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- Title
Clinical impact of diagnostic image-guided injections for musculoskeletal pain work-up in adolescent and adult patients at a children's hospital: initial results.
- Authors
Tran, Evelyn; Rosenfeld, Scott; Ngan, Esther; Kan, J. Herman
- Abstract
Objective: To assess the clinical impact of diagnostic musculoskeletal (MSK) injections on treatment decision-making in adolescent and adult patients at a children's hospital. Materials and methods: Retrospective study in patients who underwent diagnostic MSK injections by fluoroscopy or ultrasound (US) between 8/2020 and 3/2023 at a children's hospital. Patients received ropivacaine and triamcinolone acetonide at pain site, reporting quantitative FACES pain score prior to, immediately following, and 2–3 days following injection. Impact on patient care was subsequently assessed. Results: A total of 109 diagnostic fluoroscopic or US MSK injection referrals (mean: 17.6 years old) were included, most commonly hip (76.2%), ankle (9.2%), and iliopsoas tendon sheath (8.3%). Pain improvement occurred in 89.0% immediately and 67.9% 2–3 days after MSK injection, with net 84.4% exhibiting improvement based on pain scores and clinical exams. When there was pain improvement at the site of injection, there was a statistically higher incidence of operative intervention or additional therapeutic injections compared with the cohort that did not have symptom improvement (88% versus 35.3%, P < 0.0001). For the 15.6% (N = 17) of referrals that did not have pain improvement, 17.6% (n = 3) ultimately had an operative intervention at a separate site from the diagnostic injection, as an alternative etiology for the pain was found. Conclusion: Image-guided MSK injections play an important role in the management of musculoskeletal disorders. 84.4% of referrals experienced symptom relief, improving confidence for treatment decision-making. Importantly, 15.6% of patients were found to have an alternative etiology for symptoms, altering management altogether.
- Subjects
HOSPITAL care of children; CHILDREN'S hospitals; MUSCULOSKELETAL pain; INJECTIONS; TRIAMCINOLONE acetonide; SURGICAL site infections; MUSCULOSKELETAL system injuries
- Publication
Skeletal Radiology, 2024, Vol 53, Issue 8, p1573
- ISSN
0364-2348
- Publication type
Article
- DOI
10.1007/s00256-024-04635-1