Galli Melissa M, Protzman Nicole M, Mandelker Eiran M, Malhotra Amit, Schwartz Edward, Brigido Stephen A
Coordinated Health, Bethlehem, Pennsylvania, USA (MMG, NMP, EMM, AM, ES, SAB).
Coordinated Health, Bethlehem, Pennsylvania, USA (MMG, NMP, EMM, AM, ES, SAB)
Foot Ankle Spec. 2014 Dec;7(6):449-56. doi: 10.1177/1938640014539805. Epub 2014 Jul 7.
With the increased prevalence of obesity, there has been a parallel rise in musculoskeletal disorders. However, the effect of body mass index (BMI) on pathology of the hindfoot and ankle is scarcely understood. The purpose of the present report was to compare the number of tendinous and ligamentous pathologies within the hindfoot and ankle between overweight (BMI ≥ 25.00 kg/m(2)) and nonoverweight (BMI < 25.00 kg/m(2)) atraumatic patients. We hypothesized that overweight patients would demonstrate more tendinous and ligamentous pathologies compared with their nonoverweight counterparts. Five hundred consecutive magnetic resonance images were reviewed. One hundred eight patients met the inclusion and exclusion criteria. Sixty-six patients were overweight and 42 patients were nonoverweight. Ninety-eight percent of overweight patients demonstrated pathology of a tendinous or ligamentous nature, whereas 62% of nonoverweight patients demonstrated pathology of a tendinous or ligamentous nature. Thus, the prevalence of pathology was 1.59 times higher among overweight patients compared with nonoverweight patients. Moreover, controlling for age, overweight patients demonstrated approximately twice as many tendinous and ligamentous pathologies compared with nonoverweight patients (adjusted mean ± SD = 4.44 ± 2.14 vs 1.98 ± 2.07, respectively), which was statistically significantly different (P < .001). To definitively assess causation and the clinical evolution of hindfoot and ankle pathology, prospective, longitudinal cohort studies are warranted.
Diagnostic, Level III: Case series.
随着肥胖患病率的增加,肌肉骨骼疾病也相应增多。然而,体重指数(BMI)对后足和踝关节病理的影响却鲜为人知。本报告的目的是比较超重(BMI≥25.00kg/m²)和非超重(BMI<25.00kg/m²)的无创伤患者后足和踝关节内肌腱和韧带病变的数量。我们假设超重患者与非超重患者相比,会表现出更多的肌腱和韧带病变。回顾了连续500例磁共振成像。108例患者符合纳入和排除标准。66例患者超重,42例患者非超重。98%的超重患者表现出肌腱或韧带性质的病变,而62%的非超重患者表现出肌腱或韧带性质的病变。因此,超重患者的病变患病率是非超重患者的1.59倍。此外,在控制年龄后,超重患者的肌腱和韧带病变数量约为非超重患者的两倍(调整后均值±标准差分别为4.44±2.14和1.98±2.07),差异有统计学意义(P<0.001)。为了明确评估后足和踝关节病理的因果关系及临床演变,有必要进行前瞻性纵向队列研究。
诊断性,Ⅲ级:病例系列。