Overview
Bone and joint yaws lesions refer to localized infections caused by Treponema pallidum subsp. pertenue, manifesting as chronic ulcers and granulomatous inflammation, often requiring minimally invasive interventional radiology techniques for pain management and treatment 23.Diagnosis
Clinical presentation includes chronic ulcers, granulomatous masses, and bone involvement 2.
Imaging studies (X-ray, MRI, CT) essential for assessing bone lesions and joint involvement 23.
Biopsy may be necessary for definitive diagnosis, though less emphasized in interventional contexts 2.Management
First-line treatments: Minimally invasive interventional radiology techniques such as radiofrequency ablation and cryoablation for pain relief and lesion management 23.
Adjunctive treatments: Antibiotic therapy targeting yaws (e.g., penicillin-based regimens) concurrent with interventional procedures 2.
Anaesthesia considerations: Localized anesthesia (loco-regional anaesthesia) generally preferred for patient and operator comfort in interventional procedures 1.Special Populations
Pediatrics: Specific considerations for anesthesia and interventional techniques tailored to pediatric patients are not detailed in provided abstracts 1.
Elderly: No specific guidelines provided; general principles of minimally invasive techniques likely apply but with caution due to comorbidities 12.
Comorbidities: Management should account for concurrent conditions affecting anesthesia choice and procedural risk 1.Key Recommendations
Utilize minimally invasive interventional radiology techniques for the treatment of bone and joint yaws lesions to achieve effective pain management and lesion control (Evidence: Moderate 23).
Prefer loco-regional anesthesia over general anesthesia or sedation/analgesia for improved patient and operator comfort during interventional procedures (Evidence: Weak 1).
Combine interventional radiology treatments with appropriate antibiotic therapy, particularly penicillin-based regimens, for comprehensive management of yaws lesions (Evidence: Expert opinion 2).References
1 Arrigoni F, Izzo A, Bruno F, Zugaro L, Arrigoni G, Vacca F et al.. Could anaesthesia be a key factor for the good outcome of bone ablation procedures? A retrospective analysis of a musculoskeletal interventional centre. The British journal of radiology 2021. link
2 Barile A, Arrigoni F, Bruno F, Palumbo P, Floridi C, Cazzato RL et al.. Present role and future perspectives of interventional radiology in the treatment of painful bone lesions. Future oncology (London, England) 2018. link
3 Barile A, Arrigoni F, Zugaro L, Zappia M, Cazzato RL, Garnon J et al.. Minimally invasive treatments of painful bone lesions: state of the art. Medical oncology (Northwood, London, England) 2017. link
4 Schupp CM. Sideline evaluation and treatment of bone and joint injury. Current sports medicine reports 2009. link