All Diagnostic Tests Articles

MR Neurography: Using Peripheral Nerve Imaging as a Pain Diagnostic

Magnetic resonance neurography (MR neurography) is growing as a diagnostic and assessment imaging tool for painful nerve conditions.

What types of risk screening tests are available to clinicians prescribing opioid therapy?

A guide to risk-assessment tests clinicians can use before starting a patient on chronic opioid therapy for pain.

Neural Pathway Pain — A Call for More Accurate Diagnoses

Brain-induced pain, as opposed to inflammatory or neuropathic pain, may call for unique diagnoses and treatment plans.

Alcohol Screen Recommended to Reduce Opioid-Induced Respiratory Depression Overdose

Alcohol monitoring of urine in patients receiving long-term opioid therapy can be a useful tool.

Guide to Laboratory Testing in Patients With Suspected Rheumatic Disease

A guide to selecting the right tests to properly diagnose rheumatic disorders

Spinal Fluid Flow and Pain Management

In this month's Editor's Memo, Forest Tennant, MD, DPH, discusses the importance of recognizing and promoting optimum flow of spinal fluid to improve pain management for patients.

Genetic Testing: Adjunct in the Medical Management of Chronic Pain

This case report presents the use of pharmacogenetic testing to help improve pain management and reduce adverse drug effects, with a result of appropriate medication changes to reflect his cytochrome P450 (CYP) profile.

Hormone Testing and Replacement: Status Report 2016

Learn more about the critical role hormones play in promoting analgesia, neuroprotection, healing, and neurogenesis.

Pharmacogenetic Testing in Pain Management: Where Do We Stand?

Dr. Forest Tennant discusses the current status of pharmacogenetic testing in pain management.

Pharmacogenetics and Pain Management

This article presents an up-to-date status and review of the clinical use and interpretation of the common pharmacogenetic markers that have relevance to pain management.

New App Helps Interpret Urine Drug Test Results

An interview with Jeffrey Fudin, PharmD, DAAPM, FCCP, FASHP

False-Positive Screen for Marijuana

An estimated 20 million Americans smoke marijuana. Having a positive urine drug screen, therefore, may not be unusual—except if the patient swears they don't smoke pot. Learn why non-smokers may test positive for marijuana.

Ask The Expert: False-Positive Screen for Benzodiazepines

What can cause a false positive urine drug screening for benzodiazepines? Our expert ask your questions.

Ask the Expert: False Positive Amphetamine Urine Screens

Question: What can cause a false positive urine drug screening for amphetamine?

Hormone Abnormalities in Uncontrolled Chronic Pain Patients: Use of Hormone Profiles

Hormone profile testing is readily available and may be recommended for any chronic pain patient who is not achieving good pain control with their current medical regimen.

Risk Assessment in the Digital Age: Developing Meaningful Screening Tools for Opioid Prescribers

Pain management physicians have been presented with a conundrum: providing patients with the best care available while preventing the misuse, abuse, and diversion of opioid pain medications. This often places the clinician in opposing roles—health care provider sworn to first do no harm and amateur drug enforcement agent. How can caring physicians walk this ethical tightrope?

Is Marijuana Use Associated With Non-adherence To Opioid Therapy—Insights Gained From Urine Drug Monitoring

Marijuana and its active ingredient tetrahydrocannabinol (THC) have been used for pain relief for centuries. While the legalization of marijuana for recreational and/or medical use was being hotly debated across the country, investigators from the Substance Abuse and Mental Health Services Administration (SAMHSA) were compiling the latest statistics on THC use and abuse.

Specimen Validity Testing

Focus on Screens looks at interpreting urine drug assay results.

The Bewildering Terminology of Genetic Testing

Practical Pain Management Editor in Chief Forest Tennant discusses new genetic tests and their impact on the pain field.

Using Dynamic MRI to Diagnose Neck Pain: The Importance of Positional Cervical Cord Compression (PC3)

Article considers how to better image cervical pain using dynamic magnetic resonance imaging.

