• Title/Summary/Keyword: 스테로이드 주입술

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Treatment of Simple Bone Cyst in Calcaneus with Endoscopic Curettage and Autologous Bone Graft - Case Report - (종골에 발생한 단순 골낭종의 내시경적 소파술 및 골 이식술 - 증례 보고 -)

  • Jung, Gu-Hee;Kim, Jae-Do;Kim, Ji-Youn
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.182-186
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    • 2008
  • Simple bone cysts are common, benign bone tumor and for the treatment, curettage with bone grafting, resection and intralesional steroid or autogenic bone marrow injections were usually performed. Simple bone cysts of the calcaneus are relatively uncommon and curettage with autologous bone grafting were proposed for management rather than intralesional steroid injections. We would like to report 9 year-old male with calcaneal simple bone cyst treated satisfactorily by minimally invasive endoscopic curettage and autologous bone grafting with review of the relevant literature.

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Efficacy of Fluoroscopy-Guided Lumbar Facet Joint Synovial Cyst Rupture with Intra-Articular Steroid Injection after Laminectomy (척추 후궁절제술 이후 발생한 요추 후관절 활액낭에서 투시유도 하 낭종파열술 및 관절 내 스테로이드 주입술의 임상적 경험)

  • Hyo Jin Kim;Eugene Lee;Joon Woo Lee;Yusuhn Kang;Joong Mo Ahn
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.162-172
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    • 2021
  • Purpose We retrospectively evaluated the technical success rate and long-term efficacy of fluoroscopy-guided synovial cyst rupture followed by an intra-articular steroid injection at the post-laminectomy lumbar facet. Materials and Methods We selected subjects who had undergone a fluoroscopy-guided synovial cyst rupture with simultaneous intra-articular steroid injection within 6 months of MRI and demonstrated a symptomatic facet joint synovial cyst at the level of a previous lumbar laminectomy. Fourteen patients were enrolled, and we determined whether cyst rupture and symptom improvement were achieved after each procedure. The degrees of symptom improvement were categorized into 4: 1) symptoms improved (30% or more reduction, based on pre-procedural and post-procedural Numerical Pain Rating Scale scores), 2) symptoms not improved, 3) patient underwent surgery after injection, and 4) loss of follow-up. Results The success rate of percutaneous synovial cyst rupture decreased with repeated procedures (62.5% for the first procedure and 0% to 33.3% for additional procedures). However, 80% of the patients had symptom improvement with the procedures, overall. The surgery rate was 14.3% in 14 patients. Conclusion For patients with post-laminectomy symptomatic lumbar facet joint synovial cysts, fluoroscopy-guided synovial cyst rupture with intra-articular steroid injection may be an effective and less invasive treatment before considering a surgical approach.

The Effect of Steroid Injection of Simple Bone Cyst in Adults (성인에서 발생한 단순성 골 낭종에 대한 스테로이드 주입의 효과)

  • Yang, Jun-Young;Lee, June-Kyu;Kim, Dong-Hee;Kim, Tae-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.23-29
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    • 2006
  • Purpose: To evaluate the effectiveness of steroid injection for treatment of simple bone cyst in adults. Materials and Methods: 11 patients who were able to be followed up from February 1998 to February 2003. These lesions were attained by needle aspiration or trepanation and 80 mg to 200 mg of Depo-medrol (methylprednisolone acetate, Shin Poong Pharm. Co., Korea) was injected. The follow-up roentgenograms were done every 2 weeks, and if there were no evidence of recovery, re-injection was done 8 weeks later. Injection has done maximally 5 times, and we evaluated the result with modified Neer, Pentimalli, Scaglietti and Sandra classification. Results: There were no cases in which one Injection was enough for full recovery, and 3 cases after 2 injections, 3 cases after 3 injections, 2 case after 5 injections had good result. but 2 cases after more than 5 injections did not show improvements and are currently under observation. One case showed a increase in size of the bone cyst after 2 injections of steroid and underwent curettage and autogenous bone graft. Overall outcomes by Pentimalli classification were good in One case, fair in 7 cases and poor in 3 cases at final follow-up. Conclusion: Local injection of steroids is effective method in adults and can be considered as a first line treatment modality.

