PMID: 9638836Jun 25, 1998Paper

Synovial effusion in reflex sympathetic dystrophy: an additional sign for diagnosis and staging

Skeletal Radiology
M GraifS Mandel

Abstract

To improve the present MRI criteria for diagnosis and staging of reflex sympathetic dystrophy (RSD) by including increased joint fluid as an additional MRI sign of RSD. One hundred and fourteen extremities (69 affected and 45 contralateral controls) in 57 consecutive patients with RSD were evaluated using a 1.5-T unit. T1- and T2-weighted pulse sequences, often with fat suppression, were used before and after administration of intravenous contrast enhancement (Gd). Following T2-weighted image digitization the volume of synovial fluid was measured with a computer model. Effusions were detected in 61% of the extremities suspected of RSD and in 44% of the contralateral control joints. The mean fluid quantity measured in the symptomatic articulation was 201 mm3. MRI diagnosis of RSD based on previously described criteria was done in 62% of the patients, yielding a sensitivity of 60%. Effusions were present in 79% of the false negative MRI cases. Retrospectively considering the presence of fluid as a potential positive criterion for RSD increases the sensitivity by 31% (to 91%). Joint effusions are probably associated with early stages of RSD. Adding effusion to the list of radiological criteria for RSD increases the sensitivity of ...Continue Reading

Citations

May 13, 2010·Current Pain and Headache Reports·Dennis Naleschinski, Ralf Baron
May 17, 2005·Radiologic Clinics of North America·Frédéric E LecouvetBruno C Vande Berg
Nov 27, 2002·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Roslyn B EvansPaul Fiolkowski
May 23, 2007·The Clinical Journal of Pain·Matthias SchürmannGeorg Gradl
Jan 13, 2012·European Journal of Nuclear Medicine and Molecular Imaging·Martin W HuellnerPatrick Veit-Haibach
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Nov 16, 2004·Lancet·Ralf Baron, Wilfrid Jänig
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Nov 29, 2016·PM & R : the Journal of Injury, Function, and Rehabilitation·Martino BussaSimona Rinaldi
Jul 22, 2014·JBJS Reviews·Thuan-Tzen KohAndrew Hardidge
Jun 14, 2020·European Journal of Radiology·Christoph A AgtenFlorian Brunner
Nov 1, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Daehyun YoonSandip Biswal

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