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Journal articles on the topic 'Joint pain diagnosis'
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1
Cohen, Steven P., and Srinivasa N. Raja. "Pathogenesis, Diagnosis, and Treatment of Lumbar Zygapophysial (Facet) Joint Pain." Anesthesiology 106, no. 3 (2007): 591–614. http://dx.doi.org/10.1097/00000542-200703000-00024.
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Lumbar zygapophysial joint arthropathy is a challenging condition affecting up to 15% of patients with chronic low back pain. The onset of lumbar facet joint pain is usually insidious, with predisposing factors including spondylolisthesis, degenerative disc pathology, and old age. Despite previous reports of a "facet syndrome," the existing literature does not support the use of historic or physical examination findings to diagnose lumbar zygapophysial joint pain. The most accepted method for diagnosing pain arising from the lumbar facet joints is with low-volume intraarticular or medial branch blocks, both of which are associated with high false-positive rates. Standard treatment modalities for lumbar zygapophysial joint pain include intraarticular steroid injections and radiofrequency denervation of the medial branches innervating the joints, but the evidence supporting both of these is conflicting. In this article, the authors provide a comprehensive review of the anatomy, biomechanics, and function of the lumbar zygapophysial joints, along with a systematic analysis of the diagnosis and treatment of facet joint pain.
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Lee, Anderson, Monik Gupta, Kiran Boyinepally, Phillip J. Stokey, and Nabil A. Ebraheim. "Sacroiliitis: A Review on Anatomy, Diagnosis, and Treatment." Advances in Orthopedics 2022 (December 28, 2022): 1–8. http://dx.doi.org/10.1155/2022/3283296.
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Introduction. Sacroiliitis is an inflammation of one or both of the sacroiliac (SI) joints, most often resulting pain in the lower back that can extend down the legs. Pain arising from the SI joint can be difficult to diagnose and treat due to the intricate surrounding ligamentous structure, nerve innervation, and its role in transferring weight from the upper body to the lower limbs. SI joint dysfunction accounts for up to 25% of cases of lower back pain and has a debilitating effect on patient functionality. This review aims to provide comprehensive coverage of all aspects of SI joint pain, with a specific focus on differential diagnosis and treatment. Methods. Current literature on SI joint pain and inflammation, other etiologies of lower back pain, and new treatment options were compiled using the databases PubMed and Cochrane and used to write this comprehensive review. There were no restrictions when conducting the literature search with regard to publication date, study language, or study type. Results. The diagnosis protocol of SI joint pain arising from sacroiliitis usually begins with the presentation of lower back pain and confirmatory diagnostic testing through fluoroscopy joint block. Reduction in pain following the anesthetic is considered the golden standard for diagnosis. The treatment begins with the conservative approach of physical therapy and analgesics for symptom relief. However, refractory cases often require interventional methods such as corticosteroid injections, prolotherapy, radiofrequency ablation, and even SI joint fusion surgery. Conclusion. SI joint pain is a complex problem that can present with varying patterns of pain due to uncertainty regarding its innervation and its prominent surrounding structure. It is therefore especially important to obtain a thorough history and physical on top of diagnostic tests such as a diagnostic block to properly identify the source of pain. Conservative treatment options with physical therapy and analgesics should be attempted first before interventional strategies such as ablation, injections, and prolotherapy can be considered. SI joint fusion surgery is a solution to cases in which previous methods do not provide significant relief.
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Chichasova, N. V. "Differential diagnosis in joint and spine damages." Modern Rheumatology Journal 14, no. 2 (2020): 14–19. http://dx.doi.org/10.14412/1996-7012-2020-2-14-19.
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The lecture covers main approaches to differential diagnosis in rheumatic diseases. It highlights the key questions that should be answered at the primary examination of the patient. The most important signs that can identify severe, sometimes urgent nonrheumatic diseases are presented. The author describes pain of different patterns and intensity and the most common variants of acute or chronic onset of mono-, oligo-, or polyarthritis. The 2016 European League Against Rheumatism (EULAR) definition of arthralgia suspicious for the development of rheumatoid arthritis is given. The lecture presents the signs indicating the inflammatory nature of back pain in cases of suspected spondyloarthritis (SpA), as well as a two-step diagnostic strategy for axial SpA. Attention is paid to the semiotics of joint damage and extra-articular manifestations in various rheumatic diseases. A brief algorithm for a differential diagnostic search for joint pain is given.
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Laslett, Mark. "Clinical Diagnosis of Sacroiliac Joint Pain." Techniques in Orthopaedics 34, no. 2 (2019): 76–86. http://dx.doi.org/10.1097/bto.0000000000000333.
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Dong, Xiaoqi, and Lu Wang. "The Imaging Diagnosis of Patients with Shoulder Pain Caused by Sports Injury." Applied Bionics and Biomechanics 2022 (April 21, 2022): 1–12. http://dx.doi.org/10.1155/2022/5272446.
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The shoulder joint is the most complex and movable joint of the human body. A variety of diseases can affect the shoulder joint and cause shoulder pain. Sports injuries are an important and common cause of shoulder pain. In the clinical diagnosis of shoulder joint injury, the most commonly used diagnostic methods are X-ray photography and CT imaging, but X-ray photography has poor ability to distinguish shoulder joints and other tiny tissue structures and has a sense of inspiration for shoulder joint injuries. In addition, CT arthrography has a certain risk to the lesion and is easy to form trauma, and it cannot clearly show the shoulder joint structures such as the rotator cuff and the labrum. Therefore, this article conducts MR imaging diagnostic research on patients with shoulder pain caused by sports injuries and plays an important role in imaging. This article deeply studied the clinical manifestations of shoulder joint pain and image processing technology, designed a research experiment on imaging diagnosis results of patients with shoulder joint pain caused by sports injuries, selected 87 patients with shoulder joint pain in a hospital, and analyzed X-ray photography, CT imaging, and MR imaging diagnosis, three methods to compare the diagnostic accuracy and inspection results and conduct an in-depth analysis of the causes of shoulder joint injury. The experimental results showed that there were 87 patients with shoulder joint pain, 65 patients with rotator cuff tear were diagnosed using arthroscopy, and 63 patients with rotator cuff tear were diagnosed by MR imaging. The accuracy rate was as high as 95.6%. Among them, the proportion caused by sports injuries is the highest, reaching 56%.
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Laslett, Mark. "Pain provocation tests for diagnosis of sacroiliac joint pain." Australian Journal of Physiotherapy 52, no. 3 (2006): 229. http://dx.doi.org/10.1016/s0004-9514(06)70037-x.
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Wislowska, Malgorzata. "Current Management in Osteoarthritis." Clinical Studies and Medical Case Reports 6, no. 3 (2019): 1–8. http://dx.doi.org/10.24966/csmc-8801/1000073.
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Osteoarthritis (OA) is a process of destruction of joint cartilage, subchondral bone and other joint structures, leading to anatomical damage to the joint, impaired movement and pain. Secondary changes may be accompanied by synovitis, caused by degradation products of cartilage and bone. There is a disturbance in balance between the synthesis of articular cartilage components and their degradation. Osteoarthritis is the most common chronic disease of the joints. It causes joint pain, stiffness, distortion and impairment of function, leading to disability. The disease occurs in the elderly, but it is not a consequence of aging. Optimal treatment requires early diagnosis and removal of risk factors. Early diagnosis may be treatment non-pharmacologically, according to NICE’s treatment in chronological order, and may still benefit from physical therapy. Late diagnosis requires more invasive treatments, including alloplasty, and prognosis is poorer. Diagnosis must be based on clinical examination and supported by imaging. Obesity is the main modifiable risk factor for OA. Other factors are hyperglycemia, diabetes, and hypercholesterolemia, injuries of knees and hips and meniscus damage. Unmodifiable risk factors are female gender, age, joint malformations, trauma. Pain and stiffness are symptoms of OA. Joint pain occurs after joint movement and disappears after rest. As the disease progresses, the pain appears already after small joint movements and finally during sleep. The main goals of treatment are patient education, pain reduction, function optimization, and the degenerative process modification. The current treatments OA are non-pharmacological methods, topically capsaicin and topically NSAIDs, paracetamol, then oral NSAIDs and, finally, arthroplasty.
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Corral, Cheryl. "Joint pain and mobility." Veterinary Nurse 14, no. 3 (2023): 110–12. http://dx.doi.org/10.12968/vetn.2023.14.3.110.
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This workshop discussed the diagnosis of developmental joint disease and degenerative conditions in dogs and cats, and looked at a multimodal approach to managing pain caused by these conditions, which involves surgery, pain medication, physical therapy, exercise and lifestyle modifications, weight management and joint supplements. It also considers how best to help owners manage these conditions.
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Kumar, Nishant, Kumari Jyotsana, M. Srinivasa Raju, and Basavaraj T. Bhagawati. "Gout Arthritis of Temporomandibular Joint - A Rare Case Report and Review of Literature." Indian Journal of Dental Research 35, no. 1 (2024): 111–13. http://dx.doi.org/10.4103/ijdr.ijdr_15_22.
