The development and implementation of an outcomes database for imaging-guided therapeutic musculoskeletal injections

Peterson, Cynthia; Pfirrmann, Christian W. A.; Hodler, Juerg

doi:10.1007/s00256-014-1881-y

Cited by 3 publications

(6 citation statements)

References 28 publications

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“…25 However, when comparing the results of the entire CNRI cohort of 52 patients in this study where 49% were "improved" at 3 months with the shorter-term 1-month outcomes of all CNRI patients (n = 195) currently listed in the radiology database, there is surprisingly little difference, as only 43% of patients reported clinically relevant improvement even at the 1-month data collection time point. 26 Therefore, the longer data collection time point of 3 months does not appear to have been a negative factor in the proportion of clinically improved CNRI patients. Comparing the treatment costs between the SMT and CNRI patients shows a minimal difference of only CHF 42.47 even though the SMT patients were treated multiple times.…”

Section: Discussionmentioning

confidence: 98%

Symptomatic, Magnetic Resonance Imaging–Confirmed Cervical Disk Herniation Patients: A Comparative-Effectiveness Prospective Observational Study of 2 Age- and Sex-Matched Cohorts Treated With Either Imaging-Guided Indirect Cervical Nerve Root Injections or Spinal Manipulative Therapy

Peterson

Pfirrmann

Hodler

et al. 2016

Journal of Manipulative and Physiological Therapeutics

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Section: Discussionmentioning

confidence: 98%

Symptomatic, Magnetic Resonance Imaging–Confirmed Cervical Disk Herniation Patients: A Comparative-Effectiveness Prospective Observational Study of 2 Age- and Sex-Matched Cohorts Treated With Either Imaging-Guided Indirect Cervical Nerve Root Injections or Spinal Manipulative Therapy

Peterson

Pfirrmann

Hodler

et al. 2016

Journal of Manipulative and Physiological Therapeutics

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“…Reasons for this gender discrepancy One strength of this study is that it is a prospective outcome study, using two simple and validated outcome measures. 14,15 Secondly, this study examines three well-defined categories of intra-articular hip pathologies in patients over age 40. This results in a homogeneous middle age and older patient group with degenerative pathologies, excluding growing disorders or conditions manifest in younger populations.…”

Section: Discussionmentioning

confidence: 99%

“…Pochon et al therapeutic injections and were described in previous studies as "the most valid, reliable, and time-effective outcome measures. " 14,15 The PGIC is a 7-point scale including the responses "much better," "better," "slightly better," "unchanged," "slightly worse," "worse" and "much worse." This scale includes the subjective improvement in terms of activity limitations, symptoms, emotions and overall quality of life.…”

Section: Bjrmentioning

confidence: 99%

“…The responses "much better" and "better" were considered clinically relevant "improvement" consistent with other studies. [14][15][16][17] All other responses were considered "not improved." The responses "slightly worse," "worse," and "much worse" were all considered worsening of the condition and dichotomized as "worse."…”

Section: Bjrmentioning

confidence: 99%

“…All other responses were "not worse." [14][15][16][17] The responses "slightly better" and "unchanged" were categorized as "unchanged.…”

Section: Bjrmentioning

confidence: 99%

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Hip MRI findings and outcomes following imaging-guided hip injections

Pochon¹,

Peterson²,

Sutter

et al. 2020

The British Journal of Radiology

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Objective: To determine if MRI findings prior to intra-articular corticosteroid hip infiltration are related to treatment outcomes. Methods: This prospective outcome study with retrospective MRI evaluation includes 100 consecutive patients with MRI within 6 months before a therapeutic intra-articular hip injection. Labrum, bone marrow, acetabular and femoral cartilage abnormalities were assessed by two radiologists blinded to patient outcomes: the proportion reporting "improvement" on the Patient’s Global Impression of Change (PGIC) scale at 1 day, 1 week and 1 month follow-up were compared based on MRI findings using χ2. The t-test was used to compare pain change scores with MRI abnormalities. Results: Patients with a normal labrum in the posterosuperior quadrant were more likely to report PGIC "improvement" at 1 week compared to labral degeneration (p = 0.048). Significant differences in pain change scores were found at all time points for the labral anteroinferior quadrant (p = 0.001, 1 day; p = 0.010, 1 week; p = 0.034, 1 month) with the highest reduction in patients with labral degeneration. Females were 2.80 times more likely to report clinically relevant "improvement" at 1 day (p = .049) and 2.90 times more likely to report clinically relevant "improvement" at 1 month (p = .045). Conclusion: Cartilage defects and marrow abnormalities were not associated with outcomes. Patients with a normal labrum in the posterosuperior quadrant had better outcomes at 1 week. Patients with labral degeneration of the anteroinferior quadrant had higher levels of pain reduction at all time points. Females were significantly more likely to report PGIC "improvement" Advances in knowledge: A significant treatment outcome was observed amongst gender, although there were no significant differences in the MRI findings.

