Purpose or Case Report: Minimally invasive procedures are common practice for pain management in pediatrics. The use of image guided therapies for axial skeletal pain management have been proven to not only be safe and effective, but also can be performed routinely in the interventional radiology (IR) department. The goal of this educational exhibit is to illustrate image guided techniques for pain management in pediatric patients. Specifically, techniques involving image-guided injections for treatment of headache, back pain, and other axial skeletal sources will be highlighted.
Methods & Materials: Retrospective chart review of pediatric patients between 0-18 years of age who received an image guided pain management procedure performed as routine clinical care between January 2008 and September 2016 in a dedicated pediatric IR setting will be included in this educational exhibit. Procedural techniques and image evaluation of routinely performed nerve block and steroid injection procedures will be described for the pediatric interventional radiologist.
Results: Educational review of sphenopalatine ganglion, occipital nerve, intercostal nerve and celiac plexus blocks as well as, interlaminar epidural (Fig. 1), transforaminal epidural (Fig. 2), Bertolotti, sacroiliac (SI) and pars interarticularis (Fig. 3) steroid injections procedures will be described in detail of technique and image evaluation.
Conclusions: Pediatric interventional radiologists are well suited to employ these techniques and incorporate them into their practice. With the proper procedural and imaging technique, these procedures can be performed as routine clinical care for axial skeletal pain management.