Pseudoarticulation

[Formication]

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Has anybody ever had any success injecting the pseudoarticulation of a transitional segment for localized pain?
I did one recently mostly for diagnostic purposes. He left feeling great. we'll see what happens.
Also, how would you code that?

 

[Tenesma]

i code it as a facet injection

i have done it - mixed results - always worth a try though

 

[lobelsteve]

Perfect for intra-articular injection of the TP-iliac joint.
But RF of L4, L5, and S1 is met with limited success (n<10).

 

[arik79]

Did a review paper on bertolotti syndrome after seeing a patient, transitional vertebrae, literature is pretty scarce, decent surgical results after failed conservative management. Injections described that I could find where studies were done included intra-articular "facet like" injections.

 

[Mister Mxyzptlk]

I agree with lobel's comments.

I had one case where the guy led me on a merry chase for paravertebral pain and I got a CT to evaluate the relationship between the TP and the ilium. To my surprise it showed that the L4 and L5 TP's were almost "kissing". He plays a lot of golf and I figured when he did his swing the TP's were rubbing. I infiltrated around the TP's under fluoro and he's been a happy man for over a year.

Can I name this syndrome after myself?

 

[lobelsteve]

I agree with lobel's comments.

I had one case where the guy led me on a merry chase for paravertebral pain and I got a CT to evaluate the relationship between the TP and the ilium. To my surprise it showed that the L4 and L5 TP's were almost "kissing". He plays a lot of golf and I figured when he did his swing the TP's were rubbing. I infiltrated around the TP's under fluoro and he's been a happy man for over a year.

Can I name this syndrome after myself?

After Myself Syndrome, I like the sound of that.

 

[Mister Mxyzptlk]

Is "Eat Me, Lobel Syndrome" already taken?

 

[lobelsteve]

EMLS* is a temporary facial dystonia whose etiology has been traced back to patients displaying aberrant opioid behaviors and then being told that they are no longer deemed good candidates for ongoing opioid treatment for chronic non-malignant pain. It is usauuly associated with a mild cervical dystonia inducing a head tilit. The patient makes a frowning mouth position with raised eyebrows, squinted eyes, flarede nostrils, and a slighlty wrinkled up nose. It is followed by a realization that opioids were becoming a barrier to getting better and follow up in 3-4 weeks to determine what interventions would be appropriate or loss to follow-up.

*EMLS: Eat Me Lobel Syndrome (sans comma) is also called bitter beer face by some.