1
|
Pérez-Barbosa L, Garza-Elizondo MA, Vega-Morales D, Esquivel-Valerio JA, Peláez-Ballestas I, Vázquez-Fuentes BR, Galarza-Delgado DÁ. High frequency of rheumatic regional pain syndromes in first-degree relatives of patients with rheumatoid arthritis. Clin Rheumatol 2020; 39:3303-3307. [PMID: 32388744 DOI: 10.1007/s10067-020-05029-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/20/2020] [Accepted: 03/05/2020] [Indexed: 01/08/2023]
Abstract
First-degree relatives (FDR) of patients with rheumatoid arthritis (RA) have a higher risk for the development of RA. In the stages prior to the development of arthritis, nonspecific musculoskeletal (MSK) manifestations may occur. The aim of the study is to describe the frequency of rheumatic regional pain syndromes (RRPS) in FDR of RA patients. A cross-sectional study was carried out from July 2016 to September 2018. Parents, offspring, and siblings of RA patients completed the Community Oriented Program in the Rheumatic Diseases (COPCORD) questionnaire. Rheumatoid factor (RF) IgG, IgM, and IgA; anticitrullinated peptide antibodies (ACPAs); C-reactive protein (CRP); and erythrocyte sedimentation rate (ESR) were determined. All subjects with a positive COPCORD (defined by the presence of musculoskeletal pain) were evaluated and classified. Three hundred thirty-five FDRs participated, 75.8% were female, mean age of 44.15 years; 138 (41.2%) were diagnosed with at least one RRPS; 72 (21.5%) had rotator cuff tendinitis, 51 (15.2%) pes anserine bursitis, and 39 (11.6) lateral epicondylitis; RA was diagnosed in 24 (7.16%) subjects, undifferentiated arthritis (UA) in 30 (8.9%) and inflammatory arthralgia (AI) in 104 (31%). We found anti-CCP positivity in 6.8%, RF IgA in 22.3%, RF IgM in 48.6%, and RF IgG in 8.9%. The presence of RRPS was higher in this RA-FDR group compared to general population. Clinical evaluation of this risk group should include screening for RRPS.
Collapse
Affiliation(s)
- Lorena Pérez-Barbosa
- Rheumatology Service and Internal Medicine Department at Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Ave. Gonzalitos 235 Norte, Colonia Mitras Centro, 64020, Monterrey, Nuevo León, Mexico
| | - Mario Alberto Garza-Elizondo
- Rheumatology Service and Internal Medicine Department at Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Ave. Gonzalitos 235 Norte, Colonia Mitras Centro, 64020, Monterrey, Nuevo León, Mexico.
| | - David Vega-Morales
- Rheumatology Service and Internal Medicine Department at Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Ave. Gonzalitos 235 Norte, Colonia Mitras Centro, 64020, Monterrey, Nuevo León, Mexico
| | - Jorge Antonio Esquivel-Valerio
- Rheumatology Service and Internal Medicine Department at Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Ave. Gonzalitos 235 Norte, Colonia Mitras Centro, 64020, Monterrey, Nuevo León, Mexico
| | - Ingris Peláez-Ballestas
- Rheumatology Unit, Hospital General de México "Dr. Eduardo Liceaga", Dr. Balmis 148, Doctores, 06720, México City, Mexico
| | - Brenda Roxana Vázquez-Fuentes
- Rheumatology Service and Internal Medicine Department at Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Ave. Gonzalitos 235 Norte, Colonia Mitras Centro, 64020, Monterrey, Nuevo León, Mexico
| | - Dionicio Ángel Galarza-Delgado
- Rheumatology Service and Internal Medicine Department at Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Ave. Gonzalitos 235 Norte, Colonia Mitras Centro, 64020, Monterrey, Nuevo León, Mexico
| |
Collapse
|
2
|
Algarni AD. Pes anserinus pain syndrome following total knee arthroplasty for degenerative varus: incidence and predictors. INTERNATIONAL ORTHOPAEDICS 2020; 44:1083-1089. [PMID: 32047961 DOI: 10.1007/s00264-020-04498-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/31/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Pes anserinus pain syndrome (PAPS) is a well-described condition in the native knee; however, its incidence after total knee arthroplasty (TKA) is unknown. This study aimed to determine the incidence of PAPS after primary TKA, identify potential risk factors, and assess its response to treatment. Few case reports have been published until now; to our knowledge, ours is the first study assessing the incidence and predictors of post-TKA PAPS. METHODS A total of 389 primary TKAs performed for degenerative varus knee at a single institution by the same surgeon were analyzed. We recorded demographic variables, medical comorbidities, and clinical, radiographic, and surgical data. Specific predictors of interest were compared between post-TKA PAPS and controls. RESULTS The incidence was 5.6% (22/389). On univariate analysis, female sex (p = 0.03), body mass index (BMI) (41.3% ± 7.9; p < 0.001), and absence of pes anserinus release (p = 0.04) were significant predictors. On multivariable regression analysis, only BMI was a significant independent risk factor (p = 0.01). All patients were treated non-operatively; 81.8% responded to nonsteroidal anti-inflammatory drug-physical therapy program and 18.2% required an additional local steroid injection. CONCLUSION PAPS occurs after TKA; the incidence was found to be 5.6%. BMI seems to be an independent risk factor. It is a benign condition and can be effectively treated conservatively in most cases.