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Conservative Management in Simple Bone Cyst (단순 골 낭종의 보존적 치료)

  • Kim, Ji-Youn;Cho, Yong-Jin;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.51-57
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    • 2011
  • Purpose: This study evaluated the results of conservative treatment for simple bone cyst. Materials and Methods: We studied 126 cases of simple bone cyst, which were treated by observation or steroid injection from February 1990 to May 2010. Their mean age at diagnosis was 14 years (${\pm}9$ years, 2-60 years) and the mean follow-up duration for this study were 41 months (${\pm}37$ months, 12-159 months). Observation and steroid injection was applied for conservative management of simple bone cyst and results was scored by modified Neer classification. Results: 31 cases (24.6%) were treated by observation and 95 cases (75.4%) were treated by steroid injection. The 95 patients were treated by a mean of 1.1 (${\pm}0.9$, 0-4) steroid injections and a single steroid injection was given in 65 cases (51.6%). The 102 cases (80.9%) were resulted in modified Neer classification I and II which could be considered as healing of simple bone cyst. Conclusion: Conservative management can be considered as an initial treatment for simple bone cyst with good result.

Treatment Outcome of Langerhans Cell Histocytosis (랑게르한스 세포 조직구증의 치료 결과)

  • Chung, So Hak;Kim, Jae Do;Jo, Hyun Ik
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.14-21
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    • 2014
  • Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

The Efficacy of Percutaneous Steroid Injection via Cricothyroid Membrane for Reinke's Edema (라인케씨 부종 환자에서 경윤상 갑상막 접근을 통한 성대 내 스테로이드 주입술의 효용)

  • Nam, Woojoo;Kim, Sun Woo;Jin, Sung Min;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.101-106
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    • 2019
  • Background and Objectives Reinke's edema is a benign vocal fold disease caused by an edematous laryngeal superficial layer of lamina propria. The first line treatment is cessation of smoking and laryngeal microsurgery. The aim of the study is to evaluate the feasibility and efficacy of percutaneous steroid injection via cricothyroid membrane in patients with Reinke's edema. Materials and Method From Jan 2010 to July 2018, 33 Patients with Reinke's edema managed by vocal fold steroid injection via the cricothyroid membrane were included in this study. We compared medical records of laryngoscopy, stroboscopy and Multi-Dimensional Voice Program analysis at pre-treatment and post-treatment. Subjective voice improvement was evaluated using Voice Handicap Index-30 (VHI-30). Results 75.7% of the patients showed partial response and 6.06% showed complete response. 93.94% were present smokers and only 4 patients ceased smoking after the treatment. In acoustic analysis, the pre-treatment mean value of jitter, shimmer, and noise to harmonic ratio was 2.30±3.21, 9.34±10.37, 1.11±2.90 each. The post-treatment value was 2.20±1.89, 6.96±5.30, 0.20±0.09 respectively and none of the parameters were statistically significant. For subjective symptom improvement, 25 (75.8%) patients showed a better score on post-treatment VHI-30 compared to pre-treatment. Conclusion According to our study, steroid injection is a relatively safe and effective procedure for patients with Reinke's edema. A vocal fold steroid injection via the cricothyroid membrane can be an alternative treatment option for those who are not able to undergo conventional laryngeal microscopic surgery, however cessation of smoking is necessary for effective treatment.

Outcomes of Treatment for Pathologic Fractures Secondary to Simple Bone Cyst (장관골 단순성 골낭종에 동반된 병적 골절의 치료결과)

  • Jeon, Si-Hyun;Song, Kwang-Soon;Kim, Chul-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.38-44
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    • 2003
  • Purpose: To suggest an appropriate treatment modality regarding analyze outcomes of treatment for pathologic fracture to simple bone cyst of the long bone. Materials and Methods: We selected 12 cases with pathologic fracture of the long bone among the 31 cases treated for simple bone cyst from December. 1993 to May. 2001. The mean age was 9 years ranged from 2 years to 19 years, male was 11 cases and female was 1 cases, and the mean follow up interval was 32.9 month ranged from 12 month to 69 month. The principle of treatment for pathologic fracture of the long bone was conservative treatment except operative treatment for fracture with displacement of the femur. After fracture was united, the residual lesion was treated by local steroid injection, cortical drilling, curettage & bone graft. But we observed without specific treatment in cases that had healing process of simple bone cyst followed by bony union. The clinical results were evaluated as exellent if simple bone cyst was completely healed, as good if that had process of healing, as poor if that was no change or more increased in size. Results: The pathologic fracture was united in all cases treated with conservative treatment in 9cases and by open reduction with internal fixation in 3 cases. After fracture was united, the 6 cases were observed without specific treatment, because they had healing process of cyst, and had outcomes as good and excellent. Conclusion: We suggest to need observation when simple bone cyst has healing process after pathologic fracture was united, otherwise secondary treatment will be needed when residual lesion is persisted.

