With orthopedic specialists in St. Louis and Kansas City, we have treated a host of orthopedic bone and joint issues that have impacted the lives of hundreds of thousands of patients, young and old, for decades. Lippincott Williams & Wilkins. Foot Ankle Int. Sagittal T1-weighted (Images 18A and 18B) and fat suppressed fast spin-echo T2-weighted images (Images 18C and 18D) demonstrate thickening, irregularity and mild increased signal in the cervical ligament (CL), consistent with chronic sprain. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Stanislavsky A, Worsley C, Yap J, et al. Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. Reference article, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-12370, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":12370,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/rheumatoid-arthritis-musculoskeletal-manifestations-2/questions/1796?lang=us"}. Coronal (Image 5A) and axial (Image 5B) T1-weighted images through the tarsal canal and sinus tarsi visualize most of the interosseous talocalcaneal ligament (ITCL) on single slices. A bone contusion is present in the anterior calcaneus (asterisks). Sinus tarsi syndrome: a postoperative analysis. Click here to review the details. The SlideShare family just got bigger. Radiographics. 2-12%. Hip osteonecrosis: what is it and what do we do about it? 2018;23(3):397-413. Fat pad impingement is a common cause of pain in the front of the knee. Alternatively, injections can be suitable for some patients with trochanteric tendonitis. 2013;43(2):196-201. Orthopedic Imaging. - H. Brent Bamberger, MD, Cleveland Combined Hand Fellowship Lecture Series 2021-2022, Cleveland Combined Hand Fellowship Lecture Series 2020-2021, Trauma | Distal Radial Ulnar Joint (DRUJ) Injuries, Closed fracture dislocation lower third both bones forearm fracture in a 34M, Radius and Ulna shaft fracture with DRUJ dislocation in a 60M. PRP injection if you fail other treatments. 2018;39(11):1360-1369. Pain is worse with lying directly on your hip, walking up and down stairs, and prolonged walking and running. My x ray shows that new hip is in place ? Foot Ankle Int. Recently a new type of injection called PRP or platelet-rich plasma has been used for complex cases of trochanteric tendonitis. Brant WE, Helms CA. Clipping is a handy way to collect important slides you want to go back to later. Case 20 Gout involving the subtalar joint and sinus tarsi. But, again, there are different types of injections. 2014 Jul;10(2):153-66. The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. Commonly used sequences include T1-weighted contrast-enhanced spin-echo with fat saturation and T2-weighted spin-echo or gradient-echo sequences 2. Sagittal T1-weighted (Image 22A) and fat suppressed fast spin-echo T2-weighted (Image 22B) images demonstrate erosions (arrowheads) involving the middle subtalar joint. See the page for ankle joint for more information. Rominger M, Bernreuter W, Kenney P, Morgan S, Blackburn W, Alarcon G. MR Imaging of the Hands in Early Rheumatoid Arthritis: Preliminary Results. Case 19 Chronic injury with heterotopic ossification in the sinus tarsi and sinus tarsi syndrome. The sinus tarsi ligaments are often oblique to the imaging planes obtained on MR imaging, and therefore will be visualized in cross section on contiguous slices. Sometimes, we need further investigations such as ultrasound or MRI to confirm the cause and rule out these other causes of hip pain. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. subchondral cyst formation: the destruction of cartilage presses synovial fluid into the bone, ulnar deviation of the metacarpophalangeal joints, carpal instability: scapholunate dissociation, ulnar translocation, scallop sign: erosion of the ulnar aspect of the distal radius which may be predictive of extensor tendon rupture (Vaughan-Jackson syndrome), pencil-in-cup deformity: classically psoriatic arthropathy but well-recognized in rheumatoid arthritis, similar to the hands, there is a predilection for the proximal interphalangeal and metatarsophalangeal joints (especially of the fourth and fifth toes), marginal erosions of the humeral head: the superolateral aspect is a typical location 2, reduction in the acromiohumeral distance: "high-riding shoulder" due to subacromial-subdeltoid bursitis and high incidence of rotator cuff tear, concentric loss of joint space,compared with osteoarthritis (OA) where there is a tendency for superior loss of joint space, typically involves the lateral or non-weight bearing portion of the joint, loss of joint space involving all three compartments, lack of subchondral sclerosis and osteophytes,compared with osteoarthritis. If ineffective, then we recommend shockwave therapy or injections. Sagittal (Image 19C) and coronal (Image 19D) fat suppressed fast spin-echo T2-weighted images through the cervical ligament reveal thickening and increased signal in the ligament (CL), consistent with chronic sprain. To provide the best experiences, we use technologies like cookies to store and/or access device information. Lee et al. Sagittal (Image 20A) and coronal (Image 20B) fat suppressed fast spin-echo T2-weighted images, along with an axial fast spin-echo T2-weighted image (Image 20C) show a large ganglion cyst (asterisks) occupying most of the sinus tarsi. 1. Axial (Image 15A) and sagittal (Images 15B and 15C) fat suppressed fast spin-echo T2-weighted images reveal chronic sprain of the interosseous talocalcaneal ligament (ITCL) with irregular morphology. Akiyama K, Takakura Y, Tomita Y, Sugimoto K, Tanaka Y, Tamai S. Neurohistology of the sinus tarsi and sinus tarsi syndrome. 