Introduction to Reflex Sympathetic Dystrophy

Subgroups of Reflex Sympathetic Dystrophy

There is no consensus of how to categorize subgroups of reflex sympathetic dystrophy (RSD) but several methods have been proposed including by the pattern of spread and by prominent symptoms.

Pattern of Spread

• Contiguous spread - This occurs in almost all patients and involves the gradual enlargement of the affected area.
• Independent spread - Signs and symptoms appear at distant sites not adjacent to the initial site of the injury. This pattern occurs in up to 70% of patients with RSD.
• Mirror image spread - Signs and symptoms appear in the same area on the opposite (contralateral) limb. This pattern occurs in up to 15% of patients.

Prominent Symptoms

Some experts have recommended that patients with RSD be classified into subgroups on the basis of prominence of symptoms. In addition to pain, which is the most prominent feature of RSD, additional prominent symptoms which may serve as a basis for differentiating subgroups of patients include:

• Sensory abnormalities - allodynia (extreme sensitivity to touch)
• Motor changes such as tremor
• Autonomic dysfunction including edema (tissue swelling) and hyperhydrosis excessive sweating)
• Progressive trophic changes to skin, muscle, and bone
• Reduced range of motion