1
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Refahee SM, Mahrous AI, Shabaan AA. Clinical efficacy of magnesium sulfate injection in the treatment of masseter muscle trigger points: a randomized clinical study. BMC Oral Health 2022; 22:408. [PMID: 36123724 PMCID: PMC9484239 DOI: 10.1186/s12903-022-02452-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Myofascial pain syndrome with trigger points is the most common cause of nonodontogenic pain. Although injection of the trigger points is the most effective pain reduction treatment, many patients exhibit recurrence after a short period. Therefore, the aim of the current study was to evaluate the clinical efficacy of magnesium sulfate injections in the treatment of the masseter muscle trigger points when compared to saline injections.
Material and method This study randomly (1:1) assigned 180 patients to one of two treatment groups based on whether their trigger points were injected with 2 ml of saline or magnesium sulfate. Pain scores, maximum mouth opening (MMO), and quality of life were measured at the pre-injection and 1, 3, and 6 months post-injection.
Results The pain scores were significantly higher in the saline group during all follow-up assessments, whereas the MMO was significantly higher in the magnesium sulfate group up to 3 months of follow-up (p < 0.001). However, the difference in MMO ceased to be statistically significant after 6 months of follow-up (p = 0.121). Additionally, the patient’s quality of life score was significantly higher in the magnesium sulfate group compared to the saline group (p < 0.001). Conclusion Injection of magnesium sulfate is an effective treatment measure for myofascial trigger points. However, further studies with a proper design addressing the limitations of the current study are necessary. ClinicalTrials: org (ID: NCT04742140) 5/2/2021.
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Affiliation(s)
- Shaimaa Mohsen Refahee
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
| | - Aliaa Ibrahim Mahrous
- Fixed Prosthodontic Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
| | - Alshaimaa Ahmed Shabaan
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
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2
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Anwar N, Li S, Long L, Zhou L, Fan M, Zhou Y, Wang S, Yu L. Combined effectiveness of extracorporeal radial shockwave therapy and ultrasound-guided trigger point injection of lidocaine in upper trapezius myofascial pain syndrome. Am J Transl Res 2022; 14:182-196. [PMID: 35173837 PMCID: PMC8829647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Myofascial pain syndrome (MPS) is a major musculoskeletal problem and a leading cause of disability worldwide. Extracorporeal shockwave therapy (ESWT) and trigger point injection (TPI) have shown positive results for MPS but no previous study has investigated the combined effects of radial shockwave and trigger point injection of lidocaine for upper trapezius myofascial pain syndrome. METHOD For this purpose, forty-five participants were randomly divided into shockwave (n = 15), shockwave with ultrasound-guided trigger point injection (combined; n = 15), and control (standard care; n = 15) groups. Participants were assessed at baseline, one week and four weeks by using the visual analog scale, neck disability index, electromyography, infrared thermography, and sonoelastography. RESULTS Compared with control group, both shockwave and combined groups showed a statistically significant reduction in pain (P<0.01), functional disability (P<0.01), skin temperature (P<0.01), and elastic stiffness, with greater reduction in the combined group (P<0.01) than shockwave group (P<0.05) at four weeks. However, no significant difference was found in electrical activity between the groups (P>0.05). The combined group also showed significant differences in pain (P<0.05) and elastic stiffness (P<0.01) compared with shockwave group at four weeks. CONCLUSION Our study revealed that extracorporeal radial shockwave therapy combined with trigger point injection of lidocaine was more effective for decreasing pain and elastic stiffness in upper trapezius myofascial pain syndrome at four weeks.
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Affiliation(s)
- Nadia Anwar
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010, China
| | - Shuangyu Li
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010, China
| | - Lu Long
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010, China
| | - Li Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010, China
| | - Meng Fan
- Department of Traditional Chinese Medicine, Weinan Central HospitalWeinan 714000, Shaanxi Province, China
| | - Yi Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010, China
| | - Sanrong Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010, China
| | - Lehua Yu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010, China
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3
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Lee DH, Martel ML, Reardon RF. Erector Spinae Plane Block in the Emergency Department for Upper Extremity: A Case Report. Clin Pract Cases Emerg Med 2021; 5:353-356. [PMID: 34437046 PMCID: PMC8373174 DOI: 10.5811/cpcem.2021.3.51803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/12/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction The erector spinae plane block (ESPB) has been described as an effective analgesic modality in the emergency department (ED) for thoracic pain. It has not previously been described to treat ED patients with pain in the upper extremity. Case Report We present a case of a 52-year-old female who presented to the ED with an acute exacerbation of her chronic radicular left arm pain originating after a fall she sustained one year prior. After a variety of analgesic modalities failed to control her pain, an ESPB was used to successfully treat her pain and facilitate discharge from the ED. Conclusion A significant portion of patients who present to the ED have underlying chronic pain; however, opioids are a potentially dangerous and ineffective modality to treat chronic pain. In addition to avoiding opiates, the ESPB has the advantage of preserving motor function, thus avoiding the complications associated with brachial plexus blockade.