1999;4(4):299-303. Revision reduction and intramedullary fixation, Reduction of interposed extensor carpi ulnaris tendon, Reduction of interposed pronator quadratus tendon, Reduction of interposed flexor carpi ulnaris tendon, 2023 Bobby Menges Memorial HSS Limb Reconstruction Course, Type in at least one full word to see suggestions list, 6th Annual Frontiers in Upper Extremity Surgery, DRUJ Instability: Which Procedure Would You Consider for Stabilization? Foot Ankle Int. Arthroscopy. The concept was introduced by Franz Reuleaux, a mechanical engineer, in 1875. Usually, youll first notice pain on the outside of the hip. Im in need of a good recommendation for an exercise routine or possibly the PRP injection but would like to know if its approved medically and if so, is it available in the US? The interosseous ligament therefore appears to be the most functionally important of the sinus tarsi ligaments, experimentally and clinically. Chin J Traumatol. 48 year-old male with trauma 3 weeks ago, medial and lateral hindfoot pain. Subtalar joint arthroscopy for sinus tarsi syndrome: a review of 29 cases. This condition occurs primarily from an overuse injury to the tendons outside the hip. Subtalar arthroscopy for sinus Tarsi syndrome: arthroscopic findings and clinical outcomes of 33 consecutive cases. Sagittal (Image 7A), coronal (Image 7B), and axial (Image 7C) fat-suppressed fast spin-echo T2-weighted images reveal small cysts (arrowheads) and edema adjacent to the cervical ligament and roots of the inferior extensor retinaculum, without disruption of the ligaments. 2020 Spring;8(2):153-156. Calcaneal cystic changes extend further anteriorly than the common incidental cysts and are accompanied by marrow edema. Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. Finally, repair of the gluteal tendon may be considered in cases that fail other treatments. 1997;21(2):274-279. I had a total right hip replacement 2 yrs ago and still have severe pain , bursitis , tendonitis, and I get sudden cramping in the right groin daily , ,, what should I do next ? Dr. Masci is a specialist sport doctor in London. Toward the end of rehab, adding exercises with high load and speed, such as a step up with weights is essential. Jung ST, Kong IK. The decision is made to proceed with operative stabilization of the distal radius. Ligaments of the lateral aspect of the ankle and sinus tarsi: an MR imaging study. Compartment Syndrome Leg Compartment Syndrome Thigh Compartment Syndrome Subtalar Dislocations Calcaneus FX Other Trauma Topics 2023 Bobby Menges Memorial HSS Limb Reconstruction Course Jan 27 - To avoid impingement with the proximal ulna, you need to carefully place your fixation. Lee KB, Bai LB, Song EK, Jung ST, Kong IK. The disease tends to affect the proximal joints in a bilaterally symmetrical distribution. On practical example is reducing the step count to 50% of normal or reducing running intensity. Posterior ankle impingement, FHL entrapment. Beltran J, Munchow AM, Khabiri H, Magee DG, McGhee RB, Grossman SB. Shepherd's fracture. Case 22 Middle subtalar coalition causing sinus tarsi narrowing. Related topics: Patellar tendonitis; Pain at front of the knee; Causes of inner knee pain; Plica knee syndrome Radiology. 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Tumors Excluding Liver Tumors, Reduction Mammaplasty for Breast-Related Symptoms, Skilled Nursing Facility (standard option plan ONLY), Surgical Treatment of Bilateral Gynecomastia, Surgical Treatment of Morbid Obesity (Benefit), Virtual Colonoscopy Computed Tomography Colonography. 3D renders illustrate the major ligamentous structures within the sinus tarsi region including the interosseous talocalcaneal ligament (ITCL), the lateral (L), intermediate (I), and medial (M) roots of the inferior extensor retinaculum, and the cervical ligament (CL). It appears that you have an ad-blocker running. 1990;177(2):455-458. A bone contusion in the neck of the talus (asterisks)and osteochondral injury at the medial talar dome (arrowhead) are also visible. Essex-Lopresti injuries. Surgical intervention is reported to achieve satisfactory results in most patients. 1993;186(1):233-240. Fat Pad impingement; PRP injection for knee arthritis; Plica syndrome of knee; Discoid meniscus; Popliteus tendonitis; CLOSE Accessory Navicular Syndrome; Subtalar joint arthritis; CLOSE Hand and Wrist Common conditions responsive to injection treatment: Carpal tunnel syndrome; By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. This procedure involves repeated needling of the hip tendon using a low dose of a local anaesthetic. Case 9 Acute sprain of the interosseous ligament in a 65 year-old female, injury 1 week prior to MRI. I received a corticosteroid injection in my left hip for bursitis. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. We think shockwave reduces pain by healing the tendon or stunning the small nerves sending pain messages to the brain. On occasion, running assessment on a treadmill can detect subtle changes such as pelvic drop or cross-over gait. It is also referred to as trochanteric tendonitis or bursitis and is common and readily treatable. Hi Joanne, Sorry to hear about your hip. Breitenseher MJ, Haller J, Kukla C, et al. Achilles tendinitis is a common injury, particularly in sports that involve lunging and jumping. Ultrasound also has a role in guiding corticosteroid injectionsin this setting. 