• Title/Summary/Keyword: Radicular pain

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Successful Treatment of Rectus Femoris Calcification with Ultrasound-guided Injection: A Case Report

  • Hong, Myong Joo;Kim, Yeon Dong;Park, Jeong Ki;Kang, Tai Ug
    • The Korean Journal of Pain
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    • v.28 no.1
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    • pp.52-56
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    • 2015
  • Painful periarticular calcification most commonly occurs within the rotator cuff of the shoulder and rarely around the elbow, hip, foot, and neck. As acute inflammatory reaction develops, severe pain, exquisite tenderness, local swelling, and limitation of motion with pain occur. In case of calcific tendinitis of the shoulder, it can be easily diagnosed according to the symptoms and with x-ray. However, in lesions of the hip, as it is a rare location and usually involves pain in the posterolateral aspect of the thigh, which can simulate radicular pain from a lumbar intervertebral disc, it could be difficult to diagnose. Hence, physicians usually focus on lumbar lesions; therefore, misdiagnosis is common and leads to a delayed management. Here, we report the case of a 30-year-old female patient with calcific tendinitis of the rectus femoris that was successfully managed with ultrasound-guided steroid injection. This study offers knowledge about the rectus femoris calcification.

Zoster Paresis Misconceived as a Radiculopathy due to Herniated Intervertebral Disc (추간판 탈출증에 의한 신경근병증으로 오인된 대상포진성 부전마비)

  • Kim, Hyun Jee;Yeo, Jin Seok;Jeon, Young Hun;Choi, Jy Young;Ha, Mi Jin;Hong, Jung Gil
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.181-185
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    • 2009
  • Herpes zoster is a viral disease of the posterior root ganglion and sensory nerve fiber, which presents clinically with vesicular eruption of the skin, radicular pain and sensory changes in the distribution of the affected ganglion. However, involvement of the motor neurons can be seen as well. If classic cutaneous lesions are present, herpes zoster-related motor paresis is easily diagnosed. Otherwise, the diagnosis may be more difficult and suspicious, especially if weakness occurs as a symptom before cutaneous lesions appear, or abnormal findings on the MRI are consistent with the signs. There have been few reports of sciatica with motor loss preceding skin lesions. Here, we report a patient with herpes zoster-related motor paresis preceding skin lesions. In the preliminary diagnosis, the herpes zoster-related motor paresis was confused for some structural disorder.

A Case of Tuberculous Meningitis Combined with Acute Cervical Epidural Abscess and Cervical Spondylitis (급성 경추 경막외 농양 및 경추척추염과 동반된 결핵성 수막염 1예)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.140-145
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    • 2002
  • Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

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Hemorrhagic Lumbar Synovial Cyst

  • Park, Hyun Seok;Sim, Hong Bo;Kwon, Soon Chan;Park, Jun Bum
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.567-569
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    • 2012
  • Synovial cysts of the lumbar spine are an uncommon cause of back and radicular pain. These cysts most frequently present as back pain, followed by chronic progressive radiculopathy or gradual onset of symptoms secondary to spinal canal compromise. Although less common, they can also present with acute spinal cord or root compression symptoms. We report of a case in which hemorrhaging into a right L2-3 facet synovial cyst caused an acute onset of back pain and radiculopathy, requiring surgical excision.

TREATMENT OF RADICULAR CYST USING DECOMPRESSION (감압술을 이용한 치근단 낭의 처치)

  • Kim, Nam-Hyuk;Choi, Byung-Jai;Lee, Jae-Ho;Son, Heung-Kyu;Kim, Seong-Oh;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.275-280
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    • 2009
  • Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department. Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.

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Cervical Radiculopathy due to Cervical Degenerative Diseases : Anatomy, Diagnosis and Treatment

  • Kim, Kyoung-Tae;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.473-479
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    • 2010
  • A cervical radiculopathy is the most common symptom of cervical degenerative disease and its natural course is generally favorable. With a precise diagnosis using appropriate tools, the majority of patients will respond well to conservative treatment. Cervical radiculopathy with persistent radicular pain after conservative treatment and progressive or profound motor weakness may require surgery. Options for surgical management are extensive. Each technique has strengths and weaknesses, so the choice will depend on the patient's clinical profile and the surgeon's judgment.

