A Proposed Staging Classification for Minimally Invasive Management of Haglund's Syndrome with Percutaneous and Endoscopic Surgery

Haglund ’s syndrome encompasses several different pathologies, including Haglund’s deformity, insertional Achilles tendonopathy, retrocalcaneal bursitis, and superficial bursitis. Traditionally treated with open surgery, there is increasing interest in a more minimally invasive approach to this difficul t region to reduce complications and improve the rate and ease of recovery. We review the evidence available for 2 of these techniques: the endoscopic calcaneoplasty and percutaneous Zadek’s calcaneal osteotomy (also known as Keck and Kelly’s osteotomy). The senior author’s classification for management of the condition is presented as well as describing his operative technique for these procedures.
Source: Foot and Ankle Clinics - Category: Orthopaedics Authors: Source Type: research

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AbstractWe aimed to identify predictors of inadequate response to glucocorticoid (GC) treatment in patients with polymyalgia rheumatica (PMR). We retrospectively studied 32 patients as a derivation cohort and 24 patients as a validation cohort. The patients were divided into two groups according to the response to GC treatment: GC-responders and GC-inadequate responders (GC-IRs). We compared laboratory data and bilateral shoulder ultrasound findings between the groups. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cutoff value of candidate predictors of treatment response; the pred...
Source: Rheumatology International - Category: Rheumatology Source Type: research
Authors: Snyder LL, Knox SC, Smutny CJ Abstract Hip pain in adults is a common complaint. Secondary processes can often mask underlying conditions, prolonging the course to diagnosis and definitive treatment. In this case, a 74-year-old man presented to an outpatient clinic after 6 weeks of right hip pain that began upon initiation of a rehabilitation program following coronary artery bypass graft surgery. Various imaging and treatment modalities (including radiography, osteopathic manipulative treatment, injection of the greater trochanteric bursa, L2-3 paravertebral block, magnetic resonance imaging, and intra-ar...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Distal triceps ruptures are uncommon, usually caused by a fall on an outstretched hand or a direct blow. Factors linked to injury include eccentric loading of a contracting triceps, anabolic steroid use, weightlifting, and traumatic laceration. Risk factors include local steroid injection, hyperparathyroidism, and olecranon bursitis. Initial diagnosis can be complicated by pain and swelling, and a palpable defect is not always present. Plain radiographs can be helpful. MRI confirms the diagnosis and directs treatment. Incomplete tears can be treated nonsurgically; complete tears are best managed surgically. Good to excelle...
Source: Clinics in Sports Medicine - Category: Sports Medicine Authors: Source Type: research
AbstractInjection of steroid and anesthetic into the greater trochanteric bursa is commonly performed for trochanteric bursitis, gluteus medius/minimus tendinopathy, or as a part of a barbotage procedure for gluteus medius or minimus calcific tendonosis. Trochanteric bursal injection is widely performed both with and without image guidance, and is typically viewed as low-difficulty; however optimum needle tip position can be challenging. We discuss a simple dynamic technique to aid the practitioner in optimal needle placement.
Source: Skeletal Radiology - Category: Radiology Source Type: research
AbstractFirst-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 ...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Ultrasound (US) assists in the determination of the pathology underlying greater trochanteric pain syndrome (GTPS); however, there exists no consensus regarding the US criteria used to define these pathologies. We aim to explore these US definitions and their associated prevalence. “Trochanteric bursitis” was defined in 10 studies (13 included studies) and was heterogeneously described. “Tendinopathy” was defined in 4 studies, while 7 studies defined “tendinosis.” “Tendon tears” were defined in 8 studies, 6 of which distinguished between “partial- and full-th ickness te...
Source: Ultrasound in Medicine and Biology - Category: Radiology Authors: Tags: Review Article Source Type: research
Olivia posted this incredible story of wheat-free release in the comments on this blog some time back. Her story so powerfully encapsulates how far off course health can go by consuming this thing called “wheat,” that I thought it was worth sharing with everybody again. During her wheat-consuming days, Olivia was clearly suffering body-wide inflammation and other effects that were being ineffectively “treated” by her doctor, effects largely due to the indigestible or only partially-digestible proteins from the seeds of grasses AKA wheat. As often happens, she managed to reverse the entire collection...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Open gluten-free grain-free grains wheat belly Source Type: blogs
AbstractPurposeGreater trochanteric pain syndrome (GTPS) is a condition resulting in lateral hip pain, most commonly caused by tendinosis or tear of the gluteus medius and minimus tendons, and greater trochanteric bursitis. Our aim was to assess pelvic parameters and proximal femoral anatomy in patients suffering from surgical-stage GTPS compared with a control group.MethodsThis retrospective, case-control study assessed 43 patients suffering from GTPS, matched according to age, gender, body mass index and level of sport and physical activity to 43 control patients, between 2013 and 2018. Pelvic parameters, including pelvi...
Source: Skeletal Radiology - Category: Radiology Source Type: research
Abstract INTRODUCTION: The broad aim of this study was to compare the safety and efficacy of using barbed sutures and running closure versus interrupted placement of standard of care sutures for closure of the arthrotomy during total hip arthroplasty (THA). Specifically, we compared duration of arthrotomy closure, the number of sutures utilised for arthrotomy closure, and 90-day outcomes including wound-related readmission, reoperation, and complications. METHODS: A total of 60 patients undergoing 60 THAs were enrolled in a prospective, single-blinded trial and randomised to receive either running closure of ...
Source: Hip International - Category: Orthopaedics Authors: Tags: Hip Int Source Type: research
Conditions:   Gluteal Tendinitis;   Trochanteric Bursitis;   Tendinopathy Interventions:   Drug: Leukocyte-Rich Platelet-Rich Plasma;   Procedure: Percutaneous Ultrasonic Tenotomy Sponsor:   Andrews Research & Education Foundation Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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