Distal arthrogryposis IIB is characterized by contractures of the distal joints (especially of the fingers and toes) and ptosis. We recently encountered a father and son with these manifestations. The father was reported 54 years ago as a case of amyoplasia congenita (arthrogryposis multiplex congenita). Both father and son have ...

One of the recently introduced procedures for studying the posterior subtalar joint is subtalar arthroscopy. There is no reference in the literature to the possibility of a medial portal that might be used either for arthroscopic insertion, probing, or instrumental manipulation. The two portals mentioned in the literature are the ...

This is a report on two cases of IgA nephropathy associated with psoriasis vulgaris, having hyper IgAnemia (above 500 mg/dl) and ossification. Case 1 is a 47-year-old woman with a 7-year history of psoriasis vulgaris, and case 2 is a 57-year-old man with a 17-year history of this disease. IgA ...

Synovial chondromatosis of the joint is a rare benign condition characterized by the formation of metaplastic cartilage in the synovium of the joint resulting in numerous attached and unattached osteocartilagenous bodies. It may recur after surgical intervention. For this reason removal of the synovium and the bodies is advocated. This ...

Two cases of osteitis condensans of the medial clavicle with an unusual course toward spontaneous resolution of clinical and roentgenographic manifestations are reported. The relevant literature is reviewed. A pathogenic hypothesis for condensing osteitis of the clavicle, ilium, and pubis is suggested. At all these sites, the sclerosis occurs in ...

STUDY DESIGN: This is a case report. OBJECTIVES: To the authors' knowledge, simultaneous septic arthritis of a lumbar facet joint and another joint has not been described as yet. Therefore, a patient is presented in whom both a lumbar facet joint (L4-L5 on the right) and a sternoclavicular joint were ...

This is a case report of calcific bursitis adjacent to the first metatarsophalangeal (MP) joint in a 3-year-old boy. The patient had two attacks of pain on the medial side of the first MP joint, resembling an acute gouty attack. Roentgenograms showed calcified opacity adjacent to the medial side of ...

Reconstruction of malunited or an incongruous talocrural articulation is relatively unrecognized within the literature and few procedures have been described. This article reviews a case of a 36-year-old male who presented with chronic ankle pain, secondary to a malunion of the ankle joint. The case presentation, including surgical treatment and ...

Plain radiographs help establish the diagnosis and pattern of dislocation of the carpal scaphoid. Isolated dislocations can be treated with closed reduction, but dislocations in conjunction with axial carpal disruption must be treated with open reduction to fix the unstable radial half of the carpus to the stable ulnar half. ...

Disorders of the patella are the most common cause of anterior knee pain. The etiologies of anterior knee pain are reviewed. A case report of an acute displaced patella fracture in a bipartite union is presented. Bipartite patellar development, incidence, radiographic findings, and clinical symptoms follow. Treatment of excision of ...

In this review, three areas are highlighted: knee injuries due to athletic events, carpal tunnel syndrome, and shoulder problems, especially glenoid labral tears. In patients with chronic anterior cruciate ligament insufficiency, an increasing incidence of meniscal tears was seen. A Finnish study showed that athletes from all types of competitive ...

An asymptomatic preauricular swelling in a 58-year-old man appeared as a parotid mass and was diagnosed as calcium pyrophosphate dihydrate crystal deposition disease of the temporomandibular joint. This article describes the diagnostic criteria and management of this rare condition and reviews the 13 cases that have been reported to date.

This paper reports on a case of complex dorsal dislocations of both the right index and middle metacarpophalangeal joints. A 32-year-old man involved in a motor vehicle accident presented with both the index and middle metacarpal heads protruding through a transverse laceration in his right palm. After irrigation with normal ...

STUDY DESIGN: The authors present an unusual case of pure traumatic bilateral lumbosacral dislocation in a 5-year-old boy, the conservative treatment carried out, and the long-term result. OBJECTIVES: To describe a rare traumatic lesion in children and evaluate the result obtained with conservative treatment. SUMMARY OF BACKGROUND DATA: Watson-Jones was ...

Hypothyroidism is frequently accompanied by musculoskeletal manifestations ranging from myalgias and arthralgias to true myopathy and arthritis. A case is presented in which an arthropathic process in the hip was the isolated finding in a young man who was severely hypothyroid. Previous literature on bone and joint manifestations of hypothyroidism ...

Synovial tuberculosis is a rare, but important differential diagnosis of synovial diseases. Three cases of arthroscopic synovectomy of tubercular monarthritis affecting the knee joint are reported. The Lysholm scoring scale modified by Klein and Kloos was excellent in two cases, but poor in one. In all three cases there was ...

Many pathoanatomic studies of clubfeet have been made. Bone changes and ligament and tendon alterations are among the different deformities reported in the literature. The socket of the talocalcaneonavicular joint is termed the acetabulum pedis (AP), and alterations of the joint have been reported previously as malformations associated with clubfoot. ...

Conversion of a hip arthrodesis to a total joint arthroplasty is an uncommon procedure compared to the standard or revision total hip replacement. In this report, two illustrative cases are presented in which conversion to a total joint arthroplasty was performed, and a review of the literature for indications, complications, ...

