Joint dysfunction associated with venous malformations of the limbs: Which patients are at high risk?

Abstract

Objectives Joint dysfunction occurs frequently in patients with venous malformations of the extremities. This study aims to describe the risk factors of joint dysfunction in these patients. Method We retrospectively collected clinical and radiological aspects of 168 patients with extremity venous malformations from January 2013 to August 2015. Patients were categorized into "with joint dysfunction" or "without joint dysfunction" groups according to the symptoms. Results Forty-four (26%) patients were assigned into with joint dysfunction group. Univariate analysis showed that the significant variables were age (P = 0.008), location (P = 0.005), size (P < 0.001), involved tissue (P < 0.001), visual analogue scale scores of pain (P = 0.004), pain duration (P = 0.018), and therapy history (P < 0.001). Multivariate analysis showed that the factors associated with joint dysfunction were age below 10 years (adjusted odds ratio = 2.70, P = 0.004), lower limb (adjusted odds ratio = 2.72, P = 0.042), pain duration over 1 year (adjusted odds ratio = 3.47, P = 0.001) and therapy history (yes) (adjusted odds ratio = 3.71, P = 0.004). Conclusion This study provides preliminary evidence indicating which patients are at high risk for joint dysfunction associated with limb venous malformations.

Intra-articular venous malformation of the knee in children: magnetic resonance imaging findings and significance of synovial involvement

“…MRI is pivotal in the diagnostics of intraarticular venous malformation of the knee [10] and in evaluating their anatomical location and possible sequelae. In the context of venous malformations of the limb, clinical risk factors for subsequent joint dysfunction were an age younger than 10 years, and pain duration over 1 year according to a recent series [11].…”

Interventional Treatment Options in Children with Extracranial Vascular Malformations

“…37 An important aspect in case of pediatric patients is an intra-articular lesion extension, presented frequently around the knee, as this may lead to recurrent hemarthroses with consecutive potential to cause destructive arthropathy. 38 Preventing this severe complication indicates early intervention even in asymptomatic joints of young children. While the choice of the sclerosing agent is rarely different between adults and children, it is essential to keep in mind that there are severe potential side effects and specific weight-dependent dose limitations.…”

Operative management of equinus associated with lower limb venous malformations

“…23 A previous study also demonstrated that patients with limb VMs who experienced chronic pain had a higher risk of joint dysfunction. 6 This calf pain is likely due to lesion engorgement resulting from the venous pooling of blood during exercise. The study concluded that lesions located in long narrow muscles are more frequently associated with pain induction than lesions in wide, flat muscles, which provided greater room for expansion.…”

“…[3][4][5] A previous study revealed that 26% of patients with limb VMs presented with functional impairment. 6 Among them, equinus is commonly seen in patients with lower limb involvement, especially the calf muscle. Toe-walking is considered a normal stage of gait development but should resolve by 3 to 7 years of age.…”