Localized painful, rheumatic syndromes are very common in rheumatology daily practice, but are sometimes hard to differentiate and treat.
The underlying pathology may be triggered by inflammation, overuse or degeneration of structures like joints, ligaments, tendons, tendon sheets, bursae, entheses, or periosteal structures.
Even with the best treatment strategy relating to non-biologic DMARDs, biologic DMRADs, glucocorticoids or non-steroidal anti-inflammatory drugs, and opioid analgesics painful, localized syndromes may persist. Furthermore, in the case of only localized painful problems an increase of the mentioned systemic treatment options may tremendously increase the risk of severe side effects and is therefore not a wise treatment choice.
A precise history, clinical examination and the use of ultrasound may unravel the underlying problem for the localized pain. Because of the localized nature, the best treatment option often is a local application of drugs, especially anesthetics and glucocorticoids.
This talk discusses:
– Typical sonographic appearances and treatment options in common localized painful rheumatic syndromes occurring in daily practice.
– Why local therapy is superior to systemic therapy in localized syndromes?
– Which problems might occur with local application of glucocorticoids?
– How to learn ultrasound guided treatment easily?
Disclosure of Interest None declared