Imagen de la columna en pacientes con cáncer
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Imaging of the spine in patients with malignancy.
MacVicar D.
Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK. david.macvicar@rmh.nhs.uk
Cancer Imaging. 2006 Oct 31;6:S22-6.
Abstract
This contribution presents an approach to the diagnosis of symptoms referable to spinal pathology in patients with known malignancy. Pain and neurological disturbance are distressing and disabling symptoms, which in patients with cancer may be a result of bony metastases, paraspinal soft tissue disease and meningeal and intra-axial spinal metastases. Imaging studies are pivotal, and typical and atypical imaging features are presented.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805056/pdf/ci060022.pdf
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| Inyección de la articulación facetaria guiada por imagen |
Image-guided facet joint injection
Peh WCG
National University of Singapore, Singapore
Peh Biomed Imaging Interv J 2011; 7(1):e4
ABSTRACT
Chronic spine pain poses a peculiar diagnostic and therapeutic challenge due to multiple pain sources, overlapping clinical features and nonspecific radiological findings. Facet joint injection is an interventional pain management tool for facet-related spinal pain that can be effectively administered by a radiologist. This technique is the gold standard for identifying facet joints as the source of spinal pain. The major indications for facet injections include strong clinical suspicion of the facet syndrome, focal tenderness over the facet joints, low back pain with normal radiological findings, post-laminectomy syndrome with no evidence of arachnoiditis or recurrent disc disease, and persistent low back pain after spinal fusion. The contraindications are more ancillary, with none being absolute. Like any synovial joint degeneration, inflammation and injury can lead to pain on motion, initiating a vicious cycle of physical deconditioning, irritation of facet innervations and muscle spasm. Image-guided injection of local anesthetic and steroid into or around the facet joint aims to break this vicious cycle and thereby provide pain relief. This outpatient procedure has high diagnostic accuracy, safety and reproducibility but the therapeutic outcome is variable.
Keywords: Facet syndrome, intra-articular facet injection, imaging-guided injections, interventional spinal procedures, low back pain, spinal pain.
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| Imagen de la columna cervical dolorosa |
Imaging of the painful cervical spine
Chevrot A, Drapé JL, Godefroy D, Dupont AM.
Service de Radiologie B, CHU Cochin, 27 rue Faubourg Saint Jacques, 75679 PARIS cedex 14. alian.chevrot@cch.ap-hop-paris.fr
J Radiol. 2003 Feb;84(2 Pt 2):181-239.
Abstract
Neck pain can occur in several circumstances: traumatic, spontaneous, associated or not with motion, with or without head or upper limb irradiations. Each case requires appropriate clinical examination and radiographs. CT and MRI can be used to obtain additional information. Myelography and arteriography are exceptionally used. Cervical discography and facet joint arthrography are used therapeutically. After a brief anatomical review, normal and pathological patterns will be reviewed using radiographs. Each circumstance is studied: traumatic, degenerative, inflammatory and tumoral. It is emphasized that discogenic cervico-brachial neuralgia usually has a favorable spontaneous outcome. A special chapter is dedicated to calcifying and ossifying diseases of the cervical spine. Cervico-occipital neuralgia is also discussed.http://www.em-consulte.com/showarticlefile/121485/pdf_48903.pdf
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| Uso de técnicas guiadas por imagen para el dolor lumbar bajo |
Using image-guided techniques for chronic low back pain.
Boyajian SS.
Advanced Pain Consultants, PA, 805 Cooper Rd, Suite 2, Voorhees, NJ 08043-3814, USA. sboyajian@comcast.net
J Am Osteopath Assoc. 2007 Nov;107(10 Suppl 6):ES3-9.
Abstract
Image-guided spine intervention is used primarily for its precise diagnostic capabilities. This article reviews basic principles of the more common image-guided diagnostic techniques specifically as they relate to patients with low back pain. It also includes discussion of advanced modes of therapy, including spinal cord stimulation and intrathecal therapy, providing primary care physicians with an understanding of the primary indications for these therapeutic modalities. Two illustrative case presentations have been added to "refresh" this article, which was originally published in a supplement to the September 2005 issue of the JAOA and to further enhance primary care physicians' understanding of spinal intervention.http://www.jaoa.org/cgi/reprint/107/suppl_6/ES3
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