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BACKGROUND: Lateral epicondylitis (LE) is a common disease especially at middle age. Different types of treatments have been used to address LE. Corticosteroid (CS) injections and dry needling (DN) are utilized options in the treatment. However, the question of which one is better has not been entirely discussed in the literature. We hypothesized that the use of DN to treat LE would be at least as effective as using CS injections. We compared the pain relief afforded and improvements in functional disability after DN and CS injection. METHODS: A total of 108 LE patients whose pain was not relieved by 3 weeks of first-line treatment were included in a randomized manner, using an online application into DN or CS groups (54 patients each). The minimum follow-up duration was 6 months. We recorded "Patient-Rated Tennis Elbow Evaluation" (PRTEE) scores before treatment and after 3 weeks and 6 months of treatment. RESULTS: Seven patients were excluded for various reasons; thus, 101 patients were finally evaluated. Before treatment, the groups were similar in terms of age, symptom duration, and PRTEE score, but after treatment, DN-treated patients showed better improvement in the PRTEE score than CS-treated patients (P < .01). Both treatments were effective (both P < .01). From assessments at 3 weeks and 6 months post-treatment, PRTEE scores decreased over time. Four CS-treated patients (7.6%) developed skin atrophy and whitening. One DN-treated patient (2.04%) could not tolerate the pain of the intervention and withdrew from treatment. CONCLUSION: DN and CS injection afforded significant improvements during the 6 months of follow-up. However, compared with CS injection, DN was more effective.
Assuntos
Agulhamento Seco , Cotovelo de Tenista , Corticosteroides/uso terapêutico , Humanos , Injeções , Pessoa de Meia-Idade , Estudos Prospectivos , Cotovelo de Tenista/tratamento farmacológicoRESUMO
Plantar fasciopathy (PF) is a common disorder for which there is no consensus regarding an optimal treatment strategy. We hypothesized that dry needling would be as effective as the use of corticosteroid injections for treating PF while avoiding the potential adverse effects of corticosteroids. After approval was received from the institutional review board, patients diagnosed with PF were prescribed a 3-week nonoperative treatment regimen. In addition to using oral and topical antiinflammatory drugs, patients engaged in plantar fascia and gastrocnemius stretching exercises. A study population of 98 patients was planned. An appointment was made in the third week of first-line treatment. Patients whose pain did not abate and who required further treatment were included in the study. One week later, we randomly divided patients into 2 groups using an online random number generator. Group 1 underwent dry needling, and group 2 underwent corticosteroid injection. All dry needling was performed by a single physiotherapist, and all corticosteroid injections were performed by the second author. Patients were assessed in the third week and sixth month by a single investigator using the foot function index. In terms of foot function index scores, dry needling caused significant decrease in the third week and also in the sixth month. However, although corticosteroid use led to a significant decrease at the third week, it lost efficacy in the sixth month (p < .001). In conclusion, dry needling seems to be a reliable procedure for treating PF, with better outcomes than corticosteroid injection.
Assuntos
Terapia por Acupuntura/métodos , Corticosteroides/uso terapêutico , Terapia por Exercício/métodos , Fasciíte Plantar/terapia , Medição da Dor , Administração Tópica , Adulto , Terapia Combinada , Fasciíte Plantar/diagnóstico , Feminino , Seguimentos , Hospitais Universitários , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Resultado do Tratamento , TurquiaRESUMO
PURPOSE: Lateral epicondylitis (LE), a common disease, especially in middle age, causes decreased productivity and economic losses. The first-line treatment for LE is conservative and consists of topical and oral anti-inflammatory drugs, ice application, and brace use. If the first-line treatment fails, second-line treatment modalities, which are generally invasive, are offered. Second-line therapeutic regimens include saline, corticosteroid, or platelet-rich plasma injections. Dry needling is relatively new. We hypothesized that dry needling would be at least as effective as first-line treatment for LE. We compared the outcomes of first-line treatment and dry needling. METHODS: The study allocated 110 patients into groups using online randomization software. After completing the Patient-rated Tennis Elbow Evaluation (PRTEE), patients in group I received dry needling, whereas those in group II received first-line treatment, consisting of ibuprofen 100 mg twice a day and a proximal forearm brace. The patients were evaluated after three weeks and six months. RESULTS: The study ultimately analyzed 92 patients. Although both treatment methods were effective at three weeks, dry needling was significantly more effective than the first-line treatment at six months. CONCLUSION: Because of the low complication rate, dry needling is a safe method, and it might be an effective treatment option for LE.
Assuntos
Manejo da Dor/métodos , Cotovelo de Tenista/terapia , Pontos-Gatilho/lesões , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Braquetes , Feminino , Humanos , Ibuprofeno/uso terapêutico , Injeções , Masculino , Pessoa de Meia-Idade , Manejo da Dor/efeitos adversos , Medição da Dor , Estudos Prospectivos , Resultado do TratamentoRESUMO
In multifocal findings, the possibility of multifocal osteoid osteomas should be considered and this case helps us to be attentive for the unusual radiographical presentation of osteoid osteoma.
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Schwannomas are benign neurogenic tumors of peripheral nerves that originate from neural sheath. The aim of this case report is to bring to mind the schwannoma in the patient with knee pain. A 39-year-old woman presented with a complaint of knee pain of three months history. After surgical intervention, the patient's complaints completely disappeared in the post-operative period. This should come to mind in the differential diagnosis of knee pain.
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Aspergillus can cause invasive disease of various organs especially in patients with weakened immune systems. Aspergillus synovitis and arthritis are uncommon types of involvement due to this infection. Approaches to fungal osteoarticular infections are based on only case reports. This paper presents a rare case of chronic granulomatous Aspergillus synovitis in an immunocompromised 5-year old girl who was treated for acute lymphoblastic leukemia.