How to Use Adrenocorticotropin As a Biomarker in Pain Management

Although pain cannot, per se, be measured, an adrenocorticotropin hormone serum level is an excellent proxy or biomarker to help the pain practitioner manage severe, chronic pain.

Musculoskeletal Ultrasound: A Primer for Primary Care

Musculoskeletal ultrasound involves the use of high-frequency sound waves (3-17 MHz) to image soft tissues and bony structures in the body.

Guide to Chronic Pain Assessment Tools

Many busy clinicians struggle with finding the time to conduct a thorough assessment of the pain patient, especially the patient with chronic pain. This article reviews how to properly assess a patient with chronic pain.

The Value of Blood Analysis for Compliance Monitoring

In the field of compliance monitoring, blood testing offers an effective means for providing physicians with information that is not available through urine drug testing . Article provides more information on blood testing for compliance.

The Role of MMPI-2 in Assessment of Chronic Pain

Article discusses the role of MMPI-2 in assessment of chronic pain. Includes discussion of how the Minnesota Multiphasic Personality Inventory (MMPI-2) data are best viewed as one of multiple sources of patient information, including history, social support networks, coping ability, job, and life satisfaction/success, etc.

Mobile MRI—Imaging on Wheels

Article explains how mobile magnetic resonance imaging (MRI)—also known as "imaging on wheels"—can help with the diagnostic process for chronic pain patients.

Strength Testing in Pain Assessment

Quantitative, objective measurement of muscle strength in the extremities is suggested as a means of improving the validity and reliability of strength measurements in pain assessment.

Clinical Drug Testing for Pain Medicine

The demand for clinical drug testing in the field of pain management has increased dramatically as clinicians, regulatory agencies and insurance payers seek objective measures to enhance and augment pharmacotherapy, monitor pharmacotherapeutic compliance, assess treatment efficacy, and identify individuals at risk following the use or misuse of illicit substances, prescription drugs, over the c

Musculo-Skeletal Diagnostic Ultrasound Imaging

Musculo-skeletal diagnostic ultrasound imaging is an evolving, first-line imaging test for soft tissue lesions that can provide superior diagnostic accuracy by visualizing internal soft tissue architecture and associated pathologies.

Urinary Drug Testing in Pain Management

Urinary drug testing as a means to assure compliance and monitoring of proper medication use is becoming common place in the clinical practice of pain management.

Chronic Pain, Osteoporosis, and Bone Density Testing

Osteoporosis is a disease manifested by low bone density and poor quality of bone, resulting in skeletal fragility and increased risk of fracture.1 While osteoporosis is generally a silent and asymptomatic disease until a fracture occurs, pain and osteoporosis are often associated.

Trends in Pain Syndrome Diagnostic Technology

Article discusses current diagnostic technological devices, which can help identify numerous disorders of the peripheral and central nervous system in patients with chronic pain.

Thermography in Pain Management

Learn how thermography—a technique used to assess and track changes in vascular-related pain syndromes—is used in pain management.

Diagnosing Diffuse Aches and Pains

How do you deal with the patient who describes his/her pain as "it hurts all over"? Article on differential diagnosis for various chronic pain disorders.

Objective Musculo-skeletal Measurement Protocols

Utilizing surface electromyography and systematic, standardized protocols, clinicians can objectively diagnose and document outcomes in the treatment of musculo-skeletal pain and disorders.

A Conceptual Model of Pain

A review of how we view pain and how the pain practitioner should view pain. This article also discusses pain diagnoses and treatments and how those are informed by our understanding of pain.

A Conceptual Model of Pain: Measurement and Diagnosis

Detailed article on the nervous system and how we interpret pain. Also reviews how nerve tests can help diagnose pain.

Playing Dual Roles

A doctor discusses sEMG as the perfect tool for neuromuscular investigation and re-education.

Accurate Diagnosis

Sonography, or ultrasound imaging, is a dynamic study permitting physiologic real time observation of an anatomic region. It is a perfect tool for detecting stenosing tenosynovitis and has distinct advantages over magnetic resonance imaging (MRI) and computerized tomography (CT).

