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American Family Physician Jan 2021Adults commonly present to their family physicians with hip pain, and diagnosing the cause is important for prescribing effective therapy. Hip pain is usually located... (Review)
Review
Adults commonly present to their family physicians with hip pain, and diagnosing the cause is important for prescribing effective therapy. Hip pain is usually located anteriorly, laterally, or posteriorly. Anterior hip pain includes referred pain from intra-abdominal or intrapelvic causes; extra-articular etiologies, such as hip flexor injuries; and intra-articular etiologies. Intra-articular pain is often caused by a labral tear or femoroacetabular impingement in younger adults or osteoarthritis in older adults. Lateral hip pain is most commonly caused by greater trochanteric pain syndrome, which includes gluteus medius tendinopathy or tear, bursitis, and iliotibial band friction. Posterior hip pain includes referred pain such as lumbar spinal pathology, deep gluteal syndrome with sciatic nerve entrapment, ischiofemoral impingement, and hamstring tendinopathy. In addition to the history and physical examination, radiography, ultrasonography, or magnetic resonance imaging may be needed for a definitive diagnosis. Radiography of the hip and pelvis should be the initial imaging test. Ultrasound-guided anesthetic injections can aid in the diagnosis of an intra-articular cause of pain. Because femoroacetabular impingement, labral tears, and gluteus medius tendon tears typically have good surgical outcomes, advanced imaging and/or early referral may improve patient outcomes.
Topics: Adult; Buttocks; Diagnosis, Differential; Family Practice; Female; Hip; Hip Injuries; Hip Joint; Humans; Male; Musculoskeletal Diseases; Pain
PubMed: 33448767
DOI: No ID Found -
Aesthetic Surgery Journal. Open Forum 2023Cellulite is an aesthetically distressing skin condition that manifests as dimples and depressions, producing an uneven surface to the skin. Occurring in 80% to 90% of... (Review)
Review
Cellulite is an aesthetically distressing skin condition that manifests as dimples and depressions, producing an uneven surface to the skin. Occurring in 80% to 90% of females, mostly on the thighs, buttocks, and hips, it is associated with profound negative psychosocial and quality of life issues. Its ethiopathogenesis and pathophysiology are likely to be multifactorial and complex and not fully understood. There is no effective treatment for cellulite, although a number of different treatment modalities are available, from noninvasive to minimally invasive. The efficacy of most treatments is unpredictable and improvements in cellulite appearance are short lived, although significant progress has been made with newer treatments. This review provides an update on the current state of knowledge about cellulite, with an emphasis on patient assessment and an individualized treatment approach for optimal results.
PubMed: 37424836
DOI: 10.1093/asjof/ojad050 -
Dermatologic Surgery : Official... Oct 2020The etiology of cellulite is unclear. Treatment of cellulite has targeted adipose tissue, dermis, and fibrous septae with varying degrees of success and durability of... (Review)
Review
BACKGROUND
The etiology of cellulite is unclear. Treatment of cellulite has targeted adipose tissue, dermis, and fibrous septae with varying degrees of success and durability of response.
OBJECTIVE
Results from clinical trials that target different anatomical aspects of cellulite can provide insights into the underlying pathophysiology of cellulite.
MATERIALS AND METHODS
A search of the PubMed database and ClinicalTrials.gov website was conducted to identify clinical trials that have investigated treatments for cellulite.
RESULTS
A lack of trial protocol standardization, objective means for quantification of improvement and reported cellulite severity, and short-term follow-up, as well as variation in assessment methods have made comparisons among efficacy studies challenging. However, the lack of durable efficacy and inconsistency seen in clinical results suggest that dermal or adipose tissue changes are not the primary etiologies of cellulite. Clinical studies targeting the collagen-rich fibrous septae in cellulite dimples through mechanical, surgical, or enzymatic approaches suggest that targeting fibrous septae is the strategy most likely to provide durable improvement of skin topography and the appearance of cellulite.
CONCLUSION
The etiology of cellulite has not been completely elucidated. However, there is compelling clinical evidence that fibrous septae play a central role in the pathophysiology of cellulite.
