Online MSK Days
Day 3 | Pain

November 8, 2022 | 7 pm (CET) / 1 pm (EST)

Pain | Ultrasound/MRI/CT/Interventional Radiology

Deciphering the Signs – Problem-Solving Pain Using Imaging

MSK related pain starts with any number of injuries or diseases, but it’s also often part of the process of getting older. Chronic pain is also one of the most common reasons adults seek medical advice (1). Contemporary high-resolution medical imaging including functional scanning has bought new perspectives to evaluating nerve and muscle diseases. Join our experts as we explore how state-of-the-art imaging is transforming our understanding of the physical causes of MSK related pain as well as guiding treatment.
This webinar occurs in the past. The recording is available now. Click here to watch it now.
Program
  • Dynamic 4-D CT of Joints: Role in the Diagnosis of Musculoskeletal Pain of Indeterminate Origin - Prof. Pedro Teixeira
  • Value of High Resolution MRI in Wrist Pain - Dr. Jan Veryser
  • The New Hype: Pain Management in The Spine With Ultrasound - Assoc. Prof. Alexander Loizides
  • Pain Management in the Angio Suite - Prof. Alexis Kelekis
  • Live Q&A - moderated by Prof. Pedro Augusto Gondim Teixeira
Learning Objectives:
  1. Understand the role of ADCT and 4D CT in MSK clinical practice for the treatment of MSK lesions
  2. Gain insight into the role and limitations of shoulder imaging
  3. Better understand the use of imaging in managing interventions for pain

INFORMATION ON SPEAKERS AND THEIR PRESENTATIONS

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Moderator & Speaker: Prof. Pedro Augusto Gondim Teixeira, MD, PhD
Radiologist
Central Hospital, University Hospital Center of Nancy
Nancy, France

Prof. Pedro Augusto Gondim Teixeira is a professor of Radiology and Researcher at the University Hospital and Nancy's School of Medicine of Lorraine University, France. He graduated from Medical School at the Federal University of Bahia (UFBA) in 2004. He completed his radiology residency in São José do Rio Preto, São Paulo, Brazil in 2009. He was then enrolled in two fellowship programs in MSK the US and France. He is currently conducting research activities at the Interventional and Diagnostic Adaptive Imaging Laboratory (IADI) and government funded research laboratory focused on advances image post-processing and dynamic imaging. His main research focuses include Functional MRI on MSK Oncology (Perfusion, Diffusion and Proton Spectroscopy) and Advanced CT imaging (Metal Artifact Reduction, Dynamic CT, Bone Subtraction, ultra-high resolution imaging) on Wide Area-Detector and ultra high resolution CT scanners

Presentation title: Dynamic 4-D CT of Joints: Role in the Diagnosis of Musculoskeletal Pain of Indeterminate Origin
Standard MSK imaging is largely dependent on static or step-and-shoot imaging methods. Given the importance of motion in the pathogenesis of various musculoskeletal disorders, standard imaging methods may provide insufficient information on the origin of the patient’s symptoms. In this lecture, our experience on the application of 4D-CT of various joints in daily practice for the evaluation of clinically challenging situations will be presented. The potential advantages of this method for common conditions such as: carpal instability, snapping scapula, thoracic outlet syndrome and popliteal entrapment syndrome.

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Speaker: Dr. Jan Veryser, MD
Radiologist
Open MRI Zen
Sluis, the Netherlands

Dr. Jan Veryser is the founder of Open MRI Zen, a private center in the Netherlands dedicated to musculoskeletal radiology. He is an active ESSR member and a member of the Imaging Guided Intervention Subcommittee. Dr. Veryser has a strong focus on musculoskeletal radiology and interventional ultrasound, especially in the field of nerve interventions. He regularly organizes workshops and lectures during international conventions (ECR, Arab Health, etc.) to improve the quality of ultrasound diagnosis and guided treatments.

Presentation Title: Value of High Resolution MRI in Wrist Pain
Dr. Veryser will explain how in wrist imaging with MRI, it is often necessary to acquire high-resolution images to be able to depict subtle pathologies. Intra-articular contrast injection can be used to show subtle intra-articular pathologies like TFCC lesions and capsular or ligamentous tears. With the Vantage Galan 3T system and the features it has, Dr. Veryser is able to obtain high-quality images of the wrist. This offers several benefits in comparison to standard wrist imaging. Some cases will be presented to demonstrate the value of high-resolution wrist imaging.

