Reflex sympathetic dystrophy

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aka Complex Region Pain Syndrome, Transient Osteoporosis

Normal contralateral foot

Poorly understood entity of non-anatomic, disproportionate pain, with vasomotor disturbances and trophic changes. No specific pathologic, histologic or biochemical markers exist.

Image is of a health 31 y.o. male who presents with ankle pain after a knee injury two months prior. Right foot demonstrates osteopenia while the contralateral foot is normal.

Plain radiographs show only local osteopenia. Three phase nuclear medicine bone scan very sensitive.