Ultrasound-guided diagnostic IPACK as a valuable tool in the management of a patient with soleal sling syndrome: a doubly rare case report.
Pain Manag
; 12(1): 5-12, 2022 Jan.
Article
em En
| MEDLINE
| ID: mdl-34284601
Lay abstract This case report describes the use of an infiltration between the popliteal artery and capsule of the knee joint (IPACK), a technique in which local anesthetic is injected between the popliteal artery and the back side of the knee joint, to diagnose a compression of the tibial nerve (TN) in a patient with chronic knee pain. A female adult patient presented for further evaluation of chronic pain in the inner side of the back of her left knee. A previous electromyography showed no evidence of tibial or common peroneal nerve disease. After a positive diagnostic block of the left sciatic nerve, the patient was evaluated for a left TN block, so as to ascertain whether a compression of this nerve at the back side of the knee could be the origin of the patient's symptoms. During the ultrasound scanning of the TN, a group of abnormal vessels was found wrapping around the nerve, which made it impossible to inject the TN in a safe manner, even with the guidance of ultrasound. For this reason, the patient was instead submitted to a diagnostic left IPACK. A negative IPACK suggested that a compression of the TN at the popliteal fossa, the region behind the knee joint, was the most likely source of the patient's symptoms. After surgical decompression of the TN at the popliteal fossa, the patient's symptoms decreased substantially.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Diagnostic_studies
/
Guideline
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article