Fluoroscopically guided retrocalcaneal bursa steroid injection

description of the technique and pilot study of short-term patient outcomes

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To describe a lateral fluoroscopically guided retrocalcaneal bursa injection technique, report patient outcomes at 1–4 weeks after steroid/anesthetic retrocalcaneal bursal therapeutic injection, and correlate pre-injection diagnostic heel ultrasound variables with improvement in patient pain scores. Materials and methods: After IRB approval, fluoroscopically guided therapeutic retrocalcaneal bursa injections performed using a lateral approach were retrospectively reviewed. Pre-injection heel ultrasound results and pre- and post-injection patient VAS pain scores (scale 0–10) were recorded. The Wilcox matched-pair test compared pain scores, and Spearman’s rho assessed for correlation between pain score changes and heel ultrasound results. Results: Thirty-two injections were performed in 30 patients (25 females, 5 males; mean 56.5 ± 9.3 years, range 39–75 years; 21 left heel, 11 right heel) with technical success in 32 of 32 cases (100 %). Insertional Achilles tendon pathology and retrocalcaneal bursitis were present in 31 of 32 cases (97 %) and 16 of 32 cases (50 %), respectively. Median pre- and post-procedure pain scores were 8 (IQR 7, 10) and 1.75 (IQR 0, 6). A statistically significant decrease in pain score was observed following injection, with a median change of 4.75 (IQR 3, 8; p <0.001). Clinically significant response (>50 % reduction in pain score) was present in 69 % (95 % CI, 0.52–0.86; p <0.001). No significant correlation was identified between a decrease in pain score and a sonographically abnormal Achilles tendon or retrocalcaneal bursa. Conclusion: Fluoroscopically guided retrocalcaneal bursal steroid/anesthetic using a lateral approach is an effective technique. This technique yielded 100 % technical success and a clinically significant decrease in patient pain scores (p <0.001).

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalSkeletal Radiology
DOIs
StateAccepted/In press - Mar 28 2016

Fingerprint

Steroids
Heel
Pain
Injections
Achilles Tendon
Anesthetics
Bursitis
Research Ethics Committees
Ultrasonography
Pathology
Therapeutics

Keywords

  • Musculoskeletal intervention
  • Retrocalcaneal bursitis
  • Steroid injection, fluoroscopic guidance

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{e4d7759cd72c43da90e18a852022d36b,
title = "Fluoroscopically guided retrocalcaneal bursa steroid injection: description of the technique and pilot study of short-term patient outcomes",
abstract = "Objective: To describe a lateral fluoroscopically guided retrocalcaneal bursa injection technique, report patient outcomes at 1–4 weeks after steroid/anesthetic retrocalcaneal bursal therapeutic injection, and correlate pre-injection diagnostic heel ultrasound variables with improvement in patient pain scores. Materials and methods: After IRB approval, fluoroscopically guided therapeutic retrocalcaneal bursa injections performed using a lateral approach were retrospectively reviewed. Pre-injection heel ultrasound results and pre- and post-injection patient VAS pain scores (scale 0–10) were recorded. The Wilcox matched-pair test compared pain scores, and Spearman’s rho assessed for correlation between pain score changes and heel ultrasound results. Results: Thirty-two injections were performed in 30 patients (25 females, 5 males; mean 56.5 ± 9.3 years, range 39–75 years; 21 left heel, 11 right heel) with technical success in 32 of 32 cases (100 {\%}). Insertional Achilles tendon pathology and retrocalcaneal bursitis were present in 31 of 32 cases (97 {\%}) and 16 of 32 cases (50 {\%}), respectively. Median pre- and post-procedure pain scores were 8 (IQR 7, 10) and 1.75 (IQR 0, 6). A statistically significant decrease in pain score was observed following injection, with a median change of 4.75 (IQR 3, 8; p <0.001). Clinically significant response (>50 {\%} reduction in pain score) was present in 69 {\%} (95 {\%} CI, 0.52–0.86; p <0.001). No significant correlation was identified between a decrease in pain score and a sonographically abnormal Achilles tendon or retrocalcaneal bursa. Conclusion: Fluoroscopically guided retrocalcaneal bursal steroid/anesthetic using a lateral approach is an effective technique. This technique yielded 100 {\%} technical success and a clinically significant decrease in patient pain scores (p <0.001).",
keywords = "Musculoskeletal intervention, Retrocalcaneal bursitis, Steroid injection, fluoroscopic guidance",
author = "Goldberg-Stein, {Shlomit A.} and Netanel Berko and Thornhill, {Beverly Ann} and Elsinger, {Elisabeth C.} and Eric Walter and Catanese, {Dominic J.} and Popowitz, {Daniel B.}",
year = "2016",
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doi = "10.1007/s00256-016-2368-9",
language = "English (US)",
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journal = "Skeletal Radiology",
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T1 - Fluoroscopically guided retrocalcaneal bursa steroid injection

T2 - description of the technique and pilot study of short-term patient outcomes

AU - Goldberg-Stein, Shlomit A.

