Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report
Identifieur interne : 005E48 ( Ncbi/Curation ); précédent : 005E47; suivant : 005E49Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report
Auteurs : Gen Kuroyanagi ; Kunio Yamada ; Tsukasa Imaizumi ; Jun Mizutani ; Ikuo Wada ; Osamu Kozawa ; Haruhiko Tokuda [Japon] ; Takanobu OtsukaSource :
- Experimental and Therapeutic Medicine [ 1792-0981 ] ; 2013.
Abstract
The present study describes a case of leg lymphedema due to iliopectineal bursitis associated with rheumatoid arthritis (RA), which was satisfactorily controlled by surgery and combination therapy with methotrexate (MTX) and tacrolimus. A 68-year-old male, who had a six-year history of RA, developed an iliopectineal bursa associated with destruction of the hip joint. The mass gradually increased in size, and there was swelling in his right lower extremity. The patient was subsequently hospitalized with increasing right hip pain and leg edema. A colorless transparent lymph fluid leaked from his leg, and leg lymphedema was thus diagnosed. The patient also had a 20-year history of myelodysplastic syndrome. Therefore, the extensive or total resection of the bursa was considered to be too invasive, so a partial bursal excision was performed via an anterior approach. Following the partial bursal excision, total hip arthroplasty (THA) was performed using the Hardinge approach. The leg lymphedema disappeared following the surgery, and the iliopectineal bursa was no longer enlarged. MTX and tacrolimus were postoperatively administered to strictly control the RA. The RA was subsequently well controlled, without any increases in the levels of inflammatory markers, such as C-reactive protein and matrix metalloproteinase-3. This case demonstrated that iliopectineal bursitis was resolved following THA, without complete excision of the intrapelvic bursa, and that strict RA control led to a good clinical course without recurrent inflammation of the bursa. Similar procedures may be beneficial in other patients contraindicated for resection of the entire bursa.
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DOI: 10.3892/etm.2013.1243
PubMed: 24137283
PubMed Central: 3797314
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Gen Kuroyanagi<affiliation><nlm:aff id="af1-etm-06-04-0887">Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601;</nlm:aff><wicri:noCountry code="subfield">Aichi 467-8601</wicri:noCountry></affiliation><affiliation><nlm:aff id="af2-etm-06-04-0887">Department of Pharmacology, Gifu University Graduate School of Medicine, Gifu 501-1194;</nlm:aff><wicri:noCountry code="subfield">Gifu 501-1194</wicri:noCountry></affiliation><affiliation><nlm:aff id="af2-etm-06-04-0887">Department of Pharmacology, Gifu University Graduate School of Medicine, Gifu 501-1194;</nlm:aff><wicri:noCountry code="subfield">Gifu 501-1194</wicri:noCountry></affiliation><affiliation><nlm:aff id="af3-etm-06-04-0887">Department of Orthopedic Surgery, Komaki City Hospital, Komaki, Aichi 485-8520;</nlm:aff><wicri:noCountry code="subfield">Aichi 485-8520</wicri:noCountry></affiliation><affiliation><nlm:aff id="af3-etm-06-04-0887">Department of Orthopedic Surgery, Komaki City Hospital, Komaki, Aichi 485-8520;</nlm:aff><wicri:noCountry code="subfield">Aichi 485-8520</wicri:noCountry></affiliation><affiliation><nlm:aff id="af1-etm-06-04-0887">Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601;</nlm:aff><wicri:noCountry code="subfield">Aichi 467-8601</wicri:noCountry></affiliation><affiliation><nlm:aff id="af1-etm-06-04-0887">Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601;</nlm:aff><wicri:noCountry code="subfield">Aichi 467-8601</wicri:noCountry></affiliation><affiliation><nlm:aff id="af2-etm-06-04-0887">Department of Pharmacology, Gifu University Graduate School of Medicine, Gifu 501-1194;</nlm:aff><wicri:noCountry code="subfield">Gifu 501-1194</wicri:noCountry></affiliation><affiliation><nlm:aff id="af1-etm-06-04-0887">Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601;</nlm:aff><wicri:noCountry code="subfield">Aichi 467-8601</wicri:noCountry></affiliation>Le document en format XML
