Hi In His hands--you know, I don't even know WHY the AMA even bothered to say that "radiographic findings" were part of the criteria:

First--the scientific literature is REPLETE with EVIDENCE that BONE scans are NOT to be "relied on", because they are basically "50-50"--just because someone has a NEGATIVE bone scan, that does NOT EXCLUDE RSD/CRPS as a diagnosis--and the AMA even CONCEDES THAT POINT!!!!

As you correctly observed, by the time MOST people have all EIGHT criteria--they have very ADVANCED RSD--and from what I understand, it is then VERY difficult to treat and control.

Now, I do not know about anyone else, but my RSD STARTED with swelling, skin discolouration, and VERY COLD skin temperature, and BURNING PAIN...
It took quite a WHILE for the PROLONGED vasoconstriction, etc., to MANIFEST itself with the CHANGES in my SKIN and FINGERNAILS, and the hair on my arms.

Fortunately, I DID receive Nerve-blocks and MEDICATION (Neurontin, in particular, PLUS Diltiazam (a vaso-dilator)) relatively early on, to help stabalize the SEVERE vaso-motor instability...I still HAVE it, and it still can really Flare-up at times. (Even "lay people" ask "why are your arms/hands red/purple? Why are your hands/arms like ICE", etc? ) My Pain Doctor is a "stickler" when it comes to EXERCISING/DESENSITIZATION--he has "beat it into my head" that the muscles will ATROPHY, my joints could get really stiff, possibly have contractures, and that the BONES will be affected due to LACK OF USE--so, i FAITHFULLY do my exercises the best I can everyday to MINIMIZE THESE POTENTIAL PROBLEMS... (and, if I DON'T do my exercises, I quickly lose what function I have...)Therefore, it is a CONTINUAL EFFORT.

Ok--so when we are receiving TREATMENT, Nerve-blocks, doing our exercises, etc., and SOME of the "objective findings" are somewhat controlled--according to the AMA--it "DOESN'T COUNT" --we DO NOT HAVE RSD because we DON'T HAVE ALL EIGHT CONCURRENT CRITERIA!

This is just CRAZY!!!!

You stated that you hoped that this "criteria" was not hurting people with RSD--very unfortunately, I know AT LEAST SIX people who are running into real problems getting the RSD CORRECTLY diagnosed and treated--the Insurance Co's are unscrupulously REFUSING to consider EVIDENCE contained in their MEDICAL RECORDS that actually VERIFY that these individuals have in fact HAD ALL EIGHT (and MORE) of the necessary criteria--JUST NOT ALL AT THE SAME TIME!!! That is the "caveat" that the ICs and their "Doctors" CONTINUE to "hang their hat on", and quite ARROGANTLY, at that!!! (But, let us not forget--the IC Doctors are IMMUNE from MALPRACTISE, because they are "Not Treating Physicians"......

Sorry for the long "vent"...thank GOODNESS that there are Doctors out there who REFUSE to "buy into" the "lunacy" of this!!!!

honestly, i have NO IDEA how, when or IF the AMA will ever "back off" on this issue-- If Dr. Fitzpatrick and his esteemed collegues can't do it, then I don't know who CAN. Any ideas, anyone?? This has to CHANGE..