Reflex sympathetic dystrophy. The other villain in chronic venous leg ulcers.

BACKGROUND

There are no previous reports addressing a link between leg ulcers and the reflex sympathetic dystrophy (RSD) syndrome.

OBJECTIVE

The purpose of this study was to define the incidence and characteristics of a possible RSD leg ulcer syndrome.

METHODS

Leg ulcers encountered in private practice were retrospectively analyzed for the presence of 12 clinical features ("special traits"), four of them because of their known association with RSD, and eight because they were suspected of resulting from vasospastic ischemia.

RESULTS

Among 111 ulcer episodes, 35 (31.5%) were associated with RSD, 14 (12.6%) with arteriosclerosis obliterans, and 62 (55.9%) were caused by pure venous insufficiency. The mean score of "special traits" was 5.03 in the RSD category, 2.57 in the arteriosclerosis obliterans category, and 1.66 in pure venous insufficiency cases.

CONCLUSION

It is concluded that an RSD leg ulcer syndrome does indeed exist and that it is common and easy to diagnose. Verification by prospective studies is called for.