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destruction of a rheumatoid hip joint: A case report</title><author><name sortKey="Kuroyanagi, Gen" sort="Kuroyanagi, Gen" uniqKey="Kuroyanagi G" first="Gen" last="Kuroyanagi">Gen Kuroyanagi</name><affiliation><nlm:aff id="af1-etm-06-04-0887">Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601;</nlm:aff><wicri:noCountry code="subfield">Aichi 467-8601</wicri:noCountry></affiliation><affiliation><nlm:aff id="af2-etm-06-04-0887">Department of Pharmacology, Gifu University Graduate School of Medicine, Gifu 501-1194;</nlm:aff><wicri:noCountry code="subfield">Gifu 501-1194</wicri:noCountry></affiliation></author><author><name sortKey="Yamada, Kunio" sort="Yamada, Kunio" uniqKey="Yamada K" first="Kunio" last="Yamada">Kunio Yamada</name><affiliation><nlm:aff id="af3-etm-06-04-0887">Department of Orthopedic Surgery, Komaki City Hospital, Komaki, Aichi 485-8520;</nlm:aff><wicri:noCountry code="subfield">Aichi 485-8520</wicri:noCountry></affiliation></author><author><name sortKey="Imaizumi, Tsukasa" sort="Imaizumi, Tsukasa" uniqKey="Imaizumi T" first="Tsukasa" last="Imaizumi">Tsukasa Imaizumi</name><affiliation><nlm:aff id="af3-etm-06-04-0887">Department of Orthopedic Surgery, Komaki City Hospital, Komaki, Aichi 485-8520;</nlm:aff><wicri:noCountry code="subfield">Aichi 485-8520</wicri:noCountry></affiliation></author><author><name sortKey="Mizutani, Jun" sort="Mizutani, Jun" uniqKey="Mizutani J" first="Jun" last="Mizutani">Jun Mizutani</name><affiliation><nlm:aff id="af1-etm-06-04-0887">Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601;</nlm:aff><wicri:noCountry code="subfield">Aichi 467-8601</wicri:noCountry></affiliation></author><author><name sortKey="Wada, Ikuo" sort="Wada, Ikuo" uniqKey="Wada I" first="Ikuo" last="Wada">Ikuo Wada</name><affiliation><nlm:aff id="af1-etm-06-04-0887">Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601;</nlm:aff><wicri:noCountry code="subfield">Aichi 467-8601</wicri:noCountry></affiliation></author><author><name sortKey="Kozawa, Osamu" sort="Kozawa, Osamu" uniqKey="Kozawa O" first="Osamu" last="Kozawa">Osamu Kozawa</name><affiliation><nlm:aff id="af2-etm-06-04-0887">Department of Pharmacology, Gifu University Graduate School of Medicine, Gifu 501-1194;</nlm:aff><wicri:noCountry code="subfield">Gifu 501-1194</wicri:noCountry></affiliation></author><author><name sortKey="Tokuda, Haruhiko" sort="Tokuda, Haruhiko" uniqKey="Tokuda H" first="Haruhiko" last="Tokuda">Haruhiko Tokuda</name><affiliation wicri:level="1"><nlm:aff id="af4-etm-06-04-0887">Department of Clinical Laboratory, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511,<country>Japan</country></nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Otsuka, Takanobu" sort="Otsuka, Takanobu" uniqKey="Otsuka T" first="Takanobu" last="Otsuka">Takanobu Otsuka</name><affiliation><nlm:aff id="af1-etm-06-04-0887">Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601;</nlm:aff><wicri:noCountry code="subfield">Aichi 467-8601</wicri:noCountry></affiliation></author></analytic><series><title level="j">Experimental and Therapeutic Medicine</title><idno type="ISSN">1792-0981</idno><idno type="eISSN">1792-1015</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The present study describes a case of leg lymphedema due to iliopectineal bursitis associated with rheumatoid arthritis (RA), which was satisfactorily controlled by surgery and combination therapy with methotrexate (MTX) and tacrolimus. A 68-year-old male, who had a six-year history of RA, developed an iliopectineal bursa associated with destruction of the hip joint. The mass gradually increased in size, and there was swelling in his right lower extremity. The patient was subsequently hospitalized with increasing right hip pain and leg edema. A colorless transparent lymph fluid leaked from his leg, and leg lymphedema was thus diagnosed. The patient also had a 20-year history of myelodysplastic syndrome. Therefore, the extensive or total resection of the bursa was considered to be too invasive, so a partial bursal excision was performed via an anterior approach. Following the partial bursal excision, total hip arthroplasty (THA) was performed using the Hardinge approach. The leg lymphedema disappeared following the surgery, and the iliopectineal bursa was no longer enlarged. MTX and tacrolimus were postoperatively administered to strictly control the RA. The RA was subsequently well controlled, without any increases in the levels of inflammatory markers, such as C-reactive protein and matrix metalloproteinase-3. This case demonstrated that iliopectineal bursitis was resolved following THA, without complete excision of the intrapelvic bursa, and that strict RA control led to a good clinical course without recurrent inflammation of the bursa. Similar procedures may be beneficial in other patients contraindicated for resection of the entire bursa.