A case report of effective intra-articular elcatonin administration in a patient with osteonecrosis of the lunate
A case report of effective intra-articular elcatonin administration in a patient with osteonecrosis of the lunate
复制标题
月骨骨坏死关节内注射有效降钙素一例报告
DOI：
10.1016/j.ijscr.2023.108056
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发表时间：
2023
影响因子：
0.6
通讯作者：
Katsunori Inagaki
中科院分区：
文献类型：
--
作者：
Takashi Nagai; Kazunari Tomita;Kazutoshi Kubo;Jun Ikeda;Keikichi Kawasaki;Katsunori Inagaki
虽然皮质类固醇对支气管哮喘有效，但它们与各种副作用有关，如股骨头和胫骨髁的骨坏死和骨质疏松症。在这里，我们报告一个病人谁是长期皮质类固醇由于严重哮喘，这被认为是导致月骨坏死的两个手腕关节。降钙素（elcatonin），一种骨质疏松症药物，被管理到腕关节。病例介绍对麻醉剂和各种非甾体抗炎药（NSAID）的过敏使手术治疗不可能和疼痛控制困难。此外，腕关节疼痛干扰日常生活活动（ADL）。当降钙素关节内注入腕关节时，腕关节疼痛减轻，ADL改善。然而，止痛效果仅持续1周，治疗后第二周疼痛恢复到原来的状态。重复注射是必要的，每2 weeks.Clinical discussionThis是第一次报告的有效性，关节内降钙素的患者骨坏死的月骨。这种治疗可能适用于对麻醉和NSAIDs.ConclusionIn目前的情况下，降钙素给药关节内手腕出现的类固醇引起的月骨坏死的疼痛控制是有效的。
Introduction and importanceAlthough corticosteroids are effective for bronchial asthma, they are associated with various side effects, such as osteonecrosis of the femoral head and tibial condyle and osteoporosis. Here, we report a patient who was on corticosteroids for a long period of time due to severe asthma, which was thought to have led to lunate osteonecrosis of both wrist joints. Calcitonin (elcatonin), an osteoporosis drug, was administered to the wrist joint.Case presentationAllergy to anesthetics and various non-steroidal anti-inflammatory drugs (NSAIDs) made surgical treatment not possible and pain control difficult. In addition, pain in the wrist joint interfered with activities of daily living (ADLs). When calcitonin was administered intra-articularly into the wrist joint, the pain in the wrist joint was relieved and ADLs were improved. However, the pain-suppressing effect lasted only 1 week, and pain returned to the original state by the second week after treatment. Repeated injections were necessary every 2 weeks.Clinical discussionThis is the first report of the effectiveness of intra-articular calcitonin in a patient with osteonecrosis of the lunate. This treatment may be applicable to patients with allergies to anesthesia and NSAIDs.ConclusionIn the present case, calcitonin administered intra-articularly to the wrist appeared to be effective in pain control for steroid-induced lunate osteonecrosis.