Diagnostic Tests for Reflex sympathetic dystrophy syndrome
Reflex sympathetic dystrophy syndrome: Diagnostic Tests
The list of diagnostic tests
mentioned in various sources as
used in the diagnosis of Reflex sympathetic dystrophy syndrome
includes:
Reflex sympathetic dystrophy syndrome Tests: Book Excerpts
Reflex sympathetic dystrophy syndrome Diagnosis: Book Excerpts
Tests and diagnosis discussion for Reflex sympathetic dystrophy syndrome:
RSDS is diagnosed primarily through
observation of the symptoms. Some physicians use thermography to detect
changes in body temperature that are common in RSDS. X-rays may also show
changes in the bone.
(Source: excerpt from NINDS Reflex Sympathetic Dystrophy Syndrome Information Page: NINDS)
Diagnostic Tests for Reflex sympathetic dystrophy syndrome: Online Medical Books
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for more information about the diagnostic tests for Reflex sympathetic dystrophy syndrome.
HYPERACTIVE REFLEXES:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Hyperactive reflexes, especially if they are unilateral, are a clear indication for an imaging study. It is wise to consult a neurologist or neurosurgeon before determining which imaging study to order. If there are cranial nerve findings and dementia, a CT scan or MRI of the brain should be ordered.
If there are hyperactive reflexes of all four extremities without dementia or cranial nerve signs, MRI of the cervical spine would probably be the most appropriate procedure. It may, however, be necessary to get a CT scan or MRI of the brain anyway.
If only the lower extremities are involved, MRI of the thoracic cord would probably be most appropriate, but then MRI of the cervical spine should be done if the thoracic MRI is negative. Spinal fluid analysis will help diagnose multiple sclerosis, central nervous system syphilis, cerebral hemorrhages, or abscess. A CBC, serum B
12
and folic acid, and Schilling test will help diagnose pernicious anemia. Plain films of the appropriate level of the spine are necessary in trauma cases. An EEG and psychometric testing should be done in cases of dementia. SSEP, VEP, and BSEP studies are helpful in diagnosing multiple sclerosis. Carotid duplex scans and four-vessel angiography may be necessary for diagnosing cerebral vascular disease.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
PATHOLOGIC REFLEXES:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
Routine studies include a CBC, sedimentation rate, urinalysis, chemistry panel, ANA assay, serum B
12
and folic acid, VDRL test, chest x-ray, and EKG. If there are cranial nerve signs, a CT scan or MRI of the brain will usually be necessary. However, it is wise to get a neurology consultation before undertaking these expensive tests. A spinal tap may be done if the imaging study is negative.
If vascular disease is suspected, carotid scans to rule out carotid stenosis or plaque and a search for an embolic source using echocardiography and blood culture should be done. A cardiologist can assist in this search. Four-vessel cerebral angiography may be necessary. In fact, if a cerebral hemorrhage has been ruled out and there is no significant hypertension, a four-vessel cerebral angiographic study should probably be done. Evoked potential studies and HIV antibody titers should also be done. If there are no cranial nerve signs, MRI of the cervical spine or thoracic spine should be done, depending on the level of the lesion. Myelography may also be helpful. Serum protein electrophoresis and immunoelectrophoresis all may be necessary in the workup.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Deep tendon reflexes, hyperactive:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
After eliciting hyperactive DTRs, take the patient's history. Ask about spinal cord injury or other trauma and about prolonged exposure to cold, wind, or water. Could the patient be pregnant? A positive response to any of these questions requires prompt evaluation to rule out life-threatening autonomic hyperreflexia, tetanus, preeclampsia, or hypothermia. Ask about the onset and progression of associated signs and symptoms. Next, perform a neurologic examination. Evaluate the patient's level of consciousness, and test motor and sensory function in the limbs. Ask about paresthesia. Check for ataxia or tremors and for speech and visual deficits. Test for Chvostek's (an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in a patient who has hypocalcemia) and Trousseau's (a carpal spasm induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes in a patient who has hypocalcemia or hypomagnesemia) signs and for carpopedal spasm. Ask about vomiting or altered bladder habits. Make sure to take the patient's vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Babinski's reflex [Extensor plantar reflex]:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
After eliciting a positive Babinski's reflex, evaluate the patient for other neurologic signs. Evaluate muscle strength in each extremity by having the patient push or pull against your resistance. Passively flex and extend the extremity to assess muscle tone. Intermittent resistance to flexion and extension indicates spasticity, and a lack of resistance indicates flaccidity.
Next, check for evidence of incoordination by asking the patient to perform a repetitive activity. Test deep tendon reflexes (DTRs) in the patient's elbow, antecubital area, wrist, knee, and ankle by striking the tendon with a reflex hammer. An exaggerated muscle response indicates hyperactive DTRs; little or no muscle response indicates hypoactivity.
