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.

Keywords

Joint dysfunction risk factors venous malformations limb

Get full access to this article

View all access options for this article.

References

Jin

Lin

Chen

et al.

Craniofacial venous malformations: magnetic resonance imaging features that predict treatment outcome. J Oral Maxillofac Surg 2009; 67: 2388–2396.

Hein

Mulliken

Kozakewich

et al.

Venous malformations of skeletal muscle. Plast Reconstr Surg 2002; 110: 1625–1635.

Theruvil

Kapoor

Thalava

et al.

Vascular malformations in muscles around the knee presenting as knee pain. Knee 2004; 11: 155–158.

Enjolras

Ciabrini

Mazoyer

et al.

Extensive pure venous malformations in the upper or lower limb: a review of 27 cases. J Am Acad Dermatol 1997; 36(2 Pt 1): 219–225.

Babiker

Yeo

Goodwin

. A venous malformation presenting as toe walking. Pediatr Neurol 2015; 52: 133–134.

Mendonca

McCafferty

Nishikawa

et al.

Venous malformations of the limbs: the Birmingham experience, comparisons and classification in children. J Plast Reconstr Aesthet Surg 2010; 63: 383–389.

Kim

Lee

Cho

et al.

Haemodynamic and clinical assessment of lateral marginal vein excision in patients with a predominantly venous malformation of the lower extremity. Eur J Vasc Endovasc Surg 2007; 33: 122–127.

Jiaji

. Management of pediatric pain. Chinese J Pain Med 2001; 7: 173–178.

Böhm

Stief

Sander

et al.

Correction of static axial alignment in children with knee varus or valgus deformities through guided growth: Does it also correct dynamic frontal plane moments during walking?

Gait Posture 2015; 42: 394–397.

10.

Rautio

Saarinen

Laranne

et al.

Endovascular treatment of venous malformations in extremities: results of sclerotherapy and the quality of life after treatment. Acta Radiol 2004; 45: 397–403.

11.

Tan

Kirby

Rajan

et al.

Percutaneous sodium tetradecyl sulfate sclerotherapy for peripheral venous vascular malformations: a single-center experience. J Vasc Interv Radiol 2007; 18: 343–351.

12.

Breugem

Maas

Breugem

et al.

Vascular malformations of the lower limb with osseous involvement. J Bone Joint Surg Br 2003; 85: 399–405.

13.

Lee

Driscoll

Gloviczki

et al.

Evaluation and management of pain in patients with Klippel-Trenaunay syndrome: a review. Pediatrics 2005; 115: 744–749.

14.

Mautner

Sussman

. Intramuscular vascular malformations: a rare cause of exertional leg pain and a novel treatment approach with ultrasound-guided doxycycline sclerotherapy. Am J Sports Med 2015; 43: 729–733.

15.

Upton

Coombs

Mulliken

et al.

Vascular malformations of the upper limb: a review of 270 patients. J Hand Surg Am 1999; 24: 1019–1035.

16.

Legiehn

Heran

. Classification, diagnosis, and interventional radiologic management of vascular malformations. Orthop Clin North Am 2006; 37: 435–474, vii-viii.

17.

Manoli

Micheel

Ernemann

et al.

Treatment algorithm and clinical outcome of venous malformations of the limbs. Dermatol Surg 2015; 41: 1164–1170.

18.

Hill

Pho

Kumar

. Resection of vascular malformations. J Hand Surg Br 1993; 18: 17–21.

19.

Yao

Lomis

Scott

et al.

Percutaneous sclerotherapy for congenital venous malformations in the extremities. Orthopedics 2001; 24: 45–51.

20.

Bonaga

Bardi

Gigante

et al.

Synovial involvement in hemangiomatosis. Arch Orthop Trauma Surg 2003; 123: 102–106.

21.

Malgor

Gloviczki

Fahrni

et al.

Surgical treatment of varicose veins and venous malformations in Klippel-Trenaunay syndrome. Phlebology 2016; 31: 209–215.

22.

Johnson

Shaughnessy

Stans

et al.

Management of knee arthropathy in patients with vascular malformations. J Pediatr Orthop 2009; 29: 380–384.