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Relationship Between Clarke’s Angle and Radiological Severity of Knee Osteoarthritis: A Cross-Sectional Study Siahaan, Henoch Gugun Parulian; Siahaan, Yusak Mangara Tua; Pradhana, Tasya Meidy
Jurnal Kedokteran Meditek Vol 31 No 3 (2025): MEI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i3.3694

Abstract

Introduction: Knee osteoarthritis (OA) is a degenerative joint disease causing disability, especially in older adults. Flatfoot, marked by reduced medial arch height, alters lower limb biomechanics and may influence knee OA severity. Objective: To evaluate the association between foot arch, measured by Clarke’s angle, and knee OA severity based on the Kellgren-Lawrence (K-L) grading to provide clinical insight for guiding management decisions. Methods: A cross-sectional study of 57 knee OA patients at Siloam Karawaci Hospital was conducted. Clarke’s angle was measured using ink footprints, and K-L grading assessed radiological severity. Statistical tests included Kolmogorov-Smirnov, one-way ANOVA, and Kruskal-Wallis, with p < 0.05 considered significant. Results: Most participants were female (77.2%) with a mean age of 65.85 ± 9.69 years. OA severity was mostly mild to moderate (K-L 2 and 3). Flatfoot prevalence was 47.4%, and lower Clarke’s angles were significantly associated with higher K-L grades (p = 0.029). No significant differences in age or BMI were found across severity groups, though BMI trended higher with severity. Conclusion: Lower Clarke’s angle correlates with increased knee OA severity. Flatfoot may contribute to or result from OA progression. Further research is needed to clarify causation and inform management strategies.
Successful Pudendal Nerve Block and Radiofrequency in 4 Years Scrotal Pain Resistant to Treatment and Three Varicocelectomies: A Case Report Arjuna, Yang Yang Endro; Pradhana, Tasya Meidy; Siahaan, Yusak Mangara Tua
Magna Neurologica Vol. 4 No. 1 (2026): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v4i1.2259

Abstract

Background: Only a small percentage of patients (2-10%) report pain symptoms during varicocele or post-varicocelectomy. The cause of the pain remains unclear and is still a matter of debate. Neither conservative nor surgical treatments provide a conclusive solution for pain. Nerve blocks can serve as a diagnostic and therapeutic tool in cases where the origin of pain is unknown. Case: A 30-year-old male presented with 4 year history of chronic scrotal pain, worsening over the past three weeks. The pain, rated 6/10 on the Numeric Rating Scale (NRS), was unrelieved by rest or analgesics and worsened at night and with prolonged sitting (NRS 7/10), significantly impacting daily activities. He had bilateral recurrent varicocele and underwent three varicocelectomies and ureteroscopy. Oral analgesics and neuropathic pain medications provided only temporary relief. The neurological examination revealed hyperalgesia in the distribution of the pudendal nerve. The imaging results were expected. Discussion: A notable reduction in pain was observed following an ultrasound-guided diagnostic pudendal nerve block with 2 mL of 2% lidocaine, confirming pudendal neuralgia related to varicocele or post-varicocelectomy. The pain is likely due to compression of the pudendal nerve branch by an enlarged pampiniform plexus.  Pulsed radiofrequency is utilized to provide longer-lasting pain relief. No complications were reported after the treatment.      Conclusion: Pudendal nerve blocks can alleviate scrotal pain and may be an alternative to genitofemoral and ilioinguinal nerve blocks. This is the first report of a successful pudendal nerve block for scrotal pain associated with varicocele or varicocelectomy.