49 year-old male with chronic lateral ankle pain. HSS J. Radiol Case Reports 2011;6:414. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. The sinus tarsi syndrome was first described in the medical literature in 1958.1 Overall incidence is unknown, but it is generally considered uncommon and without consistent gender predilection.2,3, Components of the sinus tarsi syndrome include lateral hindfoot pain, tenderness to palpation over the sinus tarsi, a sensation of instability in the hindfoot, and relief by injection of local anesthetic into the sinus.2,3,4,5 Patients typically present in the third to fourth decade of life with a history of ankle sprain. Physical exam. Primer of Diagnostic Imaging. extra-articular lateral hindfoot impingement syndrome (ELHIS) No visible disruption of the ligaments. It may or may not be associated with an Achilles tendon tear.A lack of flexibility or a stiff Achilles tendon can increase the risk of these J Foot Surg. Research suggests cortisone injections for greater trochanteric pain syndrome are effective (but less so than exercise). The roots of the inferior extensor retinaculum are not identifiable, consistent with tear. Is It Possible to Predict Radiological Damage in Early Rheumatoid Arthritis (RA)? Compartment Syndrome Leg Compartment Syndrome Thigh Compartment Syndrome Subtalar Dislocations Calcaneus FX Other Trauma Topics associated with impingement and rotator cuff symptoms and may be detected incidentally with trauma. Sonography can assess the soft tissue manifestations of rheumatoid arthritis. Lady Reading Hospital-Medical Teaching Institution, Peshawar, 2. biomechanics of the knee joint artho, osteo, Hip joint biomechanics and pathomechanics, BIOMECHANICS & PATHOMECHANICS OF KNEE JOINT AND PATELLOFEMORAL JOINT, Movement impairments of cervical and lumbar spine, anatomy and biomechanics of Shoulder joint, Spinal Involvement in Mucopolysaccharidoses, prognosticmarkers-reshama-170418164211.pdf, Management-Pregnancy-Uterine-Scar-SLCOG.pdf, Clinical Syndromes of Cerebral Ischemic Stroke.pptx, PROTOCOL FOR THE MANAGEMENT OF SARS VOC 2 AT THE PRIMARY HEALTH CARE LEVEL.pdf, No public clipboards found for this slide. The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. This effect lasts for up to a year. 1988 Sep-Oct;16(5):512-6. Recent evidence suggests that exercises are better than no treatment or injections. Now customize the name of a clipboard to store your clips. Edema extends into the tarsal canal, with irregularity of the interosseous talocalcaneal ligament (ITCL) and medial (M) root of the inferior extensor retinaculum indicating sprain of both ligaments. There is an anterolateral, posteromedial and lateral compartment of the ankle typically superficial to the joint. Sagittal (Image 14D) and coronal (Image 14E) fat-suppressed fast spin-echo T2-weighted images show thickening and mild increased signal in the cervical ligament (CL), consistent with chronic sprain, with cystic change (arrowheads) posterior to the ligament. Clin Podiatr Med Surg. On occasion, people with gluteal pain can have significant night pain. The lateral process of the talus is subluxed anteriorly and the sinus tarsi is narrowed, as a result of hindfoot valgus. You can use your phone to monitor step count. Foot Ankle Clin. greater trochanteric pain syndrome occur with PRP injections even after two years. Moreover, women are more likely to suffer from this injury than men, perhaps related to the shape of a womans pelvis. Generally, we suggest injections are done under ultrasound to improve accuracy. J Ultrasound. Signature Orthopedics - O'Fallon 9323 Phoenix Village Pkwy Winghaven O'Fallon, MO 63368 Get directions Other Locations Signature Orthopedics - Fenton Hip tendonitis exercises build muscle around the hip joint, including glutes, hip flexors, and hip adductors. Epidemiology. Id suggest leucocyte rich PRP. Kjaersgaard et al. 2008 Oct;24(10):1130-4. 4% (74/1868) L 2 Available for commercial, Shared Advantage, and BlueCard. A sagittal T1-weighted image (Image 14C) demonstrates hypointense fibrosis and edema occupying much of the sinus tarsi. Case 10 Acute injury with sinus tarsi and tarsal canal syndrome. Just having trochanteric bursitis means you also have gluteal tendonitis. Prathima institute of medical sciences Case 7 Acute injury with sprain of the cervical ligament and roots of the inferior extensor retinaculum. radioulnar impingement is prevented by soft tissue interposition. -, 5. Taillard, W., Meyer, J., Garcia, J. et al. Treatment of trochanteric bursitis includes exercise and injections. Subtalar loose body removal. 19% (147/766) 5. Adam Greenspan. Often 3-5 sessions will help with the pain. Firstly, lowering pressure on the hip tendons by not lying on the hip is helpful if the hip is irritable. Case 14 Chronic injury with attenuation of the interosseous talocalcaneal ligament. Coronal fat suppressed fast spin-echo proton density-weighted (Image 24C) and sagittal T1-weighted (Image 24D) images through the sinus tarsi reveal severe narrowing of the sinus (arrowheads). Oloff LM, Schulhofer SD, Bocko AP. The cervical ligament (CL) and intermediate (I) root of the inferior extensor retinaculum are increased in signal, consistent with sprain. Adjacent fluid extends medially into a cyst occupying the tarsal canal (arrowheads) on sagittal fat suppressed fast spin-echo T2-weighted images (Images 12B and 12C) and an axial fast spin-echo T2-weighted image (Image 12D). You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! Usually, ultrasound shows trochanteric tendonitis