Korean J Pain.  2016 Jul;29(3):197-201. 10.3344/kjp.2016.29.3.197.

Clinical Effectiveness of Ultrasound-guided Costotransverse Joint Injection in Thoracic Back Pain Patients

• Yoon KB
• Kim SH
• Park SJ
• Moon JA
• Yoon DM

• KMID: 2327643
• DOI: http://doi.org/10.3344/kjp.2016.29.3.197

Abstract

Because of its anatomical location and function, the costotransverse (CTRV) joint can be a source of thoracic back pain. In this retrospective observational study, we evaluated the clinical effectiveness of the CTRV joint injection in thoracic back pain patients with suspected CTRV joint problems. We enrolled 20 thoracic back pain patients with localized tenderness that was provoked by the application of pressure on the affected CTRV joints. We injected it with 0.5 ml of a ropivacaine and triamcinolone mixture at each level. The mean pre-injection pain score decreased by 37.9% (7.2 ± 1.5 to 4.5 ± 1.7, P < 0.001) two weeks after CTRV joint injection. In addition, 70% of patients reported an excellent or good level of satisfaction. We demonstrated that an ultrasound-guided injection of the CTRV joint reduced patients' pain scores and led to a high level of satisfaction at short-term follow-ups in patients with suspected CTRV joint problems.

Keyword

Costotransverse joint; Costovertebral joint; Intra-articular block; Sono-guided injection; Thoracic back pain; Thoracic spine

MeSH Terms

Back Pain*
Follow-Up Studies
Humans
Joints*
Observational Study
Retrospective Studies
Treatment Outcome*
Triamcinolone
Triamcinolone

Figure

• 

  Fig. 1 (A) Rib head contact with the vertebral body via two joints. Costotransverse and costovertebral joints. (B) Ultrasound image of CTRV joint. With an in-plane approach, the needle was advanced medially toward the CTRV joint. As the needle passed under the transverse process of the target CTRV joint, it was advanced until the tip penetrated the capsule. TP: transverse process, R: rib, L: lung, N: needle.

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