THE MANAGEMENT OF REFLEX SYMPATHETIC DYST ROPHY SYNDROMES - STATE-OF-THE-ART AND SUGGESTED CRITERIA FOR NEW PROTOCOLS

After a review of the prognosis of reflex sympathetic dystrophy syndro me (RSDS), current treatments are discussed, including elimination of weight-bearing or stress through the joint, hydrotherapy, physical the rapy, calcitonin, oral and intraarticular corticosteroids, beta-adrene rgic receptor antagonist therapy, and regional intravenous block (e.g. , with guanethidine or buflomedil). Same-site recurrences are rare and should be differentiated from local migration of the disease. Multifo cal forms should lead to investigations for diffuse osteoporosis respo nsible for insufficiency fractures. Future studies should subset patie nts on the basis of etiologic factors and sites involved (hands and fe et, shoulder-hand syndrome, knee, hip, multiple sites). Strict patient selection criteria are suggested.