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MRI cost neck pain

Maggie E Horn, Julie M Fritz
BACKGROUND: Patients seek care from physical therapists for neck pain but it is unclear what the association of the timing of physical therapy (PT) consultation is on 1-year healthcare utilization and costs. The purpose of this study was to compare the 1-year healthcare utilization and costs between three PT timing groups: patients who consulted a physical therapist (PT) for neck pain within 14 days (early PT consultation), between 15 and 90 days (delayed PT consultation) or between 91 and 364 days (late PT consultation)...
November 26, 2018: BMC Health Services Research
John H Y Moi, Uyen Phan, Adam de Gruchy, Danny Liew, Tanya I Yuen, John E Cunningham, Ian P Wicks
OBJECTIVES: To report on the design, implementation and evaluation of the safety and effectiveness of the Back pain Assessment Clinic (BAC) model. DESIGN: BAC is a new, community-based specialist service for assessing and managing neck and low back pain (LBP). The BAC pilot was supported by a Victorian Department of Health and Human Services grant and was evaluated using the Victorian Innovation Reform Impact Assessment Framework (VIRIAF). Data were obtained by auditing BAC activity (22 July 2014 to 30 June 2015) and conducting surveys and interviews of patients, stakeholders and referrers...
October 10, 2018: BMJ Open
Douglas W Roblin, Hangsheng Liu, Lee F Cromwell, Michael Robbins, Brandi E Robinson, David Auerbach, Ateev Mehrotra
OBJECTIVES: Debate continues on whether nurse practitioners (NPs) and physician assistants (PAs) are more likely to order ancillary services, or order more costly services among alternatives, than primary care physicians (PCPs). We compared prescription medication and diagnostic service orders associated with NP/PA versus PCP visits for management of neck or back (N/B) pain or acute respiratory infection (ARI). STUDY DESIGN: Retrospective, observational study of visits from January 2006 through March 2008 in the adult primary care practice of Kaiser Permanente in Atlanta, Georgia...
April 2017: American Journal of Managed Care
Lin-Nan Wang, Lei Wang, Yue-Ming Song, Xi Yang, Li-Min Liu, Tao Li
INTRODUCTION: To evaluate the five year clinical and radiographic outcome of unilateral open-door laminoplasty with alternative levels centerpiece mini-plate fixation for cervical compressive myelopathy. METHODS: From August 2009 to June 2010, 56 patients with cervical compressive myelopathy underwent unilateral open-door laminoplasty with alternative levels centerpiece mini-plate fixation with a mean age of 64.8 years. Clinical results were investigated including Japanese Orthopedic Association (JOA) scores, Neck Dysfunction Index (NDI), occurrences of complications and neurological deterioration...
June 2016: International Orthopaedics
Tiffany K Gill, E Michael Shanahan, Dale Allison, Daniel Alcorn, Catherine L Hill
AIM: The aim of this study was to determine the prevalence of structural shoulder pathology using magnetic resonance imaging (MRI) in three groups of older people: those with current shoulder pain, those with a previous history of shoulder pain and those with no history of shoulder pain, within a community-based sample. METHODS: Thirty subjects (10 within each of the three groups) participated in the study. Subjects were recruited by telephone and underwent a clinical examination of shoulder and neck range of movement (to ensure pain was not referred from the neck)...
November 2014: International Journal of Rheumatic Diseases
Joshua M Murphy, Paul Park, Rakesh D Patel
Magnetic resonance imaging (MRI) has been shown to be sensitive in identifying ligamentous injury to the cervical spine. The major drawbacks to its routine use are cost and availability. The purpose of this study was to compare the cost of using MRI to rule out ligamentous injury of the cervical spine with the cost of immobilization in a cervical collar and outpatient follow-up. Neurologically intact and nonobtunded patients with neck pain and normal findings on radiographs evaluated for ligamentous injury of the cervical spine were studied...
February 2014: Orthopedics
Robert J Ward, Barbara N Weissman, Mark J Kransdorf, Ronald Adler, Marc Appel, Laura W Bancroft, Stephanie A Bernard, Michael A Bruno, Ian Blair Fries, William B Morrison, Timothy J Mosher, Catherine C Roberts, Stephen C Scharf, Michael J Tuite, Adam C Zoga
Substantial cost, morbidity, and mortality are associated with acute proximal femoral fracture and may be reduced through an optimized diagnostic imaging workup. Radiography represents the primary diagnostic test of choice for the evaluation of acute hip pain. In middle aged and elderly patients with negative radiographs, the evidence indicates MRI to be the next diagnostic imaging study to exclude a proximal femoral fracture. CT, because of its relative decreased sensitivity, is only indicated in patients with MRI contraindications...
