Dystrophie sympathique réflexe ou maladie de Sudeck: diagnostics alternatifs et solution chirurgicale

13 janvier, 2020

Análisis distrofia de Sudeck_01_20191226

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In this post in his videoblog, Dr. Piñal analyzes reflex sympathetic dystrophy or Sudeck’s atrophy, proposing alternative scenarios both in the diagnosis and in the solutions to this pathology through surgery.


Sudeck’s atrophy, also known as complex regional pain syndrome (CRPS 1 and 2) causes acute pain in the patient with vasomotor alterations in the upper extremities such as swelling, color and temperature changes, burning or tingling, among others. These alterations cause serious functional limitations in the hand and arm, which are usually also accompanied by sleep disorders.

His work and decades of experience in the analysis of cases of this profile leads Dr. Piñal to consider that reflex sympathetic dystrophy does not exist per se, but is a category to which the patient is assigned when the diagnostic capabilities are overcome. Thus, from his point of view, the majority of cases of complex regional pain syndrome are due to underlying pathologies of traumatic origin or nerval irritations and injuries.

Dr. Piñal presented in Las Vegas (USA) last September the international guest presentation of the 74th edition of the annual congress of the American Society for Surgery of the Hand, which focused on reflex sympathetic dystrophy and its character of diagnostic failure . Thus, in Piñal’s opinion, many cases of chronic hand and wrist pain that “have a justification and, therefore, a solution” are mistakenly diagnosed as Sudeck’s atrophy.

The main argument of the lecture – entitled “Reflections of a Busy Surgeon: Reflex Sympathetic Dystrophy/CRPS Does Not Exist” – is based on a long investigation that includes the analysis of more than 100 cases of patients who came to Dr. Piñal with initial diagnosis of reflex sympathetic dystrophy, but in which he identified other pathologies that could be addressed after the new diagnosis.

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