Pain medicine : the official journal of the American Academy of Pain Medicine
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Case Reports
Prescription opioid forgery: reporting to law enforcement and protection of medical information.
To review confidentiality requirements of prescribers who become aware of a forged prescription. ⋯ Under common circumstances, HIPAA may prohibit prescribers from reporting prescription forgery to law enforcement. However, collaborating with a dispensing pharmacist may offer a lawful pathway to reporting prescription forgery. State legislature may consider laws that clarify the reporting responsibilities of prescribers in cases of prescription forgery.
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The aim of this study was to investigate the clinical characteristics of cluster headache (CH) in a neurology outpatient population in China. ⋯ This study details the clinical features of CH in a neurology outpatient population in China. Compared with Western studies, our patients were different in several aspects including the absence of chronic CH.
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Transforaminal epidural steroid injection (TFESI) is a widely utilized interventional pain technique for radicular pain. Although the six o'clock position of the pedicle in the so-called "safe triangle" has been used as a target location, there have been a number of reported catastrophic complications of this procedure, including paraplegia. The mechanism of this has been attributed to the intravascular injection of steroids. The goal of this study was to examine the intraforaminal location of thoracolumbar medullary arteries which would help guide pain physicians in developing safer techniques and guidelines. ⋯ At thoracolumbar levels, if needles were to encounter an artery, they are most likely to do so if placed anterosuperior to the nerve. Encountering an artery anterosuperior to the nerve is less likely at typical thoracic levels, but the likelihood is far from negligible. Pain physicians should be cognizant of this when considering optimal needle placement during transforaminal epidural steroid injections.