Decreased uptake on 3-phase bone scintigraphy in posttalar fracture reflex sympathetic dystrophy

Adult patients with reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome, of the foot and ankle characteristically have a 3-phase bone scan pattern consisting of diffusely increased tracer uptake with juxtaarticular accentuation of tracer uptake on late-phase images. The authors present an uncommon case of RSD in an adult in whom decreased activity was demonstrated on early and late phase images of bone scintigraphy in the affected limb.