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炎症性疾病对坐骨臀肌滑囊炎临床进展及治疗的影响:一项回顾性观察研究

Effects of Inflammatory Disease on Clinical Progression and Treatment of Ischiogluteal Bursitis: A Retrospective Observational Study.

作者信息

Roh Y H, Yoo S J, Choi Y H, Yang H C, Nam K W

机构信息

Department of Orthopaedics, Jeju National University Hospital, Jeju City, Republic of Korea.

出版信息

Malays Orthop J. 2020 Nov;14(3):32-41. doi: 10.5704/MOJ.2011.007.

Abstract

INTRODUCTION

The symptoms of Ischiogluteal Bursitis (IGB) are often nonspecific and atypical, and its diagnosis is more challenging. Moreover, it is difficult to predict cases of chronic progression or poor treatment response. Therefore, the aim of this study was to investigate the clinical course of IGB patients and identify factors that are predictive of failure of conservative treatment.

MATERIALS AND METHODS

Our study consisted of IGB patients diagnosed between 2010 March and 2016 December who had been followed-up for at least one year. Structured questionnaires and medical records were reviewed to analyse demographic characteristics, lifestyle patterns, blood tests, and imaging studies. We categorized the cases into two groups based on the response to conservative treatment and the need for surgical intervention.

RESULTS

The most common initial chief symptoms were buttock pains in 24 patients (37.5%). Physical examinations showed the tenderness of ischial tuberosity area in 59 (92.2%) patients, but no specific findings were confirmed in 5 patients (7.8%). 51 patients (79.7%) responded well to the conservative management, 11 patients (17.2%) needed injection, and 2 patients (3.1%) had surgical treatment performed due to continuous recurrence. There was no difference in demographic and blood lab data between the two groups. However, the incidence of inflammatory diseases (response group: 10.3% vs non-response group: 66.7%, p=0.004) was significantly different between the two groups.

CONCLUSION

The diagnosis of IGB can be missed due to variations in clinical symptoms, and cautions should be exercised in patients with inflammatory diseases as conservative treatment is less effective in them, leading to chronic progression of IGB.

摘要

引言

坐骨滑囊炎(IGB)的症状通常不具有特异性且不典型,其诊断更具挑战性。此外,很难预测慢性进展或治疗反应不佳的病例。因此,本研究的目的是调查IGB患者的临床病程,并确定预测保守治疗失败的因素。

材料与方法

我们的研究包括2010年3月至2016年12月期间诊断为IGB且随访至少一年的患者。回顾结构化问卷和病历以分析人口统计学特征、生活方式、血液检查和影像学研究。我们根据对保守治疗的反应和手术干预的需求将病例分为两组。

结果

最常见的初始主要症状是24例患者(37.5%)出现臀部疼痛。体格检查显示59例患者(92.2%)坐骨结节区域有压痛,但5例患者(7.8%)未发现特异性体征。51例患者(79.7%)对保守治疗反应良好,11例患者(17.2%)需要注射治疗,2例患者(3.1%)因持续复发接受了手术治疗。两组之间的人口统计学和血液实验室数据无差异。然而,两组之间炎症性疾病的发生率有显著差异(反应组:10.3% 对无反应组:66.7%,p = 0.004)。

结论

由于临床症状的差异,IGB可能漏诊,对于炎症性疾病患者应谨慎,因为保守治疗对他们效果较差,会导致IGB慢性进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60e5/7752025/002bc5a2c6e5/moj-14-032-f1.jpg

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