The Journal of hand surgery
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Three-phase bone scintigraphy is used often to diagnose reflex sympathetic dystrophy of the hand. This study presents an analysis of the literature relating three-phase bone scanning to reflex sympathetic dystrophy in the upper extremity. The data show a wide variability in scintigraphic accuracy in patients with clinically obvious reflex sympathetic dystrophy. ⋯ After 26 weeks, there is a poor correlation between three-phase bone scanning and reflex sympathetic dystrophy. Consequently, three-phase bone scintigraphy should not be used as a major criterion in diagnosing reflex sympathetic dystrophy. The diagnosis of reflex sympathetic dystrophy remains a clinical diagnosis made by an experienced hand surgeon.
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Two cases of Ewing's sarcoma of the hand were treated by preoperative chemotherapy and radiation therapy to decrease tumor volume. Magnetic resonance images were useful in showing the soft tissue mass and in estimating the effect of the chemotherapy. The results of surgery were satisfactory with this treatment regimen.
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Historical Article
Repetition strain injury: the Australian experience--1992 update.