Collapse
|
3
|
Yagi S, Sata M. Rupture of pes anserine bursa in a patient with pes anserine pain syndrome due to osteoarthritis. THE JOURNAL OF MEDICAL INVESTIGATION 2019; 66:211-212. [DOI: 10.2152/jmi.66.211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Shusuke Yagi
- Department of Internal Medicine, Shikoku Central Hospital, 2233 Kawanoe-cho, Shikoku-chuo, Ehime 799-0193, Japan
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- Department of Community Medicine and Human Resource Development, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| |
Collapse
|
4
|
Mun JU, Cho HR, Bae SM, Park SK, Choi S., Seo MS, Lim YS, RN SHW, Kim YU. Effect of polydeoxyribonucleotide injection on pes anserine bursitis: A case report. Medicine (Baltimore) 2017; 96:e8330. [PMID: 29069005 PMCID: PMC5671838 DOI: 10.1097/md.0000000000008330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
RATIONALE Pes anserine (PA) bursitis is an inflammatory condition of the medial knee. The PA bursa becomes more painful when infected, damaged, or irritated. Although various treatment options have been attempted to treat PA bursitis, optimal treatments are still debated. This study aims to investigate the effect of polydeoxyribonucleotide (PDRN) injection on reducing pain and inflammation in a patient presenting with PA bursitis. PATIENT CONCERNS A 50-year-old female patient was admitted to our pain clinic with symptoms of tenderness and pain over the medial knee. Physical examination revealed the pain to be located over the proximal medial tibia at the insertion of the conjoined tendons of the PA. The knee had lost its range of movement and strength, and resisted knee flexion. DIAGNOSES She was diagnosed as having PA bursitis. INTERVENTIONS Ultrasound guided PA bursa injection was carried out. OUTCOMES Follow-up for the patient was more than eight months. She showed good improvement in PA bursitis without any complications. LESSONS This is the first successful report of successful PDRN injection for PA bursa.
Collapse
Affiliation(s)
- Jong-Uk Mun
- Department of Orthopedic Surgery, Changwon Gyeongsang National University Hospital, Incheon
| | - Hyung R. Cho
- Department of Anesthesiology and Pain Medicine, Myongji Hospital, College of Medicine, Seonam University, Goyang
| | - Sae M. Bae
- Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Incheon
| | - Soo K. Park
- Department of Anesthesiology and Pain Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Incheon
| | - Soo .l Choi
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary‘s Hospital, Incheon
| | - Mi S. Seo
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary‘s Hospital, Incheon
| | - Young S. Lim
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary‘s Hospital, Incheon
| | - Soo H. Woo RN
- Department of Nursing, Kyung-In Women‘s University, Incheon, Republic of Korea
| | - Young U. Kim
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International ST. Mary‘s Hospital, Incheon
| |
Collapse
|
5
|
Khosrawi S, Taheri P, Ketabi M. Investigating the Effect of Extracorporeal Shock Wave Therapy on Reducing Chronic Pain in Patients with Pes Anserine Bursitis: A Randomized, Clinical- Controlled Trial. Adv Biomed Res 2017. [PMID: 28626745 PMCID: PMC5468784 DOI: 10.4103/2277-9175.190999] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Knee pain, is one of the most common causes of patients’ referring to physiatric clinics, and several factors, are involved in its creation. One of these factors is pes anserine bursitis (PAB) for which various treatment methods are used. This study aims to investigate the effect of this method on reducing chronic pain in these patients. Materials and Methods: This clinical trial was conducted in 2013- 2014 on patients with PAB referring to academic, physical medicine clinics. The patients with chronic PAB (pain duration more than 3 months), who were refractory to conservative treatments, were randomly divided into two 20-member experimental groups (extracorporeal shock wave therapy [ESWT] and sham ESWT). Pain scores of all patients were measured using the Visual Analog Scale (VAS) and McGill Pain Questionnaire (MPQ) (total and present pain indexes [TPIs and PPIs]) before intervention, immediately after intervention (3rd week), and after 8 weeks. The pain scores were then compared and statistically analyzed. Results: In the ESWT group, the mean patient pain score of the VAS and TPI in MPQ were significantly lower than in the sham ESWT group immediately after intervention (3rd week): P =0.02, P = 0.04 respectively; and 8 weeks after the end of treatment: P =0.01, P = 0.000. Moreover, the PPI in both groups had significantly decreased over time, although in ESWT group this decrement was significantly more than sham ESWT group (P < 0.001). Conclusion: The results showed that ESWT could be effective in reducing the pain and treating PAB.
