase I RSDS and 18 controls. BMD and BMC were significantly lower in the involved side of patients (28.4 and 45.1%, respectively) compared with the contralateral normal limb. Controls only showed a minimal variation of 2.17% in BMD and 4.38% in BMC between right and left measures. The difference between patients and controls was highly significant (p < 0.001). A second measurement of BMD and BMC was made in 8 patients following treatment (prednisone or calcitonin) and showed increments in both variables, which was significant in the affected limbs (20.1%). We believe that X-ray bone densitometry is a highly sensitive and specific technique to evaluate bone mass in patients with RSDS and aid in diagnosis and treatment monitoring.