Sonoanatomy and injection technique of the iliolumbar ligament.

Hdl Handle:
http://hdl.handle.net/10147/206325
Title:
Sonoanatomy and injection technique of the iliolumbar ligament.
Authors:
Harmon, Dominic; Alexiev, Vladimir
Affiliation:
Department of Anesthesia and Pain Medicine, Mid-Western Regional Hospital,, Dooradoyle, Limerick, Ireland. dominic.harmon@hse.ie
Citation:
Pain Physician. 2011 Sep-Oct;14(5):469-74.
Journal:
Pain physician
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206325
PubMed ID:
21927051
Abstract:
BACKGROUND: The iliolumbar ligament plays an important biomechanic role in anchoring the spine to the pelvic ring and stabilizing the sacroiliac joint. Iliolumbar syndrome is a back pain condition caused by pathology of the iliolumbar ligament. History and physical examination are important in the assessment of back pain, but they lack sufficient specificity. Injection of small volumes of local anesthetic into the structure considered to be the source of the pain (i.e. the iliolumbar ligament) increases the specificity of the diagnostic workup. OBJECTIVE: To describe an ultrasound - guided technique for injecting the iliolumbar ligament. STUDY DESIGN: Case report based on knowledge of topographic anatomy and sonoanatomy. SETTING: Outpatient clinic. METHODS: A patient with a clinical picture suggestive of iliolumbar syndrome was selected. An ultrasound-guided injection of the iliolumbar ligament with local anesthetic was performed. We recorded the patient's subjective assessment of pain and the change in range of movement and pain scores during provocative tests. RESULTS: Following the injection, the patient's pain score decreased, provocation tests became negative, and the range of movement increased. LIMITATIONS: Case report. Target specificity and dispersion of local anesthetic spread not confirmed with an independent technique (i.e. magnetic resonance imaging). CONCLUSIONS: Ultrasound guidance allows the selective deposition of small volumes of local anesthetic into structures believed to cause soft tissue back pain and thus to confirm or exclude the working diagnosis. Further studies are needed to confirm our conclusions and to prove the clinical feasibility of this technique.
Language:
eng
MeSH:
Anesthetics, Local/*administration & dosage; Biomechanics; Humans; Lidocaine/*administration & dosage; Ligaments, Articular/drug effects; Low Back Pain/*drug therapy/*ultrasonography; Male; Middle Aged; Physical Examination; Sacroiliac Joint/drug effects/ultrasonography
ISSN:
2150-1149 (Electronic); 1533-3159 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorHarmon, Dominicen_GB
dc.contributor.authorAlexiev, Vladimiren_GB
dc.date.accessioned2012-01-31T16:48:24Z-
dc.date.available2012-01-31T16:48:24Z-
dc.date.issued2012-01-31T16:48:24Z-
dc.identifier.citationPain Physician. 2011 Sep-Oct;14(5):469-74.en_GB
dc.identifier.issn2150-1149 (Electronic)en_GB
dc.identifier.issn1533-3159 (Linking)en_GB
dc.identifier.pmid21927051en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206325-
dc.description.abstractBACKGROUND: The iliolumbar ligament plays an important biomechanic role in anchoring the spine to the pelvic ring and stabilizing the sacroiliac joint. Iliolumbar syndrome is a back pain condition caused by pathology of the iliolumbar ligament. History and physical examination are important in the assessment of back pain, but they lack sufficient specificity. Injection of small volumes of local anesthetic into the structure considered to be the source of the pain (i.e. the iliolumbar ligament) increases the specificity of the diagnostic workup. OBJECTIVE: To describe an ultrasound - guided technique for injecting the iliolumbar ligament. STUDY DESIGN: Case report based on knowledge of topographic anatomy and sonoanatomy. SETTING: Outpatient clinic. METHODS: A patient with a clinical picture suggestive of iliolumbar syndrome was selected. An ultrasound-guided injection of the iliolumbar ligament with local anesthetic was performed. We recorded the patient's subjective assessment of pain and the change in range of movement and pain scores during provocative tests. RESULTS: Following the injection, the patient's pain score decreased, provocation tests became negative, and the range of movement increased. LIMITATIONS: Case report. Target specificity and dispersion of local anesthetic spread not confirmed with an independent technique (i.e. magnetic resonance imaging). CONCLUSIONS: Ultrasound guidance allows the selective deposition of small volumes of local anesthetic into structures believed to cause soft tissue back pain and thus to confirm or exclude the working diagnosis. Further studies are needed to confirm our conclusions and to prove the clinical feasibility of this technique.en_GB
dc.language.isoengen_GB
dc.subject.meshAnesthetics, Local/*administration & dosageen_GB
dc.subject.meshBiomechanicsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLidocaine/*administration & dosageen_GB
dc.subject.meshLigaments, Articular/drug effectsen_GB
dc.subject.meshLow Back Pain/*drug therapy/*ultrasonographyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPhysical Examinationen_GB
dc.subject.meshSacroiliac Joint/drug effects/ultrasonographyen_GB
dc.titleSonoanatomy and injection technique of the iliolumbar ligament.en_GB
dc.contributor.departmentDepartment of Anesthesia and Pain Medicine, Mid-Western Regional Hospital,, Dooradoyle, Limerick, Ireland. dominic.harmon@hse.ieen_GB
dc.identifier.journalPain physicianen_GB
dc.description.provinceMunster-

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