Contractures may occur. Films show 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. They may, however, show osteoporosis as soon as 3-5 weeks after onset.
Most authors feel that the best diagnostic approach is to use differential neural blockade.
For cases involving an upper extremity, a stellate ganglion block may be diagnostic and therapeutic. Failure to relieve pain, however, 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. Rationale for selective neural blockade is to interrupt stimulation to sympathetic nervous system. Once the diagnosis is established, a number of treatment modalities that have been proven helpful exist.