PSEUDODYSTROPHY AT THE LOWER-LIMB IN CHILDREN

The authors describe a 12-year old girl with a painful syndrome at the distal side of the left leg, resulting in limping, incapacity and sev ere muscle atrophy. Full investigation - no inflammatory laboratory si gns, diffuse osteoporosis at the left leg, decreased bone mineral cont ent at the same place, marked hypofixation on bone and vascular scinti graphy - suggested pseudodystrophy (5),which is often induced by psych ological factors. Successful treatment was obtained by physiotherapy, hydrotherapy, slight doses of NSAID and psychological assistance. With regard to recent literature, the authors believe that reflex sympathe tic dystrophy (RSD) in children is often over-diagnosed, since there a re no recognised criteria for diagnosiing RSD. Besides the clinical pi cture, changes on radiography (focal osteoporosis) and on scintigraphy (disturbed vascular scintigraphy with increased pooling in the initia l phase and hyperfixation on bone scintigraphy) are necessary. When th ese are not available, pseudodystrophy is a more correct diagnosis.