Topics: Aponeurosis; Buttocks; Cellulite; Clinical Trials as Topic; Extracorporeal Shockwave Therapy; Humans; Lipectomy; Massage; Microbial Collagenase; Muscle, Skeletal; Phototherapy; Radiofrequency Therapy; Skin; Skin Cream; Subcutaneous Fat; Thigh; Treatment Outcome
PubMed: 32976174
DOI: 10.1097/DSS.0000000000002388 -
Clinical, Cosmetic and Investigational... 2022The number of aesthetic procedures performed worldwide continues to grow together with an increase in the population seeking the restoration or preservation of a... (Review)
Review
The number of aesthetic procedures performed worldwide continues to grow together with an increase in the population seeking the restoration or preservation of a youthful appearance. Requests for non-surgical body rejuvenation are increasing. Patients are looking for safe and effective minimally invasive aesthetic procedures. Soft-tissue dermal fillers can meet these expectations. Based on the beneficial outcomes of these treatments in many facial areas, a new trend is developing to target body areas. Different dermal fillers are available and include collagen stimulators initially developed to restore facial volume. Furthermore, they are associated with long-lasting efficiency, a high level of patient satisfaction and a good safety profile, with mainly minor adverse events reported. In appropriate conditions of use, they are now used for body rejuvenation in clinical practice. Their use is expanding and allows addressing various issues including volume loss, skin laxity, cellulite, striae distensae and wrinkles. This review focuses on poly-L-lactic acid (PLLA), used in the first collagen stimulator and one of the most investigated in facial and in off-facial body applications. The available published data, although still limited, are presented by body area, neck and chest, buttocks, abdomen, upper arms, thighs, knees, and hands. Key features of the concerned zones and the main clinical signs affecting the body part as well as the injection modalities are provided along with the aesthetic results. This represents the state of the art on which to base further developments necessary for optimal and safe outcomes of treatment with the PLLA-based collagen stimulators and others in this class for body rejuvenation.
PubMed: 35761856
DOI: 10.2147/CCID.S359813 -
The Chinese Journal of Physiology 2021Hidradenitis suppurativa is a cutaneous chronic inflammatory disease that is estimated to affect about 1% of the population and caused pain, malodorous discharge,... (Review)
Review
Hidradenitis suppurativa is a cutaneous chronic inflammatory disease that is estimated to affect about 1% of the population and caused pain, malodorous discharge, disfigurement, and poor quality of life with psychosocial problems. The typical features are recurrent painful nodules, abscesses, and sinus tracts on the axillae, groins, gluteal areas, and anogenital regions since postpuberty. Smoking and obesity are two major triggering factors of hidradenitis suppurativa. Women are prone to have hidradenitis suppurativa than men in Western countries, but the male-to-female ratio is reversed in oriental countries. The disease severity can be affected by menstruation, pregnancy, and menopause. Furthermore, the phenotypes are different among men and women with hidradenitis suppurativa. Men are prone to have buttock involvement while women are prone to have axillary, groins, and submammary lesions. This review introduces the skin appendages and pathophysiology of hidradenitis suppurativa and then focuses on the sex difference and the effects of sex hormones on hidradenitis suppurativa and current hormone-associated treatments.
Topics: Female; Gonadal Steroid Hormones; Hidradenitis Suppurativa; Humans; Inflammation; Male; Quality of Life; Skin
PubMed: 34975118
DOI: 10.4103/cjp.cjp_67_21 -
Anatomical Science International Mar 2022Although the hip joint is regarded as inherently stable, hip pain and injuries caused by traumatic/non-traumatic hip instability are relatively common in active... (Review)
Review
Although the hip joint is regarded as inherently stable, hip pain and injuries caused by traumatic/non-traumatic hip instability are relatively common in active individuals. A comprehensive understanding of hip anatomy may provide better insight into the relationships between hip stability and clinical problems. In this review, we present our recent findings on the hip morphological characteristics, especially focusing on the intramuscular tendon of the gluteus medius tendon and its insertion sites, hip capsular attachment on the anterosuperior region of the acetabular margin, and composition of the iliofemoral ligament. We further discussed the hip stabilization mechanism based on these findings. The characteristics of the gluteus medius tendon suggest that even a single muscle has multiple functional subunits within the muscle. In addition, the characteristics of the hip capsular attachment suggest that the width of the capsular attachment is wider than previously reported, and its wide area shows adaptive morphology to mechanical stress, such as bony impression and distribution of the fibrocartilage. The composition of the iliofemoral ligament and its relation to periarticular structures suggest that some ligaments should be defined based on the pericapsular structures, such as the joint capsule, tendon, and aponeurosis, and also have the ability to dynamically coordinate joint stability. These anatomical perspectives provide a better understanding of the hip stabilization mechanism, and a biomechanical study or an in vivo imaging study, considering these perspectives, is expected in the future.
Topics: Buttocks; Hip Joint; Humans; Joint Capsule; Ligaments, Articular; Tendons
PubMed: 34686966
DOI: 10.1007/s12565-021-00638-3