OBJECTIVE: To compare the clinical assessment of overall inflammatory activity in patients with rheumatoid arthritis (RA) with grey scale and power Doppler (PD) ultrasonography (US). METHODS: Ninety four consecutive patients with RA were included. Demographic and clinical data, C reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were recorded ...

BACKGROUND: Chronic inflammatory tendon diseases in athletes are frequent, and they often result from modifications in normal kinematics of a tendon associated with a patient's anatomical determinants. De Quervain stenosing tenosynovitis is an inflammatory disease of tendons of the first dorsal compartment of the wrist. There is no literature about ...

PURPOSE: Damage to the infrapatellar branch of the saphenous nerve (IPBSN) has been described for knee arthrotomy and arthroscopy. The true incidence of damage to this structure during anterior cruciate ligament (ACL) reconstruction has not been reported. Furthermore, the traditional vertical incision for central patellar tendon harvesting runs perpendicular to ...

PURPOSE: While the etiology of de Quervain's disease is unknown, repetitive motion coupled with awkward wrist position and septation within the first dorsal compartment are considered causative factors. We hypothesize that these conditions might produce high gliding resistance, which could then induce micro-damage of the tendons and retinaculum. The purpose ...

The purpose of this investigation was to assess the utility of trial wrist pinning as an assessment tool prior to wrist arthrodesis in the paediatric patient. Ten paediatric patients who were unable to decide if a wrist arthrodesis would be beneficial to them underwent a trial wrist pinning (using temporary ...

The objectives of this study were to assess the ultrasonographic (US) findings in patients with knee osteoarthritis (OA) with pes anserinus tendinitis or bursitis (PATB) syndrome and to determine the correlation between the US findings and the response to local corticosteroid injection. We prospectively studied 26 patients with knee OA ...

Clinical and radiologic asymmetric arthritic differences between paralyzed and nonparalyzed limbs of stroke patients have been reported. Arthritic pathology aggravates motor dysfunction and compromises rehabilitation. Musculoskeletal ultrasonography plays an important role in showing soft tissue and the articular cartilage of the knee. Fifty-nine patients with either ischemic or hemorrhagic stroke-induced ...

OBJECTIVE: To evaluate the assumption that shoulder kinematic patterns of the ipsilateral, nonparetic shoulder in hemiplegia are similar to kinematics recorded in a healthy population. DESIGN: Case control study of a convenience sample of ten patients with hemiplegia due to stroke in the subacute phase compared with a control group ...

Unstable intra-articular distal radial fractures in women older than 55 years were treated by closed reduction and external fixation to achieve the best functional outcome. Sixteen women had radiographic and functional assessment. Despite initial good alignment secondary displacement occurred in 11 patients, probably due to the comminution of the fracture ...

In this study, a multi-segment foot motion analysis on hallux valgus patients were performed using the 9-segment foot model and then compared with the results from normal subjects. Results showed that there were no significant differences in hindfoot motions between normal subjects and HV patients. However, noted in HV patients ...

Historically, trunk movement has been thought to be reactionary to lower body motions. The excessive trunk movement in patients with myelomeningocele may be a primary mechanism during ambulation. The purpose of this study was to quantify three-dimensional trunk movement in patients with myelomeningocele. Patients walked with ankle-foot orthoses (AFOs), both ...

OBJECTIVES: To determine the reliability of a new shoulder joint range of motion (ROM) measurement for unconscious patients and to assess the prevalence of shoulder joint contractures in such patients. DESIGN: Prospective cohort survey. SETTING: An early rehabilitation center for adult persons with neurologic disorders. PARTICIPANTS: Fifty patients with impaired ...

AIMS: To investigate the presence of endogenous beta-endorphin, an opioid, in the synovial lavage fluid of the temporomandibular joint (TMJ), and to compare the concentration of 3-endorphin in patients with closed lock with that in symptom-free subjects. METHODS: Thirty-eight patients (38 joints) with closed lock diagnosed on the basis of ...

The aim of this study was to find intraarticular lesions after manipulation under general anesthesia in patients with primary frozen shoulder. In a prospective trial conducted between 2001 and 2003 in 30 patients with primary frozen shoulder, the affected shoulders were manipulated while the patients were under general anesthetia. Exclusion ...

We compared type I collagen degradation using serum cross-linking C-terminal telopeptide (ICTP) in 18 patients with rapidly destructive osteoarthrosis and in 20 patients with slowly progressive osteoarthrosis of the hip. The diagnosis was established by clinical examination and radiographic evaluation. Total hip arthroplasty was performed in all patients. Serum levels ...

The aim of the present study was the evaluation of differences in clinical results, proprioceptive performance and gait in patients with unicondylar and bicondylar sledge prostheses of the knee. In a retrospective study, 17 patients with unicondylar sledge prostheses were compared with 15 patients with bicondylar sledge prostheses. Clinical examination ...

INTRODUCTION: Even though rotational malalignment due to a femoral shaft fracture leads to clinical complaints, a large number of patients may have none of significance. The ability to compensate may play a role. The purpose of this study is to give insight into aspects of compensatory gait of patients with ...