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Abstract Gout is a metabolic disorder that leads to elevated serum uric acid levels and deposition of urate crystals in the joints. The disease is usually confined to the joint space and leads to pain and limitation of jaw opening. The case describes a 45-year-old female patient with a chief complaint of ‘occasional pain in the left temporal muscle region’. The case disclosed a gout manifestation in the temporomandibular joint (TMJ) after physical and radiographic findings. Gout manifestation in the TMJ is an unusual presentation and a few reports in the English literature address the subject. Gout in the TMJ should be included as a differential diagnosis for joint disorders because of its rarity. A clinician may overlook gout involving the TMJ in the differential diagnosis of facial pain even when the patient has received a diagnosis of gout in other joints.
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Kasapçopur, Özgür. "Differential diagnosis in children with joint pain." Turkiye Aile Hekimligi Dergisi 14, no. 3 (2010): 109–14. http://dx.doi.org/10.2399/tahd.10.109.
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Sembrano, Jonathan N., Mark A. Reiley, David W. Polly, and Steven R. Garfin. "Diagnosis and treatment of sacroiliac joint pain." Current Orthopaedic Practice 22, no. 4 (2011): 344–50. http://dx.doi.org/10.1097/bco.0b013e31821f4dba.
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Atluri, Sairam. "Diagnostic Accuracy of Thoracic Facet Joint Nerve Blocks: An Update of the Assessment of Evidence." Pain Physician 4;15, no. 4;8 (2012): E483—E496. http://dx.doi.org/10.36076/ppj.2012/15/e483.
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Background: Chronic mid back and upper back pain caused by thoracic facet joints has been reported in 34% to 48% of the patients based on their responses to controlled diagnostic blocks. Systematic reviews have established moderate evidence for controlled comparative local anesthetic blocks of thoracic facet joints in the diagnosis of mid back and upper back pain. Objective: To determine the diagnostic accuracy of thoracic facet joint nerve blocks in the assessment of chronic upper back and mid back pain. Study Design: Systematic review of the diagnostic accuracy of thoracic facet joint nerve blocks. Methods: A methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are presented descriptively and critically analyzed. The level of evidence was classified as good, fair, and limited (or poor) based on the quality of evidence developed by the United States Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to March 2012, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: Controlled placebo or local anesthetic blocks were utilized using at least 50% pain relief as the reference standard. Results: Three studies were identified utilizing controlled comparative local anesthetic blocks, with ≥50% pain relief as the criterion standard. The evidence is good for the diagnosis of thoracic pain of facet joint origin with controlled diagnostic blocks. Limitations: The limitations of this systematic review include a paucity of literature for the diagnosis of thoracic facet joint pain, with all included manuscripts originating from one group of authors. Conclusions: Based on this systematic review, the evidence for the diagnostic accuracy of thoracic facet joint injections is good. Key words: Chronic thoracic pain, mid back or upper back pain, thoracic facet or zygapophysial joint pain, facet joint nerve blocks, medial branch blocks, controlled comparative local anesthetic blocks
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Perepelova, M. A., A. S. Lutsenko, M. V. Utkina, N. V. Tarbaeva, and E. G. Przhiyalkovskaya. "Joint involvement in patients with acromegaly: potential markers for early diagnosis." Obesity and metabolism 21, no. 2 (2024): 195–204. http://dx.doi.org/10.14341/omet13133.
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Acromegaly is a rare neuroendocrine disease caused by excessive production of growth hormone (GH), which acts as a trigger for cartilage tissue destruction leading to joint damage.Patients with acromegaly, especially in the active stage, often complain of joint pain in various locations. Joint pain can be one of the first symptoms of the disease, the intensity of which worsens without proper treatment. Increased production of GH leads to configuration changes in the joints, which in turn trigger destructive processes typical of degenerative diseases such as osteoarthritis. Despite successful treatment of acromegaly, joint-related issues can persist and significantly worsen the quality of life for patients. In this regard, the search for potential markers of early joint involvement in acromegaly is relevant for use in predicting the severity of arthropathy progression and monitoring this cohort of patients.This review provides a general overview of the effects of growth hormone on cartilage tissue, the characteristics of musculoskeletal pathology in patients with acromegaly and possible markers associated with early joint damage.
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Kao, Ming-Chang, Ching-Wei Chuang, Sheng-Kai Hung, and Po-Ting Pan. "Diagnosis and interventional pain management options for sacroiliac joint pain." Tzu Chi Medical Journal 31, no. 4 (2019): 207. http://dx.doi.org/10.4103/tcmj.tcmj_54_19.
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Hosni, Qasim El-Mashharawi, A. Alshawwa Izzeddin, and Elkahlout Mohammed. "AN EXPERT SYSTEM FOR ARTHRITIS DISEASES DIAGNOSIS USING SL5 OBJECT." МЕДИЦИНА, ПЕДАГОГИКА И ТЕХНОЛОГИЯ: ТЕОРИЯ И ПРАКТИКА 2, no. 6 (2024): 6–12. https://doi.org/10.5281/zenodo.11519067.
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Arthritis is very common but is not well understood. Actually, “arthritis” is not a single disease; it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older. Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints. <strong>Objectives: </strong>The main goal of this expert system is to get the appropriate diagnosis of disease and the correct treatment and give the appropriate method of treatment through several tips that concern the disease and how to treat it and we will see it through the application on the expert system. <strong>Methods: </strong>in this paper the design of the proposed Expert System which was produced to help Orthopedist in diagnosing Arthritis disease through its symptoms such as: pain on pressure in a joint , Inflammation indicated by joint swelling, Stiffness especially in the morning , Loss of flexibility of joint, Limited, joint movement, Deformity of the joints , Weight loss and fatigue , Non-specific fever and Crepitus. The proposed expert system presents an overview about Arthritis disease is given, the cause of diseases is outlined and the treatment of disease whenever possible is given out. SL5 Object Expert System language was used for designing and implementing the proposed expert system. <strong>Results: </strong>The proposed Arthritis disease diagnosis expert system was evaluated by Orthopedics students and they were satisfied with its performance. <strong>Conclusions: </strong>The Proposed expert system is very useful for Orthopedist, patients with arthritis and newly graduated Orthopedics students.
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Sehgal, Nalini. "Systematic Review Of Diagnostic Utility Of Facet (Zygapophysial) Joint Injections In Chronic Spinal Pain: An Update." Pain Physician 1;10, no. 1;1 (2007): 213–28. http://dx.doi.org/10.36076/ppj.2007/10/213.
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Background: A 2-year review of literature from October 2004 to December 2006 was completed to update current scientific evidence on diagnostic utility of facet joint injections. Diagnostic injections are employed to diagnose facet joint pain because available techniques cannot identify the pain generating structure in patients with chronic spinal pain. There is no physical examination technique, laboratory test, or imaging modality that can precisely identify the spinal structure causing pain, distinguish the culprit from a variety of potential targets, and predict response to a therapeutic intervention. Zygapophysial joint injections, commonly called facet injections (intra-articular joint injections and medial branch blocks) are local anesthetic injections of the facet joint or its nerve supply. These are diagnostic procedures used to determine if pain is arising from facet joints, distinguish painful from nonpainful joints and prognosticate response to therapeutic facet joint interventions. Diagnostic injections must meet the cardinal features of a diagnostic test i.e., accuracy, safety, and reproducibility. Accuracy is based on comparison with a “gold standard” to confirm presence or absence of a disease. There is, however, no available gold standard to measure presence or absence of pain. Hence, there is a degree of uncertainty concerning the accuracy of diagnostic facet joint injections. Objectives: Evaluate and update available evidence (2004 to 2006) relating to clinical utility of facet joint injections (intraarticular and medial branch blocks) in diagnosing chronic spinal pain of facet joint origin. Study Design: Review of the literature for clinical studies on efficacy and utility of facet joint/nerve injections in diagnosing facet joint pain according to Agency for Healthcare Research and Quality (AHRQ) and Quality Assessment Studies of Diagnostic Accuracy (QUADAS) criteria. The level of evidence was classified as conclusive (Level I), strong (Level II), moderate (Level III), or limited (Level IV). Methods: Computerized database search (2004 to 2006) of PUBMED, EMBASE, CINAHL, and Web of Knowledge was conducted to identify studies on facet joint pain and diagnostic interventions. Abstracts, reviews, book chapters, case reports, studies based on single blocks or blocks without radiologic control, and studies describing techniques were excluded. Prospective studies were given priority over retrospective studies. Results: There is no change in the strength of evidence for facet joint diagnostic injections. There is strong evidence for controlled comparative local anesthetic facet joint injections or medial branch blocks in the diagnosis of neck and low back pain and moderate evidence in the diagnosis of pain arising from thoracic facet joints. Conclusion: The evidence obtained from literature review suggests that controlled comparative local anesthetic blocks of facet joints (medial branch or dorsal ramus) are reproducible, reasonably accurate and safe. The sensitivity, specificity, false-positive rates, and predictive values of these diagnostic tests for neck and low back pain have been validated and reproduced in multiple studies. Key words: Chronic spinal pain, neck pain, low back pain, cervical facet joint, thoracic facet joint, lumbar facet joint, zygapophyseal joint, medial branch block, intraarticular injection
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Gonzalez, Juan Carlos Acevedo. "VALIDATION OF A NEW CLINICAL SIGN OF LUMBAR FACET SYNDROME." Coluna/Columna 17, no. 4 (2018): 303–7. http://dx.doi.org/10.1590/s1808-185120181704160077.
