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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

MR imaging is the modality of choice for the detection, staging, and differential diagnosis of inflammatory disorders of the spine. Infectious spondylitis is characterized by the involvement of two adjacent vertebrae and the intervening disk with severe BME and early destruction of the end plates. The disk space is narrowed and typically exhibits water-equivalent signal intensity on T2-weighted or STIR images. Prevertebral and epidural extensions, abscess formation, enhancement of the BME, the disk space, and the surrounding granulation tissue are well demonstrated by gadolinium-enhanced images. Cervical spondylitis frequently involves more than one level. Bone marrow abnormalities may be subtle at this level and increased signal intensity of the disk space on T2-weighted or STIR images is an important finding. The risk for neurologic complications is increased. Granulomatous infections caused by tuberculosis, brucellosis, fungi, and parasites, including hydatid disease (Echinococcus), are frequently associated with imaging findings different from those seen with nonspecific bacterial infection. In patients with chronic infectious spondylitis, diffuse reactive bone marrow changes with decreased signal intensity on T1-weighted images, increased signal intensity on T2-weighted and STIR images, and increased uptake after gadolinium administration may occur. This phenomenon is probably caused by reactive bone marrow stimulation, simulating diffuse hematologic neoplastic disease. Erosive intervertebral osteochondrosis with bandlike disk gadolinium enhancement and BME, which is commonly associated with local pain, is the most important differential diagnosis of bacterial spondylitis.
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PMID:Imaging of spinal infection. 1122 3

Since 1996 we have gained experience in the development and clinical application of the OATS technique in 167 cases. Operative management, technical demands and early results of osteochondral cylindrical autograft plugs at the talus are presented. Between April 1996 and November 2000 we treated 39 patients (21 male, 18 female) with an average age of 28.4 years (range: 16-57 years) for osteochondral defects with an average size of 8 x 15 mm-20 x 15 mm at the medial (n = 31) and lateral (n = 6) talar dome as well as at the distal tibia (n = 2) with an OATS technique. Indications were osteochondral defects after trauma in 12 patients (med., n = 5; lat., n = 5; dist. tibia n = 2) and osteochondrosis dissecans (grades III and IV) in 27 patients (med., n = 26; lat., n = 1). The donor site was the proximal lateral femoral condyle in all patients. An additional osteotomy of the malleolus was necessary in 30 patients. All patients were scored pre- and postoperatively by a Lysholm Bruns score and monitored by postoperative MRI. The follow-up extended for an average of 19.6 months (6-42). The Lysholm score for all patients rose from 62 points (range: 20-77) up to 92 points (range: 63-100). There was no correlation between patients with and without an osteotomy of the malleolus. The postoperative MRI showed a complete incorporation and vitality of the transplanted cylinders as well as a congruence of the joint surface. Complications were pain in three cases in the region of the osteotomy, which decreased after removal of the screws, and synovialitis in one case. One patient reported femoropatellar pain for about 4 weeks. The OATS technique achieves encouraging results in limited osteochondral defects in the talar dome even in preoperated osteochondral defects. Because of the mostly posterior localization of the defect zone, osteotomy of the malleolus is necessary in most cases. Harvesting the donor cylinders from the ipsilateral knee joint by mini-arthrotomy shows a low mortality. The OATS technique is a suitable, causal and cost-effective therapy, which can possibly prevent and at least delay the development of an arthrosis.
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PMID:[Operative therapy of osteochondral lesions of the talus with autologous cartilage-bone transplantation]. 1122 53

The conducted dynamic rheovasographic investigations in 67 patients with neurological manifestations of lumbosacral osteochondrosis as well as determination of skin temperature in 162 patients, and employment of stimulation electromyography in 40 patients showed the presence of definite positive shifts (P < 0.001) both in patients with lumboischialgia and in those with the radicular pain syndrome, which fact was evidenced by the clinical data suggesting to us the feasibility of use of osteoperiostal electropuncture combined with laseropuncture with infrared radiation.
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PMID:[Changes in various neurophysiological indices in treatment of lumbosacral osteochondrosis by combined osteoperiostal electroacupuncture and laser puncture]. 1145 29

Physiotherapy with neuromuscular manual techniques was applied in programs of rehabilitation of IHD patients with reflex pain syndromes or associated osteochondrosis or early after surgery. Elimination of reflex pain syndromes in the above patients raises the treatment efficacy, improves functional state of the cardiorespiratory system.
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PMID:[Effectiveness of manual therapy in rehabilitating patients with ischemic heart disease]. 1153 Apr 6

Thirty five patients were examined. All had soft tissue spinal cord injury and were not treated in a hospital. Complete diagnostic and therapeutical protocol was carried out only for 13 patients. The goal was to compare their initial condition with condition after the control examination after the therapy. Results showed that 8 patients (23%) suffered from pain in the neck, 25 (72%) had limited neck mobility, and 17 (49%) manifested neurological symptoms. Signs of osteochondrosis at isolated spinal levels and dyscoligamental instability were noted in one fifth of the observed patients. In 24 patients (69%) the condition was defined as "serious". Although soft tissue spinal cord injuries are considered as "light" injuries, they can cause serious consequences that reduce the quality of patient's life due to inadequate treatment. From that point of view, a serious approach to diagnosis and treatment is necessary.
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PMID:[Soft tissue injuries of the neck]. 1192 3

