İsmail AĞABABAOĞLU, Özgür Ömer YILDIZ, Eray ÇINAR, Kubilay İNAN

Tietze sendromunda lokal ağrı tedavisi: Tek merkez deneyimi

Amaç: Bu çalışmada, Tietze sendromu tanısı konulan hastalarda, lokal triamsinolon ve prilokain enjeksiyonları ile ilgili deneyimlerimiz sunuldu. Çalışma planı: Ocak 2016 - Ocak 2019 tarihleri arasında, kliniğimizde Tietze sendromu tanısı konulan toplam 28 hasta (12 erkek, 16 kadın; medyan yaş: 33 yıl; dağılım, 21-51 yıl) retrospektif olarak incelendi. Ağrılı eklemlere triamsinolon heksasetonid ve prilokain hidroklorür enjeksiyonları yapıldı. Hastaların ağrı duyumları birinci haftada İngiliz Ağrı Derneği tarafından geliştirilen Ağrı Derecelendirme Ölçeği ile kaydedildi. Enjeksiyondan sonra bir, iki ve üçüncü haftalarda da ağrı kalitatif olarak ve fizik muayene ile değerlendirildi. Bulgular: Birinci haftada lokal enjeksiyon tedavisi öncesi ağrı şiddeti, ağrıya bağlı ortalama rahatsızlık oranlarının üzerinde iken, tedavi sonrası yanıt oldukça iyi idi (sırasıyla, p=0.005 ve p=0.001). Tedavi yanıtı ve başarısının genel derecelendirmede istatistiksel olarak anlamlı olduğu gözlendi (p=0.003). Hastaların toplam %75'inde enjeksiyon sonrası ağrı düzeyinde %70'den fazla azalma görüldü. Sonuç: Steroid ve lokal anestezik enjeksiyonunu içeren tedavi yaklaşımımız, Tietze sendromu tanısı konulan hastaların yaş, cinsiyet veya istihdam durumundan bağımsız olarak, ağrıdan hızlı bir şekilde kurtulmalarını sağlar.

Local treatment of pain in Tietze syndrome: A single-center experience

Background: In this study, we present our experiences with local injections of triamcinolone and prilocaine in patients diagnosed with Tietze syndrome. Methods: Between January 2016 and January 2019, a total of 28 patients (12 males, 16 females; median age: 33 years; range, 21 to 51 years) who were diagnosed with TS in our clinic were retrospectively analyzed. Triamcinolone hexacetonide and prilocaine hydrochloride were injected into painful joints. At first week, pain sensation of the patients was recorded using the Pain Rating Scale developed by the British Pain Society. Pain was also assessed at one, two, and three weeks after injections qualitatively and based on physical examination. Results: At one week, the pain severity before the local injection treatment was above average the pain-related discomfort rates, and the response was quite favorable after the treatment (p=0.005 and p=0.001, respectively). A statistically significant rating was observed for treatment response and success (p=0.003). Totally 75% of the patients experienced more than 70% reduction in pain level after the injection. Conclusion: Our treatment approach involving injection of a mixture of steroid and a local anesthetic provides a rapid relief from pain, irrespective of age, sex, or employment status in patients diagnosed with Tietze syndrome.

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