Case 39
Presentation:
A 54 year old gentleman with onset of right hand stiffness and soreness, associated with swelling and erythema13 months ago. Now he has ongoing pain with some component of allodynia/hyperalgesia. No other extremity involvement.
No abnormal finings are noted in radiographic images. No known trauma. He has history of right shoulder capsule release surgery, supraspinatus tendon repair and Subacromial and subdeltoid bursectomy in 2012.
Review three-phase bone scan images and describe the findings:
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Flow
Blood pool
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Delayed imaging
Findings and impression:
No obvious hyperemia nor increased early uptake on the flow and blood pool images. The delayed images do show mild increased diffuse bony uptake involving the right hand, wrists, periarticular joints consistent with the healing/dystrophic phase of complex regional pain syndrome.