In this work the investigators will study the relationship between chronic musculoskeletal pain and abnormal blood flow (neovascularity) around the shoulder, hip and knee. Veterans with as history of chronic shoulder, hip or knee pain and mild/moderate joint degenerative changes will be potential study subjects. Blood flow around joints will be evaluated using perfusion magnetic resonance imaging (MRI). Participants with demonstrably abnormal blood flow around their painful joint will be eligible for enrollment in a pilot study of joint embolization to treat their pain. Participants who choose to not undergo treatment will be re-assessed with MRI after one year to characterize the natural history of joint neovascularity and its relationship to pain.
Participants must be Veterans who receive care in the VA system.
Participants must have a history of chronic pain of the shoulder, hip or knee for at least 1 year.
Participants must have mild to moderate degenerative changes of the painful joint as depicted on prior imaging (X-ray, CT or MRI).
Participants must have undergone at least one failed primary treatment for their chronic pain (e.g. physical therapy, NSAIDs, steroid injection).
Acute injury in the last 12 weeks.
Age under 25.
Severe degenerative changes of painful joint (shoulder, hip or knee).
History of arthroplasty or metallic implant within the painful joint.
Palo Alto Veterans Institute for Research
Lead sponsor
Varian Medical Systems
Collaborator