Venous refill time in reflex sympathetic dystrophy (RSD) : A pilot study

Objective: Investigate the venous refill time in patients with reflex sympathetic dystrophy (RSD). Setting: Department of Physical Medicine and Rehabilitation (outpatient clinic). Patients: 18 patients with clinically confirmed acute RSD of the lower limb with a history of more than one but less than 8 months. Main outcome measures: The results of venous refill time (measured by light reflection rheography) were compared to the unaffected limb and correlated with the parameters pain, using a verbal rating scale (0 to 5), side differences in skin temperature and feet circumference, active range of movement of ankle extension and flexion, and three-phase bone scan. Results: Light reflection rheography revealed the venous refill time of healthy and affected leg to be significantly different, which suggests an involvement of the venous microcirculation in RSD. Venous refill time correlated significantly with side differences in skin temperature. A less pronounced correlation was found with arterial and soft tissue phases (bone scan), as well as with pain. Conclusion: The results of this pilot study suggest that light reflex rheography is abnormal in the affected leg of patients with acute RSD of the lower limb. Further studies will have to elucidate the underlying mechanisms of this phenomenon.