Twenty-one patients (23 feet) treated nonsurgically for severely comminuted intraarticular fractures of the calcaneus were evaluated prospectively with a clinical scoring scale and computerized gait analysis. All patients had Sanders type III and type IV fractures. The treatment protocol consisted of no closed reduction, immobilization in removable splint, physiotherapy after ...

Nine patients with chronic extensor mechanism disruption were treated with an extended medial gastrocnemius rotational flap reconstruction of the extensor mechanism. Seven patients previously had total knee arthroplasty and two patients had chronic infection of nonreplaced, native knees. Four patients previously had failed Achilles' tendon allograft reconstruction after total knee ...

OBJECTIVE: MRI and sonography are both used to evaluate patients with painful shoulders. This study was conducted to compare patients' perceptions and satisfaction with both tests. SUBJECTS AND METHODS: One hundred eighteen patients with shoulder pain and a clinically suspected rotator cuff tear underwent both MRI and sonography and filled ...

PURPOSE: In the magnetic resonance (MR) evaluation of the glenoid labrum, all studies to our knowledge have included mixed populations of patients, those with acute shoulder injuries as well as patients with chronic shoulder disorders. The focus of this investigation was to assess the effectiveness of MR arthrography in patients ...

OBJECTIVE: To examine the prevalence and characteristics of shoulder involvement in ankylosing spondylitis (AS). To analyze the sensitivity and specificity of shoulder lesions defined by magnetic resonance imaging (MRI) in patients with AS. METHODS: Prevalence of shoulder involvement was ascertained by chart review of 400 AS patients. One hundred of ...

The validity of preoperative demand matching as an indicator of patient activity following total hip arthroplasty (THA) was evaluated by studying 518 patients (mean age, 67 years; range, 26-92 years) who were assigned to 4 categories of decreasing demand: I (high demand), 68 patients (13%); II, 144 patients (28%); III, ...

This study examined the immunohistochemical expression and localization of cyclooxygenase-1 and -2 (COX-1 and COX-2) in synovial tissues from patients with internal derangement (ID) or osteoarthritis (OA) of the temporomandibular joint (TMJ). Synovial tissues from patients with condylar fractures of the mandible were studied as control. Synovial tissues from 13 ...

BACKGROUND: Ultrasonography allows assessment of soft tissue structures and has become a valued tool for diagnosing synovitis. OBJECTIVE: To assess the learning curve for ultrasonography in evaluating synovitis of the small joints in rheumatoid arthritis. METHODS: Metacarpophalangeal (MCP), metatarsophalangeal (MTP), and proximal interphalangeal (PIP) joints were evaluated using ultrasonography (Esaote ...

Therapeutic hip arthroscopy for the treatment of chondral degeneration remains controversial. A retrospective cohort study examined 70 patients of mean age 47 (range 22-87) years who had undergone hip arthroscopy and assessed them for evidence of chondral degeneration using radiological and arthroscopic means. Clinical outcome was assessed using a modified ...

OBJECTIVE: To assess the leg-length inequality in patients with hip osteoarthrosis (OA) and to evaluate a possible association between the length disparity and side of OA. DESIGN AND PATIENTS: Weight-bearing radiographs of 100 consecutive patients undergoing arthroplasty for primary OA were examined and measured for inequality of leg length, pelvic ...

Patients with diastrophic dysplasia have walking difficulties of obscure etiology; some are even wheelchair-bound. To explore the problem, physical examination, treadmill, magnetic resonance imaging (MRI), and electroneurophysiologic studies were performed on 87 patients (56 females, 31 males) with an average age of 31 (range 3-56) years. Mobility of the spine, ...

We evaluated the percentage of patients with acetabular labral tears who have a structural hip abnormality detectable by conventional radiography. Records from our institution from 1996 through 2002 were reviewed to identify all patients with labral tears. Patients were excluded who had classic hip dysplasia, advanced osteoarthritis, or a history ...

OBJECTIVE: We investigated the clinical features of Korean patients with adult-onset ankylosing spondylitis (AAS) and examined the differences between AAS patients with and without peripheral joint disease (PJD). METHODS: We studied 67 consecutive patients with primary AAS who visited the rheumatology clinic of a tertiary referral hospital. All patients experienced ...

The aim of this study was to investigate whether arthrography itself altered the range of mandibular movements, in a group of patients with locking of the temporomandibular joint (TMJ). The clinical records of a series of 161 patients who were diagnosed with locking of the TMJ were retrospectively analysed. Mouth ...

AIM: To report the incidence of avascular osteonecrosis (AVN) in severe acute respiratory syndrome (SARS) patients. MATERIALS AND METHODS: Sixty-seven SARS patients who had large joint pain between March 2003 and May 2003 underwent both plain radiographs and magnetic resonance imaging (MRI) examination on the same day. All patients received ...

Bleeding into large joints is the most common orthopaedic manifestation of hemophilia. Involvement of the shoulder rarely is reported, lending to its relative neglect in the orthopaedic literature. Through retrospective chart and radiographic reviews, the incidence and progression of radiographic and clinical changes that occur in the shoulder of patients ...