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Fluoroscopy-guided versus CT-guided Lumbar Steroid Injections: Comparison of Radiation Exposure and Outcomes

et al. 2019

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Purpose To compare the radiation exposure for participants and interventionalists as well as participant outcomes between fluoroscopy-guided versus CT-guided lumbar spinal injections. Materials and Methods This prospective, nonrandomized observational study included 1446 participants (mean age, 60.6 years; range, 18-91 years) who received transforaminal epidural injections or facet joint injections under fluoroscopic or CT guidance between October 2009 and April 2016. Effective doses were estimated by conversion from dose-area product for fluoroscopy-guided injections and dose-length product for CTguided injections. Radiation exposure for interventionalists was measured with dosimeters at the body and wrist. The Patient Global Impression of Change (PGIC) scale was used to assess clinical participant outcomes at 1 day, 1 week, and 1 month after lumbar spine injections. Student t and tests were used for statistical analysis. Results The mean effective participant dose for fluoroscopy-guided lumbar transforaminal epidural injections was 0.24 mSv ± 0.22, compared with 0.33 mSv ± 0.10 for CT-guided injections (P < .003). The mean effective participant dose for fluoroscopy-guided lumbar facet joint injections was 0.10 mSv ± 0.11, compared with 0.33 mSv ± 0.13 for CT-guided injections (P < .001). Radiation exposure for the interventionalist was higher during fluoroscopy-guided compared with CTguided lumbar transforaminal epidural injections (body: 0.42 × 10 mSv ± 0.99 vs 0.11 × 10 mSv ± 0.44, P < .03; wrist: 1.44 × 10 mSv ± 2.69 vs 0.14 × 10 mSv ± 0.55, P < .001). Radiation exposure of the wrist for the interventionalist was higher during fluoroscopy-guided compared with CT-guided lumbar facet injections (0.46 × 10 mSv ± 0.93 vs 0.06 × 10 mSv ± 0.24, respectively; P < .006). Clinical participant outcomes as determined with the PGIC scale did not differ between fluoroscopy-guided and CT-guided injections (P = .15-.96). Conclusion Radiation exposure in fluoroscopy-guided lumbar spinal injections was lower for participants and higher for physicians when compared with CT-guided injections; however, no associations were observed between clinical participant outcomes and type of imaging-guided injection technique at all evaluated time points.

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The development and implementation of an outcomes database for imaging-guided therapeutic musculoskeletal injections

Abstract: Setting up an outcomes database is straightforward and productive. The NRS and PGIC were considered the most useful outcome measures. This database facilitated critical reflection on current practice and provides the foundation for several research studies.

Cited by 3 publications

References 28 publications

Symptomatic, Magnetic Resonance Imaging–Confirmed Cervical Disk Herniation Patients: A Comparative-Effectiveness Prospective Observational Study of 2 Age- and Sex-Matched Cohorts Treated With Either Imaging-Guided Indirect Cervical Nerve Root Injections or Spinal Manipulative Therapy

Symptomatic, Magnetic Resonance Imaging–Confirmed Cervical Disk Herniation Patients: A Comparative-Effectiveness Prospective Observational Study of 2 Age- and Sex-Matched Cohorts Treated With Either Imaging-Guided Indirect Cervical Nerve Root Injections or Spinal Manipulative Therapy

Hip MRI findings and outcomes following imaging-guided hip injections

Fluoroscopy-guided versus CT-guided Lumbar Steroid Injections: Comparison of Radiation Exposure and Outcomes

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