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ABSTRACT Objective: Facet joints are true synovial joints, which derive their nerve supply from the sinuvertebral or recurrent nerve of Luschka as well as the posterior primary division of the corresponding spinal nerve. Diagnosis of low-back pain originating in the facet joints is difficult, and has traditionally relied upon invasive tests. To aid in the clinical diagnosis of this condition, the senior author described a new clinical sign. The following research project was designed to test the utility of this sign in the diagnosis of lumbar facet joint pain. Methods: We conducted a prospective evaluation of patients suspected of having low back pain secondary to facet joint involvement (Lumbar Facet joint Pain Syndrome – LFPS) during a twelve month observation period; candidate patients were evaluated clinically using the new diagnostic sign, which was then compared to findings on radionuclide bone scans and diagnostic medial branch blocks. Contingency table analysis was performed to calculate the sensitivity, specificity, positive and negative predictive values and accuracy of the new clinical sign. Results: Contingency table analysis showed the following operating characteristics for the new diagnostic sign: Sensitivity: 70.37%, Specificity: 50%, Positive predictive value: 90.47%, Negative predictive value: 20% and accuracy 67.7%. Conclusions: Although the new clinical sign failed to show the same operating characteristics as the ones originally described, it has high sensitivity coupled with a good positive predictive value. We consider that although the sign by itself is not diagnostic of lumbar facet joint pain, its presence should alert the clinician to the diagnosis and the possibility of requiring additional testing. Level of Evidence III; Case control studyg.
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Isaikin, A. I., A. V. Kavelina, Yu M. Shor, P. A. Merbaum, and T. I. Shadyzheva. "Sacroiliac joint dysfunction: clinical presentations, diagnosis, treatment." Neurology, Neuropsychiatry, Psychosomatics 11, no. 2S (2019): 62–68. http://dx.doi.org/10.14412/2074-2711-2019-2s-62-68.
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One of the most common anatomical sources of nonspecific back pain is sacroiliac joint (SIJ) injury. The paper gives data on the structure, features of diagnosis and treatment of pain caused by SIJ dysfunction. A multimodal approach, including psychotherapeutic techniques, kinesiotherapy, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants, is recommended for chronic pain. The authors give their own experience with drug treatment of 51 patients (36 women and 15 men; mean age, 56.4±2.1 years) with SIJ dysfunction, by using periarticular blockages with local anesthetics and glucocorticoids or radiofrequency SIJ denervation. They note the efficiency of using Airtal® as a NSAID and Mydocalm® as a muscle relaxant.
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Bhardwaj, Madhvi, Rajiv Ahluwalia, and Tina Chugh. "Temporomandibular joint disorders’ diagnosis." Santosh University Journal of Health Sciences 9, no. 2 (2023): 196–99. http://dx.doi.org/10.4103/sujhs.sujhs_50_23.
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ABSTRACT Temporomandibular disorders (TMD) encompass a range of musculoskeletal conditions characterized by pain and dysfunction in the temporomandibular joint and masticatory muscles. The symptoms may include limited or asymmetrical jaw movement, joint noises, and various painful and nonpainful conditions such as headaches, tinnitus, depression, and sleep disturbances. The Diagnostic Criteria for TMD offer a systematic approach to examine the masticatory structures, as well as assess psychosocial and comorbid factors in patients. Through physical examination, more accurate diagnoses can be made, including myalgia, arthralgia, disc displacement disorders, degenerative joint disease, subluxation, and headaches associated with TMD. Timely diagnosis and management, facilitated by care pathways, can significantly benefit TMD patients, leading to improved prognosis, enhanced quality of life, and reduced healthcare expenses.
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Jaiswal, Dhananjay Kumar. "Article on Osteoarthritis." Journal of Orthopedics & Bone Disorders 7, no. 3 (2023): 1–8. http://dx.doi.org/10.23880/jobd-16000245.
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Osteoarthritis, a prevalent and debilitating joint disorder, gradually erodes cartilage—the protective cushion between bones—leading to pain, stiffness, and reduced joint mobility, primarily in weight-bearing joints. While age, genetics, and joint injuries are key contributors, the symptoms, starting with minor discomfort, escalate to pronounced pain and limited movement. Timely diagnosis, involving patient history, exams, and imaging, is vital. Treatment entails pain management, physical therapy, lifestyle adjustments, and, in extreme cases, joint replacement surgery. Ongoing research offers hope for improved therapies, emphasizing early intervention and holistic approaches for enhanced joint health. This article delves into the depths of osteoarthritis, unraveling its underlying mechanisms i.e. pathophysiology, risk factors, diagnostic approaches, and management strategies including latest advancement
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Stack, John David, and Jessica Harley. "Diagnosis and treatment of sacroiliac joint region pain in horses." UK-Vet Equine 5, no. 4 (2021): 150–57. http://dx.doi.org/10.12968/ukve.2021.5.4.150.
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The sacroiliac joint and pain deriving from this complex region remains poorly understood in horses, although our understanding grows as the body of literature grows. A deeper understanding can be derived from the richer body of literature in human sacroiliac joint pain as the disease processes and biomechanics appear similar in both species. A highly specific and sensitive diagnostic test for this condition does not exist, so equine clinicians have to make presumptive diagnosis based on presenting signs, findings of clinical examination, diagnostic imaging and the response to blocking of the sacroiliac joint region. Many horses with sacroiliac joint region pain have concurrent orthopaedic injury or disease. Treatment is largely based on fundamentals, anecdotal evidence and translation of non-surgical techniques used in humans. Treatment for other orthopaedic conditions can conflict with rehabilitation for sacroiliac joint region pain, necessitating compromise.
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Xia, Minwei, Peng Ao, Bin Zhang, Yongjun Liao, and Huixue Zhao. "Automatic Diagnosis of Elbow Arthritis Based on Edge Algorithm." Journal of Sensors 2022 (October 11, 2022): 1–8. http://dx.doi.org/10.1155/2022/2199262.
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Osteoarthritis is an age-related degenerative joint disease; it is mainly because the cartilage tissue between bones is worn and thinned, which leads to the damage of the periosteum and bone including the surrounding ligaments. Clinically, its manifestations are mainly joint pain, swelling, stiffness, and even partial loss of function, which seriously affects the quality of life of patients. The main clinical manifestations are elbow joint pain and limited movement. Elbow articular cartilage degenerates and falls off, and the more serious manifestation is subchondral hyperosteogeny and sclerosis, which leads to unsmooth articular surface and narrow joint space. Finally, elbow joint pain is severe with different degrees of mobility disorder, elbow joint extension and flexion range is getting smaller and smaller, and elbow joint pain is getting more and more serious. In this paper, the segmentation of left and right elbow images is completed based on gray projection through the analysis of image gray distribution. After obtaining the region of interest of elbow joint, the extraction algorithm of elbow joint hard bone edge is studied. Firstly, the extraction of elbow joint hard bone contour edge is completed based on active shape model algorithm combined with image characteristics. Finally, according to the extraction results of hard bone contour edge, this paper realizes the automatic diagnosis of multiple elbow arthritis indexes and compares with the results given by the image set, which proves that the whole algorithm has good adaptability and accuracy.
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Kang, Kyu Bok, Jae Hee Lee, and Jung-Ro Yoon. "Patellofemoral joint disorders." Journal of the Korean Medical Association 66, no. 8 (2023): 464–69. http://dx.doi.org/10.5124/jkma.2023.66.8.464.
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Background: Patellofemoral joint problems refer to a spectrum of conditions affecting the patellofemoral joint, which is the joint between the patella and femur. These conditions can cause pain and instability in the knee and affect an individual’s ability to perform daily activities. Patellofemoral joint problems commonly cause knee pain, particularly among young athletes and physically active individuals. This review article discusses current patellofemoral joint problems, including their epidemiology, pathophysiology, diagnosis, and management.Current Concepts: Patellofemoral joint problems are presented as clinical symptoms of pain and instability. Dividing the diagnostic criteria into anterior knee pain, patella instability, and patellofemoral arthritis is useful. Anterior knee pain is diagnosed after excluding possible causes. Patellar instability is classified into recurrent dislocation, habitual dislocation (extension and flexion types), and permanent dislocation. Moreover, patellar instability can progress to the final stage of patellofemoral arthritis. Thus, patellar instability should be treated according to the Dejour criterion, and patellofemoral arthritis treatment requires artificial joint replacement surgery.Discussion and Conclusion: The pathological mechanism of patellofemoral joint problems still needs to be properly established, and multifactorial causes make it difficult to treat patellofemoral joint problems. Accurate diagnosis is considered an essential factor for successful treatment.
