scholarly journals Algorithm of Radiological Diagnostics of Dystrophic Damage to Ligaments of the Lumbosacral Spine in the Lower Back Pain Syndrome: the Potential of Sonography

2018 ◽  
pp. 109-114
Author(s):  
A. N. Mihailov ◽  
A. M. Yurkovskiy ◽  
I. V. Nazarenko
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Structural Changes ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
Diagnostic Algorithm ◽  
Pain Syndrome ◽  
Lumbosacral Spine ◽  
Lower Back ◽  
Magnetic Resonance Imaging Mri

Objective: to formulate the main points of the diagnostic algorithm in the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments based on the limits and potential of visualization methods. Material. Data of X-ray, multispiral computer tomography (MSCT), magnetic resonance imaging (MRI) and sonography of 184 patients aged 19-79 with clinical manifestations of the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments were analyzed. Results. The potential of the visualization methods in the assessment of structural changes of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments has been identified. The main points of the algorithm which makes it possible to diagnose the lower back pain syndrome, caused by pathology of ilio-lumbar, posterior long sacroiliac and sacrotuberal ligaments have been formulated. Conclusion. The choice of the visualization method in the lower back pain syndrome, caused by ligamentosis of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments must be made taking into account the limits and potential of MSCT, MRI and sonography, which will shorten the time of diagnostic search and reduce the risk of diagnostic errors.

scholarly journals Lower back pain with sciatic disorder following L5 dermatome caused by herpes zoster infection

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Roslind Karolina Hackenberg ◽  
Arnd Von den Driesch ◽  
Dietmar Pierre König
Keyword(s):  
Back Pain ◽  
Herpes Zoster ◽  
Lower Back Pain ◽  
Pain Treatment ◽  
Acute Onset ◽  
Mri Scan ◽  
Lower Back ◽  
Acyclovir Treatment ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

We report the case of a 62-year-old patient with lower back pain radiating into the right leg accompanied by numbness. The pain had an acute onset and was resistant to conservative pain treatment. A magnetic resonance imaging (MRI) scan of the lumbar spine showed no degenerative discovertebral lesions, but a swelling of the nerve root supplying the affected dermatome. For pain treatment the patient received lumbar epidural infiltrations. During this treatment the patient suddenly developed a skin rash with grouped vesicular blisters on an erythematous ground. After the diagnosis of a lumbar herpes zoster and an acyclovir treatment, the patient could be discharged in an ameliorated condition. This case demonstrates the importance to consider rare causes of lumbosciatic pain and disorders and to acknowledge unspecific changes in a MRI scan.

Chronic Benign Pain

CNS Spectrums ◽  
1999 ◽  
Vol 4 (9) ◽  
pp. 24-31
Author(s):  
David A. Klein ◽  
Daniel P. Greenfield
Keyword(s):  
Back Pain ◽  
Sickle Cell Disease ◽  
Lower Back Pain ◽  
Reflex Sympathetic Dystrophy ◽  
Pain Syndrome ◽  
Peripheral Neuropathies ◽  
Cell Disease ◽  
Lower Back ◽  
Reflex Sympathetic Dystrophy Syndrome ◽  
Metastatic Process

AbstractChronic benign pain (CBP) can be defined as a type of unpleasant sensory experience that arises from inflammation, visceral stress or damage, or other such pathophysiologic process(es), and that is not associated with a metastatic process. A patient's complaint of pain should be taken seriously by the practitioner, both in terms of the discomfort evoked and the likelihood that the potential cause of the pain requires diagnostic evaluation. This article reviews the diagnosis and treatment of the following common conditions associated with CBP syndromes: fibromyalgia, lower back pain syndrome, sickle-cell disease, reflex sympathetic dystrophy syndrome, and peripheral neuropathies.

scholarly journals Chronic musculoskeletal pain in neurological practice

2021 ◽  
pp. 22-28
Author(s):  
D. Kh. Khaibullina ◽  
Yu. N. Maksimov ◽  
F. I. Devlikamova
Keyword(s):  
Back Pain ◽  
Musculoskeletal Pain ◽  
Muscle Relaxant ◽  
Clinical Case ◽  
Pain Treatment ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
Pain Syndrome ◽  
Chronic Musculoskeletal Pain ◽  
Herniated Disc

