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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Algodystrophy can follow a wide variety of painful disorders and the Sympathetically Maintained Pain (SMP) syndromes form a chapter of medicine which is far more important than generally considered. The abnormal central sensitization of internucial pools of spinal neurones must be considered as the crucial element of these painful states. Treatment must be carried out in the first phase in order to minimize the state of spinal hypersensitivity.
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PMID:Algodystrophy: pathophysiological considerations. 266 43

Reflex sympathetic dystrophy (RSD) is a clinical syndrome defined in the English literature by pain, dystrophic tissue changes and local disturbance of autonomic function in a limb or part of a limb. Algodystrophy is the common name used for the condition in the French literature, in which the concept also includes the "transient regional osteoporosis" and the "regional migratory osteolysis". We want to discuss three points: 1) Are the RSD, transient regional osteoporosis and migratory osteolysis different diseases or different manifestations of a single condition? We believe that an objective differentiation is not possible between them. Our report about 28 cases of polytopic RSD shows the frequent association in the same patient of these manifestations and we believe that this represents the broad spectrum of a single disease. 2) Is the accepted classic pathophysiologic mechanism of RSD accurate? The conception of a disturbance of autonomic function is not easily linked with its association with conditions such as diabetes, hyperthyroidism, hyperlipidaemia and others. Even more difficult to explain is the association with malignancy and osteomalacia. The deposit of immunoglobulins that we have demonstrated in two cases in the palmar fascia of RSD associated with malignancy suggests a possible immunological mechanism. 3) What are the limits of RSD? The association between RSD and aseptic necrosis of the hip has been reported. Are they two different conditions or is the aseptic necrosis only a more developed form of RSD? Finally, we report the first single case of Munchausen syndrome mimicking a RSD of the hand with the same clinical, radiological and scintigraphic appearance.
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PMID:Concept and limits of the reflex sympathetic dystrophy. 266 64

Algodystrophy of the hip--also characterized as disappearing hip, transient demineralization of the hip, neurotropic rheumatism of the hips, or osteolytic arthropathy of the hips--is a pseudoinflammatory disease entity with normal inflammatory parameters involving movement- and load-dependent pain and radiologically visible demineralization of the femoral head. The osteolysis may be so pronounced that the femoral head has become virtually invisible (disappearing hip). The wide spectrum of possibilities in differential diagnosis, including inflammatory hip diseases in particular, together with the rarity of "disappearing hip", often allow diagnosis only retrospectively if the condition has not been thought of from the outset. The usually spontaneous course without residues can be markedly shortened by calcitonin treatment, therapy with nonsteroid antirheumatic agents, or by prednisone treatment. We report 2 cases of "disappearing hip" with typical course treated at the Orthopedic Clinic of Olten Cantonal Hospital in the period 1980 to 1988.
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PMID:[Disappearing hip--algodystrophy of the hip]. 279 36

Algodystrophy is a pathological syndrome of the limbs caused by a disturbance of the neurovegetative system of which the main consequence is a disorder of the regulation of the regional micro-circulation: pain, functional loss of use of a limb segment and the secondary appearance of trophic disorders with joint stiffening are the main symptoms of this disease. Among the etiologies, traumatic causes are first considered without forgetting nervous, visceral and drug induced causes. The treatment is based on pain killers, vascular medications, beta-blockers and Calcitonin. In addition to active physical therapy, recent experiments permit to confirm the advantages of scottish baths.
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PMID:[Algodystrophy of the upper extremity]. 288 99

Algodystrophy, which is commonly called "reflex sympathetic dystrophy syndrome" in English literature, is a common but very often unrecognized disease of the locomotor apparatus. This condition is characterized by pain with a transient, inconstant pseudo-inflammatory appearance, affecting to a variable degree the different tissue layers of one or several joint areas. Algodystrophy is often difficult to diagnose because the disease mimics the different diseases of the locomotor apparatus. The etiology, clinical symptoms, diagnosis, and treatment of this condition is discussed.
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PMID:Algodystrophy. Reflex sympathetic dystrophy syndrome. 304 25

Algodystrophy may follow surgery at the aortic bifurcation. Patients present with pain, trophic changes, and cutaneous dysaesthesia in one or both legs. Diagnostic sympathetic blocks may relieve pain, abolish dysaesthesia, and increase blood flow. Recognition of algodystrophy is important to avoid further vascular surgery which will exacerbate the symptoms.
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PMID:Algodystrophy after aortic bifurcation surgery. 614 36

