Pain physician
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Serotonin syndrome is a mild to potentially life-threatening syndrome associated with excessive serotonergic activity within the central nervous system. Serotonin syndrome is associated with medication use, drug interactions, and overdose. While serotonin syndrome is often associated with the use of selective serotonin inhibitors (SSRI), an increasing number of reports are being presented involving the use of tramadol. ⋯ In conclusion, with the increasing incidence of serotonin syndrome, prescribing physicians should be aware of and educate their patients on the potential side effects of tramadol. It is important that the prescribing physician reviews patient medications for concurrent serotonergic drugs and monitors for potential abuse.
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Review Meta Analysis
A Best-Evidence Systematic Appraisal of the Diagnostic Accuracy and Utility of Facet (Zygapophysial) Joint Injections in Chronic Spinal Pain.
Spinal zygapophysial, or facet, joints are a source of axial spinal pain and referred pain in the extremities. Conventional clinical features and other noninvasive diagnostic modalities are unreliable in diagnosing zygapophysial joint pain. ⋯ The evidence is Level I for the diagnostic accuracy of lumbar facet joint nerve blocks, Level II for cervical facet joint nerve blocks, and Level II for thoracic facet joint nerve blocks in assessment of chronic spinal pain.
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Comparative Study
Palpation Versus Ultrasound-Guided Acromioclavicular Joint Intra-articular Corticosteroid Injections: A Retrospective Comparative Clinical Study.
Primary osteoarthritis (OA) is the most common cause of pain arising from the acromioclavicular (AC) joint. The true incidence is unknown because of differences in the criteria used to define arthritis in various studies. The proper diagnosis of AC joint OA requires a thorough physical examination, radiographic findings, and a diagnostic local anesthetic injection. ⋯ US-guided AC joint IA injection for the treatment of symptomatic AC joint OA resulted in better pain and functional status improvement than palpation-guided IA injection at the 6-month follow-up.