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Journal of Hand Surgery (British and European Volume)
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Articles

Radiographic Changes in Algodystrophy of the Hand

D. R. BICKERSTAFF
D. P. O’DOHERTY
J. A. KANIS

From the Royal Hallamshire Hospital, Sheffield

Correspondence: J. A. Kanis MD, FRCP, MRCPath, Reader and Honorary Consultant, Department of Human Metabolism and Clinical Biochemistry, Sheffield Medical School, Beech Hill Rd, Sheffield S10 2RX.

It is not certain to what extent the radiographic features of post-traumatic algodystrophy can be differentiated from disuse atrophy following trauma. A semi-quantitative scoring system has been devised, grading the dominant features seen on radiography in both conditions following Colles’ fracture. The technique had intra- and inter-observer errors of 14% and 17% respectively. When applied prospectively 7 weeks after Colles’ fractures, there was a significantly greater score in patients with algodystrophy (p < 0.001) than those without. Analysis of the scores was performed to identify a score for the optimal identification of algodystrophy. At a score of four or greater, 87.5% of patients with algodystrophy were positively identified with a positive predictive value of 83%. It is suggested that use of this scoring system will aid in the early diagnosis of algodystrophy.

Journal of Hand Surgery (British and European Volume), Vol. 16, No. 1, 47-52 (1991)
DOI: 10.1016/0266-7681(91)90126-9
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