February 2014: Journal of the American College of Radiology: JACR
M H Maurer, V Froeling, R Röttgen, T Bretschneider, T Hartwig, A C Disch, M de Bucourt, B Hamm, F Streitparth
PURPOSE: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. MATERIALS AND METHODS: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50...
June 2014: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Baotram Tran, Jonathan M Saxe, Akpofure Peter Ekeh
BACKGROUND: There are variations in cervical spine (CS) clearance protocols in neurologically intact blunt trauma patients with negative radiological imaging but persistent neck pain. Current guidelines from the current Eastern Association for the Surgery of Trauma include options of maintaining the cervical collar or obtaining either magnetic resonance imaging (MRI) or flexion-extension films (FEF). We evaluated the utility of FEF in the current era of routine computerized tomography (CT) for imaging the CS in trauma...
September 2013: Journal of Surgical Research
Helen M Ackland, Rory Wolfe, Peter A Cameron, D James Cooper, Gregory M Malham, Dinesh K Varma, Gregory J Fitt, Jeffrey V Rosenfeld, Susan M Liew
INTRODUCTION: The costs associated with patients discharged with isolated clinician-elicited persistent midline tenderness and negative computed tomography (CT) findings have not been reported. Our aim was to determine the association of acute and post-acute patient and injury characteristics with health resource costs in such patients following road trauma. METHODS: In a prospective cohort study, road trauma patients presenting with isolated persistent midline cervical tenderness and negative CT, who underwent additional acute imaging with MRI, were recruited...
November 2012: Injury
John Am Taylor, André Bussières
The high prevalence of neck and low back pain in the rapidly aging population is associated with significant increases in health care expenditure. While spinal imaging can be useful to identify less common causes of neck and back pain, overuse and misuse of imaging services has been widely reported. This narrative review aims to provide primary care providers with an overview of available imaging studies with associated potential benefits, adverse effects, and costs for the evaluation of neck and back pain disorders in the elderly population...
2012: Chiropractic & Manual Therapies
Helen M Ackland, Peter A Cameron, Rory Wolfe, Gregory M Malham, Dinesh K Varma, Gregory J Fitt, D James Cooper, Jeffrey V Rosenfeld, Susan M Liew
STUDY DESIGN: A prospective observational cohort study of alert, neurologically intact trauma patients presenting to the emergency department with midline cervical tenderness. Screening cervical magnetic resonance imaging (MRI) had been conducted after negative computed tomography (CT) when tenderness was persistent. OBJECTIVE: To determine the association of acute findings and demographic characteristics with any long-term neck disability, and with time to return to work in such patients...
June 1, 2013: Spine
Ji-Le Jiang, Xi-Lei Li, Xiao-Gang Zhou, Hong Lin, Jian Dong
Adequate fixation of the opened laminar arch is the key indicator of a successful laminoplasty surgery; poor outcomes, including secondary narrowing of the spinal canal and a high risk of axial neck pain are possible when using a suturing method during conventional laminoplasty. Rigid fixation including spacers or bone struts yields satisfactory clinical outcomes. However, this approach is also associated with a longer surgical time and an increased risk of instrumentation dislodgement. Plate-only fixation with fusion was developed in our hospital to improve conventional laminoplasty; in addition, the supraspinous ligament is preserved in this procedure...
June 2012: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Nicholas V Stence, Laura Z Fenton, Neil A Goldenberg, Jennifer Armstrong-Wells, Timothy J Bernard
Diagnosis of craniocervical arterial dissection (CCAD) in children begins with a careful history and physical in a child with a transient ischemic attack (TIA) or arterial ischemic stroke (AIS). The extent of radiologic evaluation for suspected CCAD is based upon careful consideration of the risks associated with the best imaging techniques, weighed against the benefits of enhanced vascular imaging with better diagnostic sensitivity. Although conventional angiography (CA) and CT angiography (CTA) have a higher sensitivity than magnetic resonance angiography (MRA), they are accompanied by risks: for CA, femoral hematoma, femoral arterial pseudoaneurysm, recurrent AIS, and radiation exposure; for CTA, radiation...