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Mulyadi, Nabila, Dara Febriana, and Sarini Vivi Yanti. "Pengaruh pemberian kompres hangat jahe untuk mengurangi nyeri sendi pada lansia di Gampong Neusu Aceh, Kecamatan Baiturrahman, Kota Banda Aceh (The effect of warm ginger compresses to reduce joint pain in the elderly in Neusu Aceh Village, Baiturrahman District, Banda Aceh City)." Buletin Pengabdian Bulletin of Community Services 3, no. 2 (2023): 46–51. http://dx.doi.org/10.24815/bulpengmas.v3i2.33196.
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Pain in joint movement can be caused by various causes, one of them is associated with increasing age. Joint pain in the elderly is considered to be the result of various pathological processes, one of which can cause pain in the elderly is disturbances that occur in the joint cartilage matrix. In general, this joint pain makes sufferers feel uncomfortable when the joints are touched, swelling, inflammation, stiffness and limited movement are seen. The purpose of this activity is to report the results of nursing care for the elderly with joint pain in Neusu Aceh Village, Baiturrahman District, Banda Aceh City. The nursing diagnosis that appears in this case is chronic pain. The implementation provided includes non-pharmacological pain management using red ginger warm compresses to reduce the pain scale in client. Based on the evaluation of the implementation that has been carried out to client, there was an increase in knowledge about ginger warm compress therapy for joint pain, a decrease in the pain scale from 5 numerical rating scale (NRS) to 3 NRS, and pain in both knees was reduced. It is suggested to the village head and elderly health cadres in Neusu Aceh Village to increase the knowledge of the elderly regarding joint pain through the elderly Posyandu activities.
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Rimmalapudi, Varun Kumar, and Sanjeev Kumar. "Lumbar Radiofrequency Rhizotomy in Patients with Chronic Low Back Pain Increases the Diagnosis of Sacroiliac Joint Dysfunction in Subsequent Follow-Up Visits." Pain Research and Management 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/4830142.
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Chronic back pain is often a result of coexisting pathologies; secondary causes of pain can become more apparent sources of pain once the primary pathology has been addressed. The objective of our study was to determine if there is an increase in diagnosis of Sacroiliac joint pain following a Lumbar Rhizotomy. A list of patients who underwent Lumbar Radiofrequency during a 6-month period in our clinic was generated. Records from subsequent clinic visits were reviewed to determine if a new diagnosis of SI joint pathology was made. In patients who underwent a recent Lumbar Rhizotomy procedure to treat facetogenic pain, the prevalence of Sacroiliac joint pain increased to 70%. We infer that there is a significant increase in the diagnosis of Sacroiliac joint syndrome following a Lumbar Rhizotomy, potentially due to unmasking of a preexisting condition. In patients presenting with persistent back pain after Lumbar Rhizotomy, the clinician must have a high degree of suspicion for latent Sacroiliac joint pain prior to attributing the pain to block failure. It would be prudent to use >80% relief of pain after a diagnostic medial branch block as a diagnostic criterion for facetogenic pain rather than the currently accepted >50% in order to minimize unmasking of preexisting subclinical pain from the SI joint.
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Agafonova, E. M., M. V. Aristova, M. S. Eliseev, O. V. Zheliabina, Sh Erdes, and A. V. Smirnov. "Sacroiliitis in gout: Difficulties of diagnosis." Rheumatology Science and Practice 61, no. 6 (2024): 763–68. http://dx.doi.org/10.47360/1995-4484-2023-763-768.
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Gout is the most common chronic autoinflammatory disease, the development of which is associated with persistent hyperuricemia caused by both environmental and genetic factors, which leads to the deposition of sodium monourate crystals in various tissues and organs of the human body. Gout is more common in men than in women of childbearing age, due to the uricosuric effect of estrogen, however, after menopause, the incidence of gout in women increases significantly. At the onset of the disease, the first metatarsophalangeal joint, ankle and knee joints are most often involved in the pathological process. However, there are isolated reports in the literature about a rare gout lesion of the axial skeleton, for example, the sacroiliac joint, in which the nature of the pain syndrome, magnetic resonance imaging, and X-ray picture can mimic spondyloarthritis. The article presents a rare case of damage to the axial skeleton in a 57-year-old patient with gout, manifested by acute inflammatory back pain and arthritis of the lower extremities.
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International, Journal of Medical Science and Advanced Clinical Research (IJMACR). "Pigmented Villonodular Synovitis of The Knee Joint: Diagnosis, Management and Summary of Tenosynovial Giant Cell Tumors: A Rare Case Report." International Journal of Medical Science and Advanced Clinical Research (IJMACR) 8, no. 1 (2025): 168–75. https://doi.org/10.5281/zenodo.15228434.
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<strong>Abstract</strong> <strong>Introduction: </strong>Pigmented villonodular synovitis (PVNS) is a rare, benign, but potentially locally aggressive and recurrent condition characterized by synovial proliferation and hemosiderin deposition inside the joints, tendon sheaths, and bursae. It usually affects the large joints such as hip, knee, and ankle. Localised pigmented villonodular synovitis {PVNS} of the knee is rare diagnosis, with clinical signs and symptoms mimicking meniscal damage or other common knee injuries. <strong>Case Presentation:</strong> We report a case of PVNS of the knee joint in a 39-year-old female which was treated by arthroscopic subtotal synovectomy as a first stage surgery after which patient was planned for total synovectomy and postoperative radiotherapy. This case highlights the clinical presentation of this rare disorder and emphasizes its consideration as a differential diagnosis in our setup when dealing with non-traumatic persistent knee pain and swelling. <strong>Conclusion:</strong> Pigmented villonodular synovitis demonstrates a locally destructive process but is rarely fatal. PVNS is primarily a disease of quality of life as it can lead to difficulty with activities of daily living and an overall decrease in quality of life. The clinical presentation of one case found in our region is described. Patients usually present with insidious onset joint swelling associated with pain that mimics joint effusion. Joint pain subsequently supervenes, but the swelling is disproportionate to the degree of pain. The pain is mild and of insidious onset, and it progressively worsens and frequently is accompanied by decreased range of motion and sometimes locking of the joint. We recommend that PVNS should be included as a differential diagnosis when evaluating a young adult with non-traumatic persistent knee pain and swelling
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Fruth, Stacie J. "Differential Diagnosis and Treatment in a Patient With Posterior Upper Thoracic Pain." Physical Therapy 86, no. 2 (2006): 254–68. http://dx.doi.org/10.1093/ptj/86.2.254.
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Background and Purpose. Determining the source of a patient's pain in the upper thoracic region can be difficult. Costovertebral (CV) and costotransverse (CT) joint hypomobility and active trigger points (TrPs) are possible sources of upper thoracic pain. This case report describes the clinical decision-making process for a patient with posterior upper thoracic pain. Case Description. The patient had a 4-month history of pain; limited cervical, trunk, and shoulder active range of motion; limited and painful mobility of the right CV /CT joints of ribs 3 through 6; and periscapular TrPs. Interventions included CV / CT joint mobilizations, TrP release, and flexibility and postural exercises. Outcomes. The patient reported intermittent mild discomfort after 7 physical therapy sessions. Examination findings were normal, and he was able to resume all preinjury activities. Discussion. This case suggests that CV /CT mobilizations and active TrP release may have been beneficial in reducing pain and restoring function in this patient. [Fruth SJ. Differential diagnosis and treatment in a patient with posterior upper thoracic pain. Phys Ther. 2006;86:254-268.]
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Tibor, Lisa M., and Jon K. Sekiya. "Differential Diagnosis of Pain Around the Hip Joint." Arthroscopy: The Journal of Arthroscopic & Related Surgery 24, no. 12 (2008): 1407–21. http://dx.doi.org/10.1016/j.arthro.2008.06.019.
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Yamamoto, Michiro, Shukuki Koh, Masahiro Tatebe, et al. "ARTHROSCOPIC VISUALISATION OF THE DISTAL RADIOULNAR JOINT." Hand Surgery 13, no. 03 (2008): 133–38. http://dx.doi.org/10.1142/s0218810408003979.
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The diagnosis of chronic wrist pain is challenging and wrist arthroscopy has been recognised as the "gold standard". The present study investigated the efficacy of adding distal radioulnar joint (DRUJ) arthroscopy to routine wrist arthroscopy. The records of 67 patients who underwent DRUJ arthroscopy were reviewed, and the success rates for visualisation of intra-articular structures were determined. Pathological findings were correlated with ulnar-side wrist pain. In seven patients, pre-operative diagnoses were altered after DRUJ arthroscopy. The ulnar head and proximal surface of the triangular fibrocartilage complex (TFCC) were visualised in 100% and 99% of patients, respectively, while the foveal insertion of TFCC and sigmoid notch were visualised in 57% and 69%, respectively. Pathological findings of the proximal surface of TFCC tended to relate to ulnar wrist pain (p = 0.06). DRUJ arthroscopy should be included in routine wrist arthroscopy to enhance the accuracy of diagnosis.
