• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.183-187
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• 2020

Perineural cysts are usually discovered incidentally; only approximately one percent of such cysts are symptomatic. Symptomatic cervical perineural cysts, of which only five case reports have been found in the literature, are extremely rare and there is no consensus regarding treatment. When a cervical perineural cyst is discovered in a patient with cervical radiculopathy without the cause of other apparent compression, the cyst can be considered as a possible cause of cervical radiculopathy. In such cases, non-surgical conservative treatment can be considered before any surgical intervention. We reported the successful treatment of case of a 40-year-old woman with a symptomatic cervical perineural cyst by oral steroids and transforaminal epidural steroid injection.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.54-76
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• 2024

Facet joint arthrosis is a progressive degenerative disease that is frequently associated with other spinal degenerative disorders such as degenerative disc disease or spinal stenosis. Lumbar facet joint arthrosis can induce pain in the proximal lower extremities. However, symptoms and imaging findings of "facet joint syndrome" are not specific as they mimic the pain from herniated discs or nerve root compression. Currently, evidence for therapeutic intra-articular lumbar facet joint injections is still considered low, with a weak recommendation strength. Nevertheless, some studies have reported therapeutic effectiveness of facet joint injections. Moreover, the use of therapeutic facet joint injections in clinical practice has increased. This review article includes opinions based on the authors' experience with facet joint injections. This review primarily aimed to investigate the efficacy of lumbar facet joint injections and consider their associated safety aspects.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.8 no.1
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• pp.1-5
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• 2015

Purpose: The purpose of this study was to analyze the effectiveness of local steroid injection for infraspinatus under ultrasonographic guidance in patients with posterior shoulder pain during horizontal adduction test. Materials and Methods: Twenty one cases of patients, from May 2013 to May 2014, showed positive horizontal adduction test were retrospectively analyzed. We performed ultrasonography-guided infraspinatus injection using steroid to these patients in the outpatient clinics. We evalulated results for visual analogue score (VAS) for pain, UCLA score for these patients before injection, following 3 months and 6 months after injection. Results: After ultrasonography-guided infraspinatus injection using steroid, there were clinically significant improvements in VAS and UCLA score at 3 month's follow-up period (p<0.05). But there were no significant differences in VAS and UCLA score between 3 months and 6 months (p>0.05). Fourteen of 21 (67%) cases showed much improved and improved satisfaction. Respectively, seven of 21 (33%) cases showed not improved and aggravation satisfaction. Conclusion: Ultrasonography-guided infraspinatus injection using steroid is an effective treatment method for the patients with exacerbated posterior shoulder pain during horizontal adduction test.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.437-441
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• 2010

Toxic epidermal necrolysis (TEN) and Stevens Johnson syndrome (SJS) are rare, life-threatening mucocutaneous -diseases, usually attributable to drugs and infections. Corticosteroids have been used in the management of TEN for the last 30 years. This remains controversial and is still much debated. TEN can occur despite administration of high doses of systemic corticosteroids. The psychiatric side effects of corticosteroids can include headache, insomnia, depression, and mood disorders with or without psychotic episodes. Steroid-induced psychosis is dealt with by tapering or discontinuing the steroid; antipsychotics are also sometimes used. We report a case of an 11-year-old boy who was admitted with TEN. He had also been diagnosed as having nephrotic syndrome in the past. Remission was achieved through induction therapy and by maintaining the use of steroids. After a full-dose intravenous dexamethasone for TEN, he showed psychotic symptoms. We diagnosed him as having steroid-induced psychosis. We tapered the steroid use and initiated an atypical antipsychotic medication, olazapine and intravenous immunoglobulin (IV-IG). His symptoms dramatically improved and he was discharged.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.77-83
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• 2011

Purpose: We compared with USG-guided steroid injection group and blind steroid injection group for the treatment of calcific tendinitis to evaluate the effectiveness of the treatment modalities. Materials and Methods: We reviewed two groups of calcific tendinitis treated with steroid injection and follow up upto 6 month after injection. Group I was blind injection for 88 patient with average age of 53years old and female gender in 77%. Group II was USG- guided injection for 102 patients with average age of 54years old and female gender in 85%. We compared follow up results according to age, gender, size of tendon involvement, initial VAS score, and phase of the calcific tendinitis between two groups. Results: At 6 month's follow up period, USG-guided injected group was more prevalent compared to blind injection group with 92%(94/102) and 72%(64/88) (P<0.05). In Group I, 77%(49/64) patients have improved symptom. And in Group II, 92%(86/94) patients have improved symptom in formative or resorptive phase. Despite of symptom improvement, calcium deposit is remained 47%(30/64) in Group I, and 20%(19/94) in Group II. Conclusion: Conservative treatment of Shoulder calcific tendinitis patients through USG-guided injection is more effective than Blind injection in pain relief & calcium decrease. The patients USG-guided injected group was more prevalent in follow up at outpatient clinic, throughout more accurate injection with improved confidence.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.109-113
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• 2010

