Document Detail


Abuse of growth hormone increases the risk of persistent de Quervain tenosynovitis.
MedLine Citation:
PMID:  19797164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: de Quervain tenosynovitis usually responds well to nonsurgical treatment. HYPOTHESIS: Growth hormone abuse is associated with increased de Quervain tenosynovitis incidence in weight-training persons. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We treated 19 weight-training male patients with de Quervain tenosynovitis. Nine were abusing growth hormone (group A), and 10 were not (group B). Four group A patients elected to cease growth hormone abuse. Treatment was stratified into 3 grades: (1) splinting and nonsteroidal anti-inflammatory drugs, (2) same as first grade but with the addition of cortisone injections, and (3) surgical decompression (after failure of treatment of first and second grades). Follow-up was at 3, 9, and 24 months. RESULTS: First follow-up: Only 33.3% of those using growth hormone in group A responded to splinting and nonsteroidal anti-inflammatory drugs, compared with 90% in group B. Six patients (66.6%) in group A experienced persistent symptoms and received second-grade treatment, compared with 1 patient in group B (10%). Second follow-up: Four patients (44.4%) in group A moved from second- to third-grade treatment, 1 symptom-free patient (11.1%) relapsed and received second-grade treatment while 2 (22.2%) requested conservative treatment, declining surgery. Group B patients were 100% symptom-free. Final follow-up: Six patients (66.6%) in group A were operated on and 1 (11.1%) suffered from persistent de Quervain tenosynovitis, declining surgery. In group B, 1 patient relapsed and was started on second-grade treatment. No patients in group B had surgery. CONCLUSION: Our results suggest that growth hormone abuse is associated with a more recalcitrant form of de Quervain tenosynovitis that does not respond well to nonsurgical treatment, thus leading to increased likelihood of surgical decompression.
Authors:
Thomas Pagonis; Konstantinos Ditsios; Panagiotis Givissis; Athanasios Pagonis; Anastasios Christodoulou
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Publication Detail:
Type:  Journal Article     Date:  2009-09-24
Journal Detail:
Title:  The American journal of sports medicine     Volume:  37     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-30     Completed Date:  2010-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2228-33     Citation Subset:  IM    
Affiliation:
First Orthopaedic Clinic of Aristotle University of Thessaloniki, General University Hospital of George Papanikolaou, Thessaloniki, Greece. 6972550911@mycosmos.gr
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Cohort Studies
De Quervain Disease / chemically induced*,  surgery
Decompression, Surgical
Growth Hormone / adverse effects*
Humans
Male
Resistance Training / adverse effects
Substance-Related Disorders*
Treatment Failure
Young Adult
Chemical
Reg. No./Substance:
9002-72-6/Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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