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KMID : 1040020200110020052
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International Journal of Pain
2020 Volume.11 No. 2 p.52 ~ p.55
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Paravertebral Block for Pain Control in Costovertebral Arthropathy: A Case Report
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Kim Ki-Wook
Kim Hyo-Ju
Jang Hun
Park Sang-Jun
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Abstract
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Costovertebral arthropathy is associated with various musculoskeletal, visceral, and rheumatic diseases, making a timely diagnosis and effective treatment challenging. A 73-year-old man with complaints of stiffness and aching that had increased since its onset three years ago presented with both anterior chest wall and upper back pain. The initial X-ray of the cervical spine and rib cage showed nonspecific findings, as did cervical spine MRI. Computed tomography of the chest for further evaluation of upper back pain revealed costovertebral joint hypertrophy, indicating arthropathy at the right T6 level. The patient had been taking several oral medications, which were not sufficient for pain relief. We performed C-arm-guided cervical and thoracic medial branch block and trigger point injection into the rhomboid muscle, but these treatments were ineffective. Finally, an ultrasound-guided paravertebral block was successfully performed at the T6 level on the right side. The thoracic paravertebral block may be considered a therapeutic option for patients with costovertebral arthropathy.
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KEYWORD
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costovertebral arthropathy, thoracic paravertebral block, upper back pain
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