and bursitis. She reports left ankle injury 3 weeks ago. Subtalar Dislocations Calcaneus FX Other Trauma Topics ulnar impaction syndrome . Helgeson K. Examination and intervention for sinus tarsi syndrome. In addition, a general hip and spine examination exclude other causes of pain outside the hip, such as hip arthritis or referred pain from the sacroiliac joint or lumbar spine. painful os peroneum syndrome (with minimal tendon involvement) refractory to conservative treatment. Featured This Month. Which of the following findings would indicate the need for distal ulna fixation? Greater trochanteric pain syndrome or trochanteric tendonitis is a common cause of hip pain. Moreover, the outside of your hip is tender to touch, and pain occurs with moving the leg outwards. Case 23 Hindfoot valgus with lateral hindfoot impingement and sinus tarsi syndrome. Arthrography is invasive and relatively insensitive compared to MRI.6,11,20,21,22, Ultrasound evaluation of the sinus is feasible, although published reports are limited. Pieters RS, Galvin J. Greater trochanteric pain syndrome causes pain outside of the hip. Sagittal T1-weighted (Image 9A), fat suppressed fast spin-echo T2-weighted (Image 9B), and coronal fat suppressed fast spin-echo T2-weighted (Image 9C) images reveal edema and fluid signal in the sinus tarsi. Also, avoid crossing your legs if you can. I think youve given me an idea for another blog. Case 15: with concurrent OA of DIP joints, Case 27: well managed RA without significant erosion, Case 32: knee (with synovitis and erosions), general discussion of rheumatoid arthritis, atlantoaxial impaction (cranial settling), musculoskeletal manifestations of rheumatoid arthritis, rapidly destructive osteoarthritis of the hip, scaphotrapeziotrapezoidal (STT)arthritis, calcium pyrophosphate dihydrate deposition disease (CPPD), hydroxyapatite crystal deposition disease (HADD), Mayfield classification of carpal instability, dorsal intercalated segment instability (DISI), volar intercalated segment instability (VISI), scaphoid nonunion advanced collapse (SNAC), triangular fibrocartilaginous complex (TFCC) injuries, ulnar-sided wrist impaction and impingement syndromes, calcium pyrophosphate dihydrate deposition disease, Rheumatoid arthritis - musculoskeletal manifestations. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. 21 year-old male with previous ankle injury 6 months ago. 2001;40(3):152-157. The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields.This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and When examining a person with gluteal tendonitis, we perform specific tests, such as standing on the affected leg, step-ups on the affected side, and hitching maneuvers on a step. Am J Sports Med. Treatment. Case 23 Hindfoot valgus with lateral hindfoot impingement and sinus tarsi syndrome. 61 year-old female with lateral ankle pain. It worked great but in two weeks the pain was back again. One study showed that needling improved pain from trochanteric tendonitis in about 80% of people after 2-3 months. Soft tissue massage and acupuncture can sometimes help exercise in greater trochanteric tendonitis. Tarsal sinus: arthrographic, MR imaging, MR arthrographic, and pathologic findings in cadavers and retrospective study data in patients with sinus tarsi syndrome. The sinus tarsi syndrome. However, the hip joints can take a beating leading to pain. Sagittal T1-weighted (Image 10A), fat suppressed fast spin-echo T2-weighted (Image 10B), and coronal fat suppressed fast spin-echo T2-weighted (Image 10C) images show mild increased signal in the cervical ligament (CL), consistent with sprain. 2-12%. https://sportdoctorlondon.com/psoas-injection/, Advanced hydrodistension for frozen shoulder, Distal Clavicular Osteolysis (weightlifters shoulder). Subtalar arthroscopy for sinus Tarsi syndrome: arthroscopic findings and clinical outcomes of 33 consecutive cases. Lateral talocalcaneal impingement secondary to posterior tibial tendinopathy. Foot Ankle Int. Keeping pain levels low (<3/10) is crucial in hamstring tendonitis. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. Generally, in cases that dont improve with physiotherapy, other options are available. I cant lay on my hip at all for long periods of time and the pain keeps me up at night. Anatomy. Incidentally noted are prominent tibiotalar and subtalar joint effusions with synovial hypertrophy, suggesting synovitis. Sinus tarsi ligament injury can be visualized on MRI as thickening and increased intrasubstance signal, attenuation, or discontinuity. 1. Common conditions responsive to injection treatment: Acromioclavicular joint (AC joint) arthritis, Advanced lavage or barbotage for calcification of tendons, Patellofemoral joint osteoarthritis or anterior knee pain, Gluteus medius tendonitis or trochanteric bursitis, Pain and swelling after an ankle sprain or rolled ankle/ torn lateral ligaments, Os Trigonum: cause of pain at the back of the ankle, Thumb arthritis (1st carpometacarpal joint osteoarthritis), Recent evidence suggests that exercises are better than no treatment or injections, injections for greater trochanteric pain syndrome are effective (but less so than exercise), pain improved six weeks after one cortisone injection. The extensor digitorum brevis (EDB) and extensor digitorum longus (EDL) muscles, and the peroneus tertius (PTe), peroneus brevis (PT), and peroneus longus (PL) tendons are also labeled. reported MRI sensitivities of 71% or higher for cervical ligament tears, synovial thickening, and sinus tarsi fat alterations. We often start with simple exercises such as side lying hip raises, seated hip abduction with a band, and hamstring bridges with a band. Lowy A, Schilero J, Kanat IO. Tibiotalar Impingement Midfoot Arthritis Neurologic Conditions Tarsal Tunnel Syndrome Deep Peroneal Nerve Entrapment Subtalar, talonavicular, and calcaneocuboid joint arthrodesis (Triple) 4% (63/1401) L 1 Arshad Z, Bhatia M. Current concepts in sinus tarsi syndrome: A scoping review. 