Algodystrophy

Algodystrophy is a clinical syndrome characterized by intense locoregional pain, vasomotor and trophic changes and delayed recovery, mostly occurring after trauma or surgery. The variety of nomenclature reflects the spectrum of clinical presentations and the uncertain pathophysiology. Although most patients recover, it can result in persistent disability in some patients. The diagnosis is based mostly on clinical signs. The specificity and sensitivity of additional technical investigations, such as radionuclide scintigraphy and X-ray, is variable. Algodystrophy progresses in several stages, from an inflammation-like clinical picture to recovery or sequels. The management is mainly supportive and can be difficult in some patients, especially in persistent chronic cases or when recognized at a late stage. Management is based on the results of limited prospective controlled studies. There is a need for a better understanding of the pathophysiology and for prospective clinical studies about the natural course and the effect of treatment.