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Hip Pain (hip + pain)
Selected AbstractsProximal femoral resection for subluxation or dislocation of the hip in spastic quadriplegiaDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2003Steve Ackerly MD Management of a painful or contracted hip dislocation in individuals with severe spastic quadriplegia is difficult. Clinical and radiographic results of 12 proximal femoral resection-interposition operations performed in seven non-ambulatory persons (five males, two females; mean age 14 years, 8 months; age range 6 years 11 months to 19 years 8 months) with severe spasticity were reviewed to determine if pain relief and restoration of motion were maintained. At a mean follow-up of 7 years 7 months (median 9 years 6 months) all participants maintained a good sitting position and a functional range of motion with improved hygiene. Hip pain was improved in all participants compared with their preoperative status. Proximal femur migration occurred causing slight pain in one person. Heterotopic ossification was observed but was not clinically significant. Complications included traction pin loosening and infection and a late supracondylar femur fracture 3 months after the operation. Proximal femoral resection effectively decreased pain and restored hip motion in those with severe spastic quadriplegia leading to improved sitting and perineal care. [source] A comparison of the performance of the EQ-5D and SF-6D for individuals aged , 45 yearsHEALTH ECONOMICS, Issue 7 2008Garry R. Barton Abstract We sought to compare the performance of the EQ-5D and SF-6D with regard to the criteria of practicality, convergent validity, and construct validity, the level of agreement between the two measures was also assessed. Responses from 1865 individuals aged , 45 years in one general practice were analysed. Of these, 93.1% completed the EQ-5D, compared with 86.4% for the SF-6D, where individuals who were older, female, of a lower occupational skill level, from an area of lower deprivation, or used prescribed medication were significantly less likely to complete the SF-6D. The performance of both measures was comparable with regard to both convergent and construct validities, as both the EQ-5D and SF-6D scores were closely related to scores on the EuroQol visual analogue scale (VAS) (p<0.001) and able to discriminate between people who did and did not take: (i) analgesics and (ii) other prescribed medication. Despite EQ-5D and SF-6D scores being highly correlated (p<0.001), individuals who were healthier (according to the VAS) had higher mean scores on the EQ-5D (p<0.001), whereas less healthy individuals had higher mean scores on the SF-6D (individuals with knee pain, osteoarthritis, back pain, rheumatoid arthritis, and hip pain had significantly lower mean scores on the EQ-5D, p<0.001). Copyright © 2007 John Wiley & Sons, Ltd. [source] Adductor insertion avulsion syndrome with stress fracture of femoral shaft: MRI findingsJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 2007MA Lawande SUMMARY Chronic vague hip pain may be caused by stress-related injury in the proximal or mid-femoral diaphysis. This has been described as an entity called adductor insertion avulsion syndrome, or thigh splints. In the appropriate clinical setting, the radiologist interpreting the magnetic resonance imaging must be aware of this condition as its imaging findings are subtle. The diagnosis will help the clinician plan the appropriate management. Magnetic resonance imaging can also depict the complications such as stress fracture. [source] Using an osteoarthritis-specific pain measure in elders with cognitive impairment: a pilot studyJOURNAL OF NURSING MANAGEMENT, Issue 2 2006PAO-FENG TSAI PhD Aim and background, The Western Ontario and McMaster Osteoarthritis Index pain scale has not been used with cognitively impaired elders to measure their knee or hip pain. This study therefore examined the usefulness of the Western Ontario and McMaster Osteoarthritis Index pain scale for measuring pain in this population. Method, Fourteen cognitively impaired elders with osteoarthritis of the knee or hip participated in the study. Elders' pain was assessed with the Western Ontario and McMaster Osteoarthritis Index pain scale, the Verbal Descriptor Scale and the Present Pain Intensity Scale, twice 5 minutes apart. Proxy report of pain was provided by the nursing staff. Results, The correlations among the Western Ontario and McMaster Osteoarthritis Index pain scale, Verbal Descriptor Scale and Present Pain Intensity were between 0.77 and 1.00 (P < 0.01). All pain measures showed high test,retest reliability (r = 0.98,1.00, P < 0.01). Staff's pain ratings using the Western Ontario and McMaster Osteoarthritis Index pain scale were strongly correlated with elders' pain ratings using any