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Pump, Heating and Cooling Devices Used in the Home Setting, Holter Monitoring (Ambulatory Electrocardiography), Home Prothrombin Time Testing (INR Monitoring), Interferential Stimulator/Stimulation Devices, Lymphedema Pumps/Pneumatic Compression Devices, Microprocessor-Controlled Lower Limb Prosthesis, Myoelectric Prosthetic Components for the Upper Limb, Negative Pressure Wound Treatment in the Outpatient Setting, Noncontact Radiant Heat Bandage for the Treatment of Wounds, Noninvasive Positive Pressure Ventilation, Oscillatory Devices for Airway Clearance (The Vest, Intrapulmonary Percussive Ventilation (IPV), Flutter Device), Outpatient Use of Limb Pneumatic Compression Devices for Venous Thromboembolism Prophylaxis, Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence, Phototherapy for the Treatment of Skin Disorders, Stretching and Splinting Devices for the Treatment of Joint Stiffness and Contractures, Thoracic-Lumbo-Sacral Orthosis with Pneumatics, Threshold Electrical Stimulation as a Treatment of Motor Disorders, Transcutaneous Electrical Nerve Stimulation (TENS), Transtympanic Micropressure Applications as a Treatment of Menieres Disease, Tumor-Treating Fields Therapy for Glioblastoma, Analysis of Human DNA in Stool Samples as a Technique for Colorectal Cancer Screening, Antigen Leukocyte Cellular Antibody Test (ALCAT), Apolipoprotein B in the Risk Assessment and Management of Cardiovascular Disease, Apolipoprotein E Genotype or Phenotype in the Management of Cardiovascular Disease, Assays of Genetic Expression in Tumor Tissue as a Technique to Determine Prognosis in Patients with Breast Cancer, BCR-ABL1 Testing in Chronic Myelogenous Leukemia and Acute Lymphoblastic Leukemia, Biochemical Markers of Alzheimers Disease, Bio-Engineered Skin and Soft Tissue Substitutes, Bone Turnover Markers for the Diagnosis and Management of Osteoporosis, BRAF Gene Mutation Testing To Select Melanoma Patients for BRAF Inhibitor Targeted Therapy, Combination of Serum Markers for Liver Fibrosis in the Evaluation and Monitoring of Patients with Chronic Liver Disease, Detection of Circulating Tumor Cells in the Management of Patients with Cancer, DNA-Based Testing for Adolescent Idiopathic Scoliosis, End-Tidal Carbon Monoxide Measurement (ETCOc), Epidermal Growth Factor Receptor (EGFR) Mutation Analysis for Patients with Non-Small-Cell Lung Cancer (NSCLC), Facet Joint Injections, Trigger Point Injections, and Epidural Injections of Corticosteroids and/or Local Anesthetics, Fecal Analysis in the Diagnosis of Intestinal Dysbiosis, Gamma Interferon Blood Test for Diagnosis of Latent Tuberculosis, Gene Expression Testing to Predict Coronary Artery Disease, Gene-Based Tests for Screening, Detection, and/or Management of Prostate Cancer, Genetic Cancer Susceptibility Panels Using Next Generation Sequencing, Genetic Testing for Alpha-1 Antitrypsin Deficiency, Genetic Testing for Hereditary Breast and/or Ovarian Cancer, Genetic Testing for Hereditary Hemochromatosis, Genetic Testing for Inherited Cancer Predisposition and or Pharmacogenetics related to Cancer Treatment, Genetic Testing for Lipoprotein(a) Variant(s) as a Decision Aid for Aspirin Treatment, Genetic Testing for Mental Health Conditions, Genetic Testing for Non-Cancerous Inheritable Diseases, Genetic Testing, Including Chromosomal Microarray (CMA) Analysis and Next Generation Sequencing Panels, for the Genetic Evaluation of Patients with Developmental Delay/Intellectual Disability or Autism Spectrum Disorder, Genotyping for 9p21 Single Nucleotide Polymorphisms to Predict Risk of Cardiovascular Disease or Aneurysm, High-Density Lipoprotein Subclass Testing in the diagnosis and Management of Cardiovascular Disease, Homocysteine Testing in the Screening, Diagnosis, and Management of Cardiovascular Disease, Human Leukocyte Antigen (HLA) Testing for Celiac Disease, Immunoassay/Immunochemical Fecal Occult Blood Testing, In Vitro Chemoresistance and Chemosensitivity Assays, JAK2 and MPL Mutation Analysis in Myeloproliferative Neoplasms, KIF6 Genotyping for Predicting Cardiovascular Risk and/or Effectiveness of Statin Therapy, KRAS Mutation Analysis in Non-Small-Cell Lung Cancer (NSCLC), Laboratory and Genetic Testing for Use of 5-Flourouracil (5-FU) in Patients with Cancer, Laboratory Tests of Sperm Maturity, Function and DNA Integrity, Lipoprotein-Associated Phospholipase A2: PLAC Test, Magnetic Resonance Cholangiopancreatography (MRCP), Measurement of Long-Chain Omega-3 Fatty Acids in Red Blood Cell Membranes as a Cardiac Risk Factor, Measurement of Serum Antibodies to Infliximab, Measurement of Small Low Density Lipoprotein (LDL) Particles and Lipoprotein (a) [lp(a)] Enzyme Immunoassay in the Management of Cardiovascular Disease, Microarray-Based Gene Expression Profile Testing for Multiple Myeloma Risk Stratification, Microarray-Based Gene Expression Testing for Cancers of Unknown Primary, Molecular Markers in Fine Needle Aspirates of the Thyroid, Molecular Profiling for the Evaluation of Malignant Tumors, Pharmacogenomic