Ultrasound-guided injection of botulinum toxin A in the treatment of iliopsoas spasticity

Sconfienza, Luca Maria; Perrone, N.; Lacelli, Francesca; Lentino, Carmelo; Serafini, Giovanni

doi:10.1016/j.jus.2008.05.002

Cited by 12 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In these conditions US can be useful to guide needle placement of BTX-A injections [24]. Moreover, US provides information about muscle size and fibrosis (fibroadipose degeneration), factors that can be important in decision making.…”

Section: Discussionmentioning

confidence: 99%

Bedside ultrasonography of musculoskeletal complications in brain injured patients

Falsetti

Acciai

Carpinteri

et al. 2010

Journal of Ultrasound

View full text Add to dashboard Cite

KEYWORDSPower Doppler ultrasonography; Musculoskeletal pathology; Stroke; Acquired brain injury.Abstract Introduction: The aim of this study was to evaluate the role of bedside ultrasonography (US) in early diagnosis of musculoskeletal complications (MSC) of acquired brain injuries, to describe its incidence and US features in a neurorehabilitation setting. Materials and methods: All 163 patients admitted in tertiary-level neurorehabilitation unit with diagnosis of stroke or severe brain injury (SBI), with symptoms or signs of musculoskeletal pathology, underwent bedside US. Results: MSC were diagnosed in 51.5%. In 86.9% US clarified diagnosis and/or modified therapeutic approach. Shoulder pain was observed in 27.6%. US showed a shoulder subluxation in 73.3% and a frozen shoulder in 8.8% of painful shoulders. In all the cases rotator cuff abnormalities were noted. Wrist-hand syndrome was observed in 29.4%. US showed mild effusion in wrist joints and tendon sheaths and subcutaneous edema without significant vascularity.Neurogenic heterotopic ossification was observed in 1.8%. US demonstrated the "zone phenomenon" or heterogeneously hypoechoic mass with low resistance vessels within the lesions.Contractures and spasticity were observed in 18.4%. US allowed reliable guidance for Botulinum toxin A injection. Relapsing osteoarthritis and acute arthritis were diagnosed in 15.3% and 7.3% respectively. Patients with MSC had lower Functional Independence Measurement (FIM) and Katz index scores in discharge (p < 0.04 and p < 0.0294 respectively) and more length of hospital stay (p Z 0.0024). Discussion: Musculoskeletal pathology frequently complicates the course of acquired brain injuries and it delays functional recovery. Bedside US is a cheap and sensitive diagnostic tool and it can aid clinicians to define diagnosis and to choose therapeutic approach.Sommario Introduzione: Lo scopo di questo studio era quello di valutare il ruolo dell'ecografia (US) eseguita al letto del paziente nella diagnosi precoce delle complicazioni muscolo-scheletriche (MSC) delle cerebrolesioni acquisite, di descriverne incidenza e caratteristiche ecografiche, in una neuroriabilitazione. Materiali e metodi: Tutti i 163 pazienti ricoverati nella unità operativa di terzo livello di neuroriabilitazione con diagnosi di stroke o grave cerebrolesione acquisista (SBI), con sintomi o segni di patologia muscolo-scheletrica, furono sottoposti ad esame US. Risultati: MSC furono diagnosticate nel 51,5% dei pazienti. Nel 86,9% US ha chiarito la diagnosi e/o modificato l'approccio terapeutico. La spalla dolorosa fu rilevata nel 27,6%. US dimostrò una sublussazione di spalla nel 73,3% e una spalla congelata nel 8,8% delle spalle dolorose. In tutti i casi furono osservate alterazioni della cuffia dei rotatori. La sindrome polso-mano fu osservata nel 29,4%. US dimostrava modesto versamento nelle articolazioni e nelle guaine tendinee del polso con edema sottocutaneo senza significativa vascolarizzazione. Le ossificazioni eterotopiche neurogeniche furono osservat...

show abstract

Section: Discussionmentioning

confidence: 99%

Bedside ultrasonography of musculoskeletal complications in brain injured patients

