PM & R : the journal of injury, function, and rehabilitation
-
To compare the relative accuracy rates of ultrasound (US)-guided versus nonguided ankle (tibiotalar) joint and sinus tarsi injections in a cadaveric model. ⋯ In this cadaveric study, US guidance produced superior accuracy compared with nonguided injections with respect to both the tibiotalar joint and sinus tarsi. Although further research is warranted, clinicians should consider US guidance to optimize injectate placement into these areas when optimal accuracy is necessary for diagnostic or therapeutic purposes.
-
To determine which hip provocation maneuvers best predict the presence of an intra-articular hip pathology. ⋯ IROP and FABER may be worthwhile components of the clinical evaluation of hip pain to determine intra-articular hip pathology. These tests are nonspecific and therefore not necessarily negative in the absence of intra-articular hip pathology. These hip provocation maneuvers are a useful part of an evaluation that includes history, further examination findings, and other diagnostic studies.
-
Pain is a prevalent consequence of spinal cord injury (SCI) that can persist for years after the injury and can have a significant impact on physical and emotional function and quality of life. There are a variety of types of pain that may develop after a SCI, including those of primarily nociceptive origin and those of primarily neuropathic origin. Recommendations for diagnostic and treatment strategies have been varied in part because of the lack of a universal classification system and in part because of the biopsychosocial nature of pain. ⋯ For neuropathic pain in SCI, anticonvulsant agents and tricyclic antidepressants often are tried, but these treatments have had limited success in many patients, and alternative interventions (eg, massage therapy, acupuncture, meditation) often are just as successful. Treatment of nociceptive pain after SCI often includes nonsteroidal antiinflammatory agents and acetaminophen, but correction of underlying etiologies and behavior adjustments also should be implemented if possible. An overview of self-report pain questionnaires and scales is also presented to provide the clinician and researcher with a set of tools to evaluate the efficacy of pain interventions.
-
To examine changes in pain, disability, and medication usage over time from baseline to up to 12 months after facet joint injection of hylan G-F 20. ⋯ Viscosupplementation for lumbar FJ arthropathy with hylan G-F 20 is associated with modest efficacy that predominately lasts up to 6 months. Limitations include a small sample size and lack of both a control and blinding. Larger, randomized, controlled studies are indicated to better clarify its clinical safety, efficacy, and utility.