How to inject sacroiliac joints with ultrasound guidance: a pictorial essay.

Active sacroiliitis and sacroiliac joint dysfunction represent a common cause of low back pain in the population and are cause of patients' quality of life reduction and disability worldwide. The use of musculoskeletal ultrasound allows to easily identify the sacroiliac joints and to study every pathological condition affecting its most dorsal part; moreover, musculoskeletal ultrasound allows to guide highly effective injective procedures aimed at improving patients' symptoms and enhance their well-being. This paper aims to briefly explain for the musculoskeletal sonographer the anatomy and biomechanics of the sacroiliac joints, the correct ultrasound scanning method for their visualization and the most appropriate ultrasound guided injection technique to help dealing with the diagnostic and management of sacroiliac joint pain in the everyday scenario.

Espondiloartrosis cervical e hipertrofia del ligamento amarillo / Cervical Spondyloarthrosis and Hypertrophy of the Yellow Ligament

RESUMEN Introducción: La espondiloartrosis cervical es una enfermedad articular crónica degenerativa, es la afección articular más frecuentemente observada en la población madura y una de las principales causas de discapacidad en todo el mundo, por lo que es importante el diagnóstico y tratamiento en las fases tempranas. Objetivo: Informar un caso clínico representativo de espondiloartrosis cervical e hipertrofia del ligamento amarillo. Presentación del caso: Paciente femenina de 49 años que seis años atrás sufrió una caída, y se golpeó el occipucio contra la pared, lo que le provocó pérdida transitoria del conocimiento y dolor en la región cervical; tres años después comenzó con limitación a los movimientos laterales del cuello, malestar y dolor sordo, referido a la nuca y al cuello. Conclusiones: El diagnóstico de espondiloartrosis cervical e hipertrofia del ligamento amarillo representa un desafío clínico, por lo poco común de la enfermedad a esta edad. El caso presentado es una paciente con alteraciones estructuradas en el esqueleto axial y gran repercusión anatómica y funcional debido a un relativo diagnóstico tardío, con evolución insatisfactoria. Por tanto, conviene conocer la enfermedad para realizar una detección precoz y ofrecer mejor atención terapéutica(AU)

ABSTRACT Introduction: Cervical spondyloarthrosis is a chronic degenerative joint disease, it is the most frequent joint condition in the mature population and one of the main causes of disability throughout the world, so diagnosis and treatment in the early stages are important. Objective: To report a representative clinical case of cervical spondyloarthrosis and hypertrophy of the yellow ligament. Case presentation: A 49-year-old female patient suffered a fall six years ago, hitting her occiput against the wall, causing her temporary loss of consciousness and pain in the cervical region. Three years later, she began with limitation of lateral neck movements, discomfort and dull pain, referred to the nape and neck. Conclusion: The diagnosis of cervical spondyloarthrosis and hypertrophy of the yellow ligament represents a clinical challenge, due to the rare nature of the disease at this age. The case reported is a patient with structured alterations in the axial skeleton and great anatomical and functional repercussions due to a relatively late diagnosis, with unsatisfactory evolution. Therefore, it is convenient to know the disease in order to early detect it and to offer better therapeutic care(AU)

Effect of whole-body cryotherapy on the rheological parameters of blood in older women with spondyloarthrosis.

BACKGROUND: Cryotherapy is a physiotherapy method used to treat back pain in older persons. OBJECTIVE: This study aims to evaluate the changes in the rheological parameters of blood in older women with spondyloarthrosis, who underwent whole-body cryotherapy. METHODS: The experimental group comprised 69 older women with lumbar spondyloarthrosis, aged between 65 and 70 years. Due to the methodology of the procedure, the experimental group was randomly divided into three groups. Each group underwent two weeks of different types of physiotherapy: only whole-body cryotherapy (22 women); only kinesitherapy (23 women); and both cryotherapy and kinesitherapy (24 women). The control group comprised 25 women who did not undergo any form of therapy. The evaluation of the rheological properties of the blood encompassed measurements of the plasma viscosity, the erythrocyte elongation and aggregation indices, and the level of fibrinogen. RESULTS: The conducted rheological tests revealed a significant decrease in the erythrocyte elasticity and aggregation indices only in the group of women who had undergone both whole-body cryotherapy and kinesitherapy. CONCLUSIONS: Applying whole-body cryotherapy to older women with spondyloarthrosis decreases the elasticity of erythrocytes and, despite favourable changes in the aggregation parameters, problems with perfusion may still appear. For this reason, the benefit of using whole-body cryotherapy in these persons is debatable.