Falsetti

Acciai

Carpinteri

et al. 2010

Journal of Ultrasound

View full text Add to dashboard Cite

show abstract

“…US-guided injection is of value in treating olecranon bursitis . 71 In cases of chronic elbow tendonopathies , US-guided PRP injection was within the tendon in all cases. 72 …”

Section: Interventional Imaging In Rheumatology (Iii-r)mentioning

confidence: 94%

The Emerging Era of Interventional Imaging in Rheumatology: An Overview During the Coronavirus Disease-2019 (COVID-19) Pandemic

Fottouh¹,

Hamdy²,

Ali³

et al. 2022

OARRR

View full text Add to dashboard Cite

Imaging has long been taking its place in the diagnosis, monitor, and prognosis of rheumatic diseases. It plays a vital role in the appraisal of treatment. Key progress in the clinical practice of rheumatology is the innovation of advanced imaging modalities; such as musculoskeletal ultrasound (MSUS), computerized tomography (CT) and magnetic resonance imaging (MRI). These modalities introduced a promising noninvasive method for visualizing bone and soft tissues to enable an improved diagnosis. The use of MSUS in rheumatology is considered a landmark in the evolution of the specialty and its ease of use and many applications in rheumatic diseases make it a forerunner instrument in the practice. The use of MSUS among rheumatologists must parallel the development rate of the excellence revealed in the specialty. Moreover, innovative interventional imaging in rheumatology (III-R) is gaining fame and key roles in the near future for a comprehensive management of rheumatic diseases with precision. This review article throws light on the emergence of these robust innovations that may reshape the guidelines and practice in rheumatology, in particular, efforts to enhance best practice during the coronavirus disease 2019 (COVID-19) pandemic are endorsed.

show abstract

“…This leads to a subsequent blockade of neurotransmission and flaccid paralysis of the muscle [4][5][6]. An in-depth knowledge of anatomy and manual skills are a prerequisite for successful implementation of intramuscular BoNT injections, which can be particularly challenging in certain anatomical regions [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

A Bayesian Network Meta-Analysis and Systematic Review of Guidance Techniques in Botulinum Toxin Injections and Their Hierarchy in the Treatment of Limb Spasticity

Asimakidou

Sidiropoulos

2023

Toxins

View full text Add to dashboard Cite

Accurate targeting of overactive muscles is fundamental for successful botulinum neurotoxin (BoNT) injections in the treatment of spasticity. The necessity of instrumented guidance and the superiority of one or more guidance techniques are ambiguous. Here, we sought to investigate if guided BoNT injections lead to a better clinical outcome in adults with limb spasticity compared to non-guided injections. We also aimed to elucidate the hierarchy of common guidance techniques including electromyography, electrostimulation, manual needle placement and ultrasound. To this end, we conducted a Bayesian network meta-analysis and systematic review with 245 patients using the MetaInsight software, R and the Cochrane Review Manager. Our study provided, for the first time, quantitative evidence supporting the superiority of guided BoNT injections over the non-guided ones. The hierarchy comprised ultrasound on the first level, electrostimulation on the second, electromyography on the third and manual needle placement on the last level. The difference between ultrasound and electrostimulation was minor and, thus, appropriate contextualization is essential for decision making. Taken together, guided BoNT injections based on ultrasound and electrostimulation performed by experienced practitioners lead to a better clinical outcome within the first month post-injection in adults with limb spasticity. In the present study, ultrasound performed slightly better, but large-scale trials should shed more light on which modality is superior.

show abstract

Ultrasound-guided injection of botulinum toxin A in the treatment of iliopsoas spasticity

Cited by 12 publications

References 24 publications

Bedside ultrasonography of musculoskeletal complications in brain injured patients

Bedside ultrasonography of musculoskeletal complications in brain injured patients

The Emerging Era of Interventional Imaging in Rheumatology: An Overview During the Coronavirus Disease-2019 (COVID-19) Pandemic

A Bayesian Network Meta-Analysis and Systematic Review of Guidance Techniques in Botulinum Toxin Injections and Their Hierarchy in the Treatment of Limb Spasticity

Contact Info

Product

Resources

About