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Affiliation(s)
- Daniel H Lee
- Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Marc L Martel
- Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Robert F Reardon
- Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota
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4
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Salamone FJ, Kanamalla K, Songmen S, Sapire J. Bilateral supraclavicular abscesses following trigger point injections. Radiol Case Rep 2021; 16:2630-2633. [PMID: 34295446 PMCID: PMC8282958 DOI: 10.1016/j.radcr.2021.06.032] [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: 05/31/2021] [Revised: 06/09/2021] [Accepted: 06/12/2021] [Indexed: 11/17/2022] Open
Abstract
A 54-year-old-woman presented to the emergency department with worsening bilateral shoulder pain six days after trigger point injections in the bilateral supraclavicular areas for chronic pain. A computed tomography scan of the neck revealed bilateral irregular rim enhancing fluid collections. Image-guided percutaneous drainage resulted in marked improvement and near complete resolution by 17 days post-drainage. This case demonstrates the need for early detection of soft-tissue infection and abscess formation related to interventional pain procedures to avoid potentially life-threatening complications, such as Staphylococcus aureus bacteremia.
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Affiliation(s)
- Frank J Salamone
- Frank H. Netter MD School of Medicine, Quinnipiac University, 370 Bassett Rd, North Haven, CT 06473, USA
| | - Karthik Kanamalla
- Frank H. Netter MD School of Medicine, Quinnipiac University, 370 Bassett Rd, North Haven, CT 06473, USA
| | | | - Joshua Sapire
- St. Vincent's Medical Center, 2800 Main St, Bridgeport, CT 06606, USA
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5
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Ye Y, Gabriel RA, Mariano ER. The expanding role of chronic pain interventions in multimodal perioperative pain management: a narrative review. Postgrad Med 2021; 134:449-457. [PMID: 34033737 DOI: 10.1080/00325481.2021.1935281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Surgery is a risk factor for chronic pain and long-term opioid use. As perioperative pain management continues to evolve, treatment modalities traditionally used for chronic pain therapy may provide additional benefit to patients undergoing surgery. Interventions such as radiofrequency ablation, cryoneurolysis, and neuromodulation may potentially be used in conjunction with acute pain procedures such as nerve blocks and multimodal analgesia. Pharmacological agents associated with chronic pain medicine, including gabapentinoids, ketamine, and selective serotonin reuptake inhibitors, may be useful adjuncts in perioperative pain management when indicated. There may also be a role for acupuncture, music therapy, and other integrative medicine therapies. A transitional pain service can help coordinate outpatient care with inpatient perioperative pain management and promote a more personalized and comprehensive approach that can improve postoperative outcomes.
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Affiliation(s)
- Ying Ye
- Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System; Palo Alto, California, USA.,Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine; Stanford, California, USA
| | - Rodney A Gabriel
- Department of Anesthesiology, Division of Regional Anesthesia, University of California, San Diego; California, USA.,Department of Medicine, Division of Biomedical Informatics, University of California, San Diego; California, USA
| | - Edward R Mariano
- Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System; Palo Alto, California, USA.,Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine; Stanford, California, USA
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6
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Interventional Therapies for Pain in Cancer Patients: a Narrative Review. Curr Pain Headache Rep 2021; 25:44. [PMID: 33961156 DOI: 10.1007/s11916-021-00963-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW Pain is a prevalent symptom in the lives of patients with cancer. In light of the ongoing opioid epidemic and increasing awareness of the potential for opioid abuse and addiction, clinicians are progressively turning to interventional therapies. This article reviews the interventional techniques available to mitigate the debilitating effects that untreated or poorly treated pain have in this population. RECENT FINDINGS A range of interventional therapies and technical approaches are available for the treatment of cancer-related pain. Many of the techniques described may offer effective analgesia with less systemic toxicity and dependency than first- and second-line oral and parenteral agents. Neuromodulatory techniques including dorsal root ganglion stimulation and peripheral nerve stimulation are increasingly finding roles in the management of oncologic pain. The goal of this pragmatic narrative review is to discuss interventional approaches to cancer-related pain and the potential of such therapies to improve the quality of life of cancer patients.
