Alvarez-Nemegyei José
Unidad de Investigación Médica, Unidad Médica de Alta Especialidad Yucatán, Instituto Mexicano del Seguro Social, Mérida, Yucatan, Mexico.
J Clin Rheumatol. 2007 Apr;13(2):63-5. doi: 10.1097/01.rhu.0000262082.84624.37.
Pes anserinus tendinitis/bursitis (PATB) is a frequent cause of knee pain. Its predisposing factors are still controversial.
Assess the effect of a set of demographic, clinical, somatometric, and biomechanical factors on the risk for PATB.
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.
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.
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.
鹅足肌腱炎/滑囊炎(PATB)是膝关节疼痛的常见原因。其诱发因素仍存在争议。
评估一系列人口统计学、临床、人体测量学和生物力学因素对PATB风险的影响。
采用病例对照设计评估临床诊断的PATB与糖尿病、膝关节骨关节炎(及其放射学严重程度)、肥胖、膝关节侧副韧带及前后不稳定以及膝关节或后足畸形之间的关联。
纳入22例连续发病的PATB患者;均为女性,年龄62.1±11.5岁(范围45 - 82岁)。38例年龄和性别匹配(59.8±9.4岁;P = 0.41)的受试者作为对照;其中20例有无症状骨质疏松症,18例有一系列风湿综合征。病例组和对照组在糖尿病、膝关节骨关节炎、肥胖、膝关节不稳定、膝内翻畸形和后足畸形的患病率方面无差异。此外,研究组之间在总体、外侧、内侧和髌股关节骨关节炎放射学严重程度平均评分上也无差异。单独存在膝外翻畸形(比值比:5.2;95%可信区间:1.1 - 25.5)或与侧副韧带不稳定同时存在(比值比:6.0;95%可信区间:1.4 - 26.0)被确定与PATB相关。
膝外翻畸形单独或与侧副韧带不稳定相关,似乎是PATB的一个危险因素。未发现PATB与一些先前报道的诱发因素如糖尿病、膝关节骨关节炎和肥胖之间存在关联。对于有膝关节内侧疼痛和膝外翻畸形的成年女性,应高度怀疑PATB。