Purpose: To evaluate the efficacy of ultrasound guided injection of prolotherapy and steroid mixture injection in patients with adhesive capsulitis. Materials and Methods: 53 patients with adhesive capsulitis were included in the study and in all the patients a mixture of steroid and prolotherapy agent was injected into the coracohumeral ligament under the sonographic guidance. The patients were evaluated using the VAS and ROM of the shoulder before the injection and at 8 weeks and at 1 year after the injection. Results: Forward flexion was 93.4 degrees before the injection and was 142, 153 degrees at 8weeks and 1 year after injection. Abduction was 79.2 degrees before the injection and was 125.4, 152.6 degrees at 8 weeks and 1 year after the injection. The VAS score was 6.7 before the injection and was 3.5, 3.7 at 8 weeks and 1 year after the injection. Conclusion: The ultrasound guided injection of prolotherapy and steroid mixture into the coracohumeral ligament in patients with adhesive capsulitis is allowing both tissue distension and inflammatory process controlling procedure. It is effective in improving the range of shoulder motion significantly and is also effective in decreasing the pain.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.180-184
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• 2012

Fungal arthritis is a rare joint infection that occurs in immunosuppressant patient, intravenous drug abuser and long term antibiotics user, and is especially rare in a healthy adult. Two case reports of fungal arthritis have been demonstrated in the country, but those in healthy adults have not been reported yet. Here, we experienced an antifungal treatment following successful arthroscopic debridement of fungal arthritis with a popliteal cyst in a healthy adult who got repetitive intraarticular steroid injections and report the case with review of relevant literatures. Surgeons should consider the possibility of fungal arthritis although it is rare and demonstrates nonspecific clinical features.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.61-65
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• 2012

Purpose: The aim of this study was to evaluate the effectiveness of ultrasound-guide steroid injection according to Morton's neuroma size. Materials and Methods: From October 2008 to September 2011, 17 patients (23 cases) diagnosed with Morton's neuroma were investigated. All cases were female and mean age was 52.6 years old. Neuroma were measured by the horizontal and longitudinal length of the mass and underwent ultrasound-guided steroid (5 mg dexamethasone) injection. The efficacy of the injection was determined by Visual Analogue Scale pain score and patient satisfaction(subdivided 4 group-much improved, improved, not improved, aggrevation) Results: 7 of 23(30.4%) cases showed much improved and improved satisfaction and mean longitudinal and horizontal length were $0.71{\pm}0.39cm$ and $0.47{\pm}0.24cm$, respectively. 16 of 23(69.6%) cases showed not improved and aggrevation satisfaction and mean longitudinal and horizontal length were $0.83{\pm}0.42cm$ and $0.54{\pm}0.14cm$, repectively. There was a significant difference in VAS and patient satisfaction in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm. (p<0.05) Conclusion: The ultrasonography is a important modality in diagnosis and treatment of morton's neuroma. Ultrasound-guide steroid injection is effective in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm, respectively.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.68-73
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• 2009

Purpose: We retrospectively studied the outcomes of the shoulder impingement syndrome for the treatment of the ultrasound-guided subacromial bursal steroid injection. Materials and Methods: Sixty-six shoulders of sixty-two patients with shoulder impingement syndrome treated from March, 2006 to April, 2009 were involved in this study. All cases underwent standardized, nonoperative treatment protocol consisting of 5~12 MHz high resolution ultrasound-guided local steroid injection into the subacromial bursa in modified Crass position. The shoulder range of motion, VAS score and impingement signs were evaluated during the initial and 1year visits. After injection, shoulder elevation exercise was encouraged. Statistical analysis with ANOVA model and Tukey's post-hoc test with the significance level at 5% were performed using SAS program. Results: All cases showed improved range of motion without limitation of shoulder function at immediate post-injection, 6-week, 3-month and 1year visits. The average VAS score at one year follow-up decreased to 2.85 from 6.47 before injection. In all cases the impingement signs became negative immediate after injection. However, 6 cases showed positive impingement signs after 6-week, which became negative after reinjection. The range of motion and VAS score were improved at one-year follow-up compared to initial visit (p<0.0001). No complication was noted at all follow-up period. Conclusion: Ultrasound-guided subacromial steroid injection alleviated the need of surgery, because it was successful in all our cases to improve pain and function of the shoulders until one year follow-up period.

• The Journal of Korea CHUNA Manual Medicine
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• v.4 no.1
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• pp.17-28
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• 2003

We experienced a patient(53-year-old female) with knee joint effusion, pain and stiffness who had not responded to steroid injection therapy, significantly improved by bee venom acupuncture in clinical symptom. And for a opinion that prohibited bee venom acupuncture on DM because of increasing serum glucose level by increasing serum cortisol level, we also experienced that serum glucose level of DM patient stabilized by bee Venom acupuncture treatments, so we report this case with literature review of articles.