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7
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El-Tallawy SN, Nalamasu R, Salem GI, LeQuang JAK, Pergolizzi JV, Christo PJ. Management of Musculoskeletal Pain: An Update with Emphasis on Chronic Musculoskeletal Pain. Pain Ther 2021; 10:181-209. [PMID: 33575952 PMCID: PMC8119532 DOI: 10.1007/s40122-021-00235-2] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/09/2021] [Indexed: 12/28/2022] Open
Abstract
Musculoskeletal pain is a challenging condition for both patients and physicians. Many adults have experienced one or more episodes of musculoskeletal pain at some time of their lives, regardless of age, gender, or economic status. It affects approximately 47% of the general population. Of those, about 39–45% have long-lasting problems that require medical consultation. Inadequately managed musculoskeletal pain can adversely affect quality of life and impose significant socioeconomic problems. This manuscript presents a comprehensive review of the management of chronic musculoskeletal pain. It briefly explores the background, classifications, patient assessments, and different tools for management according to the recently available evidence. Multimodal analgesia and multidisciplinary approaches are fundamental elements of effective management of musculoskeletal pain. Both pharmacological, non-pharmacological, as well as interventional pain therapy are important to enhance patient’s recovery, well-being, and improve quality of life. Accordingly, recent guidelines recommend the implementation of preventative strategies and physical tools first to minimize the use of medications. In patients who have had an inadequate response to pharmacotherapy, the proper use of interventional pain therapy and the other alternative techniques are vital for safe and effective management of chronic pain patients.
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Affiliation(s)
- Salah N El-Tallawy
- Anesthesia and Pain Management Department, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia. .,Faculty of Medicine, Minia University and NCI, Cairo University, Cairo, Egypt.
| | - Rohit Nalamasu
- Department of Physical Medicine and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
| | - Gehan I Salem
- Rheumatology, Rehabilitation and Physical Medicine Department, Assiut University Hospital, Assiut, Egypt.,Rehabilitation Medicine Department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Paul J Christo
- Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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8
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Taşkesen F, Cezairli B. The effectiveness of the masseteric nerve block compared with trigger point injections and dry needling in myofascial pain. Cranio 2020; 41:96-101. [PMID: 32935643 DOI: 10.1080/08869634.2020.1820686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare the efficacy of three different treatment methods in the management of myofascial pain: masseteric nerve block (MNB), trigger point injection with local anesthetic (LA), and dry needling (DN). METHODS Forty-five patients diagnosed with myofascial pain and trigger points in masseter muscles were treated with MNB (n = 15), DN (n = 15), and trigger point injection with LA (n = 15). Pain on palpation (PoP), pain on function (PoF), and maximum mouth opening (MMO) scores were measured and compared before the injections and all follow-ups after the injections. RESULTS MMO values were significantly increased in each group. The decrease in PoF values was statistically significant between the groups at 12 weeks (baseline time period). DISCUSSION Results of the present study indicate that MNB was not as effective as trigger point injection with local anesthetic or dry-needling in the management of masticatory myofascial pain.
