To investigate the efficacy of ultrasonography (US)-guided injections in patients with low lumbar facet syndrome, compared with that in patients who received fluoroscopy (FS)-guided injections.
Fifty-seven subjects with facet syndrome of the lumbar spine of the L4-5 and L5-S1 levels were randomly divided into two groups to receive intraarticular injections into the facet joint. One group received FS-guided facet joint injections and the other group received US-guided facet joint injections. Treatment effectiveness was assessed using a visual analogue scale (VAS), physician's and patient's global assessment (PhyGA, PaGA), and the modified Oswestry Disability Index (MODI). All parameters were evaluated four times: before injections, and at a week, a month, and three months after injections. We also measured, in both groups, how long it took to complete the whole procedure.
Each group showed significant improvement from the facet joint injections on the VAS, PhyGA, PaGA, and MODI (p<0.05). However at a week, a month, and three months after injections, no significant differences were observed between the groups with regard to VAS, PhyGA, PaGA, and MODI (p>0.05). Statistically significant differences in procedure time were observed between groups (FS: 248.7±6.5 sec; US: 263.4±5.9 sec; p=0.023).
US-guided injections in patients with lumbar facet syndrome are as effective as FS-guided injections for pain relief and improving activities of daily living.
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Objective: To evaluate the efficacy of intraarticular injection of hyaluronic acid and steroid in adhesive capsulitis of shoulder.
Method: Thirty-nine patients with adhesive capsulitis of shoulder were assigned at random to receive intraarticular injection into the glenohumeral joint. The treatment groups were divided into three: group A, triamcinolone 1 ml and 1% lidocaine 3 ml and normal saline 25 ml; group B, hyaluronic acid 2 ml and 1% lidocaine 3 ml and normal saline 25 ml; group C, hyaluronic acid 2 ml and 1% lidocaine 3 ml. The same physical therapy program was carried out for all patients. Pain was assessed by visual analogue scale (VAS) and range of motion (flexion, abduction, internal rotation and external rotation) was measured before injection, and at 30 minutes, 1 week and 2 weeks after injection.
Results: The shoulder range of motion (ROM) and VAS of three groups were all improved at 30 minutes, 1 week and 2 weeks after injection compared with those of preinjection, but there was no significant difference in ROM and VAS among three groups.
Conclusion: We concluded that intraarticular injection of hyaluronic acid would be a good treatment method in adhesive capsulitis of shoulder, specially in patients with risk of steroid use.
Objective: To obtain a effect of intraarticular injection of Sodium Hyaluronate in the patient with degenerative osteoarthritis without restriction of activities of daily living.
Method: Twenty-five patients were participated in this study. These patients are diagnosed as degenerative osteoarthritis by clinical symtoms and radiographic findings. Sodium hyaluronate, 2.5 ml, 3 mg/ampule, were injected intraarticulary without local anesthesia once a week for 5 times consecutively. For evaluation of the effectiveness of sodium hyaluronate, we assess the parameters for subjective and objective symtoms scored from 0 to 3 on 3 items, and for activities of daily living scored from 0 to 4 on 4 items. And then, we compared these data between pre-injection and at post-injection 2, 4, and 5 weeks. Changes of subjective and objective symtoms, and activities of daily living are assessed using Kellgren's X-ray grading of degenerative osteoarthritis. Improvement of the subjective pain is recorded by visual analogue scale.
Results: 1. Subjective and objective symtoms, and activities of daily living with time progression were significantly increased at post-injection 4, 5 weeks compared with pre-injection status (P＜0.05). 2. Subjective and objective symtoms, and activities of daily living according to Kellgren's X-ray classification were significantly increased at stage II and III (P＜0.05). 3. Visual analogue scale is significantly decreased after injection (P＜0.05).
Conclusion: Intraarticular injection of sodium hyaluronate showed improvement of patient's subjective and objective symtoms, and activities of daily living. The improvement was pronounced in the cases of high grade of degenerative osteoarthritis (stage II, III) according to Kellgren's X-ray classification as well as low grade (Stage I).
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