Then evaluate pain sensation and proprioception in the feet. As you move the patient's toes up and down, ask the patient to identify the direction in which the toes have been moved without looking at his feet.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Deep tendon reflexes, hyperactive:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
After eliciting hyperactive DTRs, take the patient’s history. Ask about spinal cord injury or other trauma and about prolonged exposure to cold, wind, or water. Could the patient be pregnant? A positive response to any of these questions requires prompt evaluation to rule out life-threatening autonomic hyperreflexia, tetanus, preeclampsia, or hypothermia. Ask about the onset and progression of associated signs and symptoms. Next, perform a neurologic examination. Evaluate level of consciousness, and test motor and sensory function in the limbs. Ask about paresthesia. Check for ataxia or tremors and for speech and visual deficits. Test for Chvostek’s sign (an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in patients who have hypocalcemia) and Trousseau’s sign (a carpal spasm induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes in patients who have hypocalcemia or hypomagnesemia) and for carpopedal spasm. Ask about vomiting or altered urination habits. Be sure to take vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Babinski's reflex [Extensor plantar reflex]:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
After eliciting a positive Babinski’s reflex, evaluate the patient for other neurologic signs. Evaluate muscle strength in each extremity by having the patient push or pull against your resistance. Passively flex and extend the extremity to assess muscle tone. Intermittent resistance to flexion and extension indicates spasticity, and a lack of resistance indicates flaccidity.
Next, check for evidence of incoordination by asking the patient to perform a repetitive activity. Test deep tendon reflexes (DTRs) in the patient’s elbow, antecubital area, wrist, knee, and ankle by striking the tendon with a reflex hammer. An exaggerated muscle response indicates hyperactive DTRs; little or no muscle response indicates hypoactivity.
Then evaluate pain sensation and proprioception in the feet. As you move the patient’s toes up and down, ask him to identify the direction in which the toes have been moved without looking at his feet.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Deep tendon reflexes, hyperactive:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Perform a neurologic examination. Evaluate level of consciousness, and test motor and sensory function in the limbs. Check for ataxia or tremors and for speech and visual deficits. Test for Chvostek’s sign (an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in patients who have hypocalcemia), Trousseau’s sign (a carpal spasm induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes in patients who have hypocalcemia or hypomagnesemia), and carpopedal spasm. Be sure to record the patient’s vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Babinski's reflex:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
After eliciting a positive Babinski’s reflex, evaluate the patient for other neurologic signs. Evaluate muscle strength in each extremity by having the patient push or pull against your resistance. Passively flex and extend the extremity to assess muscle tone. Intermittent resistance to flexion and extension indicates spasticity, and a lack of resistance indicates flaccidity.
Next, check for evidence of incoordination by asking the patient to perform a repetitive activity. Test deep tendon reflexes (DTRs) in the patient’s elbow, antecubital area, wrist, knee, and ankle by striking the tendon with a reflex hammer. An exaggerated muscle response indicates hyperactive DTRs; little or no muscle response indicates hypoactivity.
Then evaluate pain sensation and proprioception in the feet. As you move the patient’s toes up and down, ask him to identify the direction in which the toes have been moved without looking at his feet.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Deep tendon reflexes, hyperactive:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
After eliciting hyperactive DTRs, take the patient's history. Ask about spinal cord injury or other trauma and about prolonged exposure to cold, wind, or water. Could the patient be pregnant? A positive response to any of these questions requires prompt evaluation to rule out life-threatening autonomic hyperreflexia, tetanus, preeclampsia, or hypothermia. Ask about the onset and progression of associated signs and symptoms. Next, perform a neurologic examination. Evaluate the patient's level of consciousness, and test motor and sensory function in the limbs. Ask about paresthesia. Check for ataxia or tremors and for speech and visual deficits. Test for Chvostek's (an abnormal spasm of the facial muscles elicited by light taps on the facial nerve in a patient who has hypocalcemia) and Trousseau's (a carpal spasm induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes in a patient who has hypocalcemia or hypomagnesemia) signs and for carpopedal spasm. Ask about vomiting or altered bladder habits. Be sure to take the patient's vital signs.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Babinski's reflex [Extensor plantar reflex]:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
After eliciting a positive Babinski's reflex, evaluate the patient for other neurologic signs. Evaluate muscle strength in each extremity by having the patient push or pull against your resistance. Passively flex and extend the extremity to assess muscle tone. Intermittent resistance to flexion and extension indicates spasticity, and a lack of resistance indicates flaccidity.
Next, check for evidence of incoordination by asking the patient to perform a repetitive activity. Test deep tendon reflexes (DTRs) in the patient's elbow, antecubital area, wrist, knee, and ankle by striking the tendon with a reflex hammer. An exaggerated muscle response indicates hyperactive DTRs; little or no muscle response indicates hypoactivity.
Then evaluate pain sensation and proprioception in the feet. As you move the patient's toes up and down, ask the patient to identify the direction in which the toes have been moved without looking at his feet.
Obtain a complete medical and surgical history as well as a complete drug history.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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