and Metabolite Markers for Patients Treated with Thiopurines, Proteomics-Based Testing Related to Ovarian Cancer, Routine Human Papillomavirus (HPV) Testing, Serum Biomarker Human Epididymis Protein 4 (HE4), Serum Holotranscobalamin as a Marker of Vitamin B12 (Cobalamin) Status, Systems Pathology for Predicting Risk of Recurrence in Prostate Cancer, Urea Breath Test for Diagnosis of Helicobacter Pylori, Use of Common Genetic Variants to Predict Risk of Nonfamilial Breast Cancer, Acoustic Cardiography Correlated Audioelectric Cardiography, Aerosolized Antibiotics as a Treatment of Chronic Sinusitis, Analysis of Proteomic Patterns in Serum to Identify Cancer, Anti-CCP Testing for Rheumatoid Arthritis, Automated Ambulatory Blood Pressure Monitoring, Automated Point-of-Care Nerve Conduction Tests, Bioimpedance Devices for Detection of Lymphedema, Biomarker Genes for Detection of Lymph Node Metastases in Breast Cancer, Cardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting, Cardiopulmonary Exercise Stress Test (CPET/CPX), Catheter Ablation for Cardiac Arrhythmias, Cellular Immunotherapy for Prostate Cancer, Computerized 2-lead Resting Electrocardiogram Analysis for the Diagnosis of Coronary Artery Disease, COPES Scoliosis Treatment Recovery System, Diagnosis and Management of Idiopathic Environmental Intolerance (i.e., Multiple Chemical Sensitivities), Diagnosis and Treatment of Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis, Diagnosis and Treatment of Sacroiliac Joint Pain, Electrocardiographic Body Surface Mapping, Electrostimulation and Electromagnetic Therapy for the Treatment of Chronic Wounds, Enhanced External Counterpulsation (EECP), Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal Conditions, Identification of Microorganisms Using Nucleic Acid Probes, Immune Cell Function Assay in Solid Organ Transplantation, Intra-articular Hyaluronan Injections for Osteoarthritis, Intraoperative Neurophysiologic Monitoring, Intravenous Anesthetics for the Treatment of Chronic Pain, KRAS and BRAF Mutation Analysis in Metastatic Colorectal Cancer, Left-Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation, Magnetic Esophageal Ring to Treat Gastroesophageal Reflux Disease (GERD), Management of Obstructive Sleep Apnea Syndrome, Measurement of Exhaled Nitric Oxide and Exhaled Breath Condensate in the Diagnosis and Management of Asthma and Other Respiratory Disorders, Mobile Cardiac Outpatient Telemetry and Hybrid Devices, Monitoring of Regional Cerebral Blood Flow Using an Implanted Cerebral Thermal Perfusion Probe, Navigated Transcranial Magnetic Stimulation (nTMS), Neuromuscular and Electrodiagnostic Testing (EDX): Nerve Conduction Studies (NCS) and Electromyography (EMG) Studies, Non-Contact Ultrasound Treatment for Wounds, Non-Oncologic Uses of Rituximab (Rituxan), Nutritional Treatment of Childhood Medical Conditions, Ophthalmologic Techniques for Evaluating Glaucoma, Optical Diagnostic Devices for Evaluating Skin Lesions Suspected of Malignancy, Oral Lesion Identification System (ViziLite, Velscope), Orthopedic Applications of Stem Cell Therapy, Paraspinal Surface Electromyography (SEMG) to Evaluate and Monitor Back Pain, Peripheral Subcutaneous Field Stimulation, Photodynamic Therapy for Dermatological Applications, Photodynamic Therapy, Ocular: Visudyne (Verteporfin), Placental/Umbilical Cord Blood as a Source of Stem Cells, Quantitative Assay for Measurement of HER2 Total Protein Expression and HER2 Dimers, Retinal Telescreening for Diabetic Retinopathy, Serum Antibodies for the Diagnosis of Inflammatory Bowel Disease, Serum Tumor Markers for Breast and Gastrointestinal Malignancies, Transanal Radiofrequency Treatment of Fecal Incontinence, Transcatheter Ablation of Arrhythmogenic Foci as a Treatment of Atrial Fibrillation, Transcatheter Closure Devices for Patent Foramen Ovale (PFO) Defects, Transcatheter Closure Devices for Septal Defects, Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric Disorders, Transvaginal and Transurethral Radiofrequency Tissue Remodeling for Urinary Stress Incontinence, Ultrafiltration in Decompensated Heart Failure, Ultrasonographic Measurement of Carotid Intimal-Medial Thickness as an Assessment of Subclinical Atherosclerosis, Urodynamic Testing to Evaluate Urinary Incontinence, Uses of Monoclonal Antibodies for the Treatment of Non-Hodgkin Lymphoma, including Chronic Lymphocytic Leukemia, and Acute Myeloid Leukemia in the Non-Hematopoietic Stem-Cell Transplant Setting, Opioid Antagonists Under Heavy Sedation or General Anesthesia as a Technique of Opioid Detoxification, First-Trimester Detection of Down Syndrome Using Fetal Ultrasound Assessment of Nuchal Translucency Combined with Maternal Serum Assessment, Injectable Progesterone Therapy as a Technique to Reduce Preterm Birth in High-Risk Pregnancies, Levonorgestrel-releasing Intrauterine System (LNG-IUS) (Mirena), Noninvasive Prenatal Testing for Trisomy 21 Using Cell Free Fetal DNA, Surgical Interruption of Pelvic Nerve Pathways for Primary and Secondary Dysmenorrhea, Bispectral Index Monitoring During General Anesthesia, Conjunctival Incision with Posterior Juxtascleral Placement of Anecortave Acetate Depot Suspension, Intraoperative Transesophageal Echocardiography, Nutritional Supplements for Phenylketonuria (PKU), Recombinant and Autologous Platelet-Derived Growth Factors as a Treatment of Wound Healing and Other Conditions, Suprachoroidal Delivery of Pharmacological Agents, Transciliary Fistulization for the Treatment of Glaucoma, Use of Anesthesia Services for Routine