Corticosteroid injectie cts

Elective spinal injections should be performed with imaging guidance, such as fluoroscopy or the use of a radiocontrast agent , unless that guidance is contraindicated. [7] Imaging guidance ensures the correct placement of the needle and maximizes the physician's ability to make an accurate diagnosis and administer effective therapy. [7] Without imaging, the risk increases for the injection to be incorrectly placed, and this would in turn lower the therapy's efficacy and increase subsequent risk of need for more treatment. [7] While traditional techniques without image guidance, also known as blind injections , can assure a degree of accuracy using anatomical landmarks, it has been shown in studies that image guidance provides much more reliable localization and accuracy in comparison.

“Ultrasound-guided corticosteroid injections for the treatment of De Quervain’s disease”

Introduction: De Quervain's disease is a disorder of the first extensorcompartment and is primarily treated with corticosteroid injections. This compartment is known for a large anatomical variation. A variation is the presence of a septum, which seems to have a negative impact on the effectiveness of corticosteroid injections. Accurate injection into the different compartments is important for the chances of success. With ultrasound the diagnosis can be confirmed and an accurate injection can be given simultaneously. We expect ultrasound-guided injections to have a higher efficacy rate.
Materials and Methods: In this retrospective study we included patients from the department of Plastic Surgery who were treated with an ultrasound guided corticosteroid injection for De Quervain, in the period from 01/01/2004 till 31/12/2009. The ultrasound examination and injection were performed by one musculoskeletal radiologist. Exclusion criteria were previous wrist surgery, a corticosteroid injection <3 months ago or insufficient follow-up data. Outcome was measured by perceived improvement, chance of recurrence and complications. The results from this study were compared to the results reported in the literature.
Results: From a total of 122 viewed ultrasound reports with suspicion of De Quervain. 51 wrists (47 patients) were included. The mean follow-up was months. After one injection, 94% noted significant improvement, % remained free of symptoms and % developed a recurrence after an average of 10 months. After the second injection 87% of the total remained free of symptoms and the risk of recurrence was 40%. The complication rate was 20%, all adverse events were self-limiting. Results found in literature: relieve of symptoms after one injection 73% (58-84) and after 2 injections 83% (79-91). Chance of complication is 0-38%. Our study also showed that % of the clinical De Quervain diagnoses were not confirmed by ultrasound.
Discussion and Conclusions: Ultrasound-guided corticosteroid injections are a safe and effective treatment for De Quervain's disease. In this study we found no difference in effectiveness between ultrasound-guided and blind injections as reported in literature. However, ultrasound seems to be of value in confirming or rejecting the diagnosis. These results and the very limited available literature on this subject are reasons for us to initiate a RCT comparing ultrasound-guided injections to not ultrasound-guided injection.

Triamcinolone is used to treat a number of different medical conditions, such as eczema , Lichen sclerosus , psoriasis , arthritis , allergies , ulcerative colitis , lupus , sympathetic ophthalmia , temporal arteritis , uveitis , ocular inflammation , Urushiol-induced contact dermatitis , aphthous ulcers (usually as triamcinolone acetonide ), visualization during vitrectomy and the prevention of asthma attacks. It will not treat an asthma attack once it has already begun. [2] [3] [4] It has also been used off-label for macular degeneration . [5]

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  • Citation tools Download this article to citation manager Arroll Bruce , Goodyear-Smith Felicity . Corticosteroid injections for osteoarthritis of the knee: meta-analysis BMJ 2004; 328 :869
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    Corticosteroid injectie cts

    corticosteroid injectie cts

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  • Citation tools Download this article to citation manager Arroll Bruce , Goodyear-Smith Felicity . Corticosteroid injections for osteoarthritis of the knee: meta-analysis BMJ 2004; 328 :869
    • BibTeX (win & mac) Download
    • EndNote (tagged) Download
    • EndNote 8 (xml) Download
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