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Dolgushina, A. I., G. M. Khusainova, O. B. Nesmeyanova, N. V. Kirsh, O. V. Solovieva, and E. A. Bogdanova. "Diagnostic Algorithm for Joint Pain in Patients with Inflammatory Bowel Disorders." Russian Journal of Gastroenterology, Hepatology, Coloproctology 31, no. 5 (2022): 51–60. http://dx.doi.org/10.22416/1382-4376-2021-31-5-51-60.
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Aim. An algorithm development for joint pain differential diagnosis in patients with inflammatory bowel disorders (IBD) and its validation in clinical practice.Materials and methods. A total of 349 IBD patients hospitalised for gastroenterological complaints at the Chelyabinsk Regional Clinical Hospital during 2017–2020 have been examined.Results. Upon survey, 97 (27.8%) IBD patients complained of joint pain. Ulcerative colitis (UC) predominated (79 patients; 81.4%), Crohn’s disease (CD) had a 18.6% incidence. In survey, 27% UC and 32.1% CD patients reported joint pain (p = 0.26). Among IBD patients, 52.6% had mechanical, and 47.4% — inflammatory pain. The inflammatory back pain (IBP) rate in survey cohort was 23.7%. Use of a diagnostic algorithm allowed concomitant rheumatic disease detection in 7 (7.2%) patients from the IBD–joint pain cohort: 2 patients were diagnosed with psoriatic spondyloarthritis, 2 — rheumatoid arthritis, 1 — gout and 2 — with ankylosing spondylitis. IBD-associated arthritis was diagnosed in 41 (42.3%) cases, osteoarthritis — in 38 (39.2%) IBD patients with joint pain, arthralgia with no objective inflammation, impaired joint function or lesions in X-ray and/or ultrasound — in 13 (13.4%) patients.Conclusion. Joint pain complaints are common in IBD patients and require a multispecialty rheumatologists-involving approach to proceed with differential diagnosis and opting for treatment tactics. A clinically verified algorithm coupled with laboratory tests and instrumental imaging facilitates diagnosis and optimal therapy selection in IBD patients with complaints of joint pain.
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S Al-Risi, Maimouna, Yasser AR Selim, Arwa A Al Isaii, and Noura A A lmatroushi. "Lumbar spine facet joint septic arthritis: Two case reports." International Journal of Case Reports and Images 16, no. 1 (2025): 5–9. https://doi.org/10.5348/101489z01ma2025cs.
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Introduction: Septic arthritis of the facet joint (SAFJ) is a rare spine condition. Commonly seen in older immune-compromised patients presented with acute back pain, it needs early diagnosis and intervention. Case Series: We report two cases presented to the emergency as acute onset low back pain with fever and high inflammatory markers. In both cases, patients were admitted and diagnosed with septic arthritis of the facet joint and associated epidural abscess. In the first case, blood cultures were sent to support the diagnosis, while in the second case ultrasound-guided aspiration was done. In both cases, cultures were positive for Methicillin-resistant Staphylococcus aureus (MRSA) and diagnosis confirmed with magnetic resonance imaging (MRI) findings. Both patients were treated with intravenous antibiotics and improved clinically. Conclusion: This case shows the importance of thinking about septic arthritis in the facet joint in older patients who present with sudden onset back pain associated with high inflammatory markers if other differentials are excluded. Magnetic resonance imaging is considered the imaging modality of choice in the diagnosis. As well, early diagnosis and management play an important role to prevent complications.
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Zakrzewska, Joanna M., and Troels S. Jensen. "History of facial pain diagnosis." Cephalalgia 37, no. 7 (2017): 604–8. http://dx.doi.org/10.1177/0333102417691045.
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Premise Facial pain refers to a heterogeneous group of clinically and etiologically different conditions with the common clinical feature of pain in the facial area. Among these conditions, trigeminal neuralgia (TN), persistent idiopathic facial pain, temporomandibular joint pain, and trigeminal autonomic cephalalgias (TAC) are the most well described conditions. Conclusion TN has been known for centuries, and is recognised by its characteristic and almost pathognomonic clinical features. The other facial pain conditions are less well defined, and over the years there has been confusion about their classification.
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Manchikanti, Laxmaiah. "Influence of Psychological Variables on the Diagnosis of Facet Joint Involvement in Chronic Spinal Pain." Pain Physician 2;11, no. 3;2 (2008): 145–60. http://dx.doi.org/10.36076/ppj.2008/11/145.
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Background: Facet or zygapophysial joint pain is one of the common conditions responsible for chronic spinal pain. Controlled diagnostic blocks are considered the only means of reliable diagnosis of facet joint pain, due to the inability of physical examination, clinical symptoms, radiologic evaluation, and nerve conduction studies to provide a reliable diagnosis. The prevalence of facet joint pain has been established to be 15% to 45% of patients with low back pain, 39% to 67% of patients with neck pain, and 34% to 48% of patients with thoracic pain. However, using only a single block, false-positive rates of 27% to 63% in the cervical spine, 42% to 58% in the thoracic spine, and 17% to 50% in the lumbar spine have been reported. While there are multiple reasons for false-positive results, psychological variables may also contribute to false-positive results. A lack of influence of psychological factors on the validity of controlled diagnostic local anesthetic blocks of lumbar facet joints has been demonstrated. However, no such studies have been performed in the thoracic or cervical spine. Objective: To study the influence of psychopathology (depression, generalized anxiety disorder, and somatization individually or in combinations of multiple psychopathologic conditions) on the ability of controlled, comparative local anesthetic blocks to accurately identify facet joint pain and false-positive rates with a single block. Methods: Four hundred thirty-eight patients undergoing controlled, comparative local anesthetic blocks were included in the study. Patients were allocated based on their psychological profiles — each diagnostic group or combination was divided into distinct categories. Primary groups consisted of patients with major depression, generalized anxiety disorder, and somatization disorder. Combination groups consisted of 4 categories based on multiple combinations. All the patients were treated with controlled, comparative local anesthetic blocks either with 1% lidocaine or 1% lidocaine and 0.25% bupivacaine. A positive response was defined as at least an 80% reduction in pain and the ability to perform previously painful movements with appropriate relief with 2 separate local anesthetics. Results: The prevalence of facet joint pain in chronic spinal pain ranged from 25% to 40% in patients without psychopathology, whereas it ranged from 28% to 43% in patients with a positive diagnosis of major depression, generalized anxiety disorder, and somatization disorder, respectively, compared to 23% to 39% in patients with a negative diagnosis. Regional facet joint pain prevalence and false-positive rates were higher in the cervical region in patients with major depression. In the lumbar and thoracic regions, no significant differences were noted. Conclusion: This study demonstrated that, based on patient psychopathology, there were no significant differences among the patients either in terms of prevalence or false-positive rates in the lumbar and thoracic regions. A higher prevalence and lower false-positive rates in the cervical region were established in patients with major depression. Key words: Zygapophysial joint pain, facet joint pain, prevalence, false-positive rate, controlled comparative local anesthetic blocks, major depression, generalized anxiety disorder, somatization disorder
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Atluri, Sairam. "Systematic Review of Diagnostic Utility and Therapeutic Effectiveness of Thoracic Facet Joint Interventions." October 2008 5;11, no. 10;5 (2008): 611–29. http://dx.doi.org/10.36076/ppj.2008/11/611.
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Background: Chronic mid back and upper back pain caused by thoracic facet joints has been reported in 34% to 48% of the patients based on the responses to controlled diagnostic blocks. Systematic reviews have established moderate evidence for controlled comparative local anesthetic blocks of thoracic facet joints in the diagnosis of mid back and upper back pain, moderate evidence for therapeutic thoracic medial branch blocks, and limited evidence for radiofrequency neurotomy of therapeutic facet joint nerves. Objectives: To determine the clinical utility of diagnostic and therapeutic thoracic facet joint interventions in diagnosing and managing chronic upper back and mid back pain. Study Design: Systematic review of diagnostic and therapeutic thoracic facet joint interventions. Methods: Review of the literature for utility of facet joint interventions in diagnosing and managing facet joint pain was performed according to the Agency for Healthcare Research and Quality (AHRQ) criteria for diagnostic studies and observational studies and the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials. The level of evidence was classified as Level I, II, or III based on the quality of evidence developed by United States Preventive Services Task Force (USPSTF) for therapeutic interventions. Recommendations were based on the criteria developed by Guyatt et al. Data sources included relevant literature of the English language identified through searches of Medline and EMBASE from 1966 to July 2008 and manual searches of bibliographies of known primary and review articles. Results of the analysis were performed for diagnostic and therapeutic interventions separately. Outcome Measures: For diagnostic interventions, studies must have been performed utilizing controlled local anesthetic blocks. For therapeutic interventions, the primary outcome measure was pain relief (short-term relief = up to 6 months and long-term relief > 6 months) with secondary outcome measures of improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: Based on the controlled comparative local anesthetic blocks, the evidence for the diagnosis of thoracic facet joint pain is Level I or II-1. The evidence for therapeutic thoracic medial branch blocks is Level I or II-1. The recommendation is IA or 1B/strong for diagnostic and therapeutic medial branch blocks. Conclusion: The evidence for the diagnosis of thoracic facet joint pain with controlled comparative local anesthetic blocks is Level I or II-1. The evidence for therapeutic facet joint interventions is Level I or II-1 for medial branch blocks. Recommendation is 1A or 1B/strong for diagnostic and therapeutic medial branch blocks. Key words: Chronic thoracic pain, mid back or upper back pain, thoracic facet or zygapophysial joint pain, facet joint nerve blocks, medial branch blocks, controlled comparative local anesthetic blocks, therapeutic thoracic medial branch blocks, thoracic radiofrequency neurotomy, thoracic intraarticular facet joint injections
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Malla, Irfan Ahmad, Sehrish Manzoor, Zubair ul Islam Ganie, and Maajid Mohi Ud Din Malik. "Evaluation of the Efficiency and Effectiveness of MRI in the Diagnosis of Chronic Shoulder Pain." Indian Journal Of Science And Technology 17, no. 12 (2024): 1117–28. http://dx.doi.org/10.17485/ijst/v17i12.202.