AU - Berko, Netanel

AU - Thornhill, Beverly Ann

AU - Elsinger, Elisabeth C.

AU - Walter, Eric

AU - Catanese, Dominic J.

AU - Popowitz, Daniel B.

PY - 2016/3/28

Y1 - 2016/3/28

N2 - Objective: To describe a lateral fluoroscopically guided retrocalcaneal bursa injection technique, report patient outcomes at 1–4 weeks after steroid/anesthetic retrocalcaneal bursal therapeutic injection, and correlate pre-injection diagnostic heel ultrasound variables with improvement in patient pain scores. Materials and methods: After IRB approval, fluoroscopically guided therapeutic retrocalcaneal bursa injections performed using a lateral approach were retrospectively reviewed. Pre-injection heel ultrasound results and pre- and post-injection patient VAS pain scores (scale 0–10) were recorded. The Wilcox matched-pair test compared pain scores, and Spearman’s rho assessed for correlation between pain score changes and heel ultrasound results. Results: Thirty-two injections were performed in 30 patients (25 females, 5 males; mean 56.5 ± 9.3 years, range 39–75 years; 21 left heel, 11 right heel) with technical success in 32 of 32 cases (100 %). Insertional Achilles tendon pathology and retrocalcaneal bursitis were present in 31 of 32 cases (97 %) and 16 of 32 cases (50 %), respectively. Median pre- and post-procedure pain scores were 8 (IQR 7, 10) and 1.75 (IQR 0, 6). A statistically significant decrease in pain score was observed following injection, with a median change of 4.75 (IQR 3, 8; p <0.001). Clinically significant response (>50 % reduction in pain score) was present in 69 % (95 % CI, 0.52–0.86; p <0.001). No significant correlation was identified between a decrease in pain score and a sonographically abnormal Achilles tendon or retrocalcaneal bursa. Conclusion: Fluoroscopically guided retrocalcaneal bursal steroid/anesthetic using a lateral approach is an effective technique. This technique yielded 100 % technical success and a clinically significant decrease in patient pain scores (p <0.001).

AB - Objective: To describe a lateral fluoroscopically guided retrocalcaneal bursa injection technique, report patient outcomes at 1–4 weeks after steroid/anesthetic retrocalcaneal bursal therapeutic injection, and correlate pre-injection diagnostic heel ultrasound variables with improvement in patient pain scores. Materials and methods: After IRB approval, fluoroscopically guided therapeutic retrocalcaneal bursa injections performed using a lateral approach were retrospectively reviewed. Pre-injection heel ultrasound results and pre- and post-injection patient VAS pain scores (scale 0–10) were recorded. The Wilcox matched-pair test compared pain scores, and Spearman’s rho assessed for correlation between pain score changes and heel ultrasound results. Results: Thirty-two injections were performed in 30 patients (25 females, 5 males; mean 56.5 ± 9.3 years, range 39–75 years; 21 left heel, 11 right heel) with technical success in 32 of 32 cases (100 %). Insertional Achilles tendon pathology and retrocalcaneal bursitis were present in 31 of 32 cases (97 %) and 16 of 32 cases (50 %), respectively. Median pre- and post-procedure pain scores were 8 (IQR 7, 10) and 1.75 (IQR 0, 6). A statistically significant decrease in pain score was observed following injection, with a median change of 4.75 (IQR 3, 8; p <0.001). Clinically significant response (>50 % reduction in pain score) was present in 69 % (95 % CI, 0.52–0.86; p <0.001). No significant correlation was identified between a decrease in pain score and a sonographically abnormal Achilles tendon or retrocalcaneal bursa. Conclusion: Fluoroscopically guided retrocalcaneal bursal steroid/anesthetic using a lateral approach is an effective technique. This technique yielded 100 % technical success and a clinically significant decrease in patient pain scores (p <0.001).

KW - Musculoskeletal intervention

KW - Retrocalcaneal bursitis

KW - Steroid injection, fluoroscopic guidance

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