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Fotouh AA, Hamdy M, Ali F, Mohamed EF, Allam A, Hassan WA, Elsaman A, El-Najjar A, Amer MA, Mosad D, Tharwat S, El Bakry SA, Saleh H, Zaghloul A, Mahmoud M, Mohammed RHA, El-Saadany H, Fathi HM, Hammam N, Raafat HA, Moharram AN, Gheita TA. The Emerging Era of Interventional Imaging in Rheumatology: An Overview During the Coronavirus Disease-2019 (COVID-19) Pandemic. Open Access Rheumatol 2022; 14:43-56. [PMID: 35449707 PMCID: PMC9018128 DOI: 10.2147/oarrr.s355140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/25/2022] [Indexed: 11/29/2022] Open
Abstract
Imaging has long been taking its place in the diagnosis, monitor, and prognosis of rheumatic diseases. It plays a vital role in the appraisal of treatment. Key progress in the clinical practice of rheumatology is the innovation of advanced imaging modalities; such as musculoskeletal ultrasound (MSUS), computerized tomography (CT) and magnetic resonance imaging (MRI). These modalities introduced a promising noninvasive method for visualizing bone and soft tissues to enable an improved diagnosis. The use of MSUS in rheumatology is considered a landmark in the evolution of the specialty and its ease of use and many applications in rheumatic diseases make it a forerunner instrument in the practice. The use of MSUS among rheumatologists must parallel the development rate of the excellence revealed in the specialty. Moreover, innovative interventional imaging in rheumatology (III-R) is gaining fame and key roles in the near future for a comprehensive management of rheumatic diseases with precision. This review article throws light on the emergence of these robust innovations that may reshape the guidelines and practice in rheumatology, in particular, efforts to enhance best practice during the coronavirus disease 2019 (COVID-19) pandemic are endorsed.
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Affiliation(s)
| | - Mona Hamdy
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Fatma Ali
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, AlAzhar Girls, Cairo, Egypt
| | - Abdallah Allam
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Waleed A Hassan
- Rheumatology Department, Faculty of Medicine, Benha University, Banha, Egypt
| | - Ahmed Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amany El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Marwa A Amer
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa Mosad
- Rheumatology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samar Tharwat
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samah A El Bakry
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hanan Saleh
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Zaghloul
- Interventional Pain Management and Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Mahmoud
- Orthopedic and Microsurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem H A Mohammed
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hala A Raafat
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf N Moharram
- Orthopedic and Microsurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tamer A Gheita
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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The Effectiveness of Ultrasound-Guided Steroid Injection Combined with Miniscalpel-Needle Release in the Treatment of Carpal Tunnel Syndrome vs. Steroid Injection Alone: A Randomized Controlled Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9498656. [PMID: 30915366 PMCID: PMC6409054 DOI: 10.1155/2019/9498656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 12/21/2018] [Accepted: 01/22/2019] [Indexed: 12/13/2022]
Abstract
Objectives Carpal tunnel syndrome (CTS) is one of the most common nerve entrapment syndromes, which has a serious impact on patients' work and life. The most effective conservative treatment is steroid injection but its long-term efficacy is still not satisfactory. The aim of this study was to evaluate the effectiveness of steroid injection combined with miniscalpel-needle (MSN) release for treatment of CTS under ultrasound guidance versus steroid injection alone. We hypothesized that combined therapy could be more beneficial. Methods Fifty-one patients with CTS were randomly allocated into two groups, namely, steroid injection combined with MSN release group and steroid injection group. The therapeutic effectiveness was evaluated using Boston Carpal Tunnel Questionnaire (BCTQ), cross-sectional area (CSA) of the median nerve, and four electrophysiological parameters, including distal motor latency (DML), compound muscle action potential (CMAP), sensory nerve action potential (SNAP), and sensory nerve conduction velocity (SNCV) at baseline, 4 and 12 weeks after treatment. Results Compared with baseline, all the parameters in both groups showed statistically significant improvement at week 4 and week 12 follow-up, respectively (P<0.05). When compared with steroid injection group, the outcomes including BCTQ, DML, CMAP, SNCV, and CSA of the median nerve were significantly better in steroid injection combined with MSN release group at week 12 after treatment (P<0.05). Conclusions The effectiveness of steroid injection combined with MSN release for CTS is superior to that of steroid injection alone, which may have important implications for future clinical practice. This Chinese clinical trial is registered with ChiCTR1800014530.
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