Collapse
Affiliation(s)
- Saeid Khosrawi
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Taheri
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marziyeh Ketabi
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
6
|
Sarifakioglu B, Afsar SI, Yalbuzdag SA, Ustaömer K, Bayramoğlu M. Comparison of the efficacy of physical therapy and corticosteroid injection in the treatment of pes anserine tendino-bursitis. J Phys Ther Sci 2016; 28:1993-7. [PMID: 27512249 PMCID: PMC4968491 DOI: 10.1589/jpts.28.1993] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 04/07/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients' visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured. The PATB group was randomly divided into two groups (Group A and B). Physical therapy (PT) modalities were applied to the first group (Group A), and the second group (Group B) received corticosteroid injections to the pes anserine area. Eight weeks later, patients' parameters were measured again. [Results] Initial WOMAC scores and timed up-and-go times were significantly higher in Group 1 than in Group 2. Both treatments resulted in significant improvements in all measured parameters, but no significant difference was detected between Group A and B. [Conclusion] Patients with PATB tend to have more severe pain, more altered functionality, and greater disability than those with KOA but without PATB. Both corticosteroid injection and PT are effective methods of treatment for PATB. Injection therapy can be considered an effective, inexpensive and fast therapeutic method.
Collapse
Affiliation(s)
- Banu Sarifakioglu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Namık Kemal University: Tekirdağ, Turkey
| | - Sevgi Ikbali Afsar
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Baskent University, Turkey
| | - Seniz Akcay Yalbuzdag
- Department of Physical Medicine and Rehabilitation, Izmir Bozyaka Education and Research Hospital, Turkey
| | - Kubra Ustaömer
- Department of Physical Medicine and Rehabilitation, Optimed Medical Center, Turkey
| | - Meral Bayramoğlu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Acıbadem University, Turkey
| |
Collapse
|
7
|
Artul S, Khazin F, Hakim J, Habib G. Ultrasonographic findings in a large series of patients with knee pain. J Clin Imaging Sci 2014; 4:45. [PMID: 25250194 PMCID: PMC4168644 DOI: 10.4103/2156-7514.139735] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 08/06/2014] [Indexed: 01/20/2023] Open
Abstract
Background: Musculoskeletal ultrasound (MSKUS) is becoming more and more popular in the evaluation of different musculoskeletal abnormalities. The aim of this retrospective study was to document the prevalence and spectrum of MSKUS findings at the painful knee. Materials and Methods: All the studies of MSKUS that were performed for the evaluation of knee pain during the previous 2 years at the Department of Radiology in Nazareth hospital were reviewed. Demographic and clinical parameters including age, gender, side, and MSKUS findings were documented. Results: Two hundred and seventy-six patients were included in the review. In 21 of them, both knees were evaluated at the same setting (total number of knees evaluated was 297). One hundred and forty-four knees were of the left side. Thirty-three pathologies were identified. 34% of the studies were negative. The most common MSKUS findings were medial meniscal tear (MMT) (20%), Baker's cyst (BC) (16%), and osteoarthritis (OA) (11%). Only one knee of all the knees evaluated in our study showed synovitis. Fifty-three knees (18% of all the knees evaluated) had more than one imaging finding, mosty two and while some had three findings. The most common combination of findings was MMT and BC (8 knees), MMT with OA (8 knees), and MMT with fluid (6 knee). In 67% of the patients who had simultaneous bilateral knee evaluation, at least one knee had no abnormal findings and in 43%, both knees were negative. Conclusions: MSKUS has the potential for revealing huge spectrum of abnormalities. In nearly 90% of the positive studies, degenerative/mechanical abnormalities were reported, with MMT, BC, and osteoarthritic changes being the most common.
