Fluoroscopic-guided procedures of the lower extremity

Malhotra, Gunjan; Hansford, Barry G.; Felcher, Cindy; Wuerfel, Kristie A.; Yablon, Corrie M.

doi:10.1007/s00256-022-04139-w

Cited by 2 publications

(1 citation statement)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, studies have documented a high rate of asymptomatic labral tears in adults, ranging between 69 and 85% [24, 27]. Considering this, diagnostic intra‐articular hip injections are a valuable tool for orthopedic surgeons in delineating intra‐articular versus extra‐articular pain generators [13, 21]. Previous studies have documented high sensitivity and specificity of diagnostic hip injections in predicting intra‐articular pathology at the time of arthroscopy with minimal risk to the patient [5, 7, 20].…”

Section: Introductionmentioning

confidence: 99%

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Pullen

Curtis

Jamero

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose The purpose of this paper was to evaluate the response to intra-articular hip injections with and without concurrent gadolinium administration. Our secondary outcome was to compare post-operative outcomes between patients with an initial false-negative gadolinium-containing injection and a matched control group. Methods Patients receiving a series of two hip diagnostic intra-articular injections (DIAI), the irst with gadolinium for concurrent MRA and the second without gadolinium, were retrospectively identiied. Pain response to DIAI, injectate volume, local anesthetic volume, inclusion of corticosteroids, and method of injection were compared between injections. False-negative injection was deined as < 50% pain relief with concurrent gadolinium, but ≥ 50% pain relief with subsequent anesthetic injection without gadolinium. False-negative injections in patients that ultimately underwent primary hip arthroscopy were identiied from this cohort and matched in a 3:1 ratio to a control cohort to compare short-term post-operative single assessment numerical evaluation (SANE) outcomes. Results Forty-three patients underwent a series of anesthetic injections with and without gadolinium and met inclusion and exclusion criteria. Pain response was signiicantly diferent in injections performed with and without gadolinium (18% vs. 81%; p < 0.001). There were signiicant diferences in total injectate volume, local anesthetic volume, corticosteroid use, and method of injection between injections, but these variables were not correlated with pain response. Fifteen patients with false-negative responses to injection underwent primary hip arthroscopy and were matched in a 3:1 ratio to a control cohort. There was no diference in short-term post-operative SANE scores between the gadolinium-sensitive and control groups (81.6 vs. 80.0, n.s.). Conclusion Concurrent administration of intra-articular gadolinium with DIAI may result in a false-negative response to anesthetic. Additionally, in patients with initial false-negative DIAI with gadolinium, short-term post-operative outcomes after hip arthroscopy are similar to a matched cohort. Level of Evidence Level III.

show abstract

Section: Introductionmentioning

confidence: 99%

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Pullen

Curtis

Jamero

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

Comparison of Radiation Doses for Different Techniques in Fluoroscopy-Guided Lumbar Facet Medial Branch Blocks: A Retrospective Cohort Study

Bakır,

Rumeli,

Ertargın

et al. 2024

Life

View full text Add to dashboard Cite

Chronic lumbar facet pain is commonly treated with fluoroscopy-guided facet medial branch blocks (FMBBs). However, the associated radiation exposure of both patients and clinicians is a growing concern. This study aimed to compare radiation doses and fluoroscopy times between two techniques, i.e., oblique and posterior–anterior (PA) fluoroscopic approaches, while also examining the impact of physician experience on these metrics. A retrospective analysis was conducted on 180 patients treated at Mersin University Hospital Pain Clinic between January and July 2024. Patients were divided into two groups: 90 received the oblique technique (Group O) and 90 received the AP technique (Group A). Radiation dose and fluoroscopy time data were collected for each patient. The AP technique was associated with significantly lower radiation doses (mean 66 mGy) and shorter fluoroscopy times (mean 28 s) compared to the oblique technique (mean radiation dose of 109 mGy and fluoroscopy time of 46 s) (p < 0.001). Physician experience also influenced these outcomes, with more experienced physicians consistently using less radiation. The AP technique should be considered for FMBBs, as it reduces radiation exposure while maintaining procedural efficiency, highlighting the importance of experience in optimizing outcomes.

show abstract

Fluoroscopic-guided procedures of the lower extremity

Cited by 2 publications

References 78 publications

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Comparison of Radiation Doses for Different Techniques in Fluoroscopy-Guided Lumbar Facet Medial Branch Blocks: A Retrospective Cohort Study

Contact Info

Product

Resources

About