Document Detail


CT-guided sternoclavicular joint injections: description of the procedure, reliability of imaging diagnosis, and short-term patient responses.
MedLine Citation:
PMID:  21098176     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to evaluate pain relief 20 to 30 minutes after diagnostic or therapeutic injections into the sternoclavicular joint and to compare patient outcomes based on the CT diagnosis.
MATERIALS AND METHODS: Informed consent was obtained from each patient. Ethics approval was not required. Fifty patients who had CT-guided injections of corticosteroid and local anesthetic into their sternoclavicular joints were included in the study. Preinjection and 20- to 30-minute postinjection visual analog scale data were recorded and compared with the imaging findings agreed by consensus. Kappa statistics were calculated for the reliability of imaging diagnosis. The percentage of patients improving after joint injection was calculated, and the risk ratio comparing the response of patients with osteoarthritis to those without osteoarthritis was completed. The correlation between the severity of each patient's osteoarthritis and the pain response was calculated using Spearman's correlation coefficient.
RESULTS: Sixty-six percent of the patients reported clinically significant pain reduction at between 20 and 30 minutes after injection. The proportion of patients with osteoarthritis who had a clinically significant response was 67% compared with 64% for patients who did not have osteoarthritis. This difference was not statistically or clinically significant. There was no correlation between the severity of osteoarthritis and the amount of pain reduction (r = 0.03). The reliability of imaging diagnosis was substantial.
CONCLUSION: Two thirds of patients having sternoclavicular joint injections of corticosteroids and local anesthetics report clinically significant improvement regardless of the abnormalities detected on their CT images.
Authors:
Cynthia K Peterson; Nadja Saupe; Florian Buck; Christian W A Pfirrmann; Marco Zanetti; Juerg Hodler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  195     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  W435-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008 Zürich, Switzerland. cynthia.peterson@balgrist.ch
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / administration & dosage
Aged
Anesthetics, Local / administration & dosage
Contrast Media / administration & dosage
Female
Humans
Injections, Intra-Articular*
Iopamidol / administration & dosage
Male
Middle Aged
Osteoarthritis / drug therapy*,  radiography*
Pain Measurement
Radiography, Interventional / methods*
Reproducibility of Results
Retrospective Studies
Sternoclavicular Joint / radiography*
Tomography, X-Ray Computed / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anesthetics, Local; 0/Contrast Media; 62883-00-5/Iopamidol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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