Reflex sympathetic dystrophy of the lower extremity in tetraplegia: case report.

Reflex sympathetic dystrophy (RSD) of the upper extremities has been reported to occur following complete and incomplete injuries of the cervical cord. Such reports describe the value of the three-phase radionuclide bone scan (TPBS) in differentiating RSD from pain of other sources. To our knowledge, RSD of the lower extremities has not been reported in a patient with tetraplegia. We report a case of lower extremity RSD in a patient with complete traumatic injury of the cervical cord. The case illustrates the use of the TPBS to differentiate RSD from heterotopic ossification (HO) in the lower extremities. THe successful use of the alpha-adrenergic blocker, phenoxybenzamine, in the treatment of RSD is described. Follow-up to 30 months has shown no evidence of recurrence, and complete resolution of the scintigraphic findings.