Re: Del Pi?al F. Editorial: I have a dream.. reflex sympathetic dystrophy (RSD or Complex Regional Pain Syndrome - CRPS I) does not exist. J Hand Surg Eur. 2013, 38: 595-7

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I regret to be so late in writing about Dr del Pinal's Editorial, which I have only just read. It presents a very interesting view. I am grateful to Dr del Pihal for trying to open our eyes and I understand his frustration.Dr del Pinal has been lucky to avoid patients with real reflex sympathetic dystrophy (RSD) - or Complex Regional Pain Syndrome (CRPS I) - where a meaningful cause cannot be found. I have not been so lucky, as I see them more than often enough. Of course, most cases arise after distal radius fracture, perhaps due to too tight immobilization or too lazy finger mobilization, but not due to failed reduction or other similar problems.Twenty years ago, Albrecht Wilhelm (Germany) and Robert Boome (UK) told me independently that, in certain instances, venous thoracic outlet syndrome (TOS) may be the initial cause of RSD (Boome and Jha, 2003).