Application of thermography in the diagnosis of the algodystrophic syndrome type I  in 42-year-old patient

1 Klinika Rehabilitacji, Wojskowy Instytut Medyczny, Warszawa. Kierownik Kliniki: cz.p.o. dr n. med. Józef Mróz
2 Klinika Pediatrii, Nefrologii i Alergologii Dziecięcej, Wojskowy Instytut Medyczny, Warszawa. Kierownik Kliniki: prof. dr hab. n. med. Anna Jung
3 Wydział Elektryczny, Politechnika Częstochowska
4 Wojskowy Instytut Higieny i Epidemiologii
Adres do korespondencji: Klinika Rehabilitacji, Wojskowy Instytut Medyczny, ul. Szaserów 128, 04-141 Warszawa 44
Praca finansowana ze środków własnych

Pediatr Med rodz Vol 10 Numer 1, p. 78–84
DOI: 10.15557/PiMR.2014.0012
ABSTRACT

Algodystrophic syndrome entity (type I) has not fully known pathogenesis and course. It is characterized by severe pain of the distal part of limb, oedema, vasomotor dysfunction and impaired efficiency. These symptoms occur after trauma, thoracic surgeries, myocardial infarction, stroke, peripheral nerve damage, less common in the course of venous or arterial thrombosis. Pathomechanism of the disease is unclear, but the most important factor of its pathogenesis seems to be a disorder of the autonomic nervous system. Limb pain and swelling, in the typical cases, are accompanied by vasomotor disturbances, restricted mobility, increased sensitivity to pressure and temperature changes. The course of the disease can be divided into three periods: I – acute period, II – dystrophic period, III – atrophic period. Apart from the vasomotor form, we can distinguish paralytic form (after a stroke) and toxic (druginduced). The majority of patients has emotional lability, hyperreactivity and a tendency to anxiety and depression. Imaging studies are useful in the diagnosis. The effectiveness of treatment depends on the period in which the diagnosis is made. The sooner patients are treated, the outcomes are better. Analgesics and sympatholytics are used in this therapy. Good effects of decongestants, anti-inflammatory medications and stimulating bone calcification treatment are obtained after the application of an alternating magnetic field of low frequency, low-energy laser, whirlpool limbs massage, affected limb exercises. We present a case of 42-year-old man with algodystrophic syndrome, in which the diagnosis was made in the advanced second stage of the disease. Pharmacological treatment and physiotherapy had been used for 3 months and led to a significant improvement, which is well illustrated by the thermographic examination.

Keywords: algodystrophy syndrome, post-traumatic osteoporosis, Sudeck’s disease, acute bone loss, thermal imaging study