Department of Radiology, Orthopaedic University Hospital of Balgrist, Forchstrasse 340, 8008 Zürich, Switzerland.
AJR Am J Roentgenol. 2010 Dec;195(6):W435-9. doi: 10.2214/AJR.10.4501.
The purpose of this study was to evaluate pain relief 20 to 30 minutes after diagnostic or therapeutic injections into the sternoclavicular joint and to compare patient outcomes based on the CT diagnosis.
Informed consent was obtained from each patient. Ethics approval was not required. Fifty patients who had CT-guided injections of corticosteroid and local anesthetic into their sternoclavicular joints were included in the study. Preinjection and 20- to 30-minute postinjection visual analog scale data were recorded and compared with the imaging findings agreed by consensus. Kappa statistics were calculated for the reliability of imaging diagnosis. The percentage of patients improving after joint injection was calculated, and the risk ratio comparing the response of patients with osteoarthritis to those without osteoarthritis was completed. The correlation between the severity of each patient's osteoarthritis and the pain response was calculated using Spearman's correlation coefficient.
Sixty-six percent of the patients reported clinically significant pain reduction at between 20 and 30 minutes after injection. The proportion of patients with osteoarthritis who had a clinically significant response was 67% compared with 64% for patients who did not have osteoarthritis. This difference was not statistically or clinically significant. There was no correlation between the severity of osteoarthritis and the amount of pain reduction (r = 0.03). The reliability of imaging diagnosis was substantial.
Two thirds of patients having sternoclavicular joint injections of corticosteroids and local anesthetics report clinically significant improvement regardless of the abnormalities detected on their CT images.
本研究旨在评估诊断或治疗性注射到胸锁关节后 20 至 30 分钟的疼痛缓解情况，并根据 CT 诊断比较患者的结果。
每位患者均获得知情同意。无需伦理批准。本研究纳入了 50 名接受 CT 引导下皮质类固醇和局部麻醉剂注射到胸锁关节的患者。记录了注射前和注射后 20 至 30 分钟的视觉模拟量表数据，并与共识一致的影像学发现进行比较。计算了影像学诊断的可靠性的 Kappa 统计量。计算了关节注射后改善的患者比例，并完成了比较骨关节炎患者与无骨关节炎患者反应的风险比。使用 Spearman 相关系数计算每位患者骨关节炎严重程度与疼痛反应之间的相关性。
66%的患者报告在注射后 20 至 30 分钟内出现明显的临床疼痛减轻。有骨关节炎的患者中有 67%具有明显的临床反应，而没有骨关节炎的患者为 64%。这一差异无统计学意义或临床意义。骨关节炎的严重程度与疼痛减轻量之间无相关性（r = 0.03）。影像学诊断的可靠性是相当大的。
三分之二的接受皮质类固醇和局部麻醉剂胸锁关节注射的患者报告有明显的临床改善，无论其 CT 图像上是否存在异常。
