Department of Physical Medicine & Rehabilitation/Department of Anesthesiology, Northwestern Feinberg School of Medicine/The Rehabilitation Institute of Chicago, Chicago, IL.
Department of Anesthesia, Northwestern Feinberg School of Medicine, Chicago, IL.
Pain Physician. 2017 Jul;20(5):E721-E726.
Higher body mass index (BMI) is associated with difficulty in obtaining imaging studies. While there is a small body of literature regarding the relationship between fluoroscopy time and BMI during injections for pain management, this has not been studied for intraarticular (IA) hip injections. Further, in academic training centers, trainee involvement may affect this relationship.
To determine the relationship between BMI and fluoroscopy time during IA hip injections, both with and without involvement of a trainee.
Multicenter retrospective cohort study.
Three academic, outpatient musculoskeletal and pain medicine centers.
Patients who underwent fluoroscopically guided IA hip injections with encounter data regarding fluoroscopy time during the procedure and BMI were included. Mean and standard deviation fluoroscopy time were recorded. Comparisons were made between BMI categories of normal (18.5 - 24.9 kg/m2), overweight (25.0 - 29.9 kg/m2), and obese (greater than or equal to30.0 kg/m2). Statistical significance was set at P = 0.01 due to multiple comparisons.
A total of 559 IA hip injections are represented in this cohort. Patients had a mean age of 58 (standard deviation [SD] 14) years and 63% were women. There was no significant difference in fluoroscopy time when comparing BMI categories (P = 0.02). However, when trainees were not involved in the injection, fluoroscopy times were significantly shorter with decreasing BMI category, with normal weight patients requiring the shortest fluoroscopy times (P = 0.01).
This study evaluated total fluoroscopy time, not radiation dose exposure per injection, which provides more direct and precise information with regard to provider and patient radiation exposure and overall safety. Future study of the impact of BMI on radiation dose during fluoroscopically guided IA hip injections is needed.
Fluoroscopy times during IA hip injections increase with higher BMI categories in a statistically significant manner when performed by experienced clinicians but this relationship is not observed when injections are performed with a trainee in a teaching institution. This finding appears to be related to longer fluoroscopy time required to complete an IA hip injection in patients with lower BMI when a trainee is involved.
Hip, injections, obesity, overweight, body mass index, fluoroscopy, radiation, pain.
较高的体重指数（BMI）与获得影像学研究的难度有关。虽然有一些关于在疼痛管理注射过程中透视时间与 BMI 之间关系的文献，但尚未对此进行关节内（IA）髋关节注射的研究。此外，在学术培训中心，学员的参与可能会影响这种关系。
确定在进行 IA 髋关节注射时，无论是否有学员参与，BMI 与透视时间之间的关系。
多中心回顾性队列研究。
三家学术性、门诊肌肉骨骼和疼痛医学中心。
纳入了接受透视引导 IA 髋关节注射的患者，并记录了术中透视时间和 BMI 的相关数据。记录了平均和标准差透视时间。比较了 BMI 正常（18.5-24.9kg/m2）、超重（25.0-29.9kg/m2）和肥胖（≥30.0kg/m2）三个类别的 BMI。由于多次比较，统计学意义设为 P=0.01。
该队列共纳入 559 例 IA 髋关节注射。患者的平均年龄为 58 岁（标准差 [SD] 14 岁），63%为女性。比较 BMI 类别时，透视时间无显著差异（P=0.02）。然而，当学员不参与注射时，随着 BMI 类别的降低，透视时间显著缩短，正常体重患者需要最短的透视时间（P=0.01）。
本研究评估了总透视时间，而不是每次注射的辐射剂量暴露，这提供了更直接和精确的信息，涉及到提供者和患者的辐射暴露和整体安全性。需要进一步研究 BMI 对透视引导 IA 髋关节注射中辐射剂量的影响。
当由经验丰富的临床医生进行时，IA 髋关节注射的透视时间随着 BMI 类别的增加而呈统计学显著增加，但在教学机构中，当学员参与时，这种关系并不观察到。这一发现似乎与学员参与时 BMI 较低的患者进行 IA 髋关节注射所需的更长透视时间有关。
髋关节、注射、肥胖、超重、体重指数、透视、辐射、疼痛。
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