Abuse of growth hormone increases the risk of persistent de Quervain tenosynovitis.
BACKGROUND
de Quervain tenosynovitis usually responds well to nonsurgical treatment.


OBJECTIVE
Growth hormone abuse is associated with increased de Quervain tenosynovitis incidence in weight-training persons.


METHODS
Cohort study; Level of evidence, 3.


METHODS
We treated 19 weight-training male patients with de Quervain tenosynovitis. Nine were abusing growth hormone (group A), and 10 were not (group B). Four group A patients elected to cease growth hormone abuse. Treatment was stratified into 3 grades: (1) splinting and nonsteroidal anti-inflammatory drugs, (2) same as first grade but with the addition of cortisone injections, and (3) surgical decompression (after failure of treatment of first and second grades). Follow-up was at 3, 9, and 24 months.


RESULTS
First follow-up: Only 33.3% of those using growth hormone in group A responded to splinting and nonsteroidal anti-inflammatory drugs, compared with 90% in group B. Six patients (66.6%) in group A experienced persistent symptoms and received second-grade treatment, compared with 1 patient in group B (10%). Second follow-up: Four patients (44.4%) in group A moved from second- to third-grade treatment, 1 symptom-free patient (11.1%) relapsed and received second-grade treatment while 2 (22.2%) requested conservative treatment, declining surgery. Group B patients were 100% symptom-free. Final follow-up: Six patients (66.6%) in group A were operated on and 1 (11.1%) suffered from persistent de Quervain tenosynovitis, declining surgery. In group B, 1 patient relapsed and was started on second-grade treatment. No patients in group B had surgery.


CONCLUSIONS
Our results suggest that growth hormone abuse is associated with a more recalcitrant form of de Quervain tenosynovitis that does not respond well to nonsurgical treatment, thus leading to increased likelihood of surgical decompression.
First Orthopaedic Clinic of Aristotle University of Thessaloniki, General University Hospital of George Papanikolaou, Thessaloniki, Greece. 6972550911@mycosmos.gr
Thomas
T
Pagonis
Konstantinos
K
Ditsios
Panagiotis
P
Givissis
Athanasios
A
Pagonis
Anastasios
A
Christodoulou
D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D053684:De Quervain Disease / Q000139:chemically induced* / Q000601:surgery; D019299:Decompression, Surgical; D013006:Growth Hormone / Q000009:adverse effects*; D006801:Humans; D008297:Male; D055070:Resistance Training / Q000009:adverse effects; D019966:Substance-Related Disorders; D017211:Treatment Failure; D055815:Young Adult
D013006:Growth Hormone