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Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report

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...

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Autores principales: KUROYANAGI, GEN, YAMADA, KUNIO, IMAIZUMI, TSUKASA, MIZUTANI, JUN, WADA, IKUO, KOZAWA, OSAMU, TOKUDA, HARUHIKO, OTSUKA, TAKANOBU
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797314/
https://www.ncbi.nlm.nih.gov/pubmed/24137283
http://dx.doi.org/10.3892/etm.2013.1243
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author KUROYANAGI, GEN
YAMADA, KUNIO
IMAIZUMI, TSUKASA
MIZUTANI, JUN
WADA, IKUO
KOZAWA, OSAMU
TOKUDA, HARUHIKO
OTSUKA, TAKANOBU
author_facet KUROYANAGI, GEN
YAMADA, KUNIO
IMAIZUMI, TSUKASA
MIZUTANI, JUN
WADA, IKUO
KOZAWA, OSAMU
TOKUDA, HARUHIKO
OTSUKA, TAKANOBU
author_sort KUROYANAGI, GEN
collection PubMed
description 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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spelling pubmed-37973142013-10-17 Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report KUROYANAGI, GEN YAMADA, KUNIO IMAIZUMI, TSUKASA MIZUTANI, JUN WADA, IKUO KOZAWA, OSAMU TOKUDA, HARUHIKO OTSUKA, TAKANOBU Exp Ther Med Case Report 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. D.A. Spandidos 2013-10 2013-08-02 /pmc/articles/PMC3797314/ /pubmed/24137283 http://dx.doi.org/10.3892/etm.2013.1243 Text en Copyright © 2013, Spandidos Publications http://creativecommons.org/licenses/by/3.0 This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.
spellingShingle Case Report
KUROYANAGI, GEN
YAMADA, KUNIO
IMAIZUMI, TSUKASA
MIZUTANI, JUN
WADA, IKUO
KOZAWA, OSAMU
TOKUDA, HARUHIKO
OTSUKA, TAKANOBU
Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report
title Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report
title_full Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report
title_fullStr Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report
title_full_unstemmed Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report
title_short Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: A case report
title_sort leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797314/
https://www.ncbi.nlm.nih.gov/pubmed/24137283
http://dx.doi.org/10.3892/etm.2013.1243
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