Andreea E Stroiescu, Judita Laurinkiene, Kenneth Courtney, Heather K Moriarty, Ian P Kelly, Anthony G Ryan
{"title":"在超声和透视引导下抽吸治疗症状性贝克氏囊肿,然后治疗性注射Depomedrone和Bupivacaine,可使大多数患者的疼痛症状持久减轻;个案系列及文献回顾。","authors":"Andreea E Stroiescu, Judita Laurinkiene, Kenneth Courtney, Heather K Moriarty, Ian P Kelly, Anthony G Ryan","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of ultrasound and fluoroscopic-guided aspiration and therapeutic injection of Baker's cysts in the relief of pain and pressure symptoms.</p><p><strong>Methods: </strong>A retrospective, observational, single-arm study of consecutive patients referred from the Orthopaedic service for image-guided aspiration followed by therapeutic injection of symptomatic Baker's cysts was performed with institutional approval in the context of a Quality Improvement project. Patients' pain was graded using a 10-point Likert scale. Under standard sterile conditions, a 10 cm 5 Fr Yueh centesis needle was advanced into the cyst under direct ultrasound guidance, septae disrupted as necessary, the contents of the cyst aspirated, and a sample sent for microbiological analysis. Bursography was performed in an attempt to identify the expected communication with the knee joint, the contrast was aspirated and 40 mg of DepoMedrone and 5 ml of Bupivacaine were injected.</p><p><strong>Results: </strong>Thirteen patients were referred, nine of whom satisfied the inclusion criteria (all female, average age 63.8 years). Over a 35-month period, 11 procedures were performed (bilateral in 1, repeated in another) yielding an average volume of 20.1 ml (range 10 - 50 mls). In 2/11 procedures the communication with the knee joint was outlined. The average follow up post-procedure was 8.3 months. The average patient's pain score reduced to zero from 5.7 for an average period of 5.96 months. After this period patients reported a gradual return of an ache, but none returned to the pre-procedure severity which, in some cases, had prevented them from sleeping.</p><p><strong>Conclusion: </strong>Aspiration of symptomatic Baker's cysts under Ultrasound and fluoroscopic guidance followed by therapeutic injection of DepoMedrone and Bupivacaine leads to a durable reduction in pain symptoms in a majority of patients.</p>","PeriodicalId":38815,"journal":{"name":"Ulster Medical Journal","volume":"92 1","pages":"24-28"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/1a/umj-92-01-24.PMC9899033.pdf","citationCount":"0","resultStr":"{\"title\":\"Management of symptomatic Baker's cysts with ultrasound and fluoroscopic-guided aspiration followed by therapeutic injection with Depomedrone and Bupivacaine leads to a durable reduction in pain symptoms in a majority of patients; A case series and literature review.\",\"authors\":\"Andreea E Stroiescu, Judita Laurinkiene, Kenneth Courtney, Heather K Moriarty, Ian P Kelly, Anthony G Ryan\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the efficacy of ultrasound and fluoroscopic-guided aspiration and therapeutic injection of Baker's cysts in the relief of pain and pressure symptoms.</p><p><strong>Methods: </strong>A retrospective, observational, single-arm study of consecutive patients referred from the Orthopaedic service for image-guided aspiration followed by therapeutic injection of symptomatic Baker's cysts was performed with institutional approval in the context of a Quality Improvement project. Patients' pain was graded using a 10-point Likert scale. Under standard sterile conditions, a 10 cm 5 Fr Yueh centesis needle was advanced into the cyst under direct ultrasound guidance, septae disrupted as necessary, the contents of the cyst aspirated, and a sample sent for microbiological analysis. Bursography was performed in an attempt to identify the expected communication with the knee joint, the contrast was aspirated and 40 mg of DepoMedrone and 5 ml of Bupivacaine were injected.</p><p><strong>Results: </strong>Thirteen patients were referred, nine of whom satisfied the inclusion criteria (all female, average age 63.8 years). Over a 35-month period, 11 procedures were performed (bilateral in 1, repeated in another) yielding an average volume of 20.1 ml (range 10 - 50 mls). In 2/11 procedures the communication with the knee joint was outlined. The average follow up post-procedure was 8.3 months. The average patient's pain score reduced to zero from 5.7 for an average period of 5.96 months. After this period patients reported a gradual return of an ache, but none returned to the pre-procedure severity which, in some cases, had prevented them from sleeping.</p><p><strong>Conclusion: </strong>Aspiration of symptomatic Baker's cysts under Ultrasound and fluoroscopic guidance followed by therapeutic injection of DepoMedrone and Bupivacaine leads to a durable reduction in pain symptoms in a majority of patients.</p>\",\"PeriodicalId\":38815,\"journal\":{\"name\":\"Ulster Medical Journal\",\"volume\":\"92 1\",\"pages\":\"24-28\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/1a/umj-92-01-24.PMC9899033.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ulster Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ulster Medical Journal","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Management of symptomatic Baker's cysts with ultrasound and fluoroscopic-guided aspiration followed by therapeutic injection with Depomedrone and Bupivacaine leads to a durable reduction in pain symptoms in a majority of patients; A case series and literature review.
Purpose: To evaluate the efficacy of ultrasound and fluoroscopic-guided aspiration and therapeutic injection of Baker's cysts in the relief of pain and pressure symptoms.
Methods: A retrospective, observational, single-arm study of consecutive patients referred from the Orthopaedic service for image-guided aspiration followed by therapeutic injection of symptomatic Baker's cysts was performed with institutional approval in the context of a Quality Improvement project. Patients' pain was graded using a 10-point Likert scale. Under standard sterile conditions, a 10 cm 5 Fr Yueh centesis needle was advanced into the cyst under direct ultrasound guidance, septae disrupted as necessary, the contents of the cyst aspirated, and a sample sent for microbiological analysis. Bursography was performed in an attempt to identify the expected communication with the knee joint, the contrast was aspirated and 40 mg of DepoMedrone and 5 ml of Bupivacaine were injected.
Results: Thirteen patients were referred, nine of whom satisfied the inclusion criteria (all female, average age 63.8 years). Over a 35-month period, 11 procedures were performed (bilateral in 1, repeated in another) yielding an average volume of 20.1 ml (range 10 - 50 mls). In 2/11 procedures the communication with the knee joint was outlined. The average follow up post-procedure was 8.3 months. The average patient's pain score reduced to zero from 5.7 for an average period of 5.96 months. After this period patients reported a gradual return of an ache, but none returned to the pre-procedure severity which, in some cases, had prevented them from sleeping.
Conclusion: Aspiration of symptomatic Baker's cysts under Ultrasound and fluoroscopic guidance followed by therapeutic injection of DepoMedrone and Bupivacaine leads to a durable reduction in pain symptoms in a majority of patients.