The reflex sympathetic dystrophy syndrome. II. Roentgenographic and scintigraphic evidence of bilaterality and of periarticular accentuation.

Patchy osteoporosis is the primary roentgenologic manifestation of the reflex sympathetic dystrophy syndrome (RSDS). As recent clinical and histologic data suggested articular changes in RSDS, fine-detail roentgenograms were obtained in eight consecutive patients. Juxta-articular and soft-tissue swelling, osteoporosis and erosions of the subchondral bone were found. 99mTcO4 and 99mTc-EHDP scintigraphy showed localization of nuclide predominantly in the juxta-articular tissues. Serial roentgenographic, scintigraphic and quantitative bone densitometric measurements showed changes that reflected the clinical course of the disease.