Ultrasound-Guided Treatment of Meralgia Paresthetica: With or Without Corticosteroid? A Double-Blinded, Randomized Controlled Study.

Background: Blockade of the lateral femoral cutaneous nerve (LFCN) with local anesthetic (LA) has therapeutic role as well as diagnostic value for meralgia paresthetica (MP). The aim of this study was to compare the effectiveness of ultrasound-guided LA and LA + CS injections in the treatment of MP. Methods: This was a prospective, double-blinded, randomized controlled study. Thirty-two patients were evaluated clinically, and electrophysiologically and diagnosed as MP by diagnostic block. They were randomly assigned to two groups and all patients completed the study. The first group (n = 17) received 2 mL of lidocaine 2%+1 mL of betamethasone, while the second group (n = 15) received 2 mL of lidocaine 2% + 1 mL saline solution. Results: No statistically significant difference was detected between the groups in numeric rating scale (NRS) values. In both groups, NRS values were significantly decreased after the injection that confirms the diagnosis of MP. The improvement continued on the following weeks in both groups. At the 4th week, the NRS value reached to 2.47 in the CS group and reached to 3.13 in the LA group. Conclusions: Both CS and LA injections for the treatment of MP were found to be clinically effective and both may be therapeutic options. In intractable cases, once the nerve block is applied with or without CS, well-being can be achieved by keeping the patient away from the triggering factors. To provide effective and isolated injection of LFCN, that may have frequent anatomical variations, ultrasonography guidance could be suggested.

Effect of Home-Based Exercise Program on Physical Function and Balance in Older Adults With Sarcopenia: A Multicenter Randomized Controlled Study.

In the prospective, randomized, controlled multicenter study, 100 patients who were clinically diagnosed with sarcopenia were assigned to either a home-based exercise group or a control group. The home-based training program included exercises with gradually increasing intensity comprising posture, stretching and upper- and lower-extremity muscle-strengthening exercises, balance and coordination exercises, and gait training. Before and 3 months after the exercise program, all the patients were evaluated. The 6-min walking test and Berg Balance Scale scores increased significantly after 3 months in the home-based exercise group compared with the controls. There was also a significant decrease in timed up and go test scores and a significant improvement in quality of life in the exercise group compared with the control group. Our findings indicated that a home-based exercise program can have a positive effect on physical function, balance, and quality of life in patients with sarcopenia.

Clinical evaluation during the acute exacerbation of knee osteoarthritis: the impact of diagnostic ultrasonography.

We aimed to investigate (1) the probable correlation between clinical and ultrasonographic findings in chronic painful primary knee OA patients referred with acute flare-ups and (2) the impact of diagnostic ultrasonography (US) to determine the real source of pain in these patients. We included 100 patients consecutively who were admitted to our outpatient unit with a pain complaint on a single knee with the diagnosis of primary knee OA according to the ACR criteria. The control group consisted of the patients with pain-free knees at least during the last month, who were already included in the study group. The sonographic evaluation of the knee was performed by a physician who was blinded to the clinical evaluation and/or the physical and radiological evaluations. In the present study, sonographic findings were significantly more observed on the painful knees (p < 0.001). The most commonly encountered findings on the symptomatic knees were the suprapatellar effusion (55 %), the baker cyst (25 %), and the pes anserine bursitis. The distribution of the findings on the asymptomatic knees was as follows: 22 %, the suprapatellar effusion and 5 %, the Baker cyst. Effusion was detected in 55 % of the painful knees of our patients with knee OA. This finding was statistically significant compared to the painless knees of the subjects included. The results of our study also showed that there was a significant relation between the Kellgren-Lawrence grading and the frequency of suprapatellar effusion on US examination (p = 0.026). It was concluded that in chronic, primary, painful knee osteoarthritis, US is a valuable diagnostic method in the confirmation of synovitis and/or the inflammatory episode in spite of the absence of obvious clinical parameters. In advanced osteoarthritis, when we consider that the inflammatory episodes are expected findings, the early confirmation of the inflammation on US may be particularly valuable in the clinical setting.

Assessment of quality of life and depression in spouses of patients with ankylosing spondylitis.

The objective of this study is to investigate the quality of life and the rates of depression in spouses/partners of patients with AS compared with spouses/partners of healthy controls". Twenty-five persons with AS and their 25 spouses (21 women and 4 men) and 25 healthy controls were recruited consecutively. All the subjects completed 36-item Short Form Health Survey (SF-36) questionnaire forms and 17-item Hamilton Depression Rating Scale (HAM-D17). Mean age was 35 ± 6.47 years in spouse group (SG) and 36.26 ± 5.93 in control group (CG). In SG and CG, the SF-36 subscale scores were compared using Mann-Whitney U test. Social functioning, mental health, emotional role, and general health were significantly (P < 0.05) lower in SG compared with CG. The average score of social functioning was found to be 65.41 in spouses of patients compared with healthy controls (90.75). Depression scores were significantly (P < 0.001) higher in SG compared with CG. Among SF-36 subgroups in spouses, general health perception had a negatively significant correlation with depression scores (P < 0.05) and duration of ankylosing spondylitis (P < 0.05). A positively significant correlation has been identified between bodily pain and depression scores in spouses (P < 0.05). Therefore, female partners of male patients were found to be more depressive. Being a spouse of a patient with AS significantly interferes with quality of life and increases the depression frequency.

Comparison of high-power pain threshold ultrasound therapy with local injection in the treatment of active myofascial trigger points of the upper trapezius muscle.

OBJECTIVE: To compare the effects of high-power pain threshold ultrasound (HPPTUS) therapy and local anesthetic injection on pain and active cervical lateral bending in patients with active myofascial trigger points (MTrPs) of the upper trapezius muscle. DESIGN: Randomized single-blinded controlled trial. SETTING: Physical medicine and rehabilitation department of university hospital. PARTICIPANTS: Subjects (N=49) who had active MTrPs of the upper trapezius muscle. INTERVENTIONS: HPPTUS or trigger point injection (TrP). MAIN OUTCOME MEASURES: Visual analog scale, range of motion (ROM) of the cervical spine, and total length of treatments. RESULTS: All patients in both groups improved significantly in terms of pain and ROM, but there was no statistically significant difference between groups. Mean numbers of therapy sessions were 1 and 1.5 in the local injection and HPPTUS groups, respectively. CONCLUSIONS: We failed to show differences between the HPPTUS technique and TrP injection in the treatment of active MTrPs of the upper trapezius muscle. The HPPTUS technique can be used as an effective alternative to TrP injection in the treatment of myofascial pain syndrome.