Gastrointestinal Endoscopy, Xiaflex (collagenase clostridium histolyticum) for Fibroproliferative Disorders, Ado-Trastuzumab Emtansine (Trastuzumab-DM1) for Treatment of HER-2 Positive Malignancies, Growth Hormone and Insulin-Like Growth Factor-1 (IGF-1) Analogues, Immune Prophylaxis for Respiratory Syncytial Virus: Synagis (Palivizumab), Intravenous Antibiotic Therapy and Associated Diagnostic Testing for Lyme Disease, Tysabri (natalizumab) for the Treatment of Multiple Sclerosis, Beta Amyloid Imaging with Positron Emission Tomography (PET) for Alzheimers disease, Cardiac Computed Tomography (CCT), Cardiac Computed Tomography Angiography (CCTA), Charged-Particle (Proton or Helium Ion) Radiation Therapy, Chromoendoscopy as an Adjunct to Colonoscopy, Computed Tomography and Computed Tomographic Angiography of Extremity or Joint, Computed Tomography and Computed Tomographic Angiography of the Abdomen and Pelvis, Computed Tomography and Computed Tomographic Angiography of the Chest and Thorax, Computed Tomography and Computed Tomographic Angiography of the Head and Neck, Computed Tomography of Cervical, Thoracic, and Lumbar Spine, Computed Tomography to Detect Coronary Artery Calcification, Computer-aided Detection (CAD) Mammography, Dopamine Transporter Imaging with Single Photon Emission Computed Tomography (DAT-SPECT), Electromagnetic Navigational Bronchoscopy, Functional Magnetic Resonance Imaging (MRI), High-Dose Rate Temporary Prostate Brachytherapy, Intensity-Modulated Radiation Therapy (IMRT), Intracavitary Balloon Catheter Brain Brachytherapy for Malignant Gliomas or Metastasis to the Brain, Intraocular Radiation Therapy for Age-Related Macular Degeneration, Locoregional Therapies for Hepatocellular Carcinoma and Metastatic Liver Carcinoma and Metastatic Carcinoid Tumors of the Liver, Lung Cancer Screening Using Computed Tomography (CT) or Chest Radiographs, Magnetic Resonance Angiography (MRA) of the Chest (excluding the heart), Magnetic Resonance Angiography of Vessels of the Head, Neck, Abdomen, Pelvis, Spinal Canal, and Upper and Lower Extremity, Magnetic Resonance Imaging (MRI) of Neck, Face, Orbit, Magnetic Resonance Imaging (MRI) of the Abdomen and Pelvis, Magnetic Resonance Imaging (MRI) of the Brain, Magnetic Resonance Imaging (MRI) of the Breast, Magnetic Resonance Imaging (MRI) of the Cervical, Thoracic, and Lumbar Spine, Magnetic Resonance Imaging (MRI) of the Chest, Magnetic Resonance Imaging (MRI) of the Extremities and Extremity Joints, Magnetic Resonance Imaging (MRI) of the Heart, Magnetic Resonance Imaging (MRI) of the Temporomandibular Joint (TMJ), Magnetic Resonance Imaging for Bone Marrow Blood Supply, Magnetoencephalography/Magnetic Source Imaging, Myocardial Sympathetic Innervation Imaging in Patients with Heart Failure, Oncologic Applications of Photodynamic Therapy, Including Barretts Esophagitis, Optical Coherence Tomography (OCT) for Imaging of Coronary Arteries, Percutaneous Vertebroplasty, Kyphoplasty, Mechanical Vertebral Augmentation and Sacroplasty, Positron Emission Tomography (PET)-Cardiac Applications, Positron Emission Tomography (PET)-Miscellaneous Applications, Positron Emission Tomography (PET)-Oncologic Applications, Radioimmunoscintigraphy Imaging with Indium-111 Capromab Pendetide (ProstaScint) for Prostate Cancer, Real-Time Intra-Fraction Motion Management During Radiation Therapy, Scintimammography and Gamma Imaging of the Breast and Axilla, Standing Magnetic Resonance Imaging (MRI) (Vertical or Positional MRI), Three-D (3-D) Reconstruction for Computed Tomography, Magnetic Resonance Imaging, Ultrasound, or Other Tomographic Modalities, Ultrasonographic Evaluation of Skin Lesions, Vertebral Fracture Assessment with Dual X-Ray Absorptiometry (DEXA), Whole Body Dual X-Ray Absorptiometry (DEXA) to Determine Body Composition, Wireless Capsule Endoscopy (Given Video Capsule), Adjustable Gastric Banding for Morbid Obesity, Allogeneic Hematopoietic Stem-Cell Transplantation for Genetic Diseases and Acquired Anemias, Allogeneic Stem-Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms, Arthroscopic Debridement and Lavage as Treatment for Osteoarthritis of the Knee, Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions, Autologous Chondrocyte Implantation for Focal Articular Cartilage Lesions, Autologous Fat Grafting to the Breast and Adipose-derived Stem Cells, Autologous Hematopoietic Stem-Cell Transplantation for Malignant Astrocytomas and Gliomas, Automated Percutaneous and Endoscopic Discectomy, Balloon Ostial Dilation for Treatment of Chronic Sinusitis, Bi-Ventricular Pacemakers (Cardiac Resynchronization Therapy) for the Treatment of Heart Failure, Blepharoplasty, Brow Lift and Ptosis Repair, Composite Tissue Allotransplantation (CTA) of the Hand and Face, Computer-Assisted Endoscopic Sinus Surgery, Computer-Assisted Musculoskeletal Surgical Navigational Orthopedic Procedure, Cranial Electrotherapy Stimulation (CES) and Auricular Electrostimulation, Cryosurgical Ablation of Miscellaneous Solid Tumors Other than Liver, Prostate, or Dermatologic Tumors, Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty), Donor Lymphocyte Infusion for Malignancies Treated with an Allogeneic Hematopoietic Stem-Cell Transplant, Endoscopic Radiofrequency Ablation or Cryoablation for Barretts Esophagus, Endovascular Procedures (Angioplasty and/or Stenting) for Intracranial Arterial Disease (Atherosclerosis and Aneurysms), Extracorporeal Shock Wave Lithotripsy (ESWL) for Pancreatic Stones, Extracorporeal Shock Wave Lithotripsy of Renal