Treatment of musculoskeletal back pain is an essential problem for doctors of many specialties, including neurologists. In some cases, the chronic course of the pain syndrome is accompanied with complaints and clinical manifestations characteristic of neuropathic pain in the absence of significant damage to the neural structures, which is explained by the mechanism of central sensitization. In this case, there may be diagnostic errors in determining the nature of the pain, which entails inadequate therapy that does not lead to the desired result.The presented clinical case is devoted to the treatment of exacerbation of chronic musculoskeletal pain. Treatment of the patient for a herniated disc complicated by radiculopathy, carried out earlier, did not lead to the desired result due to the inconsistency of the diagnosis, inadequacy and lack of systematic therapy. Based on the analysis of the physical and paraclinical studies, the diagnosis was changed to « Lower back pain. Myofascial pain syndrome. Toxic polyneuropathy. Herniated disc LV-SI. Residual radiculopathy S1». Therapeutic measures were adjusted in accordance with the diagnosis. In order to relieve the pain syndrome at the first stage, a combined drug Neurodiclovit, a muscle relaxant, a drug of the SYSADOA group, soft tissue techniques of manual therapy, phonophoresis with glucocorticosteroids, and cognitive behavioral therapy were used. The assessment of the patient’s condition carried out after 7 days showed the effectiveness of the treatment, which allowed to cancel the use of a nonsteroidal anti-inflammatory drug, a muscle relaxant and a glucocorticosteroid. At the post-treatment stage, the patient was prescribed a combination of B vitamins (Neuromultivitis) and therapeutic gymnastics, as well as continued therapy with a slowacting symptomatic agent and non-drug treatment methods. Relief of the pain syndrome in the absence of adverse events confirmed the adequacy and effectiveness of the therapy.The presented clinical case demonstrates the importance of placing emphasis at the stage of diagnosis, taking into account the data of clinical and paraclinical research methods, and also illustrates the possibility of successful conservative therapy for exacerbation of chronic musculoskeletal pain in the practice of a neurologist.

Frequency of potential causes of lower back pain and incidental findings in patients with suspected sacroiliitis: retrospective analysis of 886 patients with negative sacroiliac MRI examination for sacroiliitis

2020 ◽  
pp. 028418512096856
Author(s):  
Hasan Emin Kaya ◽  
Ülkü Kerimoğlu
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Incidental Findings ◽  
Uterine Fibroids ◽  
Mri Imaging ◽  
Imaging Studies ◽  
Lower Back ◽  
Lumbosacral Transitional Vertebra ◽  
Sacral Insufficiency Fractures ◽  
Magnetic Resonance Imaging Mri

Background In a majority of patients with suspected sacroiliitis (SI) who underwent sacroiliac magnetic resonance imaging (MRI), imaging studies may be normal, may depict other causes for pain, or may show clinically irrelevant incidental findings. Purpose To determine the prevalence of possible etiologies other than SI and frequency of incidental findings demonstrated on sacroiliac MRI examinations in a cohort of patients with lower back pain and suspected SI. Material and Methods Sacroiliac MRI examinations of 1421 patients with suspected SI were retrospectively reviewed. In patients without SI findings, other potential causes for lower back pain and incidental findings were documented. Results SI was present in 535 of 1421 patients (37.6%). In 886 of the patients whose MRI studies were negative for SI, other possible causes for lower back pain or incidental findings were seen in 386 (43.5%). The most common musculoskeletal (MSK) finding was lumbosacral transitional vertebra (8.6%) followed by findings suggesting piriformis syndrome (4.2%), spondylosis (3.7%), and sacral insufficiency fractures (1.8%). The most common non-MSK findings were follicular cysts (15.3%) and uterine fibroids (4.9%). Conclusion In patients with suspected SI but negative MRI examinations for SI, some other possible causes for lower back pain and several incidental findings can be seen on imaging. The presence of these findings may explain the patient’s symptoms, and awareness of these conditions may be helpful in patient management and individualizing treatment.