We report 12 cases of transient osteoporosis in 10 patients. The presenting symptoms, diagnostic investigations and management are considered here as well as a discussion on the aetiology and the pathology. Arthroscopic surgery was carried out in some of the patients to exclude intraarticular pathology. Resolution of symptoms occurred in ...

The authors report their experience with eight patients (11 hips) with Down syndrome who sustained a slipped capital femoral epiphysis (SCFE). Six patients were diagnosed with hypothyroidism. All patients were greater than the 85th percentile for body mass index. Initial treatment was by in situ pinning in all hips. Six ...

A retrospective review of 40 patients undergoing simultaneous bilateral total knee replacement was undertaken to investigate the link between patient body weight and patellar subsidence. Of the 40 patients, three (five knees) had collapse or fracture of the patellar bone and four (five knees) had developed radiolucent lines around the ...

BACKGROUND: The molecular weight (MW) of hyaluronic acid (HA) in joints generally declines in inflammatory arthritis. As inflammation exists in certain temporomandibular disorders (TMD), we measured the MW of HA in synovial fluid (SF) recovered from patients with TMD and compared it with that from normal controls. METHODS: Synovial fluid ...

BACKGROUND: There is little information on long-term release of antibiotics from impregnated bone cement. PATIENTS AND METHODS: We assayed joint fluids obtained for diagnostic purposes from 25 patients for the presence of gentamicin. All patients had presented with failing or painful joints up to 20 years following primary hip or ...

PURPOSE: The study goal was to investigate the occurrence of serum antibodies to Chlamydia trachomatis, Chlamydia pneumoniae, and Chlamydia psittaci in patients with temporomandibular joint (TMJ) monoarthritis or chronic closed lock and in control subjects. PATIENTS AND METHODS: An indirect microimmunofluorescence test for detecting antibodies against C trachomatis was used. ...

We reviewed 27 patients with a minimally displaced proximal humeral fracture treated conservatively after a mean follow-up of 25 (12-34) months. All fractures had united. Patients were evaluated using the Constant-Murley scoring system, and isokinetic muscle strength was tested using a Cybex dynamometer. Finally, all shoulders were examined ultrasonographically. The ...

OBJECTIVE: To determine the inciting events leading to the development of sacroiliac joint syndrome (SIJS). METHODS: This was a retrospective descriptive cohort series from an academic interdisciplinary spine center. Consecutive patients presenting with low back or buttock pain with or without leg symptoms who met specific inclusion and exclusion criteria ...

OBJECTIVE: To examine differences by race/ethnicity and gender in patients' concerns regarding total knee replacement (TKR). METHODS: Focus groups of patients actively considering TKR were conducted. Discussion included patients' questions and concerns regarding TKR. The software ATLAS.ti was used to tabulate themes by race/ethnicity and gender. Concerns raised by focus ...

Dysfunction of the patellofemoral mechanism presents in many ways. Results from different realignment procedures show great variability in patient outcome. A surgical technique is presented that attempts to correct all the abnormalities of patellofemoral maltracking. The procedure consists of a lateral release, a vastus medialis (obliquus) tendon advancement, and a ...

Nineteen patients had a severe neurologic deficit and persistent dysesthetic pain after total hip replacement. During surgery their limbs had been lengthened by 1.3 to 4.1 cm. Patients with other reasons for nerve injury such as hematoma, dislocation, or direct operative trauma were excluded. Also excluded were patients whose lengthening ...

BACKGROUND: Recalcitrant calcific insertional Achilles tendinopathy is difficult to treat. HYPOTHESIS: Bursectomy, excision of the distal paratenon, disinsertion of the tendon, removal of the calcific deposit, and reinsertion of the Achilles tendon with bone anchors is safe and effective. STUDY DESIGN: Longitudinal study. METHODS: Twenty-one patients (six women) (21 feet) ...

In daily clinical practice, many patients attribute joint pain to weather conditions. There is little information published on this subject and most of it is contradictory. The objective of this study was to evaluate the effect of climatic conditions in rheumatic patients. The present work was carried out with patients ...

Survivorship analysis has become the standard statistical technique for evaluating the results of total joint arthroplasty. There are several problems associated with survivorship analysis as it is presented in the orthopaedic literature that apply to younger and older patients. Studies conducted within the same institution using the same prosthesis have ...

Polyethylene wear in vivo is multifactorial including numerous patient factors, such as gender, age, and activity. There are limitations in the clinical assessment of some of these factors and, for this reason, surrogate variables are used. For example, patient age and diagnosis frequently are used as surrogates for patient activity. ...

OBJECTIVES: To test a new neurological sign, the "abductor sign," which can distinguish between organic and non-organic leg paresis using synergic movements of the bilateral hip abductors. METHODS: The subjects were 33 patients presenting with paresis of one leg, 17 of organic origin and 16 of non-organic origin (hysteria). To ...

OBJECTIVE: The purpose of this study was to classify sonographically the joint damage of target joints in patients with rheumatoid arthritis (RA). METHODS: During a 3-year cross-sectional study, standardized arthrosonography of symptomatic target joints was performed in patients with RA. According to those findings, a classification with progressive deterioration of ...