Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?
Objective Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was...
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description | Objective
Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration.
Materials and methods
This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren–Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient.
Results
Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80,
p
|
doi_str_mv | 10.1007/s00256-011-1120-8 |
format | Article |
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Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration.
Materials and methods
This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren–Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient.
Results
Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80,
p
< 0.001). 94% of patients reporting immediate relief also reported relief 2 weeks later. Univariate and multivariate analysis revealed that neither gender nor age was related to immediate or delayed pain relief. Only severity of OA (based on radiographic analysis) was observed to be predictive of pain relief.
Conclusion
Pain relief following intra-articular hip injection correlated with radiographic severity of OA. This intervention may be of therapeutic and prognostic value in patients awaiting hip arthroplasty.</description><identifier>ISSN: 0364-2348</identifier><identifier>EISSN: 1432-2161</identifier><identifier>DOI: 10.1007/s00256-011-1120-8</identifier><identifier>PMID: 21331511</identifier><identifier>CODEN: SKRADI</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Analysis ; Anesthetics ; Anti-Inflammatory Agents - administration & dosage ; Antiarthritic agents ; Arthroplasty (hip) ; Biological and medical sciences ; Bupivacaine - administration & dosage ; Care and treatment ; Corticoids ; Corticosteroids ; Delayed response ; Diseases of the osteoarticular system ; Female ; Fluoroscopy ; Health aspects ; Hip ; Hip Joint - diagnostic imaging ; Humans ; Imaging ; Injections, Intra-Articular ; Investigative techniques, diagnostic techniques (general aspects) ; Local anesthetics ; Male ; Medical research ; Medical sciences ; Medicine & Public Health ; Medicine, Experimental ; Methylprednisolone - administration & dosage ; Methylprednisolone - analogs & derivatives ; Middle Aged ; Miscellaneous. Osteoarticular involvement in other diseases ; Multivariate analysis ; Nuclear Medicine ; Orthopedics ; Osteoarthritis ; Osteoarthritis, Hip - diagnostic imaging ; Osteoarthritis, Hip - drug therapy ; Osteoarticular system. Muscles ; Pain ; Pain Measurement ; Pathology ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Radiography ; Radiography, Interventional ; Radiology ; Regression analysis ; Scientific Article ; Therapeutic applications</subject><ispartof>Skeletal radiology, 2011-11, Vol.40 (11), p.1449-1454</ispartof><rights>ISS 2011</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c500t-d62a7cd9eb64359e03ba3689a6270e05bb9f44c45006ff714e6de2c0356594fd3</citedby><cites>FETCH-LOGICAL-c500t-d62a7cd9eb64359e03ba3689a6270e05bb9f44c45006ff714e6de2c0356594fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00256-011-1120-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00256-011-1120-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24607552$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21331511$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Deshmukh, Ajit J.</creatorcontrib><creatorcontrib>Panagopoulos, Georgia</creatorcontrib><creatorcontrib>Alizadeh, Ahmadreza</creatorcontrib><creatorcontrib>Rodriguez, Jose A.</creatorcontrib><creatorcontrib>Klein, Devon A.</creatorcontrib><title>Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?</title><title>Skeletal radiology</title><addtitle>Skeletal Radiol</addtitle><addtitle>Skeletal Radiol</addtitle><description>Objective
Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration.
Materials and methods
This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren–Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient.
Results
Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80,
p
< 0.001). 94% of patients reporting immediate relief also reported relief 2 weeks later. Univariate and multivariate analysis revealed that neither gender nor age was related to immediate or delayed pain relief. Only severity of OA (based on radiographic analysis) was observed to be predictive of pain relief.
