Therapeutic Effect of Oral Corticosteroids in Post-Stroke Reflex Sympathetic Dystrophy: Semiquantitative evaluation of three-phase bone scintigraphy.
- Author:
Duk Hyun SUNG
1
;
Kang Woo LEE
;
Byung Tae KIM
;
Jeong Yi KWON
;
Jong Moon KIM
Author Information
1. Department of Physical Medicine and Rehabilitation, Sung Kyun Kwan University, College of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Reflex sympathetic dystrophy;
Three-phase bone scintigraphy;
Corticosteroids
- MeSH:
Adrenal Cortex Hormones*;
Capillaries;
Capillary Permeability;
Diagnosis;
Follow-Up Studies;
Hand;
Humans;
Hyperalgesia;
Radionuclide Imaging*;
Reflex Sympathetic Dystrophy*;
Reflex*;
Steroids;
Stroke
- From:Journal of the Korean Academy of Rehabilitation Medicine
1997;21(5):851-859
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
In 12 Reflex Sympathetic Dystrophy(RSD) patients(13 cases) after the acute stroke, Three- phase Bone Scintigraphy(TBS) was performed to evaluate whether the amount of radioisotope reflects the disease activity of RSD. The diagnosis of RSD was based on Kozin's criteria(definite or probable group) and scintigraphic findings(increased radioisotope uptake in all three phases). Initial TBS was performed within 10 days after the onset of clinical symptoms and it was followed up within 5days after the short term steroids therapy. Before and after the steroids therapy, patients were evaluated with respect to pain, swelling and allodynia. Radioisotope uptake of ROI(Regions Of Interest) of all three images was calculated semiquantitatively in initial and follow up scintigraphy. Pain, swelling and allodynia of the affected hand were improved in all patients after short-term oral corticosteroids therapy. Radioisotope uptake in blood flow image(11 patients, 12 cases) and blood pool image(11 patients, 12 cases) were decreased(p<0.05), but radioisotope uptake in delayed image was not decreased(p>0.05). We concluded that radioisotope uptake in blood flow and blood pool images could reflect disease activity of RSD. It was suggested that decreased capillary vascular permeability by corticosteroids resulted in decreased blood flow and blood pool. The semiquantitative evaluation of TBS may be useful for monitoring the response to therapeutic intervention. The role of inflammatory mediators in RSD and pharmacologic effect of corticosteroids were also discussed.
