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US guided knee joint sensory articular branch block for chonic knee OA,lecture & clinical case 

Practical Pain Management with Dr. Lee
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Us guided Interventional treatment Of chronic Knee Joint pain. In this video, I explain chronic knee pain pathology and basic interventional treatment. If I give you an ample of dexamethasone, where would you inject it? I would select intra-articular space, Hoffa's fat pad. medial collateral ligament, lateral collateral ligament, and posterior triangular fat pad. for some cases of chronic pain, this treatment failed to relieve pain. in this patient, they usually show bone marrow edema of the tibia or femoral subchondral area. These MRI findings have the logic to put the needle to block the articular branch of the knee joint.
#chronic knee pain #articular branch #vastusmedialnerve#genicularnerve #ultrasound #GE #realtime #painreduction #osteoarthritis
#만성관절염 #무릎통증 #초음파 #시술 #관절신경차단술 #고주파시술 #이미지트레이닝

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26 авг 2024

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Комментарии : 36   
@shahidhafeez1521
@shahidhafeez1521 6 месяцев назад
Thank you informative
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 5 месяцев назад
thank you
@hyeonsunglee3173
@hyeonsunglee3173 Год назад
최고입니다 ^^*
@practicalpainmanagementwit8115
thanks
@meltemkanar6409
@meltemkanar6409 3 года назад
Hi Dr Lee. First of all, thanks for the video. All of them are really educational. But the music on the background is too loud, makes it difficult to understand what is being said.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
thank you for your comment
@soveerdhakad
@soveerdhakad 2 года назад
Thankyou for your knowledge sharing, it's very nice, their is a request for not adding background music so we can understand what you are speaking... It so loud that it's hard to understand your voice
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
thank you for your comment, Now I am reducing the music. it was the first version. Sorry for understanding
@tazkirah88
@tazkirah88 4 месяца назад
Hi Dr.Lee...do we need to inject recurrent peroneal nerve block as it supplies the infero-lateral part of knee join?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 месяца назад
I did not find a case who need recurrent peroneal nerve block
@drpain2249
@drpain2249 3 года назад
Great fan of you Dr Lee...from India...can we communicate or attend your course online
@drpain2249
@drpain2249 3 года назад
Have a degree of pain medicine after md anesthesia
@oosmaaaru2073
@oosmaaaru2073 3 года назад
좋은 영상 감사드립니다. knee effusion 이 지속될 경우 aspiration 을 계속 해주시는지요? 그리고 injection 이나 intervention 이후 NSAIDs 나 어떤 medication 처방을 선호하시는지도 궁금합니다.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
injection 이 반복되고 통증이 지속된 경우 대부분 subchondral bone marrow edema가 심하게 있어요. 먼저 evaluation을 권하는 것이 좋을 것 같아요. 초음파와 x-ray로 보이지 않은 부분은 MRI 가 도움이 많이 됩니다
@WW-wq2iz
@WW-wq2iz 2 года назад
@@practicalpainmanagementwit8115 MRI상 subchondral bone marrow edema가 있고 effusion이 반복되는 경우에 어떻게 치료하면 좋을까요? 인공관절수술 말고는 방법이 없을까요?
@user-ro1zr3fl3h
@user-ro1zr3fl3h 2 года назад
Dr.Lee thank you for your clinical sharing. Is PRF useful to intractable chronic OA knee pain?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
I will post the MSK PRF in another section
@jimmyDhamma
@jimmyDhamma Год назад
The 2nd question is what is the purpose of injecting dexa in hoffa's fat pad?thx dr lee
@practicalpainmanagementwit8115
Join the premium membership to enjoy clear explain about your questions.
@drpraveensvizagpainclinic
@drpraveensvizagpainclinic 11 месяцев назад
How to join premium membership Whats the difference between practice classes and master classes
@jimmyDhamma
@jimmyDhamma Год назад
Hi dr.lee, can we change dexamethasone palmitate to dexamethason sodium phospate bcoz we dont hv it in indonesia
@practicalpainmanagementwit8115
sure you can.
@aronraon7792
@aronraon7792 3 года назад
안녕하세요. 좋은 영상감사드립니다. hoffa's fat pad와 genicular branch block에도 관절강주사와 동일하게 dexamethasone palmitate를 사용하시나요? (즉, 동일한 용액을 쓰시는지요?)
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
@aronraon7792
@aronraon7792 3 года назад
@@practicalpainmanagementwit8115 아.. hoffa에 steroid 주사는 fat pad atrophy걱정에 하지못했는데 triam이 아닌 dexa는 fat atrophy 걱정은 안해도될까요?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
@@aronraon7792 너무 적은 양이기 때문에 fat atrophy는 문제 없어요. 대부분 이미 다 tear가 되어 이부분이 문제지요
@aronraon7792
@aronraon7792 3 года назад
@@practicalpainmanagementwit8115 와... 상세한 설명감사드립니다. 많은 도움이 되었습니다. 리메타손 주문하려고 SK케미컬에 문의해봤더니 생산 중단이라고 나오네요 ㅠㅠ 미쓰비시다나베파마코리아 로 넘어갔다해서 이쪽으로 다시 전화해봤는데 국내로 매출이 아에 안들어온다합니다ㅜㅜ 어떻게 구하셨는지요?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
@@aronraon7792 생산은 계속 하고 있고 수출은 지속되나 국내 보험가가 너무 낮아 판매를 안하고 있어 제게 직접 회사에 접촉해 쓰고 있어요. 가을에 킴스제약에서 대행해 판매 한다고 하네요
@sabiston002
@sabiston002 3 года назад
In the video, What do you inject in the knee joint? Is it triamcinolone mixed with hyaluronic acid?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
No, I always use dexamethasone palmitate, which looks like triamcinolone. 1A of Limethason has 3.5 mg of dexamethasone,
@tazkirah88
@tazkirah88 4 месяца назад
how much dexamethasone used per injection side?
@jimmy7276
@jimmy7276 2 года назад
Have u ever experienced spetic change of knee joint after inj? Its deep concern of mine when i try knee inj.
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 2 года назад
No, I have never experienced septic knee arthritis that was caused by my procedure. Aseptic preparation and technique is the most crucial factor. I had septic shoulder arthritis 17 years ago. it was a very painful experience. After that, I moved out from the old town and changed all the protocols and systems.
@Painfix_Rx
@Painfix_Rx 3 года назад
How Long It Provides analgesia ?
@practicalpainmanagementwit8115
@practicalpainmanagementwit8115 3 года назад
local anesthetics was supposed to provide only a few hours. but articular branch block provides pain relief which was not effective by only intra-articular injection.
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