RESUMO
ABSTRACT: With more than 9 million recreational certified self-contained underwater breathing apparatus divers in the United States, clinicians should be aware of the unique diving-related injuries. One of the most common diving-related injuries is type 1 decompression sickness, or "the bends." The bends commonly manifest as localized joint pain, most often occurring within 24 h of surfacing and resolving over the following 1 to 2 d. We report a unique case of a patient who experienced an exacerbation of musculoskeletal joint pain following initial recovery. This 35-year-old man had nearly complete resolution of his joint pain following the bends, then developed severe right knee pain with swelling after a high-volume lower body workout. Following unremarkable imaging and unsuccessful conservative treatment, ultrasound-guided aspiration of his right knee was performed, which resolved the patient's symptoms. This case highlights a unique presentation of the bends and demonstrates a potentially beneficial treatment if recurrence of the bends is suspected.
Assuntos
Doença da Descompressão , Mergulho , Adulto , Artralgia , Doença da Descompressão/diagnóstico por imagem , Doença da Descompressão/etiologia , Mergulho/efeitos adversos , Mergulho/lesões , Humanos , MasculinoAssuntos
Artralgia/diagnóstico por imagem , Imageamento por Ressonância Magnética , Fraturas da Tíbia/diagnóstico por imagem , Ultrassonografia , Idoso , Artralgia/etiologia , Diagnóstico Diferencial , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia , Masculino , Ilustração Médica , Uso Excessivo dos Serviços de Saúde/prevenção & controle , Fraturas da Tíbia/complicaçõesRESUMO
Local anesthetics, such as the 5% transdermal lidocaine patch (5LP), have been frequently used in the treatment of musculoskeletal pain, especially chronic low back pain (CLBP). This review compiles the literature available on the efficacy, effectiveness, and safety of 5LP when used for the management of CLBP. A systematic search method revealed seven articles that fit the inclusion criteria. For each study, efficacy, effectiveness, and adverse events data were extracted. We found no randomized controlled trials with substantial evidence to support the use of 5LP in CLBP, despite the presence of nonrandomized noncontrolled trials suggesting its effectiveness for relief of pain. Future randomized controlled trials with clinically useful outcomes are needed to assess the efficacy, effectiveness, and safety of 5LP for CLBP more appropriately.