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Affiliation(s)
- Fatih Taşkesen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erzincan Binali Yildirim University, Erzincan, Turkey
| | - Burak Cezairli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey
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9
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Kang JJ, Kim J, Park S, Paek S, Kim TH, Kim DK. Feasibility of Ultrasound-Guided Trigger Point Injection in Patients with Myofascial Pain Syndrome. Healthcare (Basel) 2019; 7:healthcare7040118. [PMID: 31618922 PMCID: PMC6956081 DOI: 10.3390/healthcare7040118] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/11/2019] [Accepted: 10/12/2019] [Indexed: 01/09/2023] Open
Abstract
We compared the feasibility of ultrasound (US)-guided myofascial trigger point (MTrP) injection with that of a blind injection technique following the use of shear wave elastography (SWE) for the measurement of stiffness at the MTrPs in patients with trapezius myofascial pain syndrome (MPS). A total of 41 patients (n = 41) were randomized to either the trial group (n = 21, SWE combined with US-guided injection) or the control group (n = 20, SWE combined with blind injection). At baseline and four weeks, they were evaluated for the manual muscle test (MMT), the range of motion (ROM), pain visual analogue scale (VAS) scores, Shoulder Pain and Disability Index (SPADI) scores and Neck Disability Index (NDI) scores during the abduction, adduction, flexion, extension, external rotation and internal rotation of the shoulder joint. Differences in changes in pain VAS scores, NDI scores and SPADI scores at four weeks from baseline between the two groups reached statistical significance (p = 0.003, 0.012, and 0.018, respectively). US-guided MTrP injection is a more useful modality as compared with a blind injection in patients with MPS.
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Affiliation(s)
- Jung Joong Kang
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju 27376, Korea.
| | - Jungin Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju 27376, Korea.
| | - Seunghun Park
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju 27376, Korea.
| | - Sungwoo Paek
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju 27376, Korea.
| | - Tae Hee Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju 27376, Korea.
| | - Dong Kyu Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju 27376, Korea.
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10
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Hutter J, Tournier JD, Price AN, Cordero‐Grande L, Hughes EJ, Malik S, Steinweg J, Bastiani M, Sotiropoulos SN, Jbabdi S, Andersson J, Edwards AD, Hajnal JV. Time-efficient and flexible design of optimized multishell HARDI diffusion. Magn Reson Med 2018; 79:1276-1292. [PMID: 28557055 PMCID: PMC5811841 DOI: 10.1002/mrm.26765] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 02/01/2023]
Abstract
PURPOSE Advanced diffusion magnetic resonance imaging benefits from collecting as much data as is feasible but is highly sensitive to subject motion and the risk of data loss increases with longer acquisition times. Our purpose was to create a maximally time-efficient and flexible diffusion acquisition capability with built-in robustness to partially acquired or interrupted scans. Our framework has been developed for the developing Human Connectome Project, but different application domains are equally possible. METHODS Complete flexibility in the sampling of diffusion space combined with free choice of phase-encode-direction and the temporal ordering of the sampling scheme was developed taking into account motion robustness, internal consistency, and hardware limits. A split-diffusion-gradient preparation, multiband acceleration, and a restart capacity were added. RESULTS The framework was used to explore different parameters choices for the desired high angular resolution diffusion imaging diffusion sampling. For the developing Human Connectome Project, a high-angular resolution, maximally time-efficient (20 min) multishell protocol with 300 diffusion-weighted volumes was acquired in >400 neonates. An optimal design of a high-resolution (1.2 × 1.2 mm2 ) two-shell acquisition with 54 diffusion weighted volumes was obtained using a split-gradient design. CONCLUSION The presented framework provides flexibility to generate time-efficient and motion-robust diffusion magnetic resonance imaging acquisitions taking into account hardware constraints that might otherwise result in sub-optimal choices. Magn Reson Med 79:1276-1292, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Jana Hutter
- Centre for the Developing BrainKing's College LondonLondonUK
- Biomedical Engineering DepartmentKing's College LondonLondonUK
| | | | - Anthony N. Price
- Centre for the Developing BrainKing's College LondonLondonUK
- Biomedical Engineering DepartmentKing's College LondonLondonUK
| | - Lucilio Cordero‐Grande
- Centre for the Developing BrainKing's College LondonLondonUK
- Biomedical Engineering DepartmentKing's College LondonLondonUK
| | - Emer J. Hughes
- Centre for the Developing BrainKing's College LondonLondonUK