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Arthroscopic Treatment of Recurrent Prepatellar Bursitis (관절경을 이용한 재발성 슬개골전 점액낭염의 치료)

  • Kyung Hee-Soo;Kim Hee-Soo;Hwang Jun-Kyung;Ihn Joo-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.183-187
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    • 2002
  • Purpose : We report a result of arthroscopic treatment of the recurrent prepatellar bursitis. Materials and Methods : Between March 2001 and May 2002, we treated 4 patients with prepatellar bursitis, the average follow-up period was 14.5 months. The causes were acute trauma 3 cases and repeated minor trauma 1 case. All cases were recurred after previous history of the conservative therapy at other hospital but one was a recurred case after operative excision. Operative technique was as follows. Before inserting the arthroscope, the bursa was inflated with saline. The portals fur 4 mm diameter arthroscope were placed 1cm away from the bursal sac through small skin incision. Superficial layer of the bursa was resected first and then deep portion was the next. Several percutaneous mattress sutures were applied to the overlying skin with deep tissue, and compressive dressing was applied and maintained for 2 weeks. Results : All 4 cases were no recurrence, no pain, no tenderness. The results were considered satisfactory, Two cases of mild skin dimpling at suture site were observed. Conclusion : Arthroscopic treatment of the prepatellar bursitis is an another method of operation technique fur recurrent prepatellar bursitis, however long term follow-up will be needed about recurrence.

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Ultrasonography-Guided Multiple Needling for Calcific Tendinitis of the Shoulder (견관절 석회화 건염의 초음파 감시하 다발성 천공술)

  • Jeong, Woong-Kyo;Park, Jung-Ho;Moon, Joon-Gyu;Kim, Ho-Joong;Lee, Soon-Hyuck
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.74-78
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    • 2009
  • Purpose: To evaluate the effectiveness of ultrasonography-guided multiple needling for calcific tendinitis of the shoulder. Materials and Methods: We included 18 symptomatic calcific tendinitis patients who underwent ultrasonography-guided multiple needling and followed for average 17 weeks. The procedures were multiple needling or aspiration of the calcific deposit and injection of local anesthetics and steroid into the subacromial bursa under the ultrasound control. Clinical improvements were evaluated using pain VAS, UCLA score and KSS score. The size and status of calcific deposits were compared. Results: A significant improvement was seen in pain VAS, UCLA score and KSS score (p<0.05). At the final follow up, the calcific deposits had resolved completely of nearly completely in 39%, and the size was decreased in 61%. Conclusion: Ultrasound-guided multiple needling is considered as a useful method which could provide prompt pain relief and reduce calcific deposit for calcific tendinitis of the shoulder.

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EXCISIONAL BIOPSY OF MUCOCELE USING BIOPSY PUNCH (생검펀치를 이용한 점액낭종의 절제)

  • Hong, Eun-Hye;Choi, Byung-Jai;Lee, Jae-Ho;Choi, Hyong-Jun;Son, Heung-Kyu;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.2
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    • pp.349-353
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    • 2007
  • Mucocele is a clinical term of the localized superficial mucosal swelling caused by salivary retention after the obstruction or the rupture of minor salivary ducts. Various treatment methods have been suggested to lower its recurrence rate, including complete excision of lesion Biopsy punch can be used easily and simply for complete excision of mucocele. It has several advantages, such as convenience in use, low bleeding tendency, and nearly no requirements for post-operative management. In this case, biopsy punch was used for the removal of mucocele in an uncooperative child, which enable fast, simple and safe procedure, with a good result.

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