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tokita, A" uniqKey="Tokita A">A Tokita</name></author><author><name sortKey="Ikari, K" uniqKey="Ikari K">K Ikari</name></author><author><name sortKey="Tsukahara, S" uniqKey="Tsukahara S">S Tsukahara</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Olsen, Nj" uniqKey="Olsen N">NJ Olsen</name></author><author><name sortKey="Stein, Cm" uniqKey="Stein C">CM Stein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kremer, Jm" uniqKey="Kremer J">JM Kremer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Weinblatt, Me" uniqKey="Weinblatt M">ME Weinblatt</name></author><author><name sortKey="Maier, Al" uniqKey="Maier A">AL Maier</name></author><author><name sortKey="Fraser, Pa" uniqKey="Fraser P">PA Fraser</name></author><author><name sortKey="Coblyn, Js" uniqKey="Coblyn J">JS Coblyn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kino, T" uniqKey="Kino T">T Kino</name></author><author><name sortKey="Hatanaka, H" uniqKey="Hatanaka H">H Hatanaka</name></author><author><name sortKey="Miyata, S" uniqKey="Miyata S">S Miyata</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kelly, Pa" uniqKey="Kelly P">PA Kelly</name></author><author><name sortKey="Burckart, Gj" uniqKey="Burckart G">GJ Burckart</name></author><author><name sortKey="Venkataramanan, R" uniqKey="Venkataramanan R">R Venkataramanan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kawai, S" uniqKey="Kawai S">S Kawai</name></author><author><name sortKey="Yamamoto, K" uniqKey="Yamamoto K">K Yamamoto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dutta, S" uniqKey="Dutta S">S Dutta</name></author><author><name sortKey="Ahmad, Y" uniqKey="Ahmad Y">Y Ahmad</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nozaki, Y" uniqKey="Nozaki Y">Y Nozaki</name></author><author><name sortKey="Nagare, Y" uniqKey="Nagare Y">Y Nagare</name></author><author><name sortKey="Kinoshita, K" uniqKey="Kinoshita K">K Kinoshita</name></author><author><name sortKey="Urase, F" uniqKey="Urase F">F Urase</name></author><author><name sortKey="Funauchi, M" uniqKey="Funauchi M">M Funauchi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Upchurch, Ks" uniqKey="Upchurch K">KS Upchurch</name></author><author><name sortKey="Kay, J" uniqKey="Kay J">J Kay</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wolfe, F" uniqKey="Wolfe F">F Wolfe</name></author><author><name sortKey="Zwillich, Sh" uniqKey="Zwillich S">SH Zwillich</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tatsumura, M" uniqKey="Tatsumura M">M Tatsumura</name></author><author><name sortKey="Mishima, H" uniqKey="Mishima H">H Mishima</name></author><author><name sortKey="Shiina, I" uniqKey="Shiina I">I Shiina</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chandler, Sb" uniqKey="Chandler S">SB Chandler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yoshioka, T" uniqKey="Yoshioka T">T Yoshioka</name></author><author><name sortKey="Tachihara, A" uniqKey="Tachihara A">A Tachihara</name></author><author><name sortKey="Koyama, T" uniqKey="Koyama T">T Koyama</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fricke, Ji" uniqKey="Fricke J">JI Fricke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yoshino, K" uniqKey="Yoshino K">K Yoshino</name></author><author><name sortKey="Momohara, S" uniqKey="Momohara S">S Momohara</name></author><author><name sortKey="Ikari, K" uniqKey="Ikari K">K Ikari</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jones, Pb" uniqKey="Jones P">PB Jones</name></author><author><name sortKey="Economou, G" uniqKey="Economou G">G Economou</name></author><author><name sortKey="Adams, J" uniqKey="Adams J">J Adams</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kataoka, M" uniqKey="Kataoka M">M Kataoka</name></author><author><name sortKey="Torisu, T" uniqKey="Torisu T">T Torisu</name></author><author><name sortKey="Nakamura, M" uniqKey="Nakamura M">M Nakamura</name></author><author><name sortKey="Uchida, K" uniqKey="Uchida K">K Uchida</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coventry, Mb" uniqKey="Coventry M">MB Coventry</name></author><author><name sortKey="Polley, Hf" uniqKey="Polley H">HF Polley</name></author><author><name sortKey="Weiner, Ad" uniqKey="Weiner A">AD Weiner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mclaughlin, Ge" uniqKey="Mclaughlin G">GE McLaughlin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Matsumoto, T" uniqKey="Matsumoto T">T Matsumoto</name></author><author><name sortKey="Juji, T" uniqKey="Juji T">T Juji</name></author><author><name sortKey="Mori, T" uniqKey="Mori T">T Mori</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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