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Re: Bone scan: RSD

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Vern,

I am not aware of bone scan specifics.

This is what I can determine from the report header:

Bone scan; limited;

Medronate TC-99, 20 MCI;

Camera: Orbiter;

She is 44 years old, faily athletic.

--

Dr. Abrahamson

> From: " LaVerne Saboe " <las@...>

> Date: Mon, 11 Mar 2002 12:52:34 -0800

> " DC group " < >, " Abrahamson "

> <drscott@...>

> Subject: Re: Bone scan: reflex sympathetic dystrophy

>

> :

>

> What type of bone scan? 3 phase? single? It may have little to do with RSD

> and everything to do with a small fracture. How old is this woman?

>

> Vern Saboe

> Bone scan: reflex sympathetic dystrophy

>

>

>> I have a pt. with seemingly simple ankle sprain and foot pain. I adjust her

>> talus, tibia-fibula, 2nd cuneiform, and cuboid,

>> I've used ultrasound, taping, and some massage. She has good orthotics

> which

>> fit.

>> She had relief from therapy which seemed progressive and hopeful then

>> worsened. She then had a bone scan at Kaiser. Results concluded " diffuse

>> mild increased activity in the right foot and ankle raising the question of

>> reflex sympathetic dystrophy " .

>> The next ortho to look at her disagreed with this conclusion on the face of

>> it and wants to look at her today.

>> Any comments would be appreciated.

>>

>> --

>> Dr. Abrahamson

>>

>>

>>

>>

>>

>>

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,

Secondary complications from ankle sprains are common. What are her

current symptoms and exacerbating activities? Also a more diffuse bone

scan uptake would be more typical of a " high " ankle sprain.

Ted

Ted Forcum, DC, DACBSP, CSCS

Back In Motion Sports Injuries Clinic, LLC

11385 SW Scholls Ferry Road

Beaverton, Oregon 97008

ph 503.524.9040

On Mon, 11 Mar 2002 13:29:26 -0800 Abrahamson

<drscott@...> writes:

> Vern,

> I am not aware of bone scan specifics.

>

> This is what I can determine from the report header:

>

> Bone scan; limited;

> Medronate TC-99, 20 MCI;

> Camera: Orbiter;

>

> She is 44 years old, faily athletic.

> --

> Dr. Abrahamson

>

> > From: " LaVerne Saboe " <las@...>

> > Date: Mon, 11 Mar 2002 12:52:34 -0800

> > " DC group " < >, " Abrahamson "

> > <drscott@...>

> > Subject: Re: Bone scan: reflex sympathetic dystrophy

> >

> > :

> >

> > What type of bone scan? 3 phase? single? It may have little to

> do with RSD

> > and everything to do with a small fracture. How old is this

> woman?

> >

> > Vern Saboe

> > Bone scan: reflex sympathetic dystrophy

> >

> >

> >> I have a pt. with seemingly simple ankle sprain and foot pain. I

> adjust her

> >> talus, tibia-fibula, 2nd cuneiform, and cuboid,

> >> I've used ultrasound, taping, and some massage. She has good

> orthotics

> > which

> >> fit.

> >> She had relief from therapy which seemed progressive and hopeful

> then

> >> worsened. She then had a bone scan at Kaiser. Results concluded

> " diffuse

> >> mild increased activity in the right foot and ankle raising the

> question of

> >> reflex sympathetic dystrophy " .

> >> The next ortho to look at her disagreed with this conclusion on

> the face of

> >> it and wants to look at her today.

> >> Any comments would be appreciated.

> >>

> >> --

> >> Dr. Abrahamson

> >>

> >>

> >>

> >>

> >>

> >>

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Doctors:

This post brought up something I would like some advice on. I recently had

a case come to me that I believe may be Reflex Sympathetic Dystophy. I saw

that someone mentioned using a bone scan. Are there any other objective

methods of assessing this condition. I do not feel up to date on this

condition, and would appreciate your advice.

DeShaw, DC, JD

Bone scan: reflex sympathetic dystrophy

> > >

> > >

> > >> I have a pt. with seemingly simple ankle sprain and foot pain. I

> > adjust her

> > >> talus, tibia-fibula, 2nd cuneiform, and cuboid,

> > >> I've used ultrasound, taping, and some massage. She has good

> > orthotics

> > > which

> > >> fit.

> > >> She had relief from therapy which seemed progressive and hopeful

> > then

> > >> worsened. She then had a bone scan at Kaiser. Results concluded

> > " diffuse

> > >> mild increased activity in the right foot and ankle raising the

> > question of

> > >> reflex sympathetic dystrophy " .

> > >> The next ortho to look at her disagreed with this conclusion on

> > the face of

> > >> it and wants to look at her today.

> > >> Any comments would be appreciated.

> > >>

> > >> --

> > >> Dr. Abrahamson

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

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Bone scan is the modality of choice for suspected RSD. This usually would

include the three phases (blood flow-seconds after injection, pool-3 to 5 min

post inj, and delayed images 2-4hrs post). About 60% of RSD pts show diffuse

increase in radioisotope uptake on all phases. The other pts may have more

equivocal results (i.e. uptake only on delayed phase or even no uptake on any

phase). Plain film radiographs may show regional osteopenia in a spotty,

band-like or uniform pattern as well as some soft tissue swelling.

