Pain - the first and primary complaint occurring in one or more extremities
described as severe, constant, and burning in nature.
Swelling - pitting or non-pitting edema is usually present and localized
to the painful and tender region.
Diminished motor function - limitation of motion - eventual development
of dystrophy and/or atrophy.
Tremor, difficulty initiating movement, muscle spasms, focal dystonia.
Skin changes - skin atrophy, tissue atrophy, dryness, scaling, increased
hair growth or hair loss, nail changes, changes in skin temperature.
Vasomotor instability:
Bone changes - patchy osteoporosis, increased vascularity, and prominent
osteoclastic activity.
When RSDS occurs in the upper extremity there may be associated pain
and limitation of motion in the shoulder. Bilateral involvement is generally
thought to be present in 18 to 50% of cases.
Duration of RSDS varies, in many cases the pain continues on for at
least two years and in some cases, indefinitely.
Joint tenderness and swelling. Specimens of Synovial tissue are histologically
abnormal. Varying degrees of synovial edema, proliferation of capillaries;
fibrosis of the sub synovium and slight perivascular infiltration with
chronic inflammatory cells (chiefly lymphocytes) are noted.
When the hand is affected there also appears to be a significant incidence
of palmar fascitis.
Some patients experience periods of remissions and exacerbations. Periods
of remission may last for weeks, months or years.
There have been several variants of this syndrome described in the literature