pain measure (r = 0.68,0.80, P < 0.05 or P < 0.01). However, staff's pain ratings using either the Verbal Descriptor Scale or Present Pain Intensity had no association with elders' pain ratings (r = ,0.07 to ,0.30, P = NS). Conclusion, The study confirmed that the Western Ontario and McMaster Osteoarthritis Index pain scale is as valid and reliable as the Verbal Descriptor Scale and Present Pain Intensity for elders with moderate and mild cognitive impairment. When used by staff, the Western Ontario and McMaster Osteoarthritis Index pain scale provides a better pain assessment for cognitively impaired elders than the Verbal Descriptor Scale or Present Pain Intensity. [source] Thalamic atrophy associated with painful osteoarthritis of the hip is reversible after arthroplasty: A longitudinal voxel-based morphometric studyARTHRITIS & RHEUMATISM, Issue 10 2010Stephen E. Gwilym Objective Voxel-based morphometry (VBM) is a method of assessing brain gray matter volume that has previously been applied to various chronic pain conditions. From this previous work, it appears that chronic pain is associated with altered brain morphology. The present study was undertaken to assess these potential alterations in patients with painful hip osteoarthritis (OA). Methods We studied 16 patients with unilateral right-sided hip pain, before and 9 months after hip arthroplasty. This enabled comparison of gray matter volume in patients with chronic musculoskeletal pain versus healthy controls, as well as identification of any changes in volume following alleviation of pain (after surgery). Assessment involved self-completion questionnaires to assess pain, function, and psychosocial variables, and magnetic resonance imaging scanning of the brain for VBM analysis. Results Significant differences in brain gray matter volume between healthy controls and patients with painful hip arthritis were seen. Specifically, areas of the thalamus in patients with chronic OA pain exhibited decreased gray matter volume. Furthermore, when these preoperative changes were compared with the brain morphology of the patients 9 months after surgery, the areas of reduced thalamic gray matter volume were found to have "reversed" to levels seen in healthy controls. Conclusion Our findings confirm that gray matter volume decreases within the left thalamus in the presence of chronic pain and disability in patients with hip OA. The results also show that these thalamic volume changes reverse after hip arthroplasty and are associated with decreased pain and increased function. These findings have potential implications with regard to optimizing the timing of orthopedic interventions such as arthroplasty. [source] Association of 25-hydroxyvitamin D with prevalent osteoarthritis of the hip in elderly men: The osteoporotic fractures in men studyARTHRITIS & RHEUMATISM, Issue 2 2010R. K. Chaganti Objective To examine the cross-sectional association of serum levels of 25-hydroxyvitamin D, or 25(OH)D, with prevalent radiographic hip osteoarthritis (OA) in elderly men. Methods In a cohort of 1,104 elderly men from the Osteoporotic Fractures in Men Study, 25(OH)D serum levels were determined by mass spectrometry, followed by pelvic radiographs ,4.6 years later. Categories of vitamin D levels were defined as follows: deficiency as ,15 ng/ml, insufficiency as 15.1,30 ng/ml, and sufficiency as >30 ng/ml. Radiographs were assessed for severity of hip OA using a summary grade of 0,4 for individual features of hip OA. Logistic regression was used to assess associations of serum 25(OH)D levels with prevalent radiographic hip OA; covariates included age, clinic site, season at the time of blood withdrawal, self-reported hip pain for >30 days, timed 6-meter walk, presence of at least 1 coexisting condition, and self-rated health status. Results Men with radiographic hip OA had a slower 6-meter walking time (P < 0.0001), reported more hip pain (P = 0.0001), had a lower vitamin D level (P = 0.0002), and had a higher prevalence of vitamin D insufficiency (P = 0.002) and vitamin D deficiency (P = 0.012) compared with controls. Higher 25(OH)D levels were associated with a lower prevalence of radiographic hip OA (odds ratio [OR] 1.39 per 1 SD decrease in 25[OH]D, 95% confidence interval [95% CI] 1.11,1.74) after adjusting for age, season, and clinic site. Men with vitamin D insufficiency had an increased likelihood of prevalent radiographic hip OA (OR 2.19, 95% CI 1.21,3.97) compared with men with sufficient levels of 25(OH)D, and in men with vitamin D deficiency, there was a tendency toward an increased likelihood of radiographic hip OA (OR 1.99, 95% CI 0.83,4.74). Conclusion Men with vitamin D deficiencies are twice as likely to have prevalent radiographic hip OA, and therefore vitamin D therapy to augment skeletal health in the elderly is warranted. [source] Defining