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First Metatarsophalangeal Joint Injection

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1. The efficacy of using intra-articular corticosteroid injections at the first metatarsophalangeal joint to relieve symptomatic osteoarthritis: a critical review of the literature

The efficacy of using intra-articular corticosteroid injections at the first metatarsophalangeal joint to relieve symptomatic osteoarthritis: a critical review of the literature Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability (...) , editorial) 2. Not an in vivo animal study 3. No metastases/ only primary tumor 4. No control group 5. Combination therapy or contamination 6. Not about analgesics used in the clinic Full text-screening: As above, with the addition of: 7. No relevant outcome measure reported ">Prioritise the exclusion criteria Example: Two reviewers will independently extract data from each article. We first try to extract numerical data from tables, text or figures. If these are not reported, we will extract data from

2019 PROSPERO

2. First Metatarsophalangeal Joint Injection

First Metatarsophalangeal Joint Injection First Metatarsophalangeal Joint Injection Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) First Metatarsophalangeal Joint Injection First Metatarsophalangeal Joint Injection Aka: First Metatarsophalangeal Joint Injection , Great Toe MTP Injection , First MTP Aspiration II. Indications (First MTP Sprain) Severe of first MTP joint III. Contraindications (rule-out before steroid injection) IV. Preparation Needle Gauge: 25 to 27 Length: 1.0 to 1.5 inches Syringe: 3 to 5 ml options (Celestone) 0.25 ml of 6 mg/ml (Sol-umedrol): 0.25 ml of 40 mg/ml Anesthetic 1%: 1 ml or 0.25% or 0.5%: 1 ml V

2018 FP Notebook

3. Rolled Tendon Allograft Interposition Arthroplasty for Salvage Surgery of the Hallux Metatarsophalangeal Joint. (PubMed)

Rolled Tendon Allograft Interposition Arthroplasty for Salvage Surgery of the Hallux Metatarsophalangeal Joint. Hallux rigidus is a common osteoarthritic disease of the first metatarsophalangeal joint (MTPJ). Few salvage treatment options exist that preserve motion for patients who have failed an initial procedure and who are not amenable to fusion, typically patients who are active or who would like to wear high heels. Allograft tendon interpositional arthroplasty is an unconventional salvage (...) treatment option that may preserve motion and prevent bone loss.A retrospective chart review is reported of 19 patients who failed previous procedures and refused fusion who underwent allograft tendon interpositional arthroplasty of the hallux MTPJ by a single surgeon between 2012 and 2015. Outcomes included the American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale assessment as well as measurement of apparent joint space on anterior to posterior and lateral

2018 Foot & Ankle International

4. Effectiveness of intra-articular hyaluronan (Synvisc, hylan G-F 20) for the treatment of first metatarsophalangeal joint osteoarthritis: a randomised placebo-controlled trial (PubMed)

Effectiveness of intra-articular hyaluronan (Synvisc, hylan G-F 20) for the treatment of first metatarsophalangeal joint osteoarthritis: a randomised placebo-controlled trial To evaluate the effectiveness of a single intra-articular injection of hylan G-F 20 (Synvisc) for symptomatic first metatarsophalangeal joint (MTPJ) osteoarthritis (OA).Participants (n = 151) with symptomatic first MTPJ OA were randomly allocated to receive up to 1 ml intra-articular injection of either hylan G-F 20 (...) or placebo (saline). Participants and assessors were blinded. Outcomes were evaluated at 1, 3 and 6 months after injection. The primary outcome measurement was the foot pain domain of the Foot Health Status Questionnaire (FHSQ) at 3 months. Secondary outcome measurements were foot function assessed via the FHSQ, first MTPJ pain and stiffness, magnitude of symptom change, global satisfaction, health-related quality of life (assessed using the Short-Form-36 version two), first MTPJ dorsiflexion range

