Background: There is a growing trend in ultrasound use in interventional pain management. Recently, the ease of use and clinical benefits of lumbar medial branch nerve block under ultrasound guidance have been identified. Objectives: In this study, we assessed the relevant anatomy and sonoanatomy of these specific interventional techniques. We also evaluated the feasibility and success rates of ultrasound guided lumbar medial branch nerve block. Patients and Methods: Thirty patients with facet joint pain who were referred to the Akhtar hospital pain clinics between 2011 and 2012 were evaluated. Eighty-nine ultrasound-guided lumbar medial branch nerve blocks were performed. The target point for the lumbar nerve block was the cephalad margin of the transverse process groove in the vicinity of the superior articular process. Carm fluoroscopy was performed to confirm the needle location. Pain levels were measured by a visual analog scale (0-10 scale), the Oswestry disability index (0-5 scale), and patient satisfaction scores (0-3 scale). The patients were followed for 6 weeks. Results: The success rate was 98% (87/89 blocks), which was due to our use of ultrasound guided needle placement for the correct positioning of the needles. The mean procedural time was 5. 9 1 minutes. The average time of needle insertion was 4 1 minutes. The pain intensity significantly improved from an initial value of 5 to 2. 8 in the final follow-up (P = 0. 0001). The oswestry disability index score significantly improved from 33. 9 to 18. 3 in the final follow-up (P = 0. 0001). Patient satisfaction significantly improved from poor satisfaction immediately after the medial branch nerve block to excellent satisfaction in the final follow-up (P = 0. 0001). Analgesic requirements were also significantly reduced after 6 weeks of follow-up (P = 0. 046). Conclusion: Lumbar medial branch nerve block under ultrasound guidance was associated with high rates of treatment success and excellent treatment outcomes for facet joint pain. It is also feasible and administers no radiation. Thus, ultrasound-guided procedures can be used instead of conventional methods.

Background: Subcutaneous fat reduction is performed using different noninvasive body contouring techniques including noninvasive radiofrequency (RF) and ultrasound cavitation (USC). Objectives: The aim of this study was to evaluate the effects of combined RF-USC on anthropometric indices among obese and overweight people. Methods: This four-group interventional study was conductedon149 obeseandoverweight individuals. Participants were allocated to an abdomen and flank group (n = 82), an abdomen and hip group (n = 34), an abdomen and thigh group (n = 13), and a control group (n = 20). Participants in the three intervention groups received combined RF-USC twice a week for five consecutive weeks and followed a low-calorie diet. Results: Except for hip circumference, other anthropometric indices (including abdomen, waist, and thigh circumferences) significantly decreased after ten-session combined RF-USC. However, no statistically significant differences were detected among the groups concerning pretest and posttest mean values of body fat mass and body weight. Conclusions: Ten-session combined RF-USC is effective in significantly reducing abdomen, waist, and thigh circumferences among obese and overweight individuals.

Background: Corticosteroid injection is frequently used for chronic coccydynia management. Ultrasonography can be used to improve the accuracy of the injection. This study aims to assess the clinical outcome of ultrasound-guided compared to blind coccygeal injection in chronic coccydynia. Methods: Thirty patients with chronic coccydynia were randomized into two groups and received a coccygeal corticosteroid injection at maximum tenderness point: 15 patients with and 15 patients without ultrasound guidance. The patient’, s pain was evaluated with the visual analog scale (VAS) at 1-, 4-, 8-, and 24-week postinjection. Furthermore, the Dallas Pain Questionnaire was assessed before injection,also, four and eight weeks after treatment. The quality of life of patients was evaluated before an assessment and four weeks after the intervention by the SF-36 questionnaire. Results: The VAS score decreased significantly 24-week after the intervention in both ultrasound-guided and blinded groups (P <. 001), without any significant difference between the groups (P =. 964). Similarly, the Dallas pain scale had a significant decrease at eight weeks after intervention in both groups (P <. 001) with no significant difference between the groups (P =. 972). Although there was a significant improvement in the patient’, s quality of life in each group eight weeks after the intervention, it was not significantly different between the two groups. Neither of the treatment groups had any adverse effects associated with the injection. Conclusion: There were no significant differences in the clinical outcome of coccygeal ultrasound-guided vs. blind steroid injection for chronic coccydynia.

Interventional studies are necessary to gain new knowledge in medical sciences,they can also be associated with several risks and impose high costs on patients and healthy people, and ethical considerations must be considered, as well. Understanding the ethical challenges and issues of interventional studies is essential. Using placebo, ethical consent, and clinical trials in specific groups are some of these challenges. This systematic review study was conducted to determine ethical considerations in interventional studies with an emphasis on the four ethical principles, including autonomy, non-maleficence principle, beneficence, and justice. Researchers in interventional studies should pay attention to ethics and take the necessary steps in line with these four biological principles.

Aim and Background: This study aimed to determine the efficacy of femoral nerve block in adductor canal and comparison it with the classical method of femoral nerve block in terms of pain relief after elective surgery of the knee.Materials and Methods: In this study clinical trial study, 92 patients who were candidate for knee arthroscopy in Rasool Akram hospital during 2014- 2015 were evaluated. All patients were blocked after surgery using femoral nerve block or adductor canal block. 1 g Apotel was infused in each group and in the case of no betterment, additional NSAID was administrated. Severity of pain and sedation was measured. Satisfaction level was also evaluated. Data then were entered to SPSS v. 16 and were analyzed.Findings: We found significant difference between two groups from the point of pain in 3, 6 and 24 hour after the block. The highest VAS score was seen in recovery time in both groups, while pain score was 5 in 50% of patients of each group and 5- 6 in 25- 75% of patients. Sedation was statistically different between the two groups just immediately after the block. Satisfaction in femoral group patients was significantly higher than adductor canal group. Adductor canal group significantly received more additional NSAIDS compared to the femoral group.Conclusion: This study showed that patients with femoral nerve block received lower additive analgesic and had more satisfaction, so this method can be used as an effective treatment for elective surgery knee.

Interventional bronchoscopy is a new and non-surgical diagnostic, therapeutic and palliative approach to patient with bronchial pathologies. It consists mostly of rigid endobronchial broncoscopy under general anesthesia, with the use of (1) Nd- YAG or KTP laser (2) Cryotherapy (3) Endobronchial prostheses (4) Photodynamic therapy (5) Brach therapy and, (6) Thermo coagulation. The idea is to treat by non-surgical measures, most of the early stage tracheobronchial cancer (insitu or micro invasive). The other utility is to associate this technique as an adjuvant treatment with chemo-radiotherapy in advance lung carcinoma. Treatments of benign structural or endobronchial pathologies as well as control of hemoptysis and foreign body removal are the other indications. In the future, interventional bronchoscopy will be a leader to diagnose and treat bronchial diseases.

Musculoskeletal interventions are routine in many radiology departments in developed countries, and also in some of the centers in Iran. These are in a wide variety of procedures from FNA to percutaneous tumor ablation and vertebroplasty.The purpose of this presentation is to cover the major current musculoskeletal interventional radiologic procedures. In this talk a summary of indications, usefulness, limitations and contraindications and a review of the last papers will be presented.