Contractures may occur. X-ray films indicate marked demineralization. Others, however, dispute the need for an underlying personality disorder. A single, reliable, sensitive, and specific diagnostic test for RSDS is not available. However, they may show osteoporosis as soon as 3-5 weeks of onset.
Most authors feel that the best diagnostic approach involves use of differential neural blockade.
For cases involving an upper extremity, a stellate ganglion block may be diagnostic and therapeutic. However, failure to relieve pain does not eliminate the diagnosis. Differential blockade has been performed using Bier blocks with a variety of agents, including local anesthetics, bretylium, steroids, ketorolac, reserpine, and guanethidine. The rationale for selective neural blockade is to interrupt stimulation to the sympathetic nervous system. Once the diagnosis is established, a number of treatment modalities that have been proven helpful are available.