Stones, Extracranial Carotid Angioplasty/Stenting, Eyelid Thermal Pulsation for the Treatment of Dry Eye Syndrome, Fetal Surgery for Prenatally Diagnosed Malformations, Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery, Hematopoietic Stem Cell Transplantation for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma, Hematopoietic Stem-Cell Transplantation for Acute Lymphoblastic Leukemia, Hematopoietic Stem-Cell Transplantation for Autoimmune Diseases, Hematopoietic Stem-Cell Transplantation for Breast Cancer, Hematopoietic Stem-Cell Transplantation for Chronic Myelogenous Leukemia, Hematopoietic Stem-Cell Transplantation for CNS Embryonal Tumors and Ependymoma, Hematopoietic Stem-Cell Transplantation for Epithelial Ovarian Cancer, Hematopoietic Stem-Cell Transplantation for Hodgkin Lymphoma, Hematopoietic Stem-Cell Transplantation for Miscellaneous Solid Tumors in Adults, Hematopoietic Stem-Cell Transplantation for Primary Amyloidosis, Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood, Hematopoietic Stem-Cell Transplantation for Waldenstrom Macroglobulinemia, Hematopoietic Stem-Cell Transplantation in the Treatment of Germ-Cell Tumors, Image-Guided Minimally Invasive Lumbar Decompression for Spinal Stenosis, Implantable Bone Conduction and Bone-Anchored Hearing Aids (BAHA), Implantable Sinus Spacers and Stents for Postoperative Use Following Endoscopic Sinus Surgery, Injectable Bulking Agents for the Treatment of Urinary and Fecal Incontinence, Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers), Intrastromal Corneal Ring Segments, ICRS, INTACS, Intratympanic Dexamethasone for the Treatment of Menieres Disease and-or Sudden Hearing Loss, Isolated Limb Perfusion/Infusion for Malignant Melanoma, Joint Manipulation under Anesthesia (Excluding Spine), Laparoscopic and Percutaneous Techniques for the Myolysis of Uterine Fibroids, Lung Volume Reduction Surgery for Severe Emphysema, Management of Excessive Skin and Subcutaneous Tissue, Meniscal Allografts and Collagen Meniscus Implants, Minimally Invasive Lumbar Interbody Fusion, Natural Orifice Transluminal Endoscopic Surgery (NOTES), Nerve Graft in Association with Radical Prostatectomy, Occlusion of Uterine Arteries Using Transcatheter Embolization or Laparoscopic Occlusion to Treat Uterine Fibroids, Ocriplasmin for Symptomatic Vitreomacular Adhesion, Ocular Photoscreening in the Primary Care Physician?s Office as a Screening Tool to Detect Amblyogenic Factors, Ovarian and Internal Iliac Vein Embolization as Treatment of Pelvic Congestion Syndrome, Percutaneous Electrical Nerve Stimulation (PENS) and Percutaneous Neuromodulation Therapy (PTN), Percutaneous Intradiscal Electrothermal Annuloplasty (IDET) and Percutaneous Intradiscal Radiofrequency Thermocoagulation, Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux, Peroral Endoscopic Myotomy (POEM) for Treatment of Esophageal Achalasia, Posterior Tibial Nerve Stimulation for Voiding and Sexual Dysfunction, Progenitor Cell Therapy for the Treatment of Damaged Myocardium due to Ischemia, Pulsed Dye Laser Treatment of Recalcitrant Verrucae, Radiofrequency Ablation of Solid Tumors Excluding Liver Tumors, Radiofrequency Ablation of the Renal Sympathetic Nerves as a Treatment for Resistant Hypertension, Sacral Nerve Modulation/Stimulation for Pelvic Floor Dysfunction, Saturation Biopsy for Diagnosis and Staging of Prostate Cancer, Semi-Implantable/Implantable Middle Ear Hearing Aid for Moderate to Severe Sensorineural Hearing Loss, Single or Tandem Courses of Hematopoietic Stem-Cell Transplantation for Multiple Myeloma, Small Bowel/Liver and Multivisceral Transplant, Stem Cell Therapy for Peripheral Arterial Disease, Stimulation of the Sacral Anterior Root Combined with Posterior Sacral Rhizotomy in Patients with Spinal Cord Injury, Surgical Deactivation of Headache Trigger Sites, Surgical Treatment of Femoroacetabular Impingement, Therapeutic Apheresis with Extracorporeal Column Immunoadsorption and Plasma Reinfusion, Thermal Capsulorrhaphy as a Treatment of Joint Instability, Transcatheter Aortic-Valve Implantation for Aortic Stenosis, Transcatheter Closure of Patent Ductus Arteriosus, Transcatheter Pulmonary Valve Implantation, Transcoronary Ablation of Septal Hypertrophy (TASH), Transesophageal Endoscopic Therapies for Gastroesophageal Reflux Disease-GERD, Treatment of Cervicogenic Headache and Occipital Neuralgia, Treatment of Twin-Twin Transfusion Syndrome with Amnioreduction and/or Fetoscopic Laser Therapy, Unicondylar Interpositional Spacer as a Treatment of Unicompartmental Arthritis of the Knee, Ventricular Assist Devices and Total Artificial Hearts, Vertical Expandable Prosthetic Titanium Rib, Videofluoroscopic/Cineradiography Evaluation of Velopharyngeal Dysfunction, Wireless Pressure Sensors in Endovascular Aneurysm Repair, Brachytherapy for Clinically Localized Prostate Cancer Using Permanently Implanted Seeds, Constraint Induced Movement or Language Therapy, Hematopoietic Stem-Cell Transplantation for Acute Myeloid Leukemia, Hematopoietic Stem-Cell Transplantation for Non-Hodgkin Lymphomas, Inpatient Intestinal Rehabilitation Therapy, Low Level Laser and High Power Laser Therapies, Manipulation under Anesthesia for Treatment of Chronic Spinal or Pelvic Pain, Sensory Integration Therapy, Auditory Integration Therapy and Facilitated Communication, Spinal Manipulation of Non-Neuromusculoskeletal Conditions, Sympathetic Therapy and Bioelectrical Nerve Block or Electroanalgesic Nerve Block for the Treatment of Pain. 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