THE ROLE OF BONE-SCINTIGRAPHY IN DIAGNOSING REFLEX SYMPATHETIC DYSTROPHY

Three-phase bone scintigraphy is used often to diagnose reflex sympath etic dystrophy of the hand. This study presents an analysis of the lit erature relating three-phase bone scanning to reflex sympathetic dystr ophy in the upper extremity. The data show a wide variability in scint igraphic accuracy in patients with clinically obvious reflex sympathet ic dystrophy. The results of bone scintigraphy correlate best with the clinical diagnosis of reflex sympathetic dystrophy within the first 2 0-26 weeks of onset. Even then, the sensitivity in the most recent ser ies approximates 50%. After 26 weeks, there is a poor correlation betw een three-phase bone scanning and reflex sympathetic dystrophy. Conseq uently, three-phase bone scintigraphy should not be used as a major cr iterion in diagnosing reflex sympathetic dystrophy. The diagnosis of r eflex sympathetic dystrophy remains a clinical diagnosis made by an ex perienced hand surgeon.