Radiofrequency Ablation is an outpatient procedure, a small area of nerve tissue is heated to decrease pain signals from that procedure is conducted under guided imaging. A needle is inserted at the offending nerve site, then an electrical current produced by a radio wave is used for the heat-and-destroy mission. The chronic pain relief lasts for a relatively long period, from six to nine months. This is a big advance because it is very localized, very specific, pain treatment. It’s not a cure-all, but it can really make a difference in specific cases. Facet joints of the spine are particularly responsive to this technique.
A 34-year-old man presented with a progressively enlarging lesion on his left calf. He reported that about 3 months prior he had developed a small ulceration at this location following a fall. With local wound care, the ulceration healed with a scar. The scar, however, continued to grow beyond the borders of the previous ulceration and became raised with violaceous discoloration. The patient denied any history of excessive scarring or keloid formation after skin surgeries or trauma. There were no personal or family histories of granulomatous diseases. Results of a physical examination showed an erythematous-to-dusky plaque measuring approximately 4X3 cm (Figure 1) on the left calf with well-defined irregular borders and discrete papules on the internal aspect of the knee. No tender nodules on the shins were noticed, and no lymphadenopathy was present. Results from a review of systems and a routine chest x-ray were unremarkable. Results of a punch biopsy revealed changes consistent with sarcoid naked granulomas (Figure 2). The patient was started on topical potent corticosteroid tapes and experienced marked improvement.