A lady presents with swelling of hands with shiny skin. She has a history of fracture radius and kept on POP cast for 4 weeks after which she develops this. Give the most likely diagnosis:
Correct Answer: Reflex sympathetic dystrophy
Description: The reflex sympathetic dystrophy or shoulder-hand syndrome is a painful periahritis or adhesive capsulitis of the shoulder ("frozen shoulder"), usually on the left side, associated with erythema, increased sweating, shiny induration, edema, tenderness, pain, and immobility of the ipsilateral hand. Reduction of finger flexion, loss of movement, temperature changes, sensory disturbances, and, hair/nail growth changes are seen. Neurotrophic ulcerations of the fingers and thickening of the palmar aponeurosis with nodules and/or Dupuytren contracture may be late sequelae. Ref: Johnston G.A., Graham-Brown R.A. (2012). Chapter 150. The Skin and Disorders of the Alimentary Tract, the Hepatobiliary System, the Kidney, and the Cardiopulmonary System. In K. Wolff (Ed), Fitzpatrick's Dermatology in General Medicine, 8e.
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