REFLEX SYMPATHETIC DYSTROPHY OF THE LOWER-EXTREMITY IN TETRAPLEGIA - CASE-REPORT

Reflex sympathetic dystrophy (RSD) of the upper extremities has been r eported to occur following complete and incomplete injuries of the cer vical cord. Such reports describe the value of the three-phase radionu clide bone scan (TPBS) in differentiating RSD from pain of other sourc es. To our knowledge, RSD of the lower extremities has not been report ed in a patient with tetraplegia. We report a case of lower extremity RSD in a patient with a complete traumatic injury of the cervical cord . The case illustrates the use of the TPBS to differentiate RSD from h eterotopic ossification (HO) in the lower extremities. The successful use of the alpha-adrenergic blocker, phenoxybenzamine, in the treatmen t of RSD is described. Follow-up to 30 months has shown no evidence of recurrence, and complete resolution of the scintigraphic findings.