scholarly journals LIGAMENTOSIS OF THE LONG DORSAL SACROILIAC LIGAMENT: OUTSTANDING ISSUES OF RADIOTHERAPY

2017 ◽  
pp. 4-7
Author(s):  
I. V. Nazarenko
Keyword(s):  
Back Pain ◽  
Diagnostic Criteria ◽  
Lower Back Pain ◽  
Imaging Techniques ◽  
Pain Syndrome ◽  
Degenerative Changes ◽  
X Ray ◽  
Information Portal ◽  
Lower Back ◽  
Modern Methods

Objective: to systematize the data on the possibility of application of imaging techniques for the diagnosis of ligamentosis of the long dorsal sacroiliac ligament. Materials. Publications containing information about the use of imaging techniques for the diagnosis of ligamentosis of the long dorsal sacroiliac ligament deposited in PubMed resources and information portal eLIBRARY.RU. Results. The work has sorted out the most important aspects regarding the possibility of application of imaging techniques for the diagnosis of ligamentosis of the long dorsal sacroiliac ligament. Conclusion. Modern methods of X-ray diagnostics are able to provide visualization of the posterior long sacroiliac ligaments, but the absence of reliable diagnostic criteria does not make it possible to diagnose degenerative changes (ligamentosis) confidently and, accordingly, to verify the related cases of lower back pain syndrome.

scholarly journals Relief of Lower Back and Leg Pain after Myelography

2016 ◽  
Vol 10 (1) ◽  
pp. 539-542
Author(s):  
Rui Guo ◽  
Toshihiko Sakakibara ◽  
Tetsutaro Mizuno ◽  
Koji Akeda ◽  
Tetsushi Kondo ◽  
...  
Keyword(s):  
Back Pain ◽  
Intermittent Claudication ◽  
Lower Back Pain ◽  
Adverse Reactions ◽  
Leg Pain ◽  
Mri Findings ◽  
Spinal Disorder ◽  
Lower Back ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Introduction: It is well-known that many patients will have adverse reactions such as headache and nausea after undergoing myelography, but we have often seen cases where symptoms such as lower back pain and leg pain were alleviated following myelography. To the best of our knowledge, such clinical cases of post-myelographic alleviation have not been reported. Materials and Methods: A total of 325 patients with a degenerative lumbar spinal disorder who underwent myelography were prospectively investigated at four hospitals from April 2012 to March 2014 to survey the post-myelographic alleviation of lower back and leg pain prospectively. The severities of lower back pain, leg pain and numbness of the lower extremities were evaluated and intermittent claudication distance was measured before myelography. The magnetic resonance imaging (MRI) findings and myelographic findings were also evaluated for the patients that their symptoms were improved. Results: Thirty-five of 325 cases (10.8%) of these patients had their symptoms alleviated after undergoing myelography; 26 cases of lower back pain, two cases of leg pain, two cases of numbness of the lower extremity, and five cases of intermittent claudication. Conclusion: In the patients of a degenerative lumbar spinal disorder, about 10% cases with lower back pain or intermittent claudication had post-myelographic alleviation. Intradural injection therapy might be a therapeutic method to alleviate these symptoms.

scholarly journals MARKER INDICATORS OF DEGENERATIVE-DYSTROPHIC PROCESSES OF THE SPINE, PELVIS AND HIP JOINTS OF DYSPLASTIC GENESIS

2018 ◽  
Vol 3 (5) ◽  
pp. 87-93
Author(s):  
Z. V. Koshkareva ◽  
M. B. Negreeva
Keyword(s):  
Mutual Influence ◽  
Plain Radiograph ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Pain Syndrome ◽  
Lumbosacral Spine ◽  
Hip Joints ◽  
Results Of Treatment ◽  
Combined Lesions ◽  
Diagnostic Signs

Degenerative and dystrophic diseases of the spine, pelvis and hip joints are considered as a single pathogenetically conditioned process with an interdependent condition. The significance of the problem is determined by the high incidence of spinal and hip dysplasia, the syndrome of mutual burdening, the diversity and polymorphism of clinical manifestations, the growth of disability, the difficulties of diagnosis and treatment. Questions remain about the root cause of the occurrence of combined lesions, their mutual influence. The aim of the work was to identify the most common, diagnostic, pathognomonic signs of dysplastic syndrome. The patients were examined according to a single diagnostic algorithm, including clinical and neurological examination, plain radiograph of the pelvis; spondylography, MSCT, MRI of the lumbar and lumbosacral spine; study of the locomotion act of walking, anthropometric measurements; statistical methods. We analyzed the results of treatment of 39 patients (26 women and 13 men; mean age – 53 years) with dysplastic syndrome including degenerative-dystrophic changes in the spine, pelvis and hip joints. The most common diagnostic signs of combined degenerative-dystrophic diseases of the spine and pelvis have been established, among which pain syndrome, noted in varying degrees in all patients. The established diagnostic indices, supplementing existing knowledge of the problem studied, will allow to specify diagnostics and optimize the treatment of combined degenerative-dystrophic diseases of dysplastic genesis.