2011 EvidenceUpdates

5. First Metatarsophalangeal Joint Injection

First Metatarsophalangeal Joint Injection First Metatarsophalangeal Joint Injection Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) First Metatarsophalangeal Joint Injection First Metatarsophalangeal Joint Injection Aka: First Metatarsophalangeal Joint Injection , Great Toe MTP Injection , First MTP Aspiration II. Indications (First MTP Sprain) Severe of first MTP joint III. Contraindications (rule-out before steroid injection) IV. Preparation Needle Gauge: 25 to 27 Length: 1.0 to 1.5 inches Syringe: 3 to 5 ml options (Celestone) 0.25 ml of 6 mg/ml (Sol-umedrol): 0.25 ml of 40 mg/ml Anesthetic 1%: 1 ml or 0.25% or 0.5%: 1 ml V

2015 FP Notebook

6. Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis: impact of joint area, repeated injections, MRI findings, anti-CCP, IgM-RF and CRP. (PubMed)

(ankles, elbows, knees, metacarpophalangeal (MCP), metatarsophalangeal, proximal interphalangeal (PIP), shoulders, wrists) were injected during 2 years. 531 Joints received a second injection, and 262 a third. At baseline, the median numbers of injections (dose of betamethasone) was 4 (28 mg), declining to 0 (0 mg) at subsequent visits. At weeks 2, 4 and 6, 50.0%, 58.1% and 61.7% had achieved a EULAR good response. After 1 and 2 years, respectively, 62.3% (95% CI 58.1% to 66.9%) and 55.5% (51.1 (...) % to 60.3%) of the joints injected at baseline had not relapsed. All joint areas had good 2-year joint injection survival, longest for the PIP joints: 73.7% (79.4% to 95.3%). 2-Year joint injection survival was higher for first injections: 56.6% (53.7% to 59.8%) than for the second: 43.4% (38.4% to 49.0%) and the third: 31.3% (25.0% to 39.3%). Adverse events were mild and transient. A high MRI synovitis score of MCP joints and anti-CCP-negativity were associated with poorer joint injection survival

2012 Annals of the rheumatic diseases

7. Heavy-slow Resistance Training and Ultrasound-guided Corticosteroid Injection in Plantar Fasciopathy

months before enrolment Pain on palpation of the medial calcaneal tubercle or the proximal plantar fascia Thickness of the plantar fascia of 4 mm or greater Mean heel pain of 30 mm or above on a 0 to 100 mm VAS during the previous week Exclusion Criteria: Below 18 years of age History of inflammatory systemic diseases Prior heel surgery Pregnancy Pain or stiffness in the 1st metatarsophalangeal joint to an extent where the exercises cannot be performed Corticosteroid injection for plantar fasciopathy (...) remove one or more studies before adding more. Heavy-slow Resistance Training and Ultrasound-guided Corticosteroid Injection in Plantar Fasciopathy The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03535896 Recruitment Status : Completed First Posted : May 24, 2018 Last Update Posted : October 30, 2018

2018 Clinical Trials

8. Metatarsophalangeal Joint Pain

, DPM, Temple University School of Podiatric Medicine Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Metatarsophalangeal joint pain usually results from tissue changes due to aberrant foot biomechanics. Symptoms and signs include pain with walking and tenderness. Diagnosis is clinical; however, infection or systemic rheumatic diseases (eg, RA) may need to be excluded by testing. Treatment includes orthotics, sometimes local injection (...) be helpful. For more severe limitation of 1st metatarsophalangeal motion or pain, the use of rigid orthoses, carbon fiber plates, or external shoe bars or rocker soles may be necessary to reduce motion at the joint. Surgery may be needed if conservative therapies are ineffective. If inflammation (synovitis) is present, injection of a local corticosteroid/anesthetic mixture may be useful. Key Points Metatarsophalangeal joint pain most often results from misalignment of joint surfaces, causing synovial