incident radiographic hip osteoarthritis for epidemiologic studies in womenARTHRITIS & RHEUMATISM, Issue 4 2009Nigel K. Arden Objective To evaluate definitions of radiographic hip osteoarthritis (RHOA) for use in longitudinal epidemiologic studies of disease incidence in women. Methods We studied 5,839 women from the Study of Osteoporotic Fractures who had had serial pelvic radiographs obtained (mean of 8.3 years apart) and who were followed up (mean followup 7.1 years from the time of the second radiograph) for evaluation of clinical outcomes. Definitions of RHOA were assessed for construct validity (association with symptoms and signs at the time of the second radiograph) and predictive validity (association with total hip replacement [THR] and signs and symptoms a mean of 7.1 years later). Odds ratios (ORs) and 95% confidence intervals were calculated to assess the strength of association using logistic regression. Results The cumulative incidence of RHOA ranged from 2.2% to 11.7%. All definitions displayed significant construct validity; the most consistent was found for composite definitions that required the concurrent presence of 2 or more individual radiographic features and definitions based on stringent criteria for joint space narrowing. All definitions except minimum joint space ,2.5 mm displayed consistent predictive validity. Composite definitions had the strongest associations with THR (OR 10.5,18.5) and hip pain (OR 2.6,2.9). The hips identified as having OA by each definition varied, with especially small overlap between findings using definitions based on osteophytes and those using definitions based on joint space narrowing alone. Conclusion Most definitions of incident RHOA display good construct and predictive validity. Composite definitions have the best overall performance, and definitions requiring the presence of both osteophytes (in particular, femoral osteophytes) and joint space narrowing would be recommended for most epidemiologic and genetic studies. [source] Varus foot alignment and hip conditions in older adultsARTHRITIS & RHEUMATISM, Issue 9 2007K. Douglas Gross Objective Mechanical strain on the hip can result from varus malalignment of the foot. This study was undertaken to explore the cross-sectional relationship between varus foot alignment and hip conditions in a population of older adults. Methods The Framingham Osteoarthritis Study cohort consists of a population-based sample of older adults. Within this sample, we measured forefoot and rearfoot frontal plane alignment using photographs of a non,weight-bearing view of both feet of 385 men and women (mean age 63.1 years). Each foot segment was categorized according to the distribution of forefoot and rearfoot alignment among cases of ipsilateral hip pain, trochanter tenderness, hip pain or tenderness, and total hip replacement (THR). The relationship of foot alignment to these conditions was examined using logistic regression and generalized estimating equations, adjusting for age, body mass index, sex, and physical activity. Results The mean ± SD rearfoot varus alignment was 0.7 ± 5.5 degrees, and the mean ± SD forefoot varus alignment was 9.9 ± 9.9 degrees. Subjects in the highest category of forefoot varus alignment had 1.8 times the odds of having ipsilateral hip pain (P for trend = 0.06), 1.9 times the odds of having hip pain or tenderness (P for trend < 0.01), and 5.1 times the odds of having undergone THR (P for trend = 0.04) compared with those in the lowest category. No significant associations were found between rearfoot varus alignment and any hip conditions. Conclusion Forefoot varus malalignment may be associated with ipsilateral hip pain or tenderness and THR in older adults. These findings have implications for treatment, since this risk factor is potentially modifiable with foot orthoses. [source] Percutaneous intervention for chronic total occlusion of the internal iliac artery for unrelenting buttock claudication,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2009Satjit Adlakha DO Abstract Internal iliac artery stenosis or occlusion has been documented to cause hip pain, erectile dysfunction, and buttock claudication. Endovascular repair for patients with significant stenosis has been well documented, but chronic total occlusion revascularizations have not been reported in the literature. The reluctance to attempt percutaneous intervention may be in part due to the extensive collateralization that forms to this vessel, or fear of complications such as wire perforation in a vessel that has a tortuous route with multiple bifurcations. This report describes two cases of patients with unrelenting buttock claudication that completely resolved after percutaneous intervention of unilateral chronic total occlusions of the internal iliac artery. © 2008 Wiley-Liss, Inc. [source] | ||||||||||