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dystrophy

Sudeck-Syndrom
Synonym: reflex sympathetic dystrophy

definition
dystrophy of all tissues of a limb segment during vegetative derailment due to various exogenous (usually traumatic), endogenous, peripheral or central causes of constitutional readiness.

first Stadium
symptoms
- redness and swelling of soft tissue
- Major Pain sensitivity
- hair and nails grow faster

diagnosis
X-ray: patchy bone atrophy as an expression of reactive reconstruction after weeks

differential diagnosis
all early stages of chronic bone and joint inflammation

second Stadium
symptoms
- cyanosis, glossy skin, reducing the temperature
- movement pain
- Trophic disorders of skin appendages, skin and muscles
- Spongiosaatrophie, secondary joint changes due to proliferation of connective tissue

diagnosis
X
Diffuse bone atrophy, especially near the joints, transverse whitening strips in the area of the former epiphyses

differential diagnosis
Chronic bone and arthritis

3. (Final) stage: defect healing
symptoms
- Verschmächtigung of the limbs (atrophy, muscle loss)
- Major movement disability of the joints
- touch, stress and temperature sensitivity

General and medical therapy
first Stadium
- General therapy
• Absolute immobilization of the whole limb in a relaxed physiological Joint position
- Drug therapy and oral anti-inflammatory drugs •
local analgesics

• • • sympatholytic
sedatives
second Stadium
- General therapy
• Temporary immobilization only in pain and increasing swelling
- Drug therapy
• Anti-inflammatory
• to improve the circulation Central
• sedatives
• Experiment with calcitonin
third Stadium
- Drug therapy
• sedatives, experiment with calcitonin

Physical Therapy

M = masseur MB = Med Bathhouse KG = physiotherapy ÆP = Medical Practice

( http://www.akh-consilium.at/daten/gelenkverletzungen.htm )

http:// science.orf.at/science/news/113918

dystrophy: pain after fracture
		a hand injury or a trivial forearm fracture in the area can, although injury and fracture healing well to chronic pain to the Paralysis of the whole arm out. For over 100 years, researchers around the world searched unsuccessfully for the causes of this insidious disease - the dystrophy, for which there was previously no cure. Vienna Scientists have solved the mystery of the disease Sudecksche now: the cell metabolism in the connective tissue is disrupted, according to them through the injuries and released oxygen radicals play a key role.

		open This finding now real opportunities to get the disease under control.

	Small cause, big effect
		Not infrequently is a minor injury triggered dystrophy, frequent bone fractures as well as operations in the arm and leg joints. Was already described these complications from the Hamburg doctor Paul Sudeck in 1900. Sudeck called the disease a "derailed healing inflammation" and described the similarity between the symptoms of an inflammatory response and the Sudeck syndrome. From dystrophy is always a joint, usually hand or foot, knee or shoulder less hip and less frequently affected.

	Individual disease The dystrophy is a very individual disease, in each patient again appears to be somewhat different, and expires. The best chance for cure, patients are treated properly in the first few weeks, but the disease usually lasts for months, unfortunately in some cases for years. You may leave permanent damage such as severe pain, stiffness and loss of tissue. Women are affected slightly more often than men, and children can suffer from this disease.
	more about the disease (morbus-sudeck.ch)

	part contradictory warning signs
		The disease usually begins one to seven weeks after the causative event of severe pain in the affected limb. The body part is often swollen and red and looks like an infection. Still no inflammation in the blood can be detected, the patients have no fever. The joint starts to stiffen painfully. The limited mobility and pain are not the only signs of Sudeck's disease. In some patients, the affected limbs are numb, this is a noticeable temperature change: The affected hand may feel colder or warmer than the healthy. This large number of, often contradictory, symptoms does not make it easy to identify the disease. Especially because all the symptoms occur only rarely in the same intensity and there may be quite different combinations.

	New Diagnostic model
		In is the first phase of the disease the best chance of recovery. Provided the disease is detected. In this case, many doctors find it difficult because they are rarely confronted with it. The researchers at the Ludwig Boltzmann Institute for Clinical and Experimental Traumatology " have therefore developed for their colleagues in practice, a diagnostic model, which lists all possible side effects of the dystrophy. With simple device, the mobility of the joints, thickening, swelling, measured and evaluated on a point system. With the score increases the probability of Sudeckschen disease. For the physician, this means that a specialist must be turned on.

	Difficult treatment
		The treatment was previously limited to pain relief, to stop the inflammation and stop the paralysis with physiotherapy. Experiment was also conducted with acupuncture and other alternative healing methods - is the resounding success of this has failed. There are also no panacea, because the disease in nearly every case with a different, individual symptoms occur.

	Mysterious causes
		Because no other explanation was, have not doctors the cause of the disease rarely located in the psychological field. From patient reports is herauszulesen: They were taken in their suffering is not always serious and were often confronted with the fact that the doctor spoke of imaginary pain. In fact, the cause is not really clarified. The injury is the trigger, what happens then lay in the dark. The researchers at the Ludwig Boltzmann Institute for Clinical and Experimental Traumatology "have now taken a promising track. With elaborate analysis and in animal models could be demonstrated that the play dystrophy released oxygen radicals play a key role.

	Dangerous radicals comes When metabolic processes, it the formation of molecular fragments, the "free radicals". While the formation of these molecules or atoms for certain reactions absolutely necessary, the release of these radicals in the cell or body fluid can be dangerous. They react and combine with everything they encounter, for example, tissue and muscle cells, the genetic material, with the blood cells including problem for the body is not only the immediate high reactivity of free radicals, but the fact that they can trigger chain reactions: this takes a radical to another molecule, destroying it and thereby releases more free radicals. Under unfavorable circumstances, such a single free radical destroying thousands of molecules. Since the body constantly radicals are released, will be continuously significant damage caused by these molecules.
	Free radicals cause cell damage but not? (26/02/2004)

	radical scavenger against dystrophy
		The detection of increased, oxygen free radicals in a Sudeckschen disease seems almost solved the puzzle. By the previous violation, it could lead to membrane damage of cells in the affected area have come. Radicals are released, a fatal chain reaction takes its beginning. now is for the scientists is to develop suitable radical scavengers, which can be used in dystrophy. Until then, the earlier the diagnosis, the greater the chances of recovery. Gerhard Roth, Modern Times Health