- Biomedical Engineering DepartmentKing's College LondonLondonUK
| | - Shaihan Malik
- Biomedical Engineering DepartmentKing's College LondonLondonUK
| | | | | | | | | | | | | | - Joseph V. Hajnal
- Centre for the Developing BrainKing's College LondonLondonUK
- Biomedical Engineering DepartmentKing's College LondonLondonUK
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11
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Soriano PK, Bhattarai M, Vogler CN, Hudali TH. A Case of Trigger-Point Injection-Induced Hypokalemic Paralysis. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:454-457. [PMID: 28442701 PMCID: PMC5413294 DOI: 10.12659/ajcr.903139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Patient: Male, 39 Final Diagnosis: Trigger-point induced hypokalemia Symptoms: Bilateral lower extremity weakness Medication: Epinephrine • Bupivacaine • Methylprednisolone Clinical Procedure: Trigger-point Injection Specialty: Nephrology and Radiology
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Affiliation(s)
- Paolo K Soriano
- Department of Internal Medicine, Southern Illinois University, Springfield, IL, USA
| | - Mukul Bhattarai
- Department of Internal Medicine, Southern Illinois University, Springfield, IL, USA
| | - Carrie N Vogler
- Department of Pharmacy Practice, Southern Illinois University School of Pharmacy, Edwardsville, IL, USA
| | - Tamer H Hudali
- Department of Internal Medicine, Southern Illinois University, Springfield, IL, USA
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12
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Artz NS, Wiens CN, Smith MR, Hernando D, Samsonov A, Reeder SB. Accelerating fully phase-encoded MRI near metal using multiband radiofrequency excitation. Magn Reson Med 2016; 77:1223-1230. [PMID: 27052204 DOI: 10.1002/mrm.26209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/18/2016] [Accepted: 02/18/2016] [Indexed: 11/10/2022]
Abstract
PURPOSE To develop a multiband radiofrequency (RF) excitation strategy for simultaneous excitation of multiple RF offsets to accelerate fully phase-encoded imaging near metallic prostheses. METHODS Multiband RF excitation was designed and incorporated into a spectrally resolved fully phase-encoded (SR-FPE) imaging scheme. A triband (-6, 0, 6 kHz) acquisition was compared with three separate single-band acquisitions at the corresponding RF offsets with a phantom containing the head of a hip prosthesis. In vivo multiband data with continuous spectral coverage were acquired in the knee of a healthy volunteer with the head of a hip prosthesis placed posteriorly and in a volunteer with a total knee prosthetic implant. RESULTS Phantom images acquired with triband excitation were essentially identical to the composite of three single-band excitations, but with an acceleration factor of three. In vivo multiband images of the healthy knee with adjacent metal demonstrated very good depiction of knee anatomy. In vivo images of the total knee replacement were successfully acquired, allowing visualization of native tissue with far less signal dropout than 2D-FSE. CONCLUSIONS FPE imaging with multiband excitation is feasible in the presence of extreme off-resonance. This approach can reduce scan time and/or increase off-resonance coverage, enabling in vivo FPE imaging near metallic prostheses over a broad off-resonance spectrum. Magn Reson Med 77:1223-1230, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Nathan S Artz
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA.,Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Curtis N Wiens
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Matthew R Smith
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Diego Hernando
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Alexey Samsonov
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA.,Department of Emergency Medicine, University of Wisconsin, Madison, Wisconsin, USA
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13
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Pal US, Kumar L, Mehta G, Singh N, Singh G, Singh M, Yadav HK. Trends in management of myofacial pain. Natl J Maxillofac Surg 2015; 5:109-16. [PMID: 25937719 PMCID: PMC4405950 DOI: 10.4103/0975-5950.154810] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We systematically reviewed the myofascial pain publications in the literature. The aim of this article is to review the methods of management and their outcome and factors associated with prognosis. The topics of interest in the diagnostic process are myofascial trigger points electromyography, jaw tracking, joint sound recorder, sonography, and vibratography, exclusion of other orofacial pain and temporomandibular disorders. Management modalities are occlusal therapy, physiotherapy, multidimensional rehabilitation antinociceptive therapy, anti-inflammatory and analgesics, muscle relaxants, stretch, and spray technique, transcutaneous electric nerve stimulation, and in severe cases botulinum toxin may be tried. The disease required interdisciplinary interaction in terms of occlusal therapy, antinociceptive therapy and physiotherapy because management of the disease may be influenced by the specialist primarily treating the patients.
