MAGNETIC-RESONANCE-IMAGING IN COLD AND WA RM REFLEX SYMPATHETIC DYSTROPHY OF THE FOOT

Purpose: To report magnetic resonance imaging abnormalities in reflex sympathetic dystrophy of the foot. Methods: Retrospective study of 22 algodystrophies of the foot, in warm phase in 17 cases, in cold phase in 5. Results: Algodystrophy in warm phase : Bone medullary abnormalit ies were noted in 17 cases (decrease of signal intensity was found in T1 weighted images, increase of signal intensity in T2 weighted images , in T1 and T2 with fat-saturation, in T1 with gadolinium), located at the increased uptake technetium site in 16 cases. T1 and T2 weighted images with fat-saturation and T1 with fat-saturation after injection of gadolinium were pathological in all cases, T1 was normal in 2 cases . Soft tissues abnormalities were noted in 11 cases, joint effusion in 8 cases, synovial hypertrophy enhanced by gadolinium in 2 cases and a subchondral linear area of hypointense signal on T1 and T2 images was not present after gadolinium injection in 1 case. Six fractures were detected. Algodystrophy in cold phase : no bone edema, no synovial hyp ertrophy, no joint effusion, no soft tissues abnormalities, no fractur es are detected. Conclusion: The results suggest that the MRI has a co nsiderable value in diagnosis during the warm phase of reflex sympatet ic dystrophy of the foot. The normal MRI findings during the cold phas e could be important to understand its etiology.