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Objective: This study aimed to evaluate MRI efficiency in diagnosing chronic shoulder pain causes. Chronic shoulder pain accounts for 5% of musculoskeletal consultations. Method: Thirty-four chronic shoulder pain patients (18-65 years) underwent shoulder MRI. Sequences included T1-weighted, T2-weighted, proton density, and STIR for comprehensive analysis. All patients were clinically diagnosed with chronic shoulder pain prior to imaging. Finding: One patient (1.96%) had normal MRI findings. Thirty-three patients (98.04%) had abnormalities. Rotator cuff injuries were most prevalent, especially partial supraspinatus tears (18.63%). Other findings included bursitis, joint effusion, AC arthropathy, Hill Sachs deformity, AC joint impingement, rotator cuff fatty atrophy, and biceps tendinopathy. Conclusion: MRI provided excellent visualization of soft tissue pathologies causing chronic shoulder pain, noninvasively without ionizing radiation. Combining MRI sequences accurately diagnosed various shoulder conditions. Fat suppression sequences were key for identifying rotator cuff tears. MRI is the gold standard for diagnosing rotator cuff injuries, the most common chronic shoulder pain cause. Novelty: This study demonstrates MRI's utility for evaluating chronic shoulder pain causes. While no single sequence visualizes all shoulder pathologies, using T1-weighted, T2-weighted, proton density, and STIR sequences together provides a comprehensive analysis to guide appropriate patient treatment. Keywords MRI, Chronic shoulder pain, Rotator cuff, Joint effusion, frozen shoulder
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Manchikanti, Laxmaiah. "Making Sense of the Accuracy of Diagnostic Lumbar Facet Joint Nerve Blocks: An Assessment of the Implications of 50% Relief, 80% Relief, Single Block, or Controlled Diagnostic Blocks." Pain Physician 2;13, no. 1;2 (2010): 133–43. http://dx.doi.org/10.36076/ppj.2010/13/133.
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Background: The presence of lumbar facet joint pain has been overwhelmingly supported and the accuracy of controlled diagnostic blocks has been demonstrated in multiple studies and confirmed in systematic reviews. However, controversy surrounds the following related issues: placebo control, the amount of relief (50% versus 80%), single block versus double block, and placebo or comparative control. Study Design: An observational report of an outcome study to establish the diagnostic accuracy of controlled lumbar facet joint nerve blocks. Setting: An interventional pain management practice setting in the United States. Objective: To determine the accuracy of controlled diagnostic blocks in managing lumbar facet joint pain at the end of 2 years, with 2 different criteria (50% or 80% relief) and single block versus double block. Methods: A previous study of 152 patients showed an 89.5% of sustained diagnosis of lumbar facet joint pain at the end of a 2-year follow-up period when the diagnosis was made with double blocks and at least 80% relief. The present evaluation includes comparison of the above results with a study of 110 patients undergoing lumbar facet joint nerve blocks with positive criteria of at least 50% relief and follow-up of 2 years. The inclusion criteria in both studies was based on a positive response to diagnostic controlled comparative local anesthetic lumbar facet joint blocks, with either 50% or 80% relief and the ability to perform previously painful movements. The treatment in both groups included therapeutic lumbar facet joint interventions either with facet joint nerve blocks or radiofrequency neurotomy. Outcome Measures: The sustained diagnosis of lumbar facet joint pain at the end of one year and 2 years based on pain relief and functional status improvement. Results: At the end of one year, the diagnosis was confirmed in 75% of the group with 50% relief, whereas it was 93% in the group with 80% relief. At the end of the 2-year follow-up, the diagnosis of lumbar facet joint pain was sustained in 51% of the patients in the group with 50% relief, whereas it was sustained in 89.5% of the patients with 80% relief. The results differed between 50% relief and 80% relief with prevalence of 61% facet joint pain with dual blocks with 50% relief, and 31% with dual blocks with 80% relief; whereas with only a single block, the prevalence was 73% with 50% relief and 53% in the 80% relief group. Limitations: The study is limited by its observational nature. Conclusion: Controlled diagnostic lumbar facet joint nerve blocks are valid utilizing the criteria of 80% pain relief and the ability to perform previously painful movements, with a sustained diagnosis of lumbar facet joint pain in at least 89.5% of the patients at the end of a 2-year follow-up. In contrast, the diagnosis was sustained in 51% of the patients with 50% relief at the end of 2 years. Thus, inappropriate diagnostic criteria will increase the prevalence of facet joint pain substantially, leading to inappropriate and unnecessary treatment. Key words: Chronic low back pain, lumbar facet or zygapophysial joint pain, facet joint nerve or medial branch blocks, controlled local anesthetic blocks, construct validity, diagnostic studies, diagnostic accuracy
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Simopoulos, Thomas T. "A Systematic Evaluation of Prevalence and Diagnostic Accuracy of Sacroiliac Joint Interventions." Pain Physician 3;15, no. 3;5 (2012): E305—E344. http://dx.doi.org/10.36076/ppj.2012/15/e305.
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Background: The contributions of the sacroiliac joint to low back and lower extremity pain have been a subject of considerable debate and research. It is generally accepted that 10% to 25% of patients with persistent mechanical low back pain below L5 have pain secondary to sacroiliac joint pathology. However, no single historical, physical exam, or radiological feature can definitively establish a diagnosis of sacroiliac joint pain. Based on present knowledge, a proper diagnosis can only be made using controlled diagnostic blocks. The diagnosis and treatment of sacroiliac joint pain continue to be characterized by wide variability and a paucity of the literature. Objective: To evaluate the accuracy of diagnostic sacroiliac joint interventions. Study Design: A systematic review of diagnostic sacroiliac joint interventions. Methods: Methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, or limited (or poor) based on the quality of evidence developed by the United States Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to December 2011, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: In this evaluation we utilized controlled local anesthetic blocks using at least 50% pain relief as the reference standard. Results: The evidence is good for the diagnosis of sacroiliac joint pain utilizing controlled comparative local anesthetic blocks. The prevalence of sacroiliac joint pain is estimated to range between 10% and 62% based on the setting; however, the majority of analyzed studies suggest a point prevalence of around 25%, with a false-positive rate for uncontrolled blocks of approximately 20%. The evidence for provocative testing to diagnose sacroiliac joint pain was fair. The evidence for the diagnostic accuracy of imaging is limited. Limitations: The limitations of this systematic review include a paucity of literature, variations in technique, and variable criterion standards for the diagnosis of sacroiliac joint pain. Conclusions: Based on this systematic review, the evidence for the diagnostic accuracy of sacroiliac joint injections is good, the evidence for provocation maneuvers is fair, and evidence for imaging is limited. Key words: Chronic low back pain, sacroiliac joint pain, sacroiliitis, sacroiliac joint injection, sacroiliac joint dysfunction, provocation manuevers, controlled diagnostic blocks, intraarticular injection, extraarticular injection.
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Manchikanti, Laxmaiah. "Comprehensive Evidence-Based Guidelines for Facet Joint Interventions in the Management of Chronic Spinal Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines." Pain Physician 3S;23, no. 5;3S (2020): S1—S127. http://dx.doi.org/10.36076/ppj.2020/23/s1.