Distribution of Cold Receptor Transient Receptor Potential Melastatin 8-Immunopositive Axons in the Mouse Dental Pulp and Periodontal Tissue

  • Kim, Tae Heon;Lee, Jae Sik;Kim, Yun Sook;Bae, Yong Chul
    • International Journal of Oral Biology
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    • v.42 no.4
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    • pp.169-174
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    • 2017
  • Transient receptor potential melastatin 8 (TRPM8) plays a crucial role in innocuous cool sensation, acute cold pain and cold-induced hyperalgesia during pathologic conditions. To help understand TRPM8-mediated cold perception in the dental pulp and periodontal tissues, we examined the distribution of TRPM8-immunopositive (+) axons in molar and incisor pulp and periodontal tissues using transgenic mice expressing a genetically encoded axonal tracer in TRPM8+ neurons. In the radicular pulp of the molar teeth, a small number of TRPM8+ axons were observed. TRPM8+ axons branched frequently and extensively in the core of coronal pulp, forming a network in the peripheral pulp. Some TRPM8+ axons ascended between odontoblasts and were observed in the dentinal tubule. TRPM8+ axons were linear-shaped in the radicular pulp, whereas many TRPM8+ axons showed portions shaped like beads connected with thin axonal stands at the peripheral pulp. TRPM8 was densely expressed in the bead portions. In the incisor pulp, TRPM8+ axons were occasionally observed in the core of the coronal pulp and rarely observed at the peripheral pulp. TRPM8+ axons were occasionally observed and showed a linear shape rather than a bead-like appearance in the periodontal ligament and lamina propria of the gingival tissue. These findings, showing differential distribution of TRPM8+ axons between radicular and coronal portions of the molar pulp, between incisor and molar pulp, and between dental pulp and periodontal tissues, may reflect differential cold sensitivity in these regions.

An Analysis of the Outcome of Transforaminal Epidural Steroid Injections in Patients with Spinal Stenosis or Herniated Intervertebral Discs (요척주관 협착증 혹은 추간판 탈출증 환자에서 실시한 경추간공 경막외 스테로이드 주입의 결과에 관한 분석)

  • Hong, Ji Hee;Lee, Yong Chul;Lee, Han Min;Kang, Chul Hyung
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.38-43
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    • 2008
  • Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.

A Case Report of Herpes zoster with acute pain by Yongdamsagan-tang(longdanxiegan-tang) (용담사간탕(龍膽瀉肝湯)을 이용한 대상포진(帶狀疱疹)의 급성기(急性期) 통증(痛症)에 대한 치험(治驗) 1례(例))

  • Park Young-Jun;Park Joo-Han;Heo Geum-Jeong;Nam Chang-Gyu;Sun Jung-Ki;Koo Chang-Mo
    • The Journal of Internal Korean Medicine
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    • v.24 no.1
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    • pp.151-156
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    • 2003
  • Herpes zoster is a viral disease characterized by unilateral radicular pain and vesicular eruptions that are generally limited to the dermatome innervated by single spinal or cranial sensory ganglion. The disease causes severe pain and in particular, put elderly patients in great risks and further it develops postherpetic nenralgia. Nowadays western medicine use antiviral durg(ex: acyclovir), analgesics, nerve block and etc for treatment of herpes zoster and pain control, but the effect is not much satisfactory. A 73-year-old patient, admitted to our hospital because of severe migrain. Two days later, her illness was diagnosed as herpes zoster so we administrated Yongdamsagan-tang. After the six-day of treatment, all symptoms improved, especially headache was cleared since the four day long administration of Yongdamsagan-tang.

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Efficacy of transforaminal laser annuloplasty versus intradiscal radiofrequency annuloplasty for discogenic low back pain

  • Park, Chan Hong;Lee, Kyoung Kyu;Lee, Sang Ho
    • The Korean Journal of Pain
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    • v.32 no.2
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    • pp.113-119
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    • 2019
  • Background: Discogenic pain is a common cause of disability and is assumed to be a major cause of non-specific low back pain. Various treatment methods have been used for the treatment of discogenic pain. This study was conducted to compare the therapeutic success of radiofrequency (an intradiscal procedure) and laser annuloplasty (both an intradiscal and extradiscal procedure). Methods: This single-center study included 80 patients and followed them for 6 months. Transforaminal laser annuloplasty (TFLA, 37 patients) or intradiscal radiofrequency annuloplasty (IDRA, 43 patients) was performed. The main outcomes included pain scores, determined by the numeric rating scale (NRS), and Oswestry disability index (ODI), at pre-treatment and at post-treatment months 1 and 6. Results: The patients were grouped according to procedure. In all procedures, NRS and ODI scores were significantly decreased over time. Mean post-treatment pain scores at months 1 and 6 were significantly lower (P < 0.01) in both groups, and between-group differences were not significant. The ODI score was also significantly decreased compared with baseline. Among patients undergoing TFLA, 70.3% (n = 26) reported pain relief (NRS scores < 50% of baseline) at post-treatment 6 months, vs. 58.1% (n = 25) of those undergoing IDRA. There were no statistically significant differences between the groups in ODI reduction of > 40%. Conclusions: Our results indicate that annuloplasty is a reasonable treatment option for carefully selected patients with lower back and radicular pain of discogenic origin, and TFLA might be superior to IDRA in patients with discogenic low back pain.