December 2011: Current Treatment Options in Neurology
Maria Rosário Giraldes
Nuclear imaging has used initially anatomic and volumetric technologies as CT or MRI. In recent years new dimensions of non invasive studies, as PET, have shown a higher utility in the effectiveness of the treatment. The evaluation of need must be done according to a principle of Horizontal Equity, equal treatment for equal need and of a principle of Vertical Equity, Different treatment, at regional level, according to each hospital level. The evaluation of need has been made according to the Potential Demand by Potential User Groups: diabetes, type 2, (50 years and more); screening colorectal (50 years and more); morbidity by cancer; surgery of lung cancer; cardiology; heart surgery; acute chest pain in the emergency department...
March 2010: Acta Médica Portuguesa
Jasper F C Wolfs, Wilco C Peul, Maarten Boers, Maurits W van Tulder, Ronald Brand, Hans J C van Houwelingen, Raph T W M Thomeer
BACKGROUND: Rheumatoid arthritis is a chronic inflammatory disease, which affects 1% of the population. Hands and feet are most commonly involved followed by the cervical spine. The spinal column consists of vertebrae stabilized by an intricate network of ligaments. Especially in the upper cervical spine, rheumatoid arthritis can cause degeneration of these ligaments, causing laxity, instability and subluxation of the vertebral bodies. Subsequent compression of the spinal cord and medulla oblongata can cause severe neurological deficits and even sudden death...
2006: BMC Musculoskeletal Disorders
Giuliano Mariani, Seza A Gulec, Domenico Rubello, Giuseppe Boni, Marco Puccini, Maria Rosa Pelizzo, Gianpiero Manca, Dario Casara, Guido Sotti, Paola Erba, Duccio Volterrani, Armando E Giuliano
Clinical or subclinical hyperparathyroidism is one of the most common endocrine disorders. Excessive secretion of parathyroid hormone is most frequently caused by an adenoma of >or=1 parathyroid gland. Unsuccessful surgery with persistent hyperparathyroidism, due to inadequate preoperative or intraoperative localization, may be observed in about 10% of patients. The conventional surgical approach is bilateral neck exploration, whereas minimally invasive parathyroidectomy (MIP) has been made possible by the introduction of (99m)Tc-sestamibi scintigraphy for preoperative localization of parathyroid adenomas...
September 2003: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
K B L Lim, A K H Eng, S M Chng, A G S Tan, F L Thoo, C O Low
INTRODUCTION: Diagnosis of hip fracture is normally readily made from clinical evaluation and plain radiographs. Occasionally, clinical suspicion of fracture is not confirmed on plain X-rays. MATERIALS AND METHOD: Between January 2001 and March 2002, 422 patients were admitted to our department for post-traumatic hip pain. The diagnosis of hip fracture was unequivocally made in 365 patients (86%). Fifty-seven (14%) patients had a negative or equivocal radiograph...
September 2002: Annals of the Academy of Medicine, Singapore
H Liu, Z Yang, T Chen
To cure patients suffering from atlanto-axial instability following old fracture of odontoid process concomitant with stenosis of lower end of cervical spinal canal, a new operative method was designed. It included atlanto-axial fusion by Gallie technique and resection of right half of the laminae of C3-C7 spine at one stage. A female of 63 years old was treated. She was admitted with neck pain and numbness of the upper and lower limbs. A history of neck injury was noted in enquiry. In physical examination showed the sensation of pain of the upper limbs was decreased and the muscle power of the upper and lower limbs ranged from III degree to IV degree...
September 1998: Chinese Journal of Reparative and Reconstructive Surgery
D L Brouillette, D T Gurske
OBJECTIVE: To present a case of cervical radiculopathy, caused by an MRI documented herniated cervical disc, which was treated with conservative care including chiropractic manipulative therapy. CLINICAL FEATURES: A 60-yr-old woman was treated by a chiropractor for symptoms including a deep, constant, burning ache in the left arm, and severe neck and left shoulder pain. A diagnosis of acute herniated cervical disc was made based on the findings of physical examination and an MRI study of the patient's cervical spine...
February 1994: Journal of Manipulative and Physiological Therapeutics
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