Tim Stecher, DC, DACBR, CCSP

Chiropractic Radiologist

Open Advanced MRI & CT

Tigard

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We could tell you but then we'd have to BILL YOU!

That's a hot one! A lawyer wanting FREE ADVICE!

Actually, the best source of info. on an obscure condition is the patient

who has run the gauntlet of doctors to get their condition dx'd and managed.

I have a pt. who has the bona fide condition. I will forwad this to her and

ask her to respond to you.

--

Dr. Abrahamson

> From: " Dr. DeShaw, Esq. " <deshaw@...>

> Date: Mon, 11 Mar 2002 23:02:37 -0800

> <drscott@...>, <tlf-3@...>

> Cc: < >

> Subject: Re: Bone scan: RSD

>

> Doctors:

> This post brought up something I would like some advice on. I recently had

> a case come to me that I believe may be Reflex Sympathetic Dystophy. I saw

> that someone mentioned using a bone scan. Are there any other objective

> methods of assessing this condition. I do not feel up to date on this

> condition, and would appreciate your advice.

>

> DeShaw, DC, JD

> Bone scan: reflex sympathetic dystrophy

>>>>

>>>>

>>>>> I have a pt. with seemingly simple ankle sprain and foot pain. I

>>> adjust her

>>>>> talus, tibia-fibula, 2nd cuneiform, and cuboid,

>>>>> I've used ultrasound, taping, and some massage. She has good

>>> orthotics

>>>> which

>>>>> fit.

>>>>> She had relief from therapy which seemed progressive and hopeful

>>> then

>>>>> worsened. She then had a bone scan at Kaiser. Results concluded

>>> " diffuse

>>>>> mild increased activity in the right foot and ankle raising the

>>> question of

>>>>> reflex sympathetic dystrophy " .

>>>>> The next ortho to look at her disagreed with this conclusion on

>>> the face of

>>>>> it and wants to look at her today.

>>>>> Any comments would be appreciated.

>>>>>

>>>>> --

>>>>> Dr. Abrahamson

>>>>>

>>>>>

>>>>>

>>>>>

>>>>>

>>>>>

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Thanks Tim. We appreciate hearing from an expert on the subject.

D Freeman

Mailing address: 2480 Liberty Street NE Suite 180

Salem, Oregon 97303

phone 503 763-3528

fax 503 763-3530

cell 503-871-0715

Re: Bone scan: RSD

> Bone scan is the modality of choice for suspected RSD. This usually would

include the three phases (blood flow-seconds after injection, pool-3 to 5

min post inj, and delayed images 2-4hrs post). About 60% of RSD pts show

diffuse increase in radioisotope uptake on all phases. The other pts may

have more equivocal results (i.e. uptake only on delayed phase or even no

uptake on any phase). Plain film radiographs may show regional osteopenia

in a spotty, band-like or uniform pattern as well as some soft tissue

swelling.

>

> Tim Stecher, DC, DACBR, CCSP

> Chiropractic Radiologist

> Open Advanced MRI & CT

> Tigard

>

>

>

>

>

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Dr. Tim

Isn't it true that the bone scan would only be effective in a long

standing case of RSD and that it would be of little to no value in an

early case?

Mike Underhill, DC

On Tue, 12 Mar 2002 21:02:15 EST timitee@... writes:

> Bone scan is the modality of choice for suspected RSD. This usually

> would include the three phases (blood flow-seconds after injection,

> pool-3 to 5 min post inj, and delayed images 2-4hrs post). About 60%

> of RSD pts show diffuse increase in radioisotope uptake on all

> phases. The other pts may have more equivocal results (i.e. uptake

> only on delayed phase or even no uptake on any phase). Plain film

> radiographs may show regional osteopenia in a spotty, band-like or

> uniform pattern as well as some soft tissue swelling.

>

> Tim Stecher, DC, DACBR, CCSP

> Chiropractic Radiologist

> Open Advanced MRI & CT

> Tigard

>

>

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Mike,

Acute and chronic RSD can be evaluated by a three phase bone scan. Staging is often performed using nuclear medicine. MRI is occasionally used to evaluate these patients - the main finding being soft tissue edema.

Tim Stecher, DC, DACBR, CCSP

Chiropractic Radiologist

Open Advanced MRI & CT

Tigard

In a message dated 3/13/2002 9:56:40 AM Pacific Standard Time, drmikeu@... writes:

Dr. Tim

Isn't it true that the bone scan would only be effective in a long

standing case of RSD and that it would be of little to no value in an

early case?

Mike Underhill, DC

On Tue, 12 Mar 2002 21:02:15 EST timitee@... writes:

> Bone scan is the modality of choice for suspected RSD. This usually

> would include the three phases (blood flow-seconds after injection,

> pool-3 to 5 min post inj, and delayed images 2-4hrs post). About 60%

> of RSD pts show diffuse increase in radioisotope uptake on all

> phases. The other pts may have more equivocal results (i.e. uptake

> only on delayed phase or even no uptake on any phase). Plain film

> radiographs may show regional osteopenia in a spotty, band-like or

> uniform pattern as well as some soft tissue swelling.

>

> Tim Stecher, DC, DACBR, CCSP

> Chiropractic Radiologist

> Open Advanced MRI & CT

> Tigard

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