Efficacy of ultrasound-guided steroid injections for pain management of midfoot joint degenerative disease

• Published in: Skeletal radiology 2011-08, Vol.40 (8), p.1001-1006
• Main Authors: Drakonaki, Eleni E., Kho, James S. B., Sharp, Robert J., Ostlere, Simon J.
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - therapeutic use; Aged; Aged, 80 and over; Biological and medical sciences; Bupivacaine; Care and treatment; Diseases of the osteoarticular system; Female; Foot Diseases - diagnostic imaging; Foot Diseases - drug therapy; Humans; Imaging; Injections, Intra-Articular; Investigative techniques, diagnostic techniques (general aspects); Joints; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Nuclear Medicine; Orthopedics; Osteoarthritis; Osteoarthritis - diagnostic imaging; Osteoarthritis - drug therapy; Osteoarticular system. Muscles; Pain; Pain - drug therapy; Pain Measurement; Pathology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiography; Radiology; Retrospective Studies; Scientific Article; Steroid hormones; Treatment Outcome; Ultrasonography, Interventional; Ultrasound
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-010-1094-y

Objective To examine the efficacy of ultrasound (US)-guided injections for midfoot joint degenerative changes. Materials and methods The US images and radiographs of 63 patients with midfoot joint degenerative changes were retrospectively reviewed. In those patients who had US-guided intra-articular steroid injection, the response to the injection was recorded by reviewing the 2-week pain diaries and clinical notes. Partial or complete pain relief was defined as a positive response and the same or increased level of pain as a negative response to the injection. Results Fifty-nine (59/63, 93.6%) patients with midfoot joint degenerative changes received US-guided injection. The majority of patients had a positive response up to 3 months post-injection (78.4% still experiencing pain relief at 2 weeks, 57.5% at 3 months and fewer than 15% of patients further than 3 months post-injection). The number of positive therapeutic responses did not differ significantly between patients with diagnostic and non-diagnostic response ( p  = 0.2636). Conclusions US-guided intra-articular injections for midfoot degenerative changes can have a good therapeutic result in the majority of patients up to 3 months post-injection. Therapeutic response cannot be predicted by a positive diagnostic response.