Algodystrophy is a poorly recognized condition of uncertain aetiology which presents with pain and tenderness, vascular instability, swelling and stiffness of an affected limb. It is most commonly seen after trauma. In order to ascertain its incidence, natural history and the degree of morbidity induced we studied prospectively 274 patients with Colles' fracture. Algodystrophy, as judged by the presence of bone pain or tenderness, vasomotor symptoms, swelling and stiffness of the hand was noted in 28% of patients. There was a significant association between the presence of these features (P < 0.0001). The degree of trauma sustained was identified as a predisposing factor. Actuarial analysis showed a gradual resolution of symptoms. Six months after injury, the proportion of patients complaining of pain and swelling had fallen to 20-30%, vascular instability and tenderness to 50% and stiffness to 80%. Failure to improve was associated with a significant loss of hand function (P < 0.0001). By 1 yr, pain and tenderness, vascular instability and swelling had decreased still further but stiffness was still apparent in 50%. We believe that algodystrophy is a neglected disorder and is far more common than formerly appreciated. Although it often resolves spontaneously, it is associated with a significant increase in short-term morbidity in the majority of patients and persistent dysfunction in a minority.
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PMID:Algodystrophy: an under-recognized complication of minor trauma. 815 86

Algodystrophy is a complex and heterogenous syndrome, better defined as a subtype of Reflex Sympathetic Dystrophy syndrome (RSD). The pathophysiological theory of RSD has been supported by basic studies and clinical efficacy of sympathetic blocks. Results may be good, but some of RSD are not responsive to sympathetic blocks, and distinction between sympathetic dependent and independent pain has been proposed as subtypes of RSD. Physiotherapy is an essential part of RSD treatment. Sympathetic blocks and other analgesic therapies are performed in order to permit painless action of the physiotherapy against sick limbs stiffness. The rule must be: no painful physiotherapy. Use of other kind of drugs has yet to be defined. Calcitonin is potentially beneficial, but must be given in combination with blocks. Some new treatments rise interesting fundamental questions and some of them are under evaluation. Psychological support is the third part of treatment of these chronic pain patients. Multidisciplinary organisation, as offered by pain centers, can help to understand this syndrome and to elaborate guidelines for diagnosis, treatment and research programs.
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PMID:[Treatment of algodystrophies. The point of view of an anesthetist]. 850 50

The differential diagnosis of erythermalgia is sometimes complicated by the absence of consensus on proposed diagnostic criteria. Unwarranted diagnosis can result from any clinical situation leading to burning sensations in the limbs. This can occurs in patients with peripheral neuropathies who often experience dysesthesia when going to bed when the legs are under the covers; in such cases, redness and local warmth are missing. Venous insufficiency can also produce sensations of warm feet, often at retiring, together with edema and an increase in local heat. Algodystrophy, during the inflammatory phase can also mimic erythermalgia with intense pain and local modifications. Nevertheless, the unilateral aspect and persistence of the symptoms together with the post-traumatic situation usually directs the diagnosis. Acrodynia is a rare disease caused by excessive mercury intake and should be discussed in children. Vasomotor impairment in the limbs is the main sign. The red color of the hands and feet is accompanied by intense paroxysmal burn-type pain. The diagnosis is confirmed by high mercury levels in urine. Fabry's disease is a hereditary sphingolipidosis transmitted on chromosome X and occurs predominantly in men, often starting early in childhood with burning sensation in the limbs. The diagnosis should be entertained in children with pseudo-erythermalgia and is confirmed by chromatographic search for abnormal sphingolipids in the urine.
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PMID:[False erythermalgia]. 875 87

Algodystrophy is a severe complication of distal radius fractures; its incidence balances from 0.02% to 37% reported from various papers. In order to ascertain its incidence and clinical picture, the following features in 100 patients 2-4 months after distal radius fracture were examined: pain in the hand, swelling, vasomotor and sudomotor instability, stiffness, trophic changes, shoulder complaints and changes on X-ray picture; the presence and intensity of each feature were noticed. There were 87 female and 13 male patients, aged from 36 to 88 years (average 60.6 years) in the group; 79% of patients complained of pain in affected hand (spontaneous or after loading) and 20% complained of pain and limitation of movement in the shoulder joint. Algodystrophy, diagnosed by the presence of at least 4 strongly expressed features was noted in 14% of patients. The syndrome developed more frequently in women than in men, in patients with displaced and manipulated fractures (particularly with fragmentation of the epiphysis) and in individuals wit poorly reduced fractures. The most specific for algodystrophy features were: deficiency of finger flexion greater than 3 cm, severe spontaneous pain, severe swelling and permanent redness of the hand; the author suggests, that algodystrophy after distal radius fracture is far more common condition than it is generally believed.
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PMID:[Algodystrophy after distal radius fractures]. 897 50


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