Utility of Radionuclide Bone Scintigraphy in Complex Regional Pain Syndrome

AbstractPurpose of ReviewTo describe the current understanding of the role of three-phase bone scintigraphy (TPBS) in the diagnosis and management of complex regional pain syndrome (CRPS), discuss its advantages and limitations, and present three examples of TPBS patterns typically seen in CRPS patients.Recent FindingsCRPS is a debilitating disorder frequently presenting with pain to ordinarily non-painful stimuli, redness, swelling, following fractures, stroke, myocardial infarction, surgery, or even minor trauma, and its diagnosis, based on clinical criteria and supportive imaging findings, is difficult. Of the available adjunctive diagnostic imaging modalities, radionuclide bone scintigraphy using a TPBS protocol is the most sensitive and specific for detecting abnormalities commonly seen with this condition —classically, increased periarticular uptake on delayed phase of TPBS, with variable increased uptake on perfusion phases, depending on chronicity. Recent studies have (1) demonstrated a more heterogeneous correlation of TPBS findings with CRPS diagnosis using the current Budapest criteria than in studies using older criteria, (2) pointed to the utility of novel quantitative scintigraphic techniques, and (3) highlighted the value of the early perfusion phases of TPBS in predicting treatment response.SummaryTPBS remains a valuable imaging adjunct to clinical diagnosis of CRPS. In combination with a multi-modal analgesic approach, TPBS can be used to follow disease...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research

Related Links:

Objectives: Use of alcohol or benzodiazepines with opioid pain-relievers increases risk of overdose and overdose death. A substantial proportion of adults receives an opioid prescription each year, and a number of these adults also use benzodiazepin...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
OBJECTIVES: Knowledge regarding delirium prevention in patients with acute brain injury remains limited. We tested the hypothesis that an intervention bundle which targeted sedation, sleep, pain, and mobilisation would reduce delirium in patients with acut...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
So I inherited a patient on actiq and fentanyl patch for>6 years. She states its the only thing that works. I told her Actiq is usually only for cancer pain and she showed me the REMS registration that says it can be used for non cancer pain. I am still planning on telling her to find another provider because I don't feel comfortable having patients on that. Is that unreasonable of me? She has been taking the medication safely for many years but I simply do not feel comfortable with... Actiq for chronic pain
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Degenerative spondylolisthesis with or without spondylolysis, multiply recurrent disk herniation, and degenerative disk disease commonly presents as back and leg pain, weakness and paresthesias. Surgical intervention, to include lumbar decompression with instrumented fusion with or without interbody fusion, is recommended to patients who are refractory to at least six weeks of nonoperative treatment, or patients with severe or progressive neurological deficits. This paper reviews the pre- and post-operative considerations, as well as the surgical technique, for a minimally invasive transforaminal lumbar interbody fusion fo...
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Surgical Technique Source Type: research
Conclusions: HRQOL metrics can accurately predict patient satisfaction with symptoms at 3 months, 2 years, and 4 years after surgical intervention for a lumbar disk herniation. Absolute outcome scores were somewhat more predictive than change scores.
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
Conclusions: Paraspinal muscles evaluated with MRI were more significantly associated with the pathology of ASD compared with appendicular skeletal muscle evaluations with dual-energy x-ray absorptiometry. The present study indicates that multifidus and erector muscles significantly influenced the maintenance of the pelvic alignment. Level of Evidence: Level III.
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Primary Research Source Type: research
where is everyone getting their news as it related to pain medicine? is it a website or journal ? professional organization? SDN echo chamber? I have been using painmedicinenews.com which isn't terrible.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
ConclusionIndividuals did not report an increase in knee pain, stiffness or disability in their ACL ‐deficient knee. Only disability was associated with worsening severity of radiographic OA in ACL‐deficient knees.
Source: International Journal of Rheumatic Diseases - Category: Rheumatology Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionsIn contrast to the well ‐established association between black race and knee or hip OA, odds of hand OA are lower in black versus nonblack subjects, which is not mediated by known hand OA risk factors. Future mechanistic works are warranted to determine the mediating protective factors for hand OA among the black subject s.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: FULL LENGTH Source Type: research
Condition:   Epilepsy Intractable Intervention:   Other: Direct electrical stimulation Sponsors:   University of Pennsylvania;   National Institute of Neurological Disorders and Stroke (NINDS);   Columbia University;   Dartmouth College;   Emory University;   University of Freiburg;   Thomas Jefferson University;   University of Texas Southwestern Medical Center;   Natio nal Institute on Aging (NIA) Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
More News: Complex Regional Pain Syndrome | Headache | Heart Attack | Migraine | Orthopaedics | Pain | Pain Management | Perfusion | Stroke | Study