2013 Merck Manual (19th Edition)

9. Compare Ultrasound Assisted Cold Therapy and Lidocaine Injection to Treat Morton's Neuroma

studies before adding more. Compare Ultrasound Assisted Cold Therapy and Lidocaine Injection to Treat Morton's Neuroma The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02838758 Recruitment Status : Completed First Posted : July 20, 2016 Last Update Posted : November 6, 2018 Sponsor: Icahn School (...) to remaining on current regimen for the duration of the study. Exclusion Criteria: Diagnosed complex regional pain syndrome (CRPS) Pregnancy - History of intolerance, hypersensitivity or known allergy to lidocaine - Recent history of recent surgical intermetatarsal neuronectomy (within previous 6 months) - Coagulation disorder - Current infection Intermetatarsal bursitis Metatarsophalangeal joint instability/capsulitis Metatarsal stress fracture Lumbar radiculopathy Tarsal tunnel syndrome Frieberg's

2016 Clinical Trials

10. Botulinum Toxin Injections by Ultrasounds Guidance and Stretching Exercise in Spastic Toe Clawing

: No Criteria Inclusion Criteria: Patient with spasticity toe clawing(metatarsophalange jointextension, proximal and distal phalange joint flexion) MAS scale of metatarsophalange joint and interphalangeal joint more than 2 Pain during walking, abnormal gait patterns and can't wear shoess due to claw toe Haven't received botox or phenol or alcohol injections before Exclusion Criteria: Lower extremities joint contrature, bone deformity Had received botox injections or phenol injections or before due to lower (...) one or more studies before adding more. Botulinum Toxin Injections by Ultrasounds Guidance and Stretching Exercise in Spastic Toe Clawing The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02586142 Recruitment Status : Completed First Posted : October 26, 2015 Last Update Posted : October 26, 2015

2015 Clinical Trials

11. The Approach to the Painful Joint (Treatment)

be felt (or heard with a stethoscope) in a rheumatoid joint when the cartilage surface is no longer smooth. Coarse crepitus or grating may be felt in joints severely damaged by long-standing RA or degenerative arthritis. Three main types of joint deformity must be distinguished. The first type is restriction of the normal range of motion (eg, a lack of full joint extension that results in a flexion deformity). The second is malalignment of the articulating bones (eg, ulnar deviation of the fingers (...) for tenderness and soft tissue swelling over talar, subtalar, and midtarsal joints. Assess range of motion of the talar joints (ie, with dorsiflexion and plantar flexion) and subtalar joints (ie, with inversion and eversion). In the feet, squeeze the row of metatarsophalangeal joints, assessing for the presence of pain or tenderness. Palpate the small joints of the feet, assessing for the presence of tenderness, bony or soft tissue swelling, or joint effusion. Previous Next: Differential Diagnosis Processes

2014 eMedicine.com

12. The Approach to the Painful Joint (Overview)

be felt (or heard with a stethoscope) in a rheumatoid joint when the cartilage surface is no longer smooth. Coarse crepitus or grating may be felt in joints severely damaged by long-standing RA or degenerative arthritis. Three main types of joint deformity must be distinguished. The first type is restriction of the normal range of motion (eg, a lack of full joint extension that results in a flexion deformity). The second is malalignment of the articulating bones (eg, ulnar deviation of the fingers (...) for tenderness and soft tissue swelling over talar, subtalar, and midtarsal joints. Assess range of motion of the talar joints (ie, with dorsiflexion and plantar flexion) and subtalar joints (ie, with inversion and eversion). In the feet, squeeze the row of metatarsophalangeal joints, assessing for the presence of pain or tenderness. Palpate the small joints of the feet, assessing for the presence of tenderness, bony or soft tissue swelling, or joint effusion. Previous Next: Differential Diagnosis Processes

2014 eMedicine.com

13. The Approach to the Painful Joint (Follow-up)

be felt (or heard with a stethoscope) in a rheumatoid joint when the cartilage surface is no longer smooth. Coarse crepitus or grating may be felt in joints severely damaged by long-standing RA or degenerative arthritis. Three main types of joint deformity must be distinguished. The first type is restriction of the normal range of motion (eg, a lack of full joint extension that results in a flexion deformity). The second is malalignment of the articulating bones (eg, ulnar deviation of the fingers (...) for tenderness and soft tissue swelling over talar, subtalar, and midtarsal joints. Assess range of motion of the talar joints (ie, with dorsiflexion and plantar flexion) and subtalar joints (ie, with inversion and eversion). In the feet, squeeze the row of metatarsophalangeal joints, assessing for the presence of pain or tenderness. Palpate the small joints of the feet, assessing for the presence of tenderness, bony or soft tissue swelling, or joint effusion. Previous Next: Differential Diagnosis Processes

