1. Reflex Sympathetic Dystrophy Osteomyelitis (RSD) / Complex Regional Pain Syndrome (CRPS)

RSD, now commonly referred to as Reflex Sympathetic Dystrophy Osteomyelitis (CRPS), is a chronic pain condition that typically affects the limbs after an injury or surgery. It is associated with abnormal nerve activity and can result in significant functional impairments.

Symptoms of RSD/CRPS:

Persistent burning or throbbing pain in the limb
Swelling and tenderness
Changes in skin color (mottled or reddish skin)
Increased or decreased sweating in the affected area
Temperature sensitivity (affected area may feel warmer or colder)
Limited range of motion or stiffness in the joint
Muscle atrophy or weakness if untreated

Treatment Options:

Pain medications: NSAIDs, corticosteroids, and neuropathic pain medications (gabapentin, pregabalin)
Physical and occupational therapy: Helps restore movement and strength
Nerve blocks or sympathetic nerve blocks: Interrupt the abnormal nerve signals
Spinal cord stimulation: For severe, intractable pain
Psychological support: Addressing the emotional impact of chronic pain

2. Osteomyelitis (Bone Infection)

Osteomyelitis is a serious infection of the bone caused by bacteria (often Staphylococcus aureus) or fungi. It can develop from an open wound, surgery, or as a result of systemic infection. This condition requires prompt treatment to prevent complications like bone necrosis (death).

Symptoms of Osteomyelitis:

Severe localized pain and swelling over the affected bone
Fever, chills, and fatigue
Warmth and redness over the affected area
Limited range of motion or difficulty bearing weight

Diagnostic Methods:

Blood tests: Elevated white blood cells and inflammatory markers (CRP, ESR)
Imaging studies: X-rays, MRI, or bone scans to detect bone damage
Bone biopsy: Identifies the specific bacteria or fungi causing the infection

Treatment Options:

Antibiotic or antifungal therapy: Long-term intravenous antibiotics (4-6 weeks)
Surgical debridement: Removal of infected or dead bone tissue
Hyperbaric oxygen therapy: Sometimes used to promote healing
Bone grafting: In cases of extensive bone damage

Connection to Rheumatology Practice:

While osteomyelitis primarily involves infectious disease specialists and surgeons, rheumatologists are often consulted for chronic joint or bone pain and differential diagnosis (e.g., distinguishing between osteomyelitis and inflammatory arthritis). In contrast, RSD/CRPS is a common complication after surgeries or injuries that rheumatologists may manage through pain control and physical rehabilitation.