Collapse
Affiliation(s)
- Suheil Artul
- Department of Radiology, Faculty of Medicine, Nazareth Hospital, Bar Ilan University, Nazareth, Zfat, Israel
| | - Fadi Khazin
- Department of Orthopedics, Carmel Medical Center, Haifa, Israel
| | - Jeries Hakim
- Department of Orthopedics, EMMS Hospital, Nazareth, Zfat, Israel
| | - George Habib
- Rheumatology Clinic, Nazareth Hospital and Department of Medicine, Faculty of Medicine, Carmel Medical Center, Technion - Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
8
|
Toktas H, Dundar U, Adar S, Solak O, Ulasli AM. Ultrasonographic assessment of pes anserinus tendon and pes anserinus tendinitis bursitis syndrome in patients with knee osteoarthritis. Mod Rheumatol 2014; 25:128-33. [PMID: 25036227 DOI: 10.3109/14397595.2014.931909] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to assess the ultrasonographic (US) findings of pes anserinus tendon and bursa in patients with knee osteoarthritis (OA) with or without clinical pes anserinus tendinitis bursitis syndrome (PATBS). METHODS A total of 157 female patients with the diagnosis of knee OA on both knees (314 knees), and 30 age, and body mass index- matched healthy female controls without knee pain (60 knees), were included in the study. PATBS was clinically diagnosed. US evaluation parameters were the measurement of the thickness of pes anserinus tendon insertion region (PA) and examination of the morphologic intratendinous PA tissue characteristics and pes anserinus bursitis (PAB). Radiographic knee osteoarthritis graded I-IV according to Kellgren and Lawrence (KL) for each knee was recorded. Pain and functional status were assessed by the Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). RESULTS There were 183 PATBS (58.3%) clinical diagnoses among the 314 knees with OA. The mean thickness of PA in the patients with knee OA graded 1,2,3,4 with/without PATBS was significantly greater than the controls (p = 0.001). The mean thickness of PA in knees with OA KL graded 3 and 4 with/without PATBS, was greater than knees with OA KL graded 1 and 2 with/without PATBS (p < 0,05) (except knee OA KL graded 2 with PATBS versus knee OA KL graded 4 without PATBS).The knee OA KL graded 1,2,3,4 with PATBS had significantly more PAB and less loss of normal fibrillar echotexture of PA compared to controls and knees with OA KL graded 1,2,3,4 without PATBS (p < 0.05). The VAS scores of knees with OA KL graded 3, 4 with PATBS were significantly greater than those of knees with OA KL graded 3,4 without PATBS (p < 0.05). PA thickness was significantly associated with the KL grade (r: 0.336, p:0.001) and PATBS (r: 0.371, p < 0.001). CONCLUSION It is concluded that the mean thickness of PA in knees with OA with/without PATBS was significantly greater than the controls. The mean thickness of PA in knees with OA, KL graded 3 and 4 with/without PATBS, was greater than in knees with OA KL graded 1 and 2 with/without PATBS. The knee OA with PATBS had significantly more PAB, less loss of normal fibrillar echotexture of PA, and higher VAS scores compared to the knees with OA without PATBS. US can serve as a useful diagnostic tool for detection of PATBS in knee OA.
Collapse
Affiliation(s)
- Hasan Toktas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University , Turkey
| | | | | | | | | |
Collapse
|
9
|
Abstract
Musculoskeletal complaints account for about 20% to 30% of all primary care office visits; of these visits, discomfort in the knee, shoulder, and back are the most prevalent musculoskeletal symptoms. Having pain or dysfunction in the front part of the knee is a common presentation and reason for a patient to see a health care provider. There are a number of pathophysiological etiologies to anterior knee pain. This article describes some of the common and less common causes, and includes sections on diagnosis and treatment for each condition as well as key points.
