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Diagnosis of Sympathetic Reflex Dystrophy
There is significant controversy and confusion surrounding the diagnosis of reflex sympathetic dystrophy (RSD) due to several factors including:
- Lack of universal recognition of RSD as a medical diagnosis. Opinions among health care professionals range from not considering RSD as a legitimate diagnosis to those who feel it is significantly underdiagnosed especially in the early stage. A diagnosis is easier to reach in severe or advanced cases, but by that time most patients are refractory to therapy. In addition, patient who reach that stage constitute a minority of those suffering from RSD.
- There is no "gold standard" regarding diagnostic criteria for RSD. There are several different guidelines that have been published and each differs in terms of the number of signs and symptoms which must be present in order to reach a diagnosis. Even so, the criteria set out in the 1994 guidelines of the IASP continue to be the most widely used for the diagnosis of RSD (see below).
- Patients may be seen by different types of physicians for their symptoms, (such as primary care physician or orthopedist) who may not be familiar with RSD perhaps because they have not seen it often in their practice or they think RSD is a rare disease so they do not include it in the differential diagnosis.