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Affiliation(s)
- Uma Shanker Pal
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Lakshya Kumar
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gagan Mehta
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nimisha Singh
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Geeta Singh
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Mayank Singh
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Hemant Kumar Yadav
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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14
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Gagoski BA, Bilgic B, Eichner C, Bhat H, Grant PE, Wald LL, Setsompop K. RARE/turbo spin echo imaging with Simultaneous Multislice Wave-CAIPI. Magn Reson Med 2015; 73:929-938. [PMID: 25640187 DOI: 10.1002/mrm.25615] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/21/2014] [Accepted: 12/22/2014] [Indexed: 02/04/2023]
Abstract
PURPOSE To enable highly accelerated RARE/Turbo Spin Echo (TSE) imaging using Simultaneous MultiSlice (SMS) Wave-CAIPI acquisition with reduced g-factor penalty. METHODS SMS Wave-CAIPI incurs slice shifts across simultaneously excited slices while playing sinusoidal gradient waveforms during the readout of each encoding line. This results in an efficient k-space coverage that spreads aliasing in all three dimensions to fully harness the encoding power of coil sensitivities. The novel MultiPINS radiofrequency (RF) pulses dramatically reduce the power deposition of multiband (MB) refocusing pulse, thus allowing high MB factors within the Specific Absorption Rate (SAR) limit. RESULTS Wave-CAIPI acquisition with MultiPINS permits whole brain coverage with 1 mm isotropic resolution in 70 s at effective MB factor 13, with maximum and average g-factor penalties of gmax = 1.34 and gavg = 1.12, and without √R penalty. With blipped-CAIPI, the g-factor performance was degraded to gmax = 3.24 and gavg = 1.42; a 2.4-fold increase in gmax relative to Wave-CAIPI. At this MB factor, the SAR of the MultiBand and PINS pulses are 4.2 and 1.9 times that of the MultiPINS pulse, while the peak RF power are 19.4 and 3.9 times higher. CONCLUSION Combination of the two technologies, Wave-CAIPI and MultiPINS pulse, enables highly accelerated RARE/TSE imaging with low SNR penalty at reduced SAR.
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Affiliation(s)
- Borjan A Gagoski
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Berkin Bilgic
- Department of Radiology, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Cornelius Eichner
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Himanshu Bhat
- Siemens Medical Solutions USA Inc., Charlestown, MA, USA
| | - P Ellen Grant
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children's Hospital, Boston, MA, USA.,Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Lawrence L Wald
- Department of Radiology, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.,Harvard-MIT Health Sciences and Technology, Cambridge, MA, USA
| | - Kawin Setsompop
- Department of Radiology, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
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Eichner C, Wald LL, Setsompop K. A low power radiofrequency pulse for simultaneous multislice excitation and refocusing. Magn Reson Med 2014; 72:949-58. [DOI: 10.1002/mrm.25389] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 07/08/2014] [Accepted: 07/08/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Cornelius Eichner
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital; Harvard Medical School Boston Massachusetts USA
- Max Planck Institute for Human Cognitive and Brain Sciences; Leipzig Germany
| | - Lawrence L. Wald
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital; Harvard Medical School Boston Massachusetts USA
| | - Kawin Setsompop
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital; Harvard Medical School Boston Massachusetts USA
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16
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Song JY, Son JB, Lee MK, Gwack J, Lee KS, Park JY. Case series of mycobacterium abscessus infections associated with a trigger point injection and epidural block at a rural clinic. Epidemiol Health 2012; 34:e2012001. [PMID: 22323979 PMCID: PMC3272546 DOI: 10.4178/epih/e2012001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 12/28/2011] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of this report is to investigate Mycobacterium abscessus infections at a rural clinic and carry out a surveillance program to determine the extent and source of these infections. METHODS The authors conducted an active surveillance investigation of 36 patients who had visited the clinic since 1 July 2008. Clinical specimens were collected from the patients and an envirnmental investigation. Pulsed-field gel elctrophoresis (PFGE) was performed for comparing with M. abscessus isolates from the patients. RESULTS Six specimens were obtained from the 6 patients respectively and 22 environmental samples were obtained. M. abscessus was isolated from the wounds of two patients, and various nosocomial pathogens, but not M. abscessus, were isolated from the surrounding environment. Two strains of M. abscessus from patients were identical as a result of PFGE. CONCLUSION Infection control education including proper hand hygiene should be emphasized for physicians performing invasive procedures. There also needs to be more attention for invasive procedures management, including trigger point injection and epidural block in rural clinics.
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Affiliation(s)
- Jun Young Song
- Epidemic Intelligence Service, Division of Public Health Administration, Gyeongnam Provincial Office, Changwon, Korea
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