Diagnosis of reflex sympathetic dystrophy requires:
(1) all 4 absolute criteria
(2) 3 or more of the relative criteria
Absolute criteria:
(1) pain
(2) impaired function
(3) symptoms beyond the area of trauma
(4) cold, warm, or intermittently cold and warm feeling in the affected area
where:
• Criteria 2 and 3 are not included in the criteria of the International Association for the Study of Pain (IASP).
Relative criteria:
(1) edema
(2) increased nail growth
(3) increased hair growth
(4) hyperhidrosis
(5) abnormal skin color
(6) hypoesthesia
(7) hyperalgesia
(8) mechanical or thermal allodynia or both
(9) patchy demineralization of bone
where:
• hyperhydrosis = increased perspiration
• hypooesthesia = decreased sensitivity
• hyperalgesia = excessive sensitivity to pain
• allodynia = a painful response to a stimulus that would normally be non-noxious.
