Since there are no definitive tests for either condition, how is it determined which one it is?

Some of the symptoms can overlap - but a good Dr should be able to figure it out by documenting all symptoms and then sorting them out.
RSD-
Extreme skin sensitivity - to air/breezes{ hot or cold}/ touch/fabrics
obvious skin changes & swelling, color changes {reds, blues, purples}, blotchiness

I'm just going by what I had read on websites and the forum discussions- I don't have any first hand knowledge of RSD.

RSD can affect any part of the body while TOS mostly affects upper body - after years may begin to spread due to myofascial components {IMO}

RSD does affect bone density ??- I think that is in the severe stages or after long term of having it...

There is objective data that can confirm RSD.....the skin color changes, swelling, excessive sweating, etc. Those go with the subjective complaint of pain seemingly out of proportion to the original injury. RSD usually occurs in the extremeties....unless something like TOS sets it off in the trunk.

Although TOS is a diagnosis of exclusion in terms of diagnostic tests, there are groups of symptoms that unite us.......Pain between the neck and shoulderblade in back and under the clavical in front, numbness and tingling down the arm in an ulnar nerve distribution, etc

If your doctor is debating which one that you have.............I'd get another doctor. Aside from pain, the other symptoms are very different.....and they are not mutually exclusive, some of us have both

Thanks Finz, I think I'm going to follow your suggestion and just see another doctor although it's not one doctor debating about diagnosis. The first 2 WC doctors say they don't know what is wrong with me but say it's not TOS because the tests are negative so I went to a doctor on my own and he says it's not TOS and that he thinks it's RSD and wants to do a bone scan but since I don't have health insurance that's out of the question at this time. Personally I don't think I have RSD because my symptoms just aren't consistent with that. The color & temperature changes in my hand are dependent on position as is the minor swelling in my hand. My symptoms are consistent with TOS which was originally brought up by 3 of the physical therapists that I saw.

Hi everyone... KLS.. I to didn't even know about RSD UNTIL I had a Bone Scan ! I would suggest if you ever can get one.. do it... I know how you feel about Insurance. Is there any state Ins. plan you can apply for ? I was diagnosed with RSD last year when my Pain Mgmt . Dr. asked for the Bone scan. He said I had 2 indicators that I had RSD atop the TOS ( all upper body like Finz said that's me to a T ) ( Hi Finz !) Hope your day goes better....

Dolfinz

If you have WC, you are allowed to pick you own doc. Can the doc that you chose petition WC for authorization for the bone scan ?

What tests were the WC docs doing that "proved" that you didn't have TOS ? For some of us, it shows on an EMG, but not for all. For some it shows on an MRI of the brachial plexus, but not for all. Even the Adson's....some with TOS don't test positive and some people in the general population do. There is no one test that will definittively prove or disprove TOS. The dx is made by exclusion....based on symptoms after other things have been ruled out....unless it's a case of an extra cervical rib.

Unfortunately in TN you don't exactly get to choose your own doctor, you have to choose from a list of 3 of "their" doctors. Their doctor released me to go back to work with no restrictions. They finally agreed to send me to a specialist for a 2nd opinion and gave me a list of 3 doctors to choose from and told me to make an appointment with one of them. Well, I did and was told that I can't make the appointment myself so now I'm back to waiting again.
The tests I've had done so far were xrays, MRI of the rotator cuff area, EMG, CT scan of the brachial plexus area, and ultrasound....all have been negative.