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Speaker: Assoc. Prof. Alexander Loizides, MD
Radiologist
Medical University of Innsbruck, Department of Radiology
Innsbruck, Austria

Assoc. Prof. Alexander Loizides currently works at the Department of Radiology, Medizinische Universität Innsbruck and is the deputy head of the Diagnostic and Interventional Sonography Innsbruck. He is specialized in musculoskeletal Sonography and peripheral Nerve Sonography, interventional Sonography and ultrasound-guided pain therapy.

Presentation Title: The New Hype: Pain Management in the Spine with Ultrasound
Injection therapies play a major role in treatment and rehabilitation of patients with back pain. Aside from physical therapy and other rehabilitative methods, injection therapies targeted to the nerve roots and facet joints are well established in the treatment of spinal pain conditions and are to date preferentially performed as fluoroscopy or CT-guided interventions. In the last years, ultrasound has proven sufficiently reliable and accurate in the demonstration in ultrasound guided injection therapies in the spine and should be taken into account as a valid alternative to the aforementioned methods, as it provides real-time guidance, is relatively inexpensive, broadly available, can be performed bedside and the most important – it is a radiation free modality.

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Speaker: Prof. Alexis Kelekis, MD, PhD, EBIR, FSIR FCIRSE
Professor of Diagnostic and Interventional Radiology
National and Kapodistrian University of Athens,
Attikon General University Hospital.
Athens, Greece

Alexis Kelekis currently works at the 2nd Department of Radiology – Radiotherapy of the National and Kapodistrian University of Athens. Prof. Kelekis does research in radiology, oncology, spine, pain management and neuroradiology. He is the president of GRIBOI Society. He is Treasurer and member of the Board for SIO. He is actively researching injectable biomaterials for bone lesions pain management and disc disease. One of their current projects is 'Prospective Randomized Trial between Percutaneous Ozone injection and Surgery for disc herniation'. Other projects include “Lesion identification and confirmation for colorectal liver metastasis-the ACLAIM study” and “PET-CT confirmation of the zone of RF ablation of spine lesions”.

Presentation Title: Pain Management in the Angio Suite
The use of the angio suite has vastly surpassed the vascular interventions it has been used so far. Today with the added tools of Cone Beam CT, MPR reconstructions and needle guidance, it has become an important tool for real time guidance in spine, nerve and bone targets. With the use of this technology, together with a dedicated CT, the 4D-CT concept allows for quick and safe access to areas with complicated anatomy for regions outside the vascular interventions. Bone treatments, including screw placement and ablation can now be performed safely, effectively, quickly and real time. In this presentation we will see how the Angio Suite can be the ideal space for non vascular pain management practice.

Scientific Evidence: Pain | Ultrasound/MRI/CT/Interventional Radiology

Download scientific evidence on MSK solutions using Canon technologies here.

CT

Gondim Teixeira PA et al. | Musculoskeletal Wide-Detector CT Kinematic Evaluation: From Motion to Image | Semin Musculoskelet Radiol. 2015
https://www.ncbi.nlm.nih.gov/pubmed/26696084

Repse SE et al. | Wide field of view computed tomography and mid-carpal instability: the value of the sagittal radius-lunate-capitate axis--preliminary experience | European Journal of Radiology 2015
http://www.ncbi.nlm.nih.gov/pubmed/25708808

Gondim Teixeira PA et al. | Musculoskeletal wide detector CT: principles, techniques and applications in clinical practice and research | Eur J Radiol. 2015
https://www.ncbi.nlm.nih.gov/pubmed/25656096

Repse SE et al. | Wide field of view computed tomography and mid-carpal instability: the value of the sagittal radius-lunate-capitate axis--preliminary experience | European Journal of Radiology. 2015
http://www.ncbi.nlm.nih.gov/pubmed/25708808

MRI

Mitsue Miyazaki et al. | Time-Resolved Noncontrast Magnetic Resonance Perfusion Imaging of Paraspinal Muscles | J Magn Reson Imaging. 2022.
https://www.ncbi.nlm.nih.gov/pubmed/35191562

Ultrasound

Jonathan M Youngner et al. | Sonographic evaluation of uncommonly assessed upper extremity peripheral nerves: anatomy, technique, and clinical syndromes | Skeletal Radiol. 2019
https://www.ncbi.nlm.nih.gov/pubmed/30033506

References

  1. StatPearls (2020). Chronic Pain Syndrome [Online]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470523/ [Accessed 3 August 2022].

Disclaimers

  • The opinions expressed in this material are solely those of the presenter and not necessarily those of Canon Medical Systems. Canon Medical Systems does not guarantee the accuracy or reliability of the information provided herein.
  • The clinical results, performance and views described in this video/webinar are the experience of the clinician. Results may vary due to clinical setting, patient presentation and other factors. Many factors could cause the actual results and performance of Canon Medical’s products to be materially different from any of the aforementioned.
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