Ramez Hanna MD, Presenter: Nothing to Disclose

Adnan Mohammad Sheikh MD, Abstract Co-Author: Nothing to Disclose

Gina Anna Di Primio MD, Abstract Co-Author: Nothing to Disclose

Mark E. Schweitzer MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study is to determine the attitudes of radiologists, rheumatologists and orthopedic surgeons in North America towards to the repeated use of intraarticular local anaesthetic injections (ILAI) and chondrolysis.

We formulated a 12 question survey which was uploaded on www.surveymonkey.com. The questions in the survey pertained to the use of local anesthetics and concerns over chondrolysis. We also asked whether recent in vivo studies demonstrating chondrolysis have affected current practice patterns. The survey link was emailed to academic program directors of radiology, orthopedic surgery and rheumatology programs across North America. Program directors were asked to forward the survey link to their respective program.

Thus far we have received 60 responses from 17 radiologists (28%), 27 Orthopaedic surgeons (45%), and 16 rheumatologists (27%). 83% of the radiology respondents have done an MSK fellowship. The median work experience of the respondents was 10 years. Orthopaedic surgeons and radiologists had a median of 5-10 years of experience compared to rheumatologists with 15-20 years. 59% of radiologists believed that chondrolysis is a concern with ILAI, this compares to 77% of orthopaedic surgeons and only 13% of rheumatologists. Interestingly only 31% of rheumatologists were aware of in vitro animal studies demonstrating chondrolysis, this compares to 79% and 92% of radiologists and orthopaedic surgeons respectively.  

Orthopaedic surgeons and radiologists appear to be more concerned about chondrolysis as a real side effect of local anaesthetic intra-articular injections. This increased concern maybe explained by their level of awareness of chondrolysis demonstrated in animal in vitro studies. This may have altered their practice patterns in comparison to rheumatologists. 

We hope that through this study we are able to shed some light on the attitudes of different specialities on this poorly understood entity.  

Hanna, R, Sheikh, A, Di Primio, G, Schweitzer, M, Thoughts and Patterns of Intraarticular Local Anaesthetic Injections between Radiologists, Rheumatologists, and Orthopedic Surgeons.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12029361.html