Conclusion
Pain relief following intra-articular hip injection correlated with radiographic severity of OA. This intervention may be of therapeutic and prognostic value in patients awaiting hip arthroplasty.</description><subject>Age</subject><subject>Analysis</subject><subject>Anesthetics</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>Antiarthritic agents</subject><subject>Arthroplasty (hip)</subject><subject>Biological and medical sciences</subject><subject>Bupivacaine - administration & dosage</subject><subject>Care and treatment</subject><subject>Corticoids</subject><subject>Corticosteroids</subject><subject>Delayed response</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Fluoroscopy</subject><subject>Health aspects</subject><subject>Hip</subject><subject>Hip Joint - diagnostic imaging</subject><subject>Humans</subject><subject>Imaging</subject><subject>Injections, Intra-Articular</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Local anesthetics</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Methylprednisolone - analogs & derivatives</subject><subject>Middle Aged</subject><subject>Miscellaneous. Osteoarticular involvement in other diseases</subject><subject>Multivariate analysis</subject><subject>Nuclear Medicine</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Osteoarthritis, Hip - diagnostic imaging</subject><subject>Osteoarthritis, Hip - drug therapy</subject><subject>Osteoarticular system. Muscles</subject><subject>Pain</subject><subject>Pain Measurement</subject><subject>Pathology</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Radiography</subject><subject>Radiography, Interventional</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Scientific Article</subject><subject>Therapeutic applications</subject><issn>0364-2348</issn><issn>1432-2161</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kktv1DAUhSMEokPhB7BBFqiCTcr122GDqopHpUpsYB05zvWMR5l4sJOi_vt6lIEKBMgLW9ffOb62T1U9p3BOAfTbDMCkqoHSmlIGtXlQrajgrGZU0YfVCrgSNePCnFRPct4CUK2lelydMMo5lZSuqvXVOCVb2zQFNw82kU3YkzBu0U0hju9IHzGTvQ0jSTgE9MTFVFZ2QvIjTBuSbB_iOtn9JjiS8QZTmG5J9CTmCWOx3ZRCyO-fVo-8HTI-O86n1bePH75efq6vv3y6ury4rp0EmOpeMatd32CnBJcNAu8sV6aximlAkF3XeCGcKLDyXlOBqkfmgEslG-F7flq9Xnz3KX6fMU_tLmSHw2BHjHNuTSONlJqrQr75L0mBGdAGjCjoyz_QbZzTWO5R_IQGMEAL9GqB1nbANow-lod1B8_2QnMwDWvgYHX-F6qMHnfBxRF9KPXfBHQRuBRzTujbfQo7m25Lg-0hBe2SgrakoD2koDVF8-LY79ztsP-l-PntBTg7AjY7O_hkRxfyPScUaClZ4djC5bI1rjHdX_zfp98BJSPH0Q</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>Deshmukh, Ajit J.</creator><creator>Panagopoulos, Georgia</creator><creator>Alizadeh, Ahmadreza</creator><creator>Rodriguez, Jose A.</creator><creator>Klein, Devon A.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20111101</creationdate><title>Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?</title><author>Deshmukh, Ajit J. ; Panagopoulos, Georgia ; Alizadeh, Ahmadreza ; Rodriguez, Jose A. ; Klein, Devon A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c500t-d62a7cd9eb64359e03ba3689a6270e05bb9f44c45006ff714e6de2c0356594fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Age</topic><topic>Analysis</topic><topic>Anesthetics</topic><topic>Anti-Inflammatory Agents - administration & dosage</topic><topic>Antiarthritic agents</topic><topic>Arthroplasty (hip)</topic><topic>Biological and medical sciences</topic><topic>Bupivacaine - administration & dosage</topic><topic>Care and treatment</topic><topic>Corticoids</topic><topic>Corticosteroids</topic><topic>Delayed response</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Fluoroscopy</topic><topic>Health aspects</topic><topic>Hip</topic><topic>Hip Joint - diagnostic imaging</topic><topic>Humans</topic><topic>Imaging</topic><topic>Injections, Intra-Articular</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Local anesthetics</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Methylprednisolone - analogs & derivatives</topic><topic>Middle Aged</topic><topic>Miscellaneous. Osteoarticular involvement in other diseases</topic><topic>Multivariate analysis</topic><topic>Nuclear Medicine</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Osteoarthritis, Hip - diagnostic imaging</topic><topic>Osteoarthritis, Hip - drug therapy</topic><topic>Osteoarticular system. Muscles</topic><topic>Pain</topic><topic>Pain Measurement</topic><topic>Pathology</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Radiography</topic><topic>Radiography, Interventional</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Scientific Article</topic><topic>Therapeutic applications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Deshmukh, Ajit J.