Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint ...Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.展开更多
BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simpl...BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.展开更多
目的:观察关节腔注射联合“经筋”手法治疗早中期冻结肩的临床疗效及安全性。方法:选择62例早中期冻结肩患者,按照治疗方法不同分为观察组和对照组,每组31例。对照组予以口服美洛昔康片,外用温性经筋通贴膏、经筋通凝胶剂,观察组予以关...目的:观察关节腔注射联合“经筋”手法治疗早中期冻结肩的临床疗效及安全性。方法:选择62例早中期冻结肩患者,按照治疗方法不同分为观察组和对照组,每组31例。对照组予以口服美洛昔康片,外用温性经筋通贴膏、经筋通凝胶剂,观察组予以关节腔注射联合“经筋”手法治疗,分别于治疗前后比较疼痛视觉模拟量表(visual analogue score,VAS)评分、肩痛和功能指数(shoulder pain and function index,SPADI)、Fugl-Meyer肩关节活动范围量表评分和Constant-Murley肩功能评分,并对临床疗效及不良反应进行评价。结果:治疗后,两组VAS、SPADI评分较治疗前降低(P<0.01),Fugl-Meyer及Constant-Murley评分均较治疗前降低(P<0.01);且观察组与对照组比较,差异有统计学意义(P<0.05);随着时间的变化,两组VAS及Fugl-Meyer评分无明显变化,但观察组SPADI及Constant-Murley评分在治疗后3个月时与治疗后1周时比较,差异有统计学意义(P<0.05)。观察组SPADI及Constant-Murley评分总有效率均高于对照组,但差异无统计学意义(P>0.05)。观察组不良事件发生率[22.6%(7/31)]低于对照组[45.2%(14/31)](P<0.05)。结论:关节腔注射联合“经筋”手法治疗早中期冻结肩疗效明显,安全性好。展开更多
Fifteen percent to forty percent of patients present with persistent disabling neck pain or radicular pain after cervical spine surgery. Persistent pain after cervical surgery is called cervical post-surgery syndrome(...Fifteen percent to forty percent of patients present with persistent disabling neck pain or radicular pain after cervical spine surgery. Persistent pain after cervical surgery is called cervical post-surgery syndrome(CPSS). This review investigates the literature about interventional pain therapy for these patients. Because different interventions with different anatomical targets exist, it is important to find the possible pain source. There has to be a distinction between radicular symptoms(radicular pain or radiculopathy) or axial pain(neck pain) and between persistent pain and a new onset of pain after surgery. In the case of radicular symptoms, inadequate decompression or nerve root adherence because of perineural scarring are possible pain causes. Multiple structures in the cervical spine are able to cause neck pain. Hereby, the type of surgery and also the number of segments treated is relevant. After fusion surgery, the so-called adjacent level syndrome is a possible pain source. After arthroplasty, the load of the facet joints in the index segment increases and can cause pain. Further, degenerative alterations progress. In general, two fundamentally different therapeutic approaches for interventional pain therapy for the cervical spine exist: Treatment of facet joint pain with radiofrequency denervation or facet nerve blocks, and epidural injections either via a transforaminal or via an interlaminar approach. The literature about interventions in CPSS is limited to single studies with a small number of patients. However, some evidence exists for these procedures. Interventional pain therapies are eligible as a target-specific therapy option. However, the risk of theses procedures(especially transforaminal epidural injections) must be weighed against the benefit.展开更多
文摘Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.
基金Supported by the Natural Science Foundation of Fujian Province,No.2021J01546the Innovation and Entrepreneurship Star Fund Project of Zhangzhou,No.ZCZZ[2019]17.
文摘BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.
文摘目的:观察关节腔注射联合“经筋”手法治疗早中期冻结肩的临床疗效及安全性。方法:选择62例早中期冻结肩患者,按照治疗方法不同分为观察组和对照组,每组31例。对照组予以口服美洛昔康片,外用温性经筋通贴膏、经筋通凝胶剂,观察组予以关节腔注射联合“经筋”手法治疗,分别于治疗前后比较疼痛视觉模拟量表(visual analogue score,VAS)评分、肩痛和功能指数(shoulder pain and function index,SPADI)、Fugl-Meyer肩关节活动范围量表评分和Constant-Murley肩功能评分,并对临床疗效及不良反应进行评价。结果:治疗后,两组VAS、SPADI评分较治疗前降低(P<0.01),Fugl-Meyer及Constant-Murley评分均较治疗前降低(P<0.01);且观察组与对照组比较,差异有统计学意义(P<0.05);随着时间的变化,两组VAS及Fugl-Meyer评分无明显变化,但观察组SPADI及Constant-Murley评分在治疗后3个月时与治疗后1周时比较,差异有统计学意义(P<0.05)。观察组SPADI及Constant-Murley评分总有效率均高于对照组,但差异无统计学意义(P>0.05)。观察组不良事件发生率[22.6%(7/31)]低于对照组[45.2%(14/31)](P<0.05)。结论:关节腔注射联合“经筋”手法治疗早中期冻结肩疗效明显,安全性好。
文摘Fifteen percent to forty percent of patients present with persistent disabling neck pain or radicular pain after cervical spine surgery. Persistent pain after cervical surgery is called cervical post-surgery syndrome(CPSS). This review investigates the literature about interventional pain therapy for these patients. Because different interventions with different anatomical targets exist, it is important to find the possible pain source. There has to be a distinction between radicular symptoms(radicular pain or radiculopathy) or axial pain(neck pain) and between persistent pain and a new onset of pain after surgery. In the case of radicular symptoms, inadequate decompression or nerve root adherence because of perineural scarring are possible pain causes. Multiple structures in the cervical spine are able to cause neck pain. Hereby, the type of surgery and also the number of segments treated is relevant. After fusion surgery, the so-called adjacent level syndrome is a possible pain source. After arthroplasty, the load of the facet joints in the index segment increases and can cause pain. Further, degenerative alterations progress. In general, two fundamentally different therapeutic approaches for interventional pain therapy for the cervical spine exist: Treatment of facet joint pain with radiofrequency denervation or facet nerve blocks, and epidural injections either via a transforaminal or via an interlaminar approach. The literature about interventions in CPSS is limited to single studies with a small number of patients. However, some evidence exists for these procedures. Interventional pain therapies are eligible as a target-specific therapy option. However, the risk of theses procedures(especially transforaminal epidural injections) must be weighed against the benefit.