Collapse
Affiliation(s)
- Engene Hong
- Division of Sports Medicine, Drexel University College of Medicine, 10 Shurs Lane, Ste 301, Philadelphia, PA 19127, USA.
| | - Michael C Kraft
- Division of Sports Medicine, Drexel University College of Medicine, 10 Shurs Lane, Ste 301, Philadelphia, PA 19127, USA
| |
Collapse
|
10
|
Vega-Morales D, Esquivel-Valerio JA, Negrete-López R, Galarza-Delgado DÁ, Garza-Elizondo MA. Safety and efficacy of methylprednisolone infiltration in anserine syndrome treatment. ACTA ACUST UNITED AC 2012; 8:63-7. [PMID: 22317851 DOI: 10.1016/j.reuma.2011.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 10/11/2011] [Accepted: 10/29/2011] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The anserine syndrome is a common cause of knee pain. Infiltration with glucocorticoids has been evaluated in studies with low level of evidence and there are no published clinical trials to determine its usefulness. The objective of this study was to determine the efficacy and safety of the infiltration of methylprednisolone in the treatment of Anserin Syndrome. METHODS We conducted a clinical trial in 58 adult patients with anserin syndrome, which presented intra-articular pathology ruled that reflected pain in the medial aspect of the knee. The WOMAC scale was assessed at baseline and patients were randomized to receive an infiltration of lidocaine plus 40 mg methylprednisolone acetate (group 1) versus xylocaine plus distilled water (group 2). Both groups received 100mg of diclofenac sodium for 10 days. The WOMAC scale was applied at 4 weeks and adverse events were recorded. RESULTS Equivalence was demonstrated in both groups for demographic variables and initial clinical evaluation. There was no statistical difference in the three domains of assessment of the baseline WOMAC score. The median baseline WOMAC in group 1 was 32 and in group 2 was 25.5 points. At 4 weeks it was 8 and 6.5 points, which corresponded to an improvement of 61.6 and 62.8% respectively. CONCLUSION The infiltration with methylprednisolone in anserin syndrome is not superior to placebo in patients taking diclofenac measured by the WOMAC scale at 4 weeks. The incidence of adverse events did not show any differences either.
Collapse
Affiliation(s)
- David Vega-Morales
- Departamento de Medicina Interna, Servicio de Reumatología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
| | | | | | | | | |
Collapse
|
11
|
Álvarez-Nemegyei J, Canoso JJ. Nombre y clasificación de los reumatismos de tejidos blandos. ACTA ACUST UNITED AC 2007; 3:151-2. [DOI: 10.1016/s1699-258x(07)73612-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Accepted: 04/26/2007] [Indexed: 11/28/2022]
|
12
|
Abstract
BACKGROUND Pes anserinus tendinitis/bursitis (PATB) is a frequent cause of knee pain. Its predisposing factors are still controversial. OBJECTIVES Assess the effect of a set of demographic, clinical, somatometric, and biomechanical factors on the risk for PATB. METHODS A case control design was used to evaluate the association between clinically diagnosed PATB and the presence of diabetes; knee osteoarthritis (and its radiographic severity); obesity; knee collateral, and anteroposterior instability; and knee or hindfoot malalignment. RESULTS Twenty-two consecutive, incident PATB patients were included; all were females 62.1 +/- 11.5-year-old (limits 45-82). Thirty-eight sex- and age-matched (59.8 +/- 9.4-year-old; P = 0.41) subjects were used as controls; these had asymptomatic osteoporosis (20) and a series of rheumatic syndromes (18). There was no difference in prevalence of diabetes, knee osteoarthritis, obesity, knee instability, varus knee deformity, and hindfoot malalignment between cases and controls. Furthermore, no difference in overall, lateral, medial, and patellofemoral knee osteoarthritis radiographic severity mean score was found between study groups. The presence of valgus knee deformity alone (OR: 5.2; 95% CI: 1.1-25.5), or in combination with collateral instability (OR: 6.0; 95% CI: 1.4-26.0), was identified as associated with PATB. CONCLUSIONS Valgus knee deformity, alone or in association with collateral instability, seems to be a risk factor for PATB. No association was found between PATB and some conditions previously reported as predisposing factors such as diabetes, knee osteoarthritis, and obesity. PATB should be kept in mind as a highly probable diagnosis in mature women with medial knee pain and valgus knee deformity.
Collapse
Affiliation(s)
- José Alvarez-Nemegyei
- Unidad de Investigación Médica, Unidad Médica de Alta Especialidad Yucatán, Instituto Mexicano del Seguro Social, Mérida, Yucatan, Mexico.
| |
Collapse
|
13
|
Álvarez-Nemegyei J. Eficacia del tratamiento local con glucocorticoides en los síndromes de dolor regional apendicular. Una revisión del conocimiento actual. ACTA ACUST UNITED AC 2005; 1 Suppl 2:S3-7. [DOI: 10.1016/s1699-258x(05)72767-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|