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Background: Chronic axial spinal pain is one of the major causes of significant disability and health care costs, with facet joints as one of the proven causes of pain. Objective: To provide evidence-based guidance in performing diagnostic and therapeutic facet joint interventions. Methods: The methodology utilized included the development of objectives and key questions with utilization of trustworthy standards. The literature pertaining to all aspects of facet joint interventions, was reviewed, with a best evidence synthesis of available literature and utilizing grading for recommendations. Summary of Evidence and Recommendations: Non-interventional diagnosis: • The level of evidence is II in selecting patients for facet joint nerve blocks at least 3 months after onset and failure of conservative management, with strong strength of recommendation for physical examination and clinical assessment. • The level of evidence is IV for accurate diagnosis of facet joint pain with physical examination based on symptoms and signs, with weak strength of recommendation. Imaging: • The level of evidence is I with strong strength of recommendation, for mandatory fluoroscopic or computed tomography (CT) guidance for all facet joint interventions. • The level of evidence is III with weak strength of recommendation for single photon emission computed tomography (SPECT) . • The level of evidence is V with weak strength of recommendation for scintography, magnetic resonance imaging (MRI), and computed tomography (CT) . Interventional Diagnosis: Lumbar Spine: • The level of evidence is I to II with moderate to strong strength of recommendation for lumbar diagnostic facet joint nerve blocks. • Ten relevant diagnostic accuracy studies with 4 of 10 studies utilizing controlled comparative local anesthetics with concordant pain relief criterion standard of ≥ 80% were included. • The prevalence rates ranged from 27% to 40% with false-positive rates of 27% to 47%, with ≥ 80% pain relief.Limitations: The limitations of these guidelines include a paucity of high-quality studies in the majority of aspects of diagnosis and therapy. Conclusions: These facet joint interventions guidelines were prepared with a comprehensive review of the literature with methodologic quality assessment with determination of level of evidence and strength of recommendations Key words: Chronic spinal pain, interventional techniques, diagnostic blocks, therapeutic interventions, facet joint nerve blocks, intraarticular injections, radiofrequency neurolysis
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Hansen, Hans C. "Sacroiliac Joint Interventions: A Systematic Review." Pain Physician 1;10, no. 1;1 (2007): 165–84. http://dx.doi.org/10.36076/ppj.2007/10/165.
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Background: The sacroiliac joint is a diarthrodial synovial joint with abundant innervation and capability of being a source of low back pain and referred pain in the lower extremity. There are no definite historical, physical, or radiological features to provide definite diagnosis of sacroiliac joint pain, although many authors have advocated provocational maneuvers to suggest sacroiliac joint as a pain generator. An accurate diagnosis is made by controlled sacroiliac joint diagnostic blocks. The sacroiliac joint has been shown to be a source of pain in 10% to 27% of suspected cases with chronic low back pain utilizing controlled comparative local anesthetic blocks. Intraarticular injections, and radiofrequency neurotomy have been described as therapeutic measures. This systematic review was performed to assess diagnostic testing (non-invasive versus interventional diagnostic techniques) and to evaluate the clinical usefulness of interventional techniques in the management of chronic sacroiliac joint pain. Objective: To evaluate and update the available evidence regarding diagnostic and therapeutic sacroiliac joint interventions in the management of sacroiliac joint pain. Study Design: A systematic review using the criteria as outlined by the Agency for Healthcare Research and Quality (AHRQ), Cochrane Review Group Criteria for therapeutic interventions and AHRQ, and Quality Assessment for Diagnostic Accuracy Studies (QUADAS) for diagnostic studies. Methods: The databases of EMBASE and MEDLINE (1966 to December 2006), and Cochrane Reviews were searched. The searches included systematic reviews, narrative reviews, prospective and retrospective studies, and cross-references from articles reviewed. The search strategy included sacroiliac joint pain and dysfunction, sacroiliac joint injections, interventions, and radiofrequency. Results: The results of this systematic evaluation revealed that for diagnostic purposes, there is moderate evidence showing the accuracy of comparative, controlled local anesthetic blocks. Prevalence of sacroiliac joint pain is estimated to range between 10% and 27% using a double block paradigm. The false-positive rate of single, uncontrolled, sacroiliac joint injections is around 20%. The evidence for provocative testing to diagnose sacroiliac joint pain is limited. For therapeutic purposes, intraarticular sacroiliac joint injections with steroid and radiofrequency neurotomy were evaluated. Based on this review, there is limited evidence for short-term and longterm relief with intraarticular sacroiliac joint injections and radiofrequency thermoneurolysis. Conclusions: The evidence for the specificity and validity of diagnostic sacroiliac joint injections is moderate. The evidence for accuracy of provocative maneuvers in diagnosis of sacroiliac joint pain is limited. The evidence for therapeutic intraarticular sacroiliac joint injections is limited. The evidence for radiofrequency neurotomy in managing chronic sacroiliac joint pain is limited. Keywords: Low back pain, sacroiliac joint pain, axial pain, spinal pain, diagnostic block, sacroiliac joint injection, thermal radiofrequency, and pulsed radiofrequency
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Yarikov, Anton V., Anton V. Morev, Мaxim V. Shpagin, and Aleksandr P. Fryerman. "Sacroiliac joint syndrome: aetiology, clinical presentation, diagnosis and management." Annals of Clinical and Experimental Neurology 13, no. 2 (2019): 60–68. https://doi.org/10.25692/acen.2019.2.7.
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Sacroiliac joint (SIJ) syndrome is a relevant disorder to study because of the high prevalence of back pain conditions in people of working age. SIJ syndrome is a cause of pain in 1530% of people with chronic pain in the lower lumbar spine. This review describes the anatomical structure of the SIJ and the aetiological factors that can lead to its dysfunction. Pathogenetic links in the development of this condition are identified separately. The issue of differential diagnosis with other vertebrogenic pain syndromes is considered in detail, and diagnostic tests are presented. The main current approaches to treating SIJ syndrome are described. Interventional methods for treating SIJ dysfunction are described in detail, including radiofrequency neuroablation as an alternative to conservative management.
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Rutkowski, Wojciech, Adam Salwa, Natalia Gajdzińska, et al. "From Aches to Answers: Understanding and Managing Hip Joint Issues in Kids." Quality in Sport 24 (October 10, 2024): 54776. http://dx.doi.org/10.12775/qs.2024.24.54776.
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Introduction: Joint pain is a prevalent concern among pediatricians, orthopedists, and general practitioners, affecting up to 50% of children during childhood. The hip joint is particularly vulnerable, with degenerative diseases of the hip joints (DDHJ) being the leading cause of pediatric orthopedic visits. Various conditions, such as developmental dysplasia of the hip (DDH), Legg-Calve-Perthes Disease (LCPD), and slipped capital femoral epiphysis (SCFE), contribute to the spectrum of hip joint disorders in children. Material and methods: We have gathered the available materials and scientific reports, analyzing and summarizing them in a single study. Aim of study: This study aims to explore the etiology, diagnosis, and management of hip joint pain in children, focusing on DDH, LCPD, SCFE, and other related conditions. By examining the risk factors, clinical presentations, and current treatment strategies, the study seeks to enhance the understanding and early detection of these disorders, ultimately improving patient outcomes. Conclusion: Hip joint pain in children encompasses a broad differential diagnosis, ranging from self-limiting conditions like transient synovitis to serious disorders such as septic arthritis and JIA. Early identification and appropriate management of conditions like DDH, LCPD, and SCFE are crucial in preventing long-term complications. While physical activity is generally safe, intense exercise may increase the risk of musculoskeletal pain. A multidisciplinary approach, supported by further research, is essential for effective pain management and treatment optimization in pediatric patients.
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Wójcicki, Jakub, Maciej Rozwadowski, Natasza Czajkowska, and Marcin Jaskólski. "Synovial osteochondromatosis of temporomandibular joint: Diagnosis and management." Balkan Journal of Dental Medicine 27, no. 2 (2023): 124–27. http://dx.doi.org/10.5937/bjdm2302124w.
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Introduction: Synovial osteochondromatosis is a rare disease related to pathological changes involving joints' synovium. In 60% it concerns knee joint. In temporomandibular joint this diagnosis has been recorded in only few international medical centres. Case report: In the study, a case of 31 years old woman who reported to the Maxillofacial Surgery Ward of 10th Military Research Hospital and Policlynic in Bydgoszcz, is presented. Main symptoms were tumor in the left temporomandibular joint area occuring for past 7 years, followed by swelling and pain. In the process of diagnostics and treatment multiple radiological imaging were involved. Also a surgical procedure was performed which included open revision and articular cavity lavage of the left temporomandibular joint. Conclusions: Treatment results, short-term, long-term observation and retrospecitve analysis show the way and dynamics of described condition development, benefits from surgical intervention as well as risk of recurrence.
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Mourya, Vandana, Mukesh Prasad Kushwaha, Dambar Sah, Shashi Shekhar Prasad Shah, and Kaushal Kishor Singh. "Role of Ultrasonography in The Diagnosis of Knee Joint Lesions." Med Phoenix 8, no. 1 (2023): 33–37. http://dx.doi.org/10.3126/medphoenix.v8i1.53622.