2014 eMedicine.com

14. The Approach to the Painful Joint (Diagnosis)

be felt (or heard with a stethoscope) in a rheumatoid joint when the cartilage surface is no longer smooth. Coarse crepitus or grating may be felt in joints severely damaged by long-standing RA or degenerative arthritis. Three main types of joint deformity must be distinguished. The first type is restriction of the normal range of motion (eg, a lack of full joint extension that results in a flexion deformity). The second is malalignment of the articulating bones (eg, ulnar deviation of the fingers (...) for tenderness and soft tissue swelling over talar, subtalar, and midtarsal joints. Assess range of motion of the talar joints (ie, with dorsiflexion and plantar flexion) and subtalar joints (ie, with inversion and eversion). In the feet, squeeze the row of metatarsophalangeal joints, assessing for the presence of pain or tenderness. Palpate the small joints of the feet, assessing for the presence of tenderness, bony or soft tissue swelling, or joint effusion. Previous Next: Differential Diagnosis Processes

2014 eMedicine.com

15. Joint Ultrasound Evaluation of Asymptomatic Rheumatic Feet

, talonavicular, naviculocuneiform, calcaneocuboid, 5th tarsometatarsal and 1st to 5th metatarsophalangeal [MTP] joints) of 50 healthy subjects and 50 patients with RA (all with asymptomatic feet) were evaluated bilaterally regarding quantitative/semi-quantitative synovitis, semi-quantitative Power Doppler (PD) signals and erosion using ultrasound. Statistical significance was set to 5%. Condition or disease Rheumatoid Arthritis Study Design Go to Layout table for study information Study Type : Observational (...) , talonavicular, medial naviculocuneiform, 5th tarsometatarsal and metatarsophalangeal (MTP) (dorsal and volar faces of 1st to 5th MTP joints and lateral face of 1st and 5th MTP joints). A modified score was used for the semi-quantitative measurement, ranging from 0 to 3: 0-no synovial thickening; 1-minimal synovial thickening in joint recess; 2-synovial thickening in entire joint recess causing bulging of joint capsule; and 3-synovial thickening in joint recess with bulging of joint capsule and extending

2012 Clinical Trials

16. Efficacy of intra-articular hyaluronan (Synvisc(R)) for the treatment of osteoarthritis affecting the first metatarsophalangeal joint of the foot (hallux limitus): study protocol for a randomised placebo controlled trial. (PubMed)

Efficacy of intra-articular hyaluronan (Synvisc(R)) for the treatment of osteoarthritis affecting the first metatarsophalangeal joint of the foot (hallux limitus): study protocol for a randomised placebo controlled trial. Osteoarthritis of the first metatarsophalangeal joint (MPJ) of the foot, termed hallux limitus, is common and painful. Numerous non-surgical interventions have been proposed for this disorder, however there is limited evidence for their efficacy. Intra-articular injections (...) of hyaluronan have shown beneficial effects in case-series and clinical trials for the treatment of osteoarthritis of the first metatarsophalangeal joint. However, no study has evaluated the efficacy of this form of treatment using a randomised placebo controlled trial. This article describes the design of a randomised placebo controlled trial to evaluate the efficacy of intra-articular hyaluronan (Synvisc(R)) to reduce pain and improve function in people with hallux limitus.One hundred and fifty community

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2009 Journal of foot and ankle research

