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Source of Chronic Back Pain Pinpointed by Molecular Imaging

By MedImaging International staff writers
Posted on 30 Jun 2011

New study findings offer potential relief for patients who suffer chronic pain after back surgery. A molecular imaging procedure that combines functional and anatomic data about the body is able to hone in on the site of abnormal bone reaction and provide more accurate diagnoses and appropriate pain management for patients who have received hardware implants or bone grafts.

"With PET/CT [positron emission tomography/computed tomography] we can pinpoint the exact screw or rod that was loose or failing. We can help doctors and patients accurately decide whether surgical and nonsurgical treatment is the best option," commented Andrew Quon, MD, assistant professor of radiology and chief of clinical PET/CT for the molecular imaging program at Stanford University (Stanford, CA, USA). "This eliminates unnecessary or erroneous hardware replacement surgeries and provides a surgical map for patients who need further operations to treat their chronic pain."

Severe spinal instability and disease frequently necessitate the implantation of hardware such as plates, cages, rods and screws or bone grafts to support the spine. There are many reasons why patients experience pain after initial surgery, including hardware failure and infection, or both. Determining the source of pain can be difficult, especially when patients have complex medical histories.

In this study, a combination of PET/CT and F18 NaF, an injected radiotracer that uses sodium fluoride to target "hot spots" or areas of high bone turnover and inflammation during imaging, was used to evaluate patients with back pain after spinal surgery. This sort of molecular imaging was shown to be highly accurate in determining the cause of the patient's chronic pain by highlighting both the structure of the bone and the physiologic processes involved in inflammation, an indication of injury and infection.

For this prospective study, 20 patients presenting with spinal pain were evaluated with PET/CT using F18 NaF at least eight months after surgery. A total of 24 bone or tissue abnormalities were found in 17 of the 20 subjects. Of the original 20 patients, 12 received exploratory surgery and 4 participants received local anesthetic nerve blockade, a common and minimally invasive treatment that numbs the affected nerve, providing short-term pain management as an alternative to surgery. The research indicated that F18 PET/CT is highly effective for the evaluation of pain after spinal surgery--in more than 85% of cases, this form of molecular imaging was able to identify the precise source of the patient's pain.

The study's findings were presented at SNM's 58th annual meeting, held June 4-8, 2011, in San Antonio (TX, USA).

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64 (589.84756469727): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

65 (!!!!! 2263.069152832): SELECT fid FROM jos_deeppockets WHERE id=294735838 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294735838 AND published='1' LIMIT 1

66 (281.81076049805): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

67 (817.06047058105): select jos_twitters.link from jos_twitters where cat=10

68 (338.07754516602): select jos_facebook.link from jos_facebook where cat=10

69 (34.809112548828): select jos_google_plus.link from jos_google_plus where cat=10

70 (185.01281738281): select jos_linkedin.link from jos_linkedin where cat=10

71 (245.80955505371): SELECT fid FROM jos_deeppockets WHERE id=294735838 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294735838 AND published='1' LIMIT 1

72 (180.00602722168): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

73 (!!!!! 1005.8879852295): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (378.84712219238): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (116.10984802246): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

76 (226.97448730469): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (180.95970153809): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (127.07710266113): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (139.95170593262): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (144.00482177734): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (!!!!! 6553.8883209229): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (464.91622924805): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (323.05717468262): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (322.10350036621): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (160.93254089355): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (37.908554077148): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

93 (524.99771118164): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (61.988830566406): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (448.94218444824): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (!!!!! 2653.8372039795): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (72.002410888672): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (173.09188842773): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (72.002410888672): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (232.93495178223): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (597.00012207031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

108 (157.11784362793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

109 (319.9577331543): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (924.82566833496): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 5105.9722900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

112 (234.12704467773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

113 (689.02969360352): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294735838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (!!!!! 1414.0605926514): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294735838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (628.94821166992): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

116 (371.93298339844): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

118 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

119 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

120 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

121 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

122 (47.206878662109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

123 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

124 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

125 (359.05838012695): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 51635.026931763): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

127 (612.97416687012): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735838 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735838 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (85.115432739258): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

129 (51.021575927734): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (67.949295043945): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

131 (35.04753112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

132 (58.174133300781): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

134 (52.928924560547): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

135 (39.100646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

136 (46.968460083008): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

137 (31.948089599609): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

138 (752.92587280273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (791.07284545898): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (213.1462097168): SELECT name FROM jos_deeppockets WHERE id=213

141 (44.822692871094): SELECT name FROM jos_deeppockets WHERE id=213

142 (863.07525634766): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (747.2038269043): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (469.92301940918): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

145 (68.187713623047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

146 (!!!!! 29818.058013916): TRUNCATE TABLE jos_trademed_module

147 (217.91458129883): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (145.91217041016): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735838 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (647.06802368164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (128.03077697754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (130.89179992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

152 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

153 (!!!!! 1924.991607666): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

154 (158.78677368164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

155 (95.129013061523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

156 (69.856643676758): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735838 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735838 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (42.915344238281): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

158 (43.153762817383): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

159 (66.041946411133): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (!!!!! 1820.0874328613): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

161 (139.95170593262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735838 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735838 AND published='1' LIMIT 1

162 (!!!!! 1951.9329071045): select jos_twitters.link from jos_twitters where cat=10

163 (83.208084106445): select jos_facebook.link from jos_facebook where cat=10

164 (64.13459777832): select jos_google_plus.link from jos_google_plus where cat=10

165 (44.822692871094): select jos_linkedin.link from jos_linkedin where cat=10

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