GREATER TROCHANTER ENTHESOPATHY: AN EXAMPLE OF "SHORT COURSE RETINOID ENTHESOPATHY"A Case Report1
作者:
Todd,
Stitik Scott,
Nadler Patrick,
Foye Luci,
期刊:
American Journal of Physical Medicine and Rehabilitation
(OVID Available online 1999)
卷期:
Volume 78,
issue 6
页码: 571-576
ISSN:0894-9115
年代: 1999
出版商: OVID
关键词: Enthesopathy;Trochanteric Bursitis;Hip Pain;Isotretinoin
数据来源: OVID
摘要:
Irreversible skeletal changes have been described in patients with dermatologic disorders treated with isotretinoin (Accutane), a synthetic vitamin A derivative. Although retinoids were developed to avoid toxicity associated with vitamin A, skeletal lesions and rheumatologic consequences are possible hazards of isotretinoin treatment. Enthesopathy is one of the potential musculoskeletal sequelae and is characterized by pathologic, sometimes painful changes at the insertion sites (entheses) of tendons, ligaments, and articular capsules into bone. We report a patient who was referred secondary to an extended history of bilateral hip region pain. She was subsequently found to have a greater trochanteric enthesopathy. A detailed patient history revealed past use of Accutane for cystic acne. The subsequent treatment course, including medications, corticosteroid injections, physical therapy, and activity modifications, is described and the pertinent literature is reviewed. We believe that patients who are prescribed isotretinoin should be warned about this potential pathologic condition at the initiation of treatment and that physicians who are treating patients with a history of Accutane use should be suspicious of underlying enthesopathies as the etiology behind pain of musculoskeletal origin.
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