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Review
. 2019 Jan-Mar;9(1):18-23.
doi: 10.4103/2045-9912.254638.

Ultrasonography for oxygen-ozone therapy in musculoskeletal diseases

Eleonora Latini  1 , Enrico Roberto Curci  1 , Andrea Massimiani  1 , Sveva Maria Nusca  1 , Flavia Santoboni  1 , Donatella Trischitta  1 , Mario Vetrano  1 , Maria Chiara Vulpiani  1
Affiliations
Review

Ultrasonography for oxygen-ozone therapy in musculoskeletal diseases

Eleonora Latini et al. Med Gas Res. 2019 Jan-Mar.

Abstract

Over the years, infiltrative oxygen-ozone therapy has shown clinical benefits in several musculoskeletal disorders, due to its potential analgesic, anti-inflammatory, antioxidant and immunomodulatory effect. Ultrasonography is a safe, non-invasive imaging, easily available, and has the additional advantage of being real time for imaging and image-guided procedures of the musculoskeletal system. This review explains the numerous promising ways in which ultrasonography can be useful in oxygen-ozone therapeutic practices for musculoskeletal disorders, in order to improve safety and accuracy of treatment.

Keywords: intraaticular ozone; musculoskeletal diseases; oxygen-ozone therapy; ozone; paravertebral injection; peritendinous zone; ultrasonography; ultrasound.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Paramedian sagittal oblique view. Note: The sacrum (arrowhead) is recognizable as a horizontal hyperechoic curvilinear structure, the L3–5 laminae (arrows) have the typical "sawtooth" appearance, and the erector spinae muscles (asterisk) are hypoechoic and lie superficial to the laminae. The images were obtained by means of a Sonoscape P50 Ultrasound (Sonoscape Europe s.r.l., Rome, Italy). The O2–O3 mixture was produced by means of a Multiossigen Medical 99IR generator (Multiossigen S.p.A., Gorle, Bergamo, Italy).
Figure 2
Figure 2
Transverse spinous process view, when the transducer is positioned directly over the spinous process. Note: The acoustic shadow of the spinous process (arrow) and of the lamina (arrowhead). Erector spinae muscle (asterisk) is easily visualized. SP: Spinous process; L: lamina; ESM: erector spinae muscle. The images were obtained by means of a Sonoscape P50 Ultrasound (Sonoscape Europe s.r.l., Rome, Italy). The O2–O3 mixture was produced by means of a Multiossigen Medical 99IR generator (Multiossigen S.p.A., Gorle, Bergamo, Italy).
Figure 3
Figure 3
Midline sagittal spinous process view, when the transducer is positioned directly over the midline. Note: The occiput (arrowhead), spinous process of C1(rudimentary)–C2–C3–C4 (arrows) can be easily identified. The images were obtained by means of a Sonoscape P50 Ultrasound (Sonoscape Europe s.r.l., Rome, Italy). The O2–O3 mixture was produced by means of a Multiossigen Medical 99IR generator (Multiossigen S.p.A., Gorle, Bergamo, Italy).
Figure 4
Figure 4
Transverse spinous process view, when the transducer is positioned directly over the spinous process at the C4 level. Note: Spinous process is small and bifid (arrows). The images were obtained by means of a Sonoscape P50 Ultrasound (Sonoscape Europe s.r.l., Rome, Italy). The O2–O3 mixture was produced by means of a Multiossigen Medical 99IR generator (Multiossigen S.p.A., Gorle, Bergamo, Italy).
Figure 5
Figure 5
Example of measurements performed in transverse spinous process view. Note: (A) At the C4 level, Skin-Muscle Distance (SMD) and Skin-Lamina Distance (SLD) are respectively 2.85 mm and 25.83 mm. (B) At the L4 level, SMD and SLD are 6.60 mm and 27.56 mm. The images were obtained by means of a Sonoscape P50 Ultrasound (Sonoscape Europe s.r.l., Rome, Italy). The O2–O3 mixture was produced by means of a Multiossigen Medical 99IR generator (Multiossigen S.p.A., Gorle, Bergamo, Italy).
Figure 6
Figure 6
Medial epicondylitis ultrasound-guided infiltration. Note: (A) The bony prominence of medial epicondyle (ME) is easily recognizable (asterisk). The needle (arrowheads) is positioned in the peritendinous soft tissue, near the tendon insertion. (B) The O2–O3 mixture (arrows) appears as hyperechoic area in the peritendinous soft tissue with a well-defined shadow that obscures the medial epicondyle below. The images were obtained by means of a Sonoscape P50 Ultrasound (Sonoscape Europe s.r.l., Rome, Italy). The O2–O3 mixture was produced by means of a Multiossigen Medical 99IR generator (Multiossigen S.p.A., Gorle, Bergamo, Italy).
Figure 7
Figure 7
Intramuscular paravertebral injection at L5 level. Note: The O2–O3 mixture (arrows) appears as hyperechoic area with a faint shadow. The images were obtained by means of a Sonoscape P50 Ultrasound (Sonoscape Europe S.p.A., Rome, Italy). The O2–O3 mixture was produced by means of a Multiossigen Medical 99IR generator (Multiossigen S.p.A., Gorle, Bergamo, Italy).
Figure 8
Figure 8
Achilles tendon ultrasound-guided infiltration. Note: The O2–O3 mixture (arrows) appears as hyperechoic area along inferior border of Achilles Tendon (AT). The images were obtained by means of a Sonoscape P50 Ultrasound (Sonoscape Europe S.p.A., Rome, Italy). The O2–O3 mixture was produced by means of a Multiossigen Medical 99IR generator (Multiossigen S.p.A., Gorle, Bergamo, Italy).
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References

    1. Bocci V. How a calculated oxidative stress can yield multiple therapeutic effects. Free Radic Res. 2012;46:1068–1075. - PubMed
    1. Bocci V, Valacchi G. Free radicals and antioxidants: how to reestablish redox homeostasis in chronic diseases? Curr Med Chem. 2013;20:3397–3415. - PubMed
    1. Bocci V. Dordrechit: Kluwer Academic Publishers; 2002. Oxygen-Ozone Therapy: A Critical Evaluation.
    1. Bocci VA. Scientific and medical aspects of ozone therapy. State of the art. Arch Med Res. 2006;37:425–435. - PubMed
    1. Bocci V, Borrelli E, Travagli V, Zanardi I. The ozone paradox: ozone is a strong oxidant as well as a medical drug. Med Res Rev. 2009;29:646–682. - PubMed