scholarly journals Possibilities of pain syndrome therapy in patients with diabetes mellitus

2021 ◽  
Vol 5 (5) ◽  
pp. 307-315
Author(s):  
O.A. Shavlovskaya ◽  
◽  
I.A. Bokova ◽  
N.I. Shavlovsky ◽  
Yu.D. Yukhnovskaya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Back Pain ◽  
Treatment Regimen ◽  
Lower Back Pain ◽  
Muscle Relaxant ◽  
Pain Syndrome ◽  
B Vitamins ◽  
Lower Back ◽  
Patients With Diabetes ◽  
Anti Inflammatory

The prevalence of lower back pain (LBP) in type 2 diabetes mellitus (DM2) is almost 2 times higher than in the similar control group (by age and gender). The association of DM2 with the severity, chronicity and recurrence of LBP was revealed. DM2 duration correlates with the severity and prevalence of degenerative-dystrophic changes. The representation of concomitant somatic pathology in patients with DM2 is significantly higher than in patients without DM2. Rational selection of the therapy regimen for LBP should be based on comorbid pathology. The molecular mechanisms of synergism of muscle relaxant (tolperizone), nonsteroidal anti-inflammatory drug (NSAID) (meloxicam), and B vitamins as part of complex pharmacotherapy of pain were analyzed. This treatment regimen has a number of benefits: lack of dependence, anti-inflammatory effect, neuroprotective and remyelinating effect, reduction of muscular hypertonus. A number of studies have shown the efficacy of such combination therapy in patients of different age groups with comorbid conditions. It does not require an increase in NSAID doses and significantly reduces the risk of adverse events (AE). The applied treatment regimen is a combination of a muscle relaxant (tolperizone), NSAID (meloxicam) and a complex of B vitamins has already demonstrated its efficacy in the treatment of LBP in patients with comorbid diseases, according to the effect on the inflammatory process indicators (in the absence of AE). KEYWORDS: diabetes mellitus, lower back pain, body mass index, nonsteroidal anti-inflammatory drugs, meloxicam, muscle relaxants, tolperizone, B vitamins. FOR CITATION: Shavlovskaya O.A., Bokova I.A., Shavlovsky N.I., Yukhnovskaya Yu.D. Possibilities of pain syndrome therapy in patients with diabetes mellitus. Russian Medical Inquiry. 2021;5(5):307–315 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-307-315.

TO THE QUESTION OF THE EPIDEMIOLOGICAL ASSESSMENT OF OCCUPATIONAL HEALTH RISK FOR THE DEVELOPMENT OF LOWER BACK PAIN SYNDROME

2021 ◽  
Author(s):  
V.A. Shirokov ◽  
◽  
N.L. Terehov ◽  
A.V. Potaturko
Keyword(s):  
Back Pain ◽  
Working Conditions ◽  
Lower Back Pain ◽  
Odds Ratio ◽  
Pain Syndrome ◽  
Epidemiological Survey ◽  
Dynamic Exercise ◽  
Cross Sectional ◽  
Lower Back ◽  
Working Posture

Abstract: The aim of the paper was to study the influence of adverse occupational factors on the prevalence and odds ratio of the development of lower back pain syndrome. A cross-sectional epidemiological survey was performed based on the findings of a periodic medical examination of 2,915 individuals engaged in various working conditions. The greatest adverse effect on the pain syndrome development was caused by a dynamic exercise (OR 5.22 and 95 % of CI – 3.50-7.81), lifting and manual moving of the load (OR 3.01 and 95% of CI -2.41-3.75) as well as an unfavorable working posture (OR 7.10 and 95 % of CI -5.65-8.94).

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