Here is a case of Reflex Sympathetic Dystrophy of Ankle for the Radiology Grand Rounds submitted by Dr Sumer Sethi of Teleradiology Providers. Concept and Archive of the Radiology Grand Rounds is available at- Radiology Grand Rounds
This is 44 year old male with history of ankle injury six months back with history of severe pain in ankle now and swelling. Bone scan done showed increase uptake around the ankle. MRI study was requested which revealed patchy marrow edema involving the bones forming tibiotalar and subtalar articulation with myofascial edema and synovial collection. A diagnosis of Reflex sympathetic dystrophy was made. The diagnosis of Reflex Sympathetic Dystrophy Syndrome (RSDS) can be difficult to establish. RSDS is a devastating condition, which can cause patients to become socially and emotionally crippled. MRI abnormalities seen in patients with RSDS of the foot vary widely and include marrow edema, synovial hypertrophy, joint effusions and soft tissue edema. However, normal MRI does not rule out RSDS of the foot.