TAME & Musculoskeletal Embolization

[Scaphoid-Trapezoid Osteoarthritis] [Transarterial Microembolization (TAME)] Successful Case Sharing

Creator: Bow Wang, M.D.
Published: 2022-09-13

2022-09-13Author and reviewer: Bow Wang, M.D.

[Scaphoid-Trapezoid Osteoarthritis] [Transarterial Microembolization (TAME)] Successful Case Sharing — related image 1

Author: Bow Wang, M.D.

Ms. H, 55 years old, had been experiencing wrist pain below her thumbs for over two years, which had worsened in the last three to four months, especially during gripping movements such as riding a motorcycle, causing excruciating pain. After consulting with Dr. Huang Jingcan at the Chi Mei Rehabilitation Department, she was diagnosed with "scaphoid-tunica minor osteoarthritis." Blood tests ruled out rheumatoid arthritis, and she was referred to the National Cheng Kung University Hospital Interventional Medical Center for further discussion with Bow Wang, M.D..

[Scaphoid-Trapezoid Osteoarthritis] [Transarterial Microembolization (TAME)] Successful Case Sharing — related image 2

After discussion, Bow Wang, M.D. was ultimately chosen to perform the [Transarterial Microembolization (TAME)] procedure on Ms. H. Guided by X-ray fluoroscopy and under local anesthesia, a microcatheter was inserted into the painful area via radial artery puncture. Under arterial angiography, contrast agent was injected to locate the corresponding disordered and proliferating arteries; then, embolizing medication was injected through the microcatheter.

After the embolization, Ms. H's pain immediately improved significantly.

After the embolization, Ms. H's pain during grasping movements also improved significantly.

[Transarterial Microembolization (TAME)], through arterial injection, embolizes the abnormally proliferating microvessels and blocks the innervation of related pain nerves, thereby improving pain caused by chronic joint inflammation.

However, Bow Wang, M.D. reminds users that the application of Transarterial Microembolization (TAME) in treating hand osteoarthritis has limitations. Its main indication is a pain index exceeding 5 points, and patients who have not shown significant improvement after more than three months of various treatments.

Furthermore, **hand osteoarthritis** needs to be differentiated from **rheumatoid arthritis**. Rheumatoid arthritis is characterized by stiffness in the joints, especially upon waking in the morning, lasting for more than an hour; osteoarthritis usually develops slowly, but is particularly painful in cold, damp weather or when moving the joints. Rheumatoid arthritis can affect joints throughout the body, typically affecting the wrist joints; while osteoarthritis usually develops slowly, most commonly causing swelling of the finger joints, especially the distal interphalangeal joints. In addition to clinical symptoms, X-rays and blood tests for rheumatoid factor can aid in diagnosis.

This treatment is not suitable in the following situations:

1. Severe tendon or ligament damage or rupture

2. Pain accompanied by other nerve compression symptoms

3. Poor kidney function (eGFR < 30 mL/min/1.73m2)

4. Low platelet count, abnormal coagulation function

5. The patient is unable to lie flat for two hours

6. Pregnancy

Side effects of the treatment may include local hematoma and bruising at the puncture site; temporary local discoloration at the embolization site may occur, which will improve and disappear within minutes to a month. It is recommended that patients undergo a thorough evaluation by a physician to identify the true source of pain, and have a full discussion with their doctor and family to understand the treatment process and related precautions before receiving treatment for better assurance.

This page is for medical education and academic communication. It does not replace individual diagnosis or treatment advice.

Continue reading this category →