Image-Guided Steroid Injections Urged in Hip OA

The sacroiliac joint (SIJ) is often overlooked as a cause of pain, partially because it is not well visualized on standard imaging and partially because other structures may refer pain to it. This chapter reviews the anatomy of the SIJ as well as the diagnosis and differential diagnosis of SI joint dysfunction and pain, including a multitude of physical exam maneuvers such as the FABER, Gaenslen, extension, Gillet’s, sacroiliac shear, thigh thrust, compression, and distraction tests. In addition, it discusses the evidence-based approach to treat sacroiliac pain, with a focus on both conservative and nonconservative approaches such as image-guided steroid injections and radiofrequency denervation procedures and outcomes.

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942 Outcome of Image Guided Intra-Articular Thumb Base Steroid Injections-Retrospective Study of Consecutive Patient Over 4 Years in A Plastic and Hand Surgery Unit in West Lothian, Scotland

British Journal of Surgery ◽

10.1093/bjs/znab259.707 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

N N Thazhathe Peedika ◽

P Goswami

Keyword(s):

Pain Relief ◽

Image Intensifier ◽

Hand Surgery ◽

The Elderly ◽

Operative Management ◽

Steroid Injections ◽

Image Guided ◽

Subjective Pain ◽

Significant Disability ◽

Hospital Management System

Abstract Introduction Osteoarthritis of the thumb base is a common condition. Usually effects the elderly population causing significant disability. Modalities of treatment of osteoarthritis which includes conservative measures, non-operative interventions, and surgery. In this study we endeavored to assess how effective are image guided steroid injections for base of thumb Osteoarthritis as assessed by subjective pain relief perceived by patient and what percentage of these patients proceed to operative treatment. Method Retrospective data between January 2015 and December 2018 of the patients who underwent Steroid injections to the Base of thumb joints (CMCJ and/or STTJ) for Osteoarthritis under image intensifier guidance was collected from Hospital management system –TRAK and eHealth services. Follow up of the patients were done for Maximum 1 to 5 years. Results A total number of 692 patients with thumb base osteoarthritis were included in the study of which 546 patients underwent Image guided steroid injection to the thumb base. The mean Age of patients was 64.5 years and the Female: Male ratio was 401:145. Mean number of injections each patient received- 3.25 (1 – 7 times). Pain relief after first, second and third injections were 3.15 months, 2.63 and 1.75 months, respectively. 127 (23.2% of injections patients) underwent trapeziectomy. Mean time between first injection & Surgery was 1.3yrs (6 months -2 years) Conclusions This study demonstrates the effectiveness of image guided steroid injections for thumb base osteoarthritis. Though about a quarter of these patients proceed to operative management, steroid injections can delay the same considerably.

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