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We report the case of a 38 year-old woman who presented with sensory symptoms of her right foot with no history of trauma. Subsequent nuclear imaging was suggestive of stage 1 complex regional pain syndrome type I (CRPS I).Keywords: Reflex sympathetic dystrophy, complex regional pain syndrome type I Case reportA 38-year old woman was admitted to hospital with sharp pain and altered sensation affecting her right foot. Two months earlier she had awoken with numbness in her right foot. This had occurred spontaneously and without a history of injury. The numbness settled over a few days but neuropathic features in her foot, mainly dysaethesia, tingling and allodynia became more apparent and caused difficulty with sleeping, mobility and dressing. There was a past medical history of childhood abuse, chronic anxiety and agoraphobia, pancreatitis, alcohol abuse (she had abstained for one year prior to admission), cholecystectomy and an ectopic pregnancy.On examination, her right foot was exquisitely painful to touch, with even light touch provoking a disproportionate reaction. The sensory symptoms did not correspond to a dermatomal or peripheral nerve distribution. Tone and power were normal but both ankle reflexes were absent. The right foot was noted to be warm and moist compared to the left foot.Initial blood tests revealed deranged liver function tests in a pattern that is normally typical of alcohol excess with a high AST to ALT ratio. These abnormal results resolved during admission. A full serological autoantibody screen and a haematinic profile revealed no positive findings. The CT brain was unremarkable apart from mild cerebral atrophy. An MRI of brain and lumbar spine showed no significant abnormality and specifically revealed no evidence of demyelination. Nerve conduction studies were also performed which showed a degree of small fibre nerve dysfunction, which could reflect an early distal axonal peripheral neuropathy. Subsequently, a 3-phase bone scan was requested as there was a high clinical suspicion that this was complex regional pain syndrome. The bone scan