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Introduction: Ultrasound can provide clinically useful information on a wide range of pathologic conditions affecting components of the knee joint, including the tendons, ligaments, muscles, synovial space, articular cartilage, nerves and surrounding soft tissues. The advantages of ultrasound include low cost, portability, real-time assessment, and facilitated side-by-side comparisons. The aim of the study was to study the various pathological conditions of painful knee joint by using ultrasound for early diagnosis and prompt therapeutic approach and to evaluate the osteoarthritic changes in the painful knee joint by ultrasound. Materials and Methods: This is a prospective observational study conducted in the Department of Radiology and Orthopedics& trauma surgery, National Medical College & teaching hospital, Birgunj, Parsa, Nepal for the 6 months duration, patients presented with knee joint pathology including swelling, and pain.Patients included in this study was above 20 years with unilateral (single) knee joint pain. With ethical clearance from the Institutional Review Committee of National Medical College and after obtaining the informed consent of the patient, prospective observational study was conducted. All ultrasound assessments were performed using the same machine with a 9 MHz linear transducer of GE Logiq P7 USG machine. A30–45-degree flexion of the knees was standardized by using the same wedge for all ultrasound assessments. Results: This study included 40 symptomatic patients with knee joints pain included in this study. In 40 patients 19 were females (47.5%) and 21 males (52.5%), with ages ranged from 20 to 70 years. Ultrasound findings showed joint effusions in 25 (62.5 %) as most common finding in painful knees,synovial thickening in 17 (42.5 %) knees, Synovitis in 14 (35.0%) and tendinopathy seen in only 1 (2.5%) knee joint pain. Osteoarthritis such as narrow joint space in 4 (10%) knees, marginal osteophytes in 4 (10%) knees, loose bodies in 3 (7.5%) knees, Baker’s cyst in 1 (2.5%) knee. Most common involved age group is 51-60 years with 17 cases followed by 41-50 years in 11 cases. Conclusion: Ultrasound is a simple and reproducible technique for the assessment of knee joint effusion, synovial changes and osteoarthritis related changes.
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Khadke, Dr Neha, Dr Abhijit Shinde, Dr Sunil Natha Mhaske, and Dr Suresh Waydande. "An Approach to Joint Pain in Paediatric Patients: A Comprehensive Review." VIMS Health Science Journal 11, no. 4 (2025): 20–26. https://doi.org/10.46858/vimshsj.110404.
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Joint pain in paediatric patients is a common but diagnostically challenging issue, with causes ranging from benign self-limiting conditions to serious diseases that may result in long-term disability. This review addresses a structured diagnostic approach to joint pain in children, covering infectious, inflammatory, traumatic, and neoplastic causes. Key diagnoses include septic arthritis, juvenile idiopathic arthritis (JIA), Lyme arthritis, and malignancies such as leukaemia and osteosarcoma. A detailed history and physical examination are essential for identifying underlying conditions, distinguishing benign causes from emergencies. Infectious causes require urgent consideration, especially septic arthritis, which risks rapid joint destruction. Inflammatory conditions like JIA are common chronic arthritides in children and need timely referral for rheumatologic assessment. Malignancies and traumatic causes also warrant careful attention to avoid delayed diagnosis. Laboratory investigations—including complete blood counts, inflammatory markers (ESR and CRP), and autoantibodies (ANA and RF)—help support diagnoses. Imaging studies, particularly radiography, ultrasound, and MRI, are pivotal for assessing trauma, inflammation, and marrow involvement. Targeted approaches for specific conditions, such as joint aspiration in septic arthritis and serological testing for Lyme arthritis, are discussed. Advances in biomarkers, imaging, and biologic therapies—especially TNF inhibitors and interleukin blockers—are highlighted as emerging tools in diagnosing and managing paediatric joint pain, offering promising avenues for early diagnosis and personalised care.
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Muhammad Iswanto Sabirin, Eri Hendra Jubhari, and Ian Afifah Sudarman. "Pain and limitations of mouth opening: a case report." Makassar Dental Journal 11, no. 2 (2022): 225–28. http://dx.doi.org/10.35856/mdj.v11i2.601.
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Temporomandibular joint disorders (TMD) do not always indicate a problem in the joints but also involve all disorders related to the function of the masticatorysystem. One of the common signs of TMD is pain and limitations of mouth opening. When a pa-tient has a joint disorder and a masticatory muscle disordersimultaneously and the primary diagnosis cannot be determined, it is generally agreed to treat the masticatory muscle disorder as the primary diagnosis. Thereforethe initial treatment is directed to-wards the muscular symptoms. If symptoms do not decrease, further therapy is required for the joint disorder. This article re-ports on muscles therapy and the use of occlusal splints to rehabilitate pain and limitations of mouth opening. A 16-year-old female came to ProsthodonticDepartment RSGM Unhas, with complaints of pain when opening and closing her mouth. The pain and sound of crack on the right side of the face were felt for a few minutes since 2 months ago. The patient chews fre-quently in the left region because of caries and pain in the maxillary right molar since 2 months ago.Tooth 36 was extracted about 1 year ago due to residual roots. It was concluded that muscles therapy and occlusal splints are effectively overcome the limitations of mouth opening and reduce pain in the jaw joint.
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Eskay-Auerbach, Marjorie, and James B. Talmage. "Sacroiliac Joint Pain: Clinical and Impairment Rating Issues." Guides Newsletter 19, no. 6 (2014): 3–7. http://dx.doi.org/10.1001/amaguidesnewsletters.2014.novdec01.
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Abstract The sacroiliac joint (SIJ) is an accepted source of pain in patients with ankylosing spondylitis and other spondyloarthropathies, osteoarthritis, infections, and tumors, but the occurrence of isolated SIJ pain in the absence of such diseases is controversial. The term, sacroiliac joint dysfunction, which is used widely, describes pain from an SIJ that has no identifiable lesion but is presumed to have some mechanical etiology. Practitioners currently have no universally accepted gold standard for identifying a disc, facet joint, of SIJ as the pain generator. Treatment options for SIJ pain include medications, physical therapy, bracing, manual therapy, injections, radiofrequency neurotomy, and arthrodesis. Optimal management of patients with SIJ pain remains controversial. In the AMA Guides, Sixth Edition, a clinically established and causally related diagnosis of SIJ dysfunction is rated using the first row in Table 17-4. Surgery does not change the diagnosis or rating: The SIJ is not a motion segment of the lumbar spine, and SIJ fusion is not an alteration of motion segment integrity. Clinically, pain presumed to be from SIJ dysfunction is low back pain, so if this is the clinical diagnosis, the spine chapter in the AMA Guides, Fifth Edition, should be used. In such cases, the first step is to determine whether to use the diagnosis-related estimate or the range-of-motion method, and the article provides guidance about situations in which the use of each is appropriate.
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Jang, Sunhee, Kijun Lee, and Ji Hyeon Ju. "Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee." International Journal of Molecular Sciences 22, no. 5 (2021): 2619. http://dx.doi.org/10.3390/ijms22052619.
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Osteoarthritis (OA) is a degenerative and chronic joint disease characterized by clinical symptoms and distortion of joint tissues. It primarily damages joint cartilage, causing pain, swelling, and stiffness around the joint. It is the major cause of disability and pain. The prevalence of OA is expected to increase gradually with the aging population and increasing prevalence of obesity. Many potential therapeutic advances have been made in recent years due to the improved understanding of the underlying mechanisms, diagnosis, and management of OA. Embryonic stem cells and induced pluripotent stem cells differentiate into chondrocytes or mesenchymal stem cells (MSCs) and can be used as a source of injectable treatments in the OA joint cavity. MSCs are known to be the most studied cell therapy products in cell-based OA therapy owing to their ability to differentiate into chondrocytes and their immunomodulatory properties. They have the potential to improve cartilage recovery and ultimately restore healthy joints. However, despite currently available therapies and advances in research, unfulfilled medical needs persist for OA treatment. In this review, we focused on the contents of non-cellular and cellular therapies for OA, and briefly summarized the results of clinical trials for cell-based OA therapy to lay a solid application basis for clinical research.
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Goss, Alastair N., Bernard Speculand, and Evan Hallet. "Diagnosis of temporomandibular joint pain in patients seen at a pain clinic." Journal of Oral and Maxillofacial Surgery 43, no. 2 (1985): 110–14. http://dx.doi.org/10.1016/0278-2391(85)90057-6.
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Boluk Senlikci, Huma, and Selin Ozen. "Sacroiliac Joint Dysfunction Treated Using Neural Therapy to the Temporomandibular Joint: A Case Report." Complementary Medicine Research 28, no. 4 (2021): 379–81. http://dx.doi.org/10.1159/000513131.
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Temporomandibular joint disorders (TMJD) include temporomandibular joint dysfunction and bruxism. Sacroiliac joint dysfunction (SJD) is a frequent cause of non-discogenic low back pain. Studies suggest a relationship between TMJD and SJD; however, the link remains unclear. Neural therapy (NT) utilises local anaesthetic injections to treat pain by normalising a dysfunctional autonomic nervous system held responsible for initiating or propagating chronic pain. A 31-year-old female presented with a 1-year history of mechanical left-sided low back pain and sleep bruxism. Examination revealed crepitation of the left TMJ and a trigger point in the masseter muscle. Range of motion of the spine and hip joints were normal, Patrick and Geanslen tests were positive on the left side. Spine and standing flexion tests were also positive. Magnetic resonance imaging of the lumbar spine and sacroiliac joints were normal. A diagnosis of SJD was made, and the patient was treated using NT. Injections of lidocaine 0.5% to the left TMJ, the masseter muscle and intradermal segmental injections at the level of C<sub>4</sub> were administered. The patient’s back pain and TMJ tenderness reduced and continued so throughout the 3-month follow-up period. SJD may be related to TMJD, and NT may be used in its treatment.