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Case Studies

Urine Drug Testing Case Studies 2
Edward Chen, MD

Today, pain management physicians registered with the state as a pain management clinic are required to perform urine drug screening on all patients prescribed a controlled substance. While obtaining a sample is at times problematic, the interpretation of the testing results can at times be confusing, and the physicians response challenging. Below are common scenarios which are open for discussion.   DISCUSSION: Marijuana is the most commonly used illicit drug. A recent survey has shown 12% of 8th graders, 29% of 10th graders, 33% of 12th graders, and 46% of high school graduates have used the drug. Amongst adult illicit …Read More

Cervical Facet Joint Injections for the Interventional Pain Management Physician

Diagnostic cervical facet joint injections are useful in the diagnosis and treatment of axial neck pain. The C1-2 joint is a source of headaches, often in patients with a history of trauma. The C2-3 third occipital nerve is often used to treat cervicogenic headaches. The C3-4 and C4-5 cervical facet joints refer pain to the neck, while the C5-6 and C6-7 cervical facets refer to the shoulder and upper back. Positioning the patient is crucial to the safe and successful procedure. An uncomfortably positioned patient will continue to move on the table, resulting in repeated repositioning of the fluoroscope, and …Read More