This would make me very nervous. RSD is a clinical diagnosis that can't really be ruled out of in from any one test. You don't need to have ALL of the symptoms of RSD to HAVE RSD...it's a very complicated thing and not well understood by many people/doctors.

Don't get me wrong...I would be absolutely THRILLED if Zachary doesn't have RSD...but the doctor's reasoning would make me very skeptical and nervous. Did he have any other ideas about what IS wrong Zachary? That is typically my first question when a doctor questions whether or not I have RSD. They typically don't and have no explanation for all the symptoms I have (all of which have been witnessed by doctors at one point or another). I would hate to see Zachary go through with the surgery and then experience spread or a worsening of the condition because of it.

My suggestion would be to see another PM specialist for another opinion. Unfortunately, these things take time. Sometimes it's hard to get a diagnosis of RSD in one visit because, as I said, it is a clinical diagnosis. If you are "lucky" and present with many of the physical symptoms at the time of the visit then perhaps you will get the diagnosis. But I know that for me, unless I am in a really bad flare, all my symptoms are not always visible at the same time. So for a doctor who doesn't know you from a stranger on the street, all they have is your word for it that you experience these symptoms.

I hope that he does not have RSD and that this PM is right...but it's a big risk to take (in my opinion) to go ahead with surgery when another doctor suspects RSD. If you get a second opinion, I would make sure you go into the appointment ready with some questions so that you don't leave the appointment confused about the situation. Things like:

What is the diagnosis? Why do you believe this?

If it is not RSD, then what IS it?

What would you suggest the treatment plan be?

If there is a CHANCE this is RSD, should be hold off on the surgery or get blocks prior to the surgery to minimize the chance of spread?

That's not really a complete list or anything but I would be ready and armed with questions (preferably written down on a piece of paper that you take WITH you to the appointment so you don't forget anything). I would make sure it is a list of things you WISH you had asked this last doctor. I know from experience how frustrating it is to leave an appointment and think of all the things you should have asked but didn't. This is why I write down my questions during the week BEFORE the visit and add to it as I think of things. Then at the appointment I have it in my hands so I don't forget anything.

I'm very sorry that you are going through all of this and I hope that you find some answers soon.