The proposed system of non-pharmacological treatment has been tried in 325 pregnant women with pain syndrome associated with spinal lesions (osteochondrosis, scoliosis, malformations, sequela of compression vertebral fractures, spondylolisthesis). The treatment combined orthopedic aids, relaxing massage, muscular relaxation, mobilization of functional blocks of intervertebral joints and pelvic junctions, therapeutic exercises. The above non-pharmacological system relieved vertebral pain syndrome partially or completely in 82% of the treated pregnant women.
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PMID:[Complex treatment of vertebrogenic pain syndrome in women during pregnancy]. 1213 21

Sixty four osteochondrosis patients after neurosurgical correction of the compression syndrome were examined psychologically before and after the course of rehabilitation. It was established that considerable relief of pain in the course of physiotherapy was seen in patients who, before the treatment, had less severe impairment of the psychological status, no significant symptoms of hypochondria, anxiety, depression. Psychologically unfavourable predictors of low efficiency of physiotherapy were psychic tension, excitability, low stress resistance, pessimism, high anxiety, intrapersonality conflicts.
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PMID:[Psychological predictors of rehabilitation efficiency of patients with radiculopathy after neurosurgical correction of compression diskogenic syndrome]. 1253 91

132 patients suffering from spinal osteochondrosis with pain syndrome were examined for pain perception and psychological status. Pain intensity in such patients showed association with hypochondriac and anxiodepressive disorders combination with rigidity and development of fixations. Deterioration of life quality correlated with severity of pain syndrome and such features as unsatisfaction, tension, anxiety, rigidity, fixation of attention on personal feelings, pessimistic outlook, low stress resistance. Psychological characteristics and quality of life depended on gender and location of vertebrogenic pain syndrome.
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PMID:[Pain perception and psychological status of patients suffering from spinal osteochondrosis with pain syndrome]. 1259 4

Posttraumatic disorders of the ankle are a common cause of chronic pain. Magnetic resonance imaging (MRI) has proved to be highly useful in clarifying a wide spectrum of underlying lesions which frequently cannot be detected on radiographs. Even if the assessment of the lateral collateral ligaments of the ankle is not regarded as a primary indication for MRI, it allows the diagnosis of subchondral contusions or cysts, anterolateral impingement syndrome, sinus tarsi syndrome, osteochondral fractures and osteochondrosis dissecans of the talus (ODT),which may not be detected with other imaging modalities. A 42 year old female patient suffered from persisting non-specific pain following an inversion trauma 4 months previously. MRI enabled the detection of an ODT which was not diagnosed on plain radiographs and which was verified upon arthroscopy. A superficial cartilage defect, as shown arthroscopically,was not delineated using MRI. Our observations indicate that MRI may be useful in patients with unclear persisting pain following ankle trauma and that it may contribute to the early detection of lesions which require surgical intervention.
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PMID:[Visualization of radiographically occult osteochondrosis dissecans of the talus using MRI]. 1265 42

The potential for using external applied energy to rectify or ameliorate musculoskeletal disorders has been explored for decades. A shock wave is a pressure disturbance: tissue effect is cavitation, producing microtrauma or microfracture and haematoma formation, inducing, as to date is thought, increase in vascularization, increased soft callus and faster enchondral ossification. Anaesthesiological interest in this field is focused in non-union or delayed osseous union, joint stiffness or osteochondrosis and femoral head necrosis in adults. Actually, because of the pain associated with high energy extracorporeal shock wave therapy on bones, anaesthesia is necessary, but, since almost all patients have no complaint after treatment, there is no need of postoperative analgesia. Therefore, short duration anaesthetic techniques and agents should be preferred. Loco-regional anaesthesia or general anaesthesia are both suitable to the purpose. Fifty patients have been treated nowadays in our Institution with shock wave therapy needing anaesthesia. 18 patients (36%) received general anaesthesia. Since patient's stay in hospital was expected to be short, short duration agents have been used, avoiding those causing unpleasent side effects, first emesis. We used Propofol or Remifentanil by continuous infusion, titrated to maintain stable haemodynamics and an appropriate level of anaesthesia. The short duration of action of Propofol depends on its rapid elimination, whereas Remifentanil undergoes rapid biotransformation to minimally active metabolites. 32 patients (64%) received regional anaesthesia. We avoided long acting agents or high concentration drugs. Spinal blocks have been performed with 0.5% hyperbaric bupivacaine; brachial plexus blocks, sciatic-femoral blocks and an epidural block have been performed with 0.5-1% xylocaine or 1% mepivacaine. Shock Wave Therapy has been done during a 3-day hospital stay. With suitable anaesthesiological treatment and preparation, almost all patients could be treated as outpatients or with an overnight hospital stay.
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PMID:Anaesthesia for shock wave therapy in musculoskeletal disorders: a preliminary report. 1277 7


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