Diagnostic and Therapeutic Joint Injections

Masala, Salvatore; Fiori, Roberto; Bartolucci, Dario Alberto; Mammucari, Matteo; Angelopoulos, Giorgios; Massari, Francesco; Simonetti, Giovanni

doi:10.1055/s-0030-1253514

Cited by 49 publications

(56 citation statements)

References 53 publications

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“…RF treatment has been used for several painful conditions such as trigeminal neuralgia, cancer pain, and spinal pain. In order to destroy nerves or disrupt the transmission of pain signals, originally by means of producing heat lesions, RF current is applied to the trigeminal ganglion, the spinothalamic tracts of the spinal cord, the medial braches of posterior rami and the dorsal root ganglion [4]. Therefore, it is essential to place the electrode tip as close as possible to the target nerve: there are several reasons for the difficulty in localising the target nerve, for example the variability of the anatomical course of each target nerve and the sensory nature of target nerves.…”

Section: Discussionmentioning

confidence: 99%

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Cooled radiofrequency system relieves chronic knee osteoarthritis pain: the first case-series

Bellini¹,

Barbieri²

2015

Anaesthesiol Intensive Ther

100

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Background: Knee osteoarthritis is a frequent cause of chronic knee pain. Therapeutic solutions include intra-articular injections with short-term pain relief and surgical therapy. Radiofrequency (RF) of genicular nerves has been previously reported with varying success. Cooling tissue adjacent to the electrode (cooled RF) increases the radius of lesion. We present here the first retrospective data on pain relief and changes in function after such cooled RF denervation. Methods: We reviewed the records of nine patients with chronic knee pain who underwent cooled RF of genicular nerves. Visual analogue scale (VAS) and Western Ontario McMaster Universities OA index (WOMAC) were analysed. Results: We observed an improvement in VAS pain scores 2 ± 0.5 at one month, 2.3 ± 0.7 at three months, 2.1 ± 0.5 at six months, and 2.2 ± 0.2 at 12 months after the procedure, and WOMAC score 20 ± 2, at one month, 22 ± 0.5 at three months, 21 ± 1.7 at six months, and 20 ± 1.0 at 12 months. Conclusion:The majority of patients with chronic knee pain experienced a clinically relevant degree of pain relief and improved function following cooled RF of genicular nerves at one, three, six and 12 months follow-up.

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Section: Discussionmentioning

confidence: 99%

“…Conservative approaches include physical therapy, analgesic drugs, intra-articular injection of steroids, and visco-supplementation [3,4]. Pharmacological therapy is often of limited benefit for OA pain, but non-steroidal anti-inflammatory drugs are associated with serious side effects, such as bleeding and gastrointestinal ulcers.…”

mentioning

confidence: 99%

Cooled radiofrequency system relieves chronic knee osteoarthritis pain: the first case-series

Bellini¹,

Barbieri²

2015

Anaesthesiol Intensive Ther

100

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“…Intra-articular contrast medium injection for CT and MR arthrography is performed under fluoroscopy control and sterile conditions by means of anterior or medial access while avoiding the dorsalis pedis artery by means of a 20 -22 gauge needle [7,23]. For the arthrography, a test infusion of local anesthetic (e. g., lidocaine 2 %) as well as iodine-based contrast agent is used to confirm the intra-articular needle position.…”

Section: Magnetic Resonance Imaging and Sequence Protocolmentioning

confidence: 99%

Modern Cartilage Imaging of the Ankle

Weber

Wünnemann

Jungmann

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TBackground Talar osteochondral lesions are an important risk factor for the development of talar osteoarthritis. Furthermore, osteochondral lesions might explain persistent ankle pain. Early diagnosis of accompanying chondral defects is important to establish the optimal therapy strategy and thereby delaying or preventing the onset of osteoarthritis. The purpose of this review is to explain modern cartilage imaging with emphasis of MR imaging as well as the discussion of more sophisticated imaging studies like CT-arthrography or functional MR imaging.Methods Pubmed literature search concerning: osteochondral lesions, cartilage damage, ankle joint, talus, 2 D MR imaging, 3 D MR imaging, cartilage MR imaging, CT-arthrography, cartilage repair, microfracture, OATS, MACT.Results and Conclusion Dedicated MR imaging protocols to delineate talar cartilage and the appearance of acute and chronic osteochondral lesions were discussed. Recent developments of MR imaging, such as isotropic 3 D imaging that has a higher signal-to noise ratio when compared to 2 D imaging, and specialized imaging methods such as CT-arthrography as well as functional MR imaging were introduced. Several classifications schemes and imaging findings of osteochondral lesions that influence the conservative or surgical therapy strategy were discussed. MRI enables after surgery the noninvasive assessment of the repair tissue and the success of implantation. Key points▪ Modern MRI allows for highly resolved visualization of the articular cartilage of the ankle joint and of subchondral pathologies. ▪ Recent advances in MRI include 3 D isotropic ankle joint imaging, which deliver higher signal-to-noise ratios of the cartilage and less partial volume artifacts when compared with standard 2 D sequences. ▪ In case of osteochondral lesions MRI is beneficial for assessing the stability of the osteochondral fragment and for this discontinuity of the cartilage layer is an important factor. ▪ CT-arthrography can be used in case of contraindications of MRI and in unclear MRI findings as further diagnostic approach. Citation Format

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“…Eklem içi ligamanların rüptürü , osteokondral defektler, impingement, adheziv kapsülit ve loose body tanılarında artrografik yöntemler kullanılmaktadır (4). BT ve MR artrografi gibi tanısal yöntemler için eklem mesafesine kontrast madde enjeksiyonu yapılabilir (5)(6)(7). İntraartiküler enjeksiyon için farklı metodlar bugüne kadar kullanılmıştır.…”

Section: Introductionunclassified