Cuidado com o diagnóstico clínico da tendinite da para de ganso em corredores recraacionais: pode se fratura por estresse no planalto tibial medial. Relato de dois casos / Beware with the clinical diagnosis of pes anserine tendinitis in recreational runners: it may be a stress fracture in the medial tibial plateau. Report of two cases

Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo

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Title Cuidado com o diagnóstico clínico da tendinite da para de ganso em corredores recraacionais: pode se fratura por estresse no planalto tibial medial. Relato de dois casos / Beware with the clinical diagnosis of pes anserine tendinitis in recreational runners: it may be a stress fracture in the medial tibial plateau. Report of two cases
Beware with the clinical diagnosis of pes anserine tendinitis in recreational runners: it may be a stress fracture in the medial tibial plateau. Report of two cases
 
Creator Santos Netto, Alfredo dos
Rodrigues, Luana Queila
Garotti, José Eduardo Rossetto
 
Description Introdução: O diagnóstico de fratura por estresse no planalto tibial medial pode ser confundida com outros diagnósticos diferencias, justamente porque o local de dor e sensibilidade a palpação é muito semelhante a lesões meniscais e tendinite da pata de ganso, que são lesões comuns em pacientes corredores. Objetivo: Relatar dois casos que foram interpretados inicialmente como tendinite na pata de ganso na avaliação inicial, e após reavaliação ambulatorial, foi realizado diagnóstico de fratura por estresse bilateral no planalto tibial medial. Relato dos Casos: Duas pacientes do sexo feminino, 31 e 32 anos respectivamente, começaram a prática de corrida de rua, sem supervisão, e seis e oito semanas após o início da prática, evoluíram com dor nos joelhos, bilateralmente, na face medial. Na avaliação inicial o quadro foi interpretado como tendinite da pata de ganso. Como não tiveram melhora, procuraram novo atendimento médico, em que foi feito suspeita diagnóstica de fratura por estresse no planalto tibial medial, e foram solicitados exames de ressonância magnética bilateral, que confirmaram o diagnóstico. Ambas as pacientes foram tratadas de forma conservadora, com restrição para atividades de impacto por 6 semanas, carga conforme dor, analgesia simples com dipirona, gelo, e ibandronato sódico por 2 meses. As pacientes  retornaram após 6 semanas com  melhora clínica. Após sessões de fisioterapia foram liberadas para atividades de impacto com sucesso. Conclusão: Esses casos enfatizam a importância da suspeita diagnóstica de fratura por estresse no planalto tibial medial em pacientes corredores recreacionais com quadro de dor na região medial do joelho, principalmente se houve uma mudança no seu padrão ou intensidade de corrida.
Palavras chave: Joelho, Fratura por estresse, Fraturas da tíbia 
 
ABSTRACTIntroduction: Diagnosis of stress fracture in the medial tibial plateau can be confused with other different diagnoses, precisely because the site of pain and tenderness is very similarto meniscal injuries and pes anserine tendinitis, which are common injuries in runner  patients. Objective: Report two cases that were initially interpreted as pes anserine tendinitis in the initial evaluation, and later were diagnosed as bilateral stress fracture in the medial  tibial plateau. Case Report: Two female patients, 31 and 32 years old respectively, started the practice of street running, without supervision, and six and eight weeks after the beginning of the practice, they evolved with knee pain, bilaterally, on the medial face. In the initial evaluation, the condition was interpreted as pes anserine tendonitis. As they had noimprovement, they sought new medical care, in which the diagnosis of a stress fracture in the medial tibial plateau was suspected, and bilateral magnetic resonance examinations were requested, which confirmed the diagnosis. Both patients were treated conservatively, with restriction to impact activities for 6 weeks, load according to pain, simple analgesia with dipyrone, ice, and sodium ibandronate for 2 months. The patients returned after 6 weeks with clinical improvement. After physiotherapy sessions, they were successfully released for impact activities. Conclusion: These cases emphasize the importance of the suspicion of stress fracture in the medial tibial plateau in recreational runners with pain in the medial side of the knee, especially if there has been a change in their pattern or intensity of running.
Keywords: Knee, Stress fracture, Tibial fracture
AbstractIntroduction: Diagnosis of stress fracture in the medial tibial plateau can be confused with other different diagnoses,precisely because the site of pain and tenderness is very similar to meniscal injuries and pes anserine tendinitis, whichare common injuries in runner patients. Objective: Report two cases that were initially interpreted as pes anserinetendinitis in the initial evaluation, and later were diagnosed as bilateral stress fracture in the medial tibial plateau.Case Report: Two female patients, 31 and 32 years old respectively, started the practice of street running, withoutsupervision, and six and eight weeks after the beginning of the practice, they evolved with knee pain, bilaterally,on the medial face. In the initial evaluation, the condition  was interpreted as pes anserine tendonitis. As they had noimprovement, they sought new medical care, in which the diagnosis of a stress fracture in the medial tibial plateauwas suspected, and bilateral magnetic resonance examinations were requested, which confirmed the diagnosis. Bothpatients were treated conservatively, with restriction to impact activities for 6 weeks, load according to pain, simpleanalgesia with dipyrone, ice, and sodium ibandronate for 2 months. The patients returned after 6 weeks with clinicalimprovement. After physiotherapy sessions, they were successfully released for impact activities. Conclusion: Thesecases emphasize the importance of the suspicion of stress fracture in the medial tibial plateau in recreational runnerswith pain in the medial side of the knee, especially if there has been a change in their pattern or intensity of running.Keywords: Knee, Stress fracture, Tibial fracture 
 
Publisher Faculdade de Ciências Médicas da Santa Casa de São Paulo
 
Date 2021-08-16
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
 
Format application/pdf
application/pdf
 
Identifier http://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/774
 
Source Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo; v. 66 (2021): Jan/Dez; 1 of 4
1809-3019
0101-6067
 
Language por
 
Relation http://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/774/1031
http://arquivosmedicos.fcmsantacasasp.edu.br/index.php/AMSCSP/article/view/774/1032
 
Rights Copyright (c) 2021 Alfredo dos Santos Netto, Luana Queila Rodrigues, José Eduardo Rossetto Garotti
https://creativecommons.org/licenses/by/4.0
 

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