Measuring Clinical Outcomes of Chronic Pain Patients

Pain is a multidimensional subjective experience 1 and has profound effects on the health and quality of life. 2 Since pain is very subjective, there is no direct measurement tool to assess the intensity and distress of pain.  

Real-Time Functional Magnetic Resonance Imaging in Pain Management

Chronic pain is debilitating to the patient and puts an enormous strain on the healthcare delivery system. It is the primary complaint resulting in physician visits and the use of healthcare resources. 1 Chronic pain costs the United States about $150 billion a year.

Functional Capacity Evaluation (FCE)

While not yet precise enough as a predictive tool, FCE can be combined with other sources of information such as medical, rehabilitative and diagnostic data to help resolve issues of compensability, disability and employability.

Assessing Pain of the Pediatric Patient in the Emergency Setting

There are numerous factors that can threaten the reliability of a self-reported pain scale of the pediatric patient in the emergency setting. This article explains those factors.

Evaluating Function/Impairment of Low Back Pain Using SEMG

Recent advances in the use of surface electromyography (SEMG) have proved useful in the evaluation of movement, gait, postural, and functional disturbances in low back pain patients.

Application of Spinal Segmental Physiology to Evaluating Chronic Pain

This article addresses how to use sensory-motor integration phenomena—taking place at the spinal cord level—as a diagnostic tool to determine possible causes of chronic pain conditions.

Musculoskeletal Ultrasound

Article gives a brief overview of musculoskeletal ultrasound, including diagnostic and therapeutic applications in musculoskeletal medicine

Screening Blood Panel to Evaluate New Chronic Pain Patients

Fundamentally, the screening panel recommended in this article is intended to distinguish a severe, chronic pain patient from a mild or moderate chronic pain patient.

Cytokine Testing in Clinical Pain Practice

If you attended medical school more than twenty years ago, you may be unfamiliar with the significance of cytokines in modern medicine. As an example of current interest in the topic, there are almost five million hits on this subject on Google and 419,000 on Pubmed.

Computerized Dynamometry in Impairment Evaluations

Isokinetic computerized dynamometry provides objective, reproducible, and valid measurements in clinical decision making regarding return to sport, return to work, and impairment and disability assessments.

Interpreting the Clinical Significance of Pain Questionnaires

A comparison of effect sizes of commonly used patient self-report pain instruments provides an objective ranking of such tools.

Evaluating Pain Intervention Effectiveness and Compliance

Innovative ways to identify patients with severe, chronic pain and assess effective pain control by various standardized, objective measures to monitor clinical progress. On monitoring patient compliance.

Practical Application of Neuropostural Evaluations

Practical application of neuropostural evaluations for the chronic pain patient are discussed. Basic principles and the first three tests in the P.A.N.E. process are also discussed.

Muscle Physiology, Kinetics, Assessment, and Rehabilitation

Article highlights muscle physiology, kinetics, assessment, and rehabilitation. Also, a review of some basic science, homeostasis, functional specialization, resting and activity tonus, objective methodology in assessment, and rehabilitation considerations are discussed.

Multidimensional Ultrasonography

Research currently supports the use of diagnostic ultrasound imaging for shoulder pain, including shoulder lesions and partial thickness rotator cuff tears.

Three Dimensional Imaging of the Foot

The use of force plate technology provides new insight into potential sources of foot and/or leg pain by providing pathoanatomical visualization of foot pressure patterns, foot velocity, and motion characteristics.

Dysfunction and Rehabilitation of the Shoulder

Considerations of muscular relationships in pain management based on Surface Electromyographic (SEMG) Studies. Focuses on shoulder pain/shoulder dysfunction.

Imaging: Osteoporosis Testing: DEXA Method

Patients at risk for painful fractures due to bone loss can benefit from dual energy x-ray absorptiometry (DEXA) testing that can numerically assess subtle changes in bone mineral density over time.

Imaging

Cardiac CT

Imaging

Dual Modality Imaging

Electromyography (EMG) and Musculoskeletal Pain

A synopsis of the clinical applications and complementarities between two predominant motor testing modalities for musculoskeletal dysfunction: needle and surface EMG.