Article
Morbidity in reflex sympathetic dystrophy
Clare S Murraya, Alison Cohenb, Tessa Perkinsb, Joyce E Davidsona, John A Sillsa
a Department of
Paediatric Rheumatology, Royal Liverpool Childrens Hospital, Eaton
Road, Liverpool L12 2AP, UK, b Department of
Physiotherapy, Royal Liverpool Childrens Hospital
Correspondence to: Dr Sills
Accepted 19
November 1999
Reflex sympathetic dystrophy (RSD), an unusual diagnosis in
general paediatrics, is well recognised by paediatric rheumatologists. This study reports the presentation and the clinical course of 46 patients (35 female, age range 8-15.2) with RSD. The patients saw
professionals from an average of 2.3 specialties (range 1-5). Twenty
five (54%) had a history of trauma. Median time to diagnosis was 12 weeks (range 1-130). Many children had multiple investigations and
treatments. Once diagnosis was made, treatment followed with physiotherapy and analgesics. Median time to recovery was seven weeks
(range 1-140), with 27.5% relapsing. Nine children required assessment by the child and adolescent psychiatry team. This disease, though rare, has significant morbidity and it is therefore important to
raise clinicians' awareness of RSD in childhood. Children with the
condition may then be recognised and referred for appropriate management earlier, and spared unnecessary investigations and treatments which may exacerbate the condition.
Keywords: reflex sympathetic dystrophy; complex regional pain syndrome
© 2000 by Archives of Disease in Childhood
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Pain (anaesthesia)
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