4 CASES OF REFLEX SYMPATHETIC DYSTROPHY S YNDROME OF THE LOWER-LIMBS WITH FRACTURES

Four cases of reflex sympathetic dystrophy syndrome (RSDS) of the lowe r limbs in which a fracture occurred as a complication are reported. T he RSDS involved the medial femoral condyle in one case, the distal ti bial metaphysis in one case, and the talus in two cases, The fracture was responsible for mechanical pain in three cases, In the remaining p atient, the fracture was an unexpected finding on a follow-up magnetic resonance imaging study done in the absence of any suggestive symptom s, Poorly visible trabecular sclerosis was seen in two patients on rad iographs obtained some time after symptom onset, In two cases, the pat tern of increased radionuclide uptake changed to dot-like or linear, P ersistence, local recurrence, and migration of RSDS are the differenti al diagnoses of fractures complicating RSDS, RSDS of the lower limbs i s responsible for transient regional osteoporosis that is associated w ith an increase risk of fracture.