Surgical Treatment for Stenosing Peroneal Tenosynovitis

Category: Ankle Introduction/Purpose: Stenosing Peroneal Tenosynovitis is an uncommon entity that is equally difficult to diagnose. In our practice, we have found 14 patients with this diagnosis. They were all successfully treated with release of the peroneal tendon sheath and debridement of the calcaneal exostosis. Further, the ultrasound guided anesthetic injection of the tendon sheath preoperatively essential in confirming this diagnosis and evaluating for successful outcomes after surgical intervention. Methods: 14 patients were diagnosed with Stenosing Peroneal Tenosynovitis. Upon initial presentation, the patients all reported a persistent history of pain along the ankle and had exhausted conservative treatment options. Patients with MRIs had images that appeared normal. In order to confirm the diagnosis as Stenosing Peroneal Tenosynovitis, ultrasound guided injections of anesthetics were administered into the peroneal tendon sheath. If the injection alleviated the pain, this confirmed the diagnosis of Stenosing Peroneal Tenosynovitis. Patients also had neurological consults to rule out possible sural neuritis. In patients with a confirmed diagnosis of stenosing peroneal tenosynovitis, we proceeded with surgical intervention. They underwent surgery between 2006 and 2014 by two fellowship trained orthopedic surgeons at one institution. Retrospective chart review was performed and functional outcomes were assessed pre-and postoperatively using the Foot and Ankle Outcome Score (FAOS) and Short Form-12 (SF-12) general health questionnaire. Results: All patients that underwent this procedure were given the Foot and Ankle Outcome Score (FAOS) and Short Form 12 (SF-12) general health questionnaire pre-operatively. Questionnaire results were collected post-operatively and were successfully obtained at one year or greater from 11 patients. Of these 11 patients, all showed significant improvements (student t test used, p<0.05) in four of five categories of the FAOS (pain, daily activities, quality of life) as well as significant improvement in their overall SF-12 score and pain scale score (Table). Conclusion: Stenosing peroneal tenosynovitis is an uncommon entity. The presentation of the disease is one of persistent lateral sided ankle pain with minimal radiologic findings. We present a case series in which the peroneal tendon sheath was diagnostically injected with an anesthetic to determine if the pain could be relieved. In each of the cases, symptomatic improvement was obtained following the injection, helping to confirm the diagnosis. With the fact that many of these patients had advanced imaging denoting no significant tears, we believe, this diagnostic injection is paramount in assisting with determining the success of surgical outcome.

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The mental and physical health of miners following the 1992 national pit closure programme a cross sectional survey using General Health Questionnaire GHQ-12 and Short Form SF-36

Public Health ◽

10.1016/s0033-3506(98)00223-6 ◽

1998 ◽

Vol 112 (3) ◽

pp. 169-173 ◽

Cited By ~ 1

Author(s):

A Avery

Keyword(s):

Physical Health ◽

General Health ◽

Short Form ◽

General Health Questionnaire ◽

Health Questionnaire ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sf 36 ◽

Mental And Physical Health

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The General Health Questionnaire and Eysenck's Three-Dimensional Model of Personality

Psychological Reports ◽

10.2466/pr0.97.1.288-290 ◽

2005 ◽

Vol 97 (1) ◽

pp. 288-290 ◽

Cited By ~ 1

Author(s):

Leslie J. Francis ◽

Mandy Robbins ◽

Catherine F. Quigley ◽

Christopher Alan Lewis

Keyword(s):

General Health ◽

Short Form ◽

General Health Questionnaire ◽

Three Dimensional ◽

Eysenck Personality Questionnaire ◽

Personality Questionnaire ◽

Health Questionnaire ◽

Dimensional Model ◽

Three Dimensional Model ◽

Men And Women

A sample of 115 men and women between the ages of 20 and 60 completed the 30-item General Health Questionnaire together with the short-form Revised Eysenck Personality Questionnaire. The data indicate psychological distress so assessed is correlated .43 ( p<.001) with Neuroticism and –.26 ( p<.01) with Introversion but is unrelated to Psychoticism scores.

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Dehydroepiandrosterone Improves Psychological Well-Being in Male and Female Hypopituitary Patients on Maintenance Growth Hormone Replacement

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2006-0316 ◽

2006 ◽

Vol 91 (10) ◽

pp. 3773-3779 ◽

Cited By ~ 48

Author(s):

Antonia M. Brooke ◽

Leonila A. Kalingag ◽

Farideh Miraki-Moud ◽

Cecilia Camacho-Hübner ◽

Katharine T. Maher ◽

...

Keyword(s):

General Health ◽

Gh Deficiency ◽

Short Form ◽

General Health Questionnaire ◽

Well Being ◽

Health Questionnaire ◽

Psychological Well Being ◽

Short Form 36 ◽

Gh Replacement ◽

Gh Deficiency In Adults

Abstract Context: Patients with panhypopituitarism have impaired quality of life (QoL) despite GH replacement. They are profoundly androgen deficient, and dehydroepiandrosterone (DHEA) has been shown to have a beneficial effect on well-being and mood in patients with adrenal failure and possibly in hypopituitarism. Objective: Our objective was to determine the effect of DHEA administration on mood in hypopituitary adults on established GH replacement with a constant serum IGF-I. Design: A double-blind, placebo-controlled trial was conducted over an initial 6 months followed by an open phase of 6 months of DHEA. Setting: The study was conducted at a tertiary referral endocrinology unit. Patients: Thirty female and 21 male hypopituitary patients enrolled. Data from 26 females and 18 males were analyzed after patient withdrawal. Interventions: DHEA (50 mg) was added to maintenance replacement including GH. Main Outcome Measures: The primary outcome objective was the effect on QoL and libido assessed by QoL assessment in GH deficiency in adults, Short Form 36, General Health Questionnaire, EuroQol, and sexual self-efficacy scale. Results: Patients had impaired QoL at baseline compared with the age-matched British population. Females showed improvement in QoL assessment in GH deficiency in adults score (−2.9 ± 2.8 DHEA vs.−0.53 ± 3 placebo; P < 0.05), in Short Form 36 social functioning (14.6 ± 23.1 DHEA vs.−4.7 ± 25 placebo; P = 0.047), and general health perception (9.6 ± 14.2 DHEA vs.−1.2 ± 11.6 placebo; P = 0.036) after 6 months of DHEA. Men showed improvement in self-esteem (−1.3 ± 1.7 DHEA vs. 0.5 ± 1.5 placebo; P = 0.03) and depression (−1.6 ± 2.2 DHEA vs. 1.2 ± 2.4 placebo, P = 0.02) domains of the General Health Questionnaire after 6 months of DHEA. Conclusions: DHEA replacement leads to modest improvement in psychological well-being in female and minor psychological improvement in male hypopituitary patients on GH replacement.

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