</creatorcontrib><creatorcontrib>Panagopoulos, Georgia</creatorcontrib><creatorcontrib>Alizadeh, Ahmadreza</creatorcontrib><creatorcontrib>Rodriguez, Jose A.</creatorcontrib><creatorcontrib>Klein, Devon A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Skeletal radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Deshmukh, Ajit J.</au><au>Panagopoulos, Georgia</au><au>Alizadeh, Ahmadreza</au><au>Rodriguez, Jose A.</au><au>Klein, Devon A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis?</atitle><jtitle>Skeletal radiology</jtitle><stitle>Skeletal Radiol</stitle><addtitle>Skeletal Radiol</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>40</volume><issue>11</issue><spage>1449</spage><epage>1454</epage><pages>1449-1454</pages><issn>0364-2348</issn><eissn>1432-2161</eissn><coden>SKRADI</coden><abstract>Objective
Intra-articular injection is being used widely for both diagnostic and therapeutic purposes in the hip. However, its efficacy is not always predictable in patients with hip osteoarthritis (OA). The purpose of this study was to determine whether the degree of radiographic severity of OA was predictive of the response to intra-articular injection of local anesthetic with corticosteroid and to determine the relationship between immediate pain relief resulting from the anesthetic and delayed pain relief resulting from corticosteroid administration.
Materials and methods
This retrospective study included 217 patients (220 injections) with diagnosis of hip OA who underwent a fluoroscopically guided therapeutic hip injection of local anesthetic and corticosteroid. Hip radiographs were scored using the Kellgren–Lawrence scale. Immediate and delayed pain relief was documented using a visual analog scale. Logistic regression analysis was performed to investigate whether age, gender or radiographic severity of OA were independent predictors of pain relief. Degree of agreement between immediate and delayed response was assessed with the kappa coefficient.
Results
Immediate pain relief was reported in 68.2% of hips and delayed relief in 71.4% of hips. A high level of agreement was observed between immediate and delayed pain relief (kappa = 0.80,
p
< 0.001). 94% of patients reporting immediate relief also reported relief 2 weeks later. Univariate and multivariate analysis revealed that neither gender nor age was related to immediate or delayed pain relief. Only severity of OA (based on radiographic analysis) was observed to be predictive of pain relief.
Conclusion
Pain relief following intra-articular hip injection correlated with radiographic severity of OA. This intervention may be of therapeutic and prognostic value in patients awaiting hip arthroplasty.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>21331511</pmid><doi>10.1007/s00256-011-1120-8</doi><tpages>6</tpages></addata></record> |
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subjects | Age Analysis Anesthetics Anti-Inflammatory Agents - administration & dosage Antiarthritic agents Arthroplasty (hip) Biological and medical sciences Bupivacaine - administration & dosage Care and treatment Corticoids Corticosteroids Delayed response Diseases of the osteoarticular system Female Fluoroscopy Health aspects Hip Hip Joint - diagnostic imaging Humans Imaging Injections, Intra-Articular Investigative techniques, diagnostic techniques (general aspects) Local anesthetics Male Medical research Medical sciences Medicine & Public Health Medicine, Experimental Methylprednisolone - administration & dosage Methylprednisolone - analogs & derivatives Middle Aged Miscellaneous. Osteoarticular involvement in other diseases Multivariate analysis Nuclear Medicine Orthopedics Osteoarthritis Osteoarthritis, Hip - diagnostic imaging Osteoarthritis, Hip - drug therapy Osteoarticular system. Muscles Pain Pain Measurement Pathology Radiodiagnosis. Nmr imagery. Nmr spectrometry Radiography Radiography, Interventional Radiology Regression analysis Scientific Article Therapeutic applications |
title | Intra-articular hip injection: does pain relief correlate with radiographic severity of osteoarthritis? |
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