17. CRACKCast E116 – Arthritis

reactive sclerosis Late bone destruction Joint space preserved Late rheumatoid arthritis (wrist, MCP, PIP, MTP, first IP joints; foot, atlantoaxial joint, glenohumeral joint) Symmetrical joint space narrowing Osteoporosis of periarticular bone Marginal erosions (no overhanging margins as in gout) Little reactive bone formation DIP, Distal interphalangeal; HHC, hereditary hemochromatosis; IP, interphalangeal; MCP, metacarpophalangeal; MTP, metatarsophalangeal; PIP, proximal interphalangeal. [5] List 2 (...) the anterior tibial tendon. Insert a 3.5-inch 20- or 22-gauge needle medial to this tendon in the depression at the anterior edge of the medial malleolus. Metatarsophalangeal Joint (Dorsomedial Approach) Identify the distal metatarsal head and the proximal base of the first phalanx. Identify the extensor tendon by asking the patient to extend the great toe. While the patient is supine, flex the toe 15 to 20 degrees, and then apply traction. Insert a 22-gauge needle dorsally just medial to the extensor

2017 CandiEM

18. Spasticity in adults: management using botulinum toxin - 2nd edition

units Dysport ® (total body dose arm and leg) • 500 units Xeomin ® (arm). Clinicians should refer to Appendix 2 for the recommended doses for individual muscles. 3.5 Electromyogram, electrical stimulation and/or ultrasound should be used to RC E1 E2 Moderate localise the BoNT-A injection, according to the site and purpose of the injection. 4 Concomitant therapies Grade of Strength evidence 4.1 Individuals at risk of contracture or loss of joint range should receive RA E1 E2 Moderate interventions (...) and reconstitution 16 6.5 Administration 16 6.6 Dosage 16 6.7 Off-label treatment 17 6.8 Duration of effect 18 6.9 Adverse effects 18 6.10 Contraindications 19 7 Using botulinum toxin to treat spasticity 20 7.1 Summary of key principles for use of BoNT-A 20 7.2 Early intervention 20 7.3 Longer-term treatment 20 7.4 Localisation and distinction of spasticity from contractures 22 7.5 Patient selection 22 7.6 Treatment goals 22 7.7 Muscle selection 22 7.8 Pre-injection patient consultation 24 7.9 Information about

2018 British Society of Rehabilitation Medicine

19. Osteoarthritis: care and management

sites of osteoarthritis such as the first metatarsophalangeal (bunion) joint, the mid-foot joints, the ankle or the shoulder. Trials should be undertaken to determine the efficacy of available treatments, both local and systemic, at such sites. New outcome instruments to measure pain, stiffness and function specific to osteoarthritis at each site may need to be developed and validated for use in such trials. 2.4 Biomechanical interventions in the management of osteoarthritis Which biomechanical (...) with osteoarthritis. [2008] [2008] 1.5.13 Do not offer intra-articular hyaluronan injections for the management of osteoarthritis. [2014] [2014] 1.6 Referral for consideration of joint surgery 1.6.1 Clinicians with responsibility for referring a person with osteoarthritis for consideration of joint surgery should ensure that the person has been offered at least the core (non-surgical) treatment options (see recommendation 1.2.5). [2008] [2008] 1.6.2 Base decisions on referral thresholds on discussions between

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

20. Clinical Assessment and Management of Foot and Ankle Osteoarthritis: A Review of Current Evidence and Focus on Pharmacological Treatment. (PubMed)

foot OA sites include the first metatarsophalangeal joint and the midfoot, with the ankle affected less often. Despite the high prevalence and disabling nature of foot and ankle OA, the condition has been neglected by clinical researchers, and there are very few trials investigating non-surgical foot or ankle OA treatment options. There are no accepted clinical diagnostic criteria for foot or ankle OA so imaging remains common. Clinical guidelines based on knee and hip OA research recommend (...) education, exercise, and weight loss in the first instance. Topical non-steroidal anti-inflammatory drugs (NSAIDs) or capsaicin may be used as an adjunct. Failing these approaches, acetaminophen (paracetamol) should be recommended; however, if there is inadequate symptomatic relief, then clinicians should trial an oral NSAID or a cyclo-oxygenase-2 inhibitor. Given that adverse events and co-morbidities are common in the elderly, older patients should be closely monitored. Some studies have investigated

2019 Drugs & Aging

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