This case report describes the experience of a 26-year-old woman who underwent multiple jaw surgeries. An initial 22 months of unsuccessful nonsurgical therapy was followed by a 7-year period during which the following were performed: 12 surgeries of her right temporomandibular joint; one surgery of her left temporomandibular joint; bilateral ...

Fungal arthritis (FA) due to a candida infection was reviewed in English literature and described in 45 cases. The increasing use of potent antibiotics, immunosuppressives, and especially the use of artificial joints, predisposed to the infection. Weightbearing joints, particularly the knees, were most frequently affected. Symptoms were described as a ...

The number of phalanges of the human toes was investigated in a series of 2,550 radiographs. Classical triphalangia of the lateral toes (2-5) was observed in 1,440 cases (56.47%). Biphalangeal disposition was observed for the 5th toe in 1,110 cases (41.02%), for the 4th toe in 64 cases (2.51%), for ...

We present the case of a patient with traumatic atlantooccipital dislocation. The initial neurological examination showed no abnormalities. Dislocation was the result of rapid deceleration in a motor vehicle accident. The mechanism of injury was hyperextension/rotation, probably combined with a distraction force. Only a few cases of atlantooccipital dislocation without ...

One case of gouty patient with aseptic loosening of cementless total hip arthroplasty was reported. Mechanical and biological factors may both play some roles in this ollsening hip. From both cup and stem, no direct evidence of loosening was found from pathologic aspect. Further study may need to define relationship ...

In most cases of cartilage avulsion, the chondral fragments are severely damaged, and refixation is therefore impossible. We present two cases with large intact cartilage fragments from the weight-bearing area of the femoral condyle after patellar dislocation. We tried refixation using fibrin sealant (Tisseel-Kit, Immuno AG, Vienna, Austria) and polydioxanone-pins ...

Three cases of congenital absence of a cervical spine pedicle are described. This anomaly comprises a radiological triad of (i) the absent pedicle producing an apparently 'giant' neural foramen; (ii) a dorsally displaced ipsilateral articular mass and lamina with a dysplastic and reversed facet joint; and (iii) deficiency or absence ...

Volar rotatory dislocation of the proximal interphalangeal (PIP) joint often cannot be reduced by closed manipulation because of interposition of soft tissues. In this case, the condyle of the proximal phalanx was trapped between the central slip and the lateral band. This case is reported to reemphasize the importance of ...

Tibiotalar dislocation without fracture is an unusual injury. Seventy-three cases have been reported in the literature. Closed posteromedial dislocation of the tibiotalar joint without fracture or diastasis is a very rare phenomenon. Eight cases have been reported. A case of this unique injury is presented, along with a literature review ...

Fifteen two- to three-week-old kids, fed artificially with goats' milk from a dairy, were found to have polyarthritis. The most affected joints were the carpals, either unilaterally or bilaterally, and in some cases the tarsal joints. Mycoplasma putrefaciens was isolated from the joints which showed an acute fibrinopurulent arthritis. No ...

Over a 10-year period, 32 trapeziometacarpal (TM) joint fusions were performed in 29 patients, and reviewed. Pin fixation with tension band wiring was used in 14 cases, screws in eight cases, a plate in six cases, K-wires in three cases and staple fixation in one case. None was bone grafted. ...

Fat embolization syndrome is a well-known complication associated with total hip arthroplasty. It is believed to be caused by high intramedullary pressures that occur during cement pressurization and femoral stem placement. Fat embolization syndrome has also been reported with intramedullary reaming and placement of an intramedullary alignment guide during total ...

Impaired vocal fold motion may result from cricoarytenoid joint fixation, bilateral vocal fold paralysis, or interarytenoid scarring. Traditional surgical techniques have focused on lateralization or resection of the arytenoid for airway improvement. This paper discusses 3 cases of bilateral reduced vocal fold motion of neurogenic cause treated with posterior cricoid ...

The authors present a review of the literature concerning the pathogenesis, diagnosis, and treatment of osteochondral defects of the lower extremity. A case of bilateral osteochondritis dissecans of the first metatarsophalangeal joint in a 43-year-old female is presented, including surgical treatment with 1- and 3-year follow-up examinations. The correlation between ...

A retrospective survey of a hospital emergency room population seen at an oral and maxillofacial surgery clinic during a 6-month period found 62 patients (2.7% of the total population) with temporomandibular joint disorders. The diagnoses were myofascial pain-dysfunction/temporomandibular joint dysfunction (MPD/TMJ) syndrome (70.9% of the cases) and dislocation (luxation) (22.5% ...

Traumatic testicular dislocation is an uncommon event, with fewer than 60 cases having been reported in literature. It is imperative that the emergency physician be aware of the possibility of testicular dislocations following perineal trauma and either seek emergent urologic consultation or attempt relocation of the testicle immediately. Testicular dislocation ...

Complete bilateral absence of the acromion, a condition not previously reported by others, was discovered in a 31-year-old housewife who had shoulder pain. Clinically, no abnormal physical sign was noted in the patient except for mild superior translation of the humeral heads. Radiographs showed bilateral absence of the lateral aspect ...

A case of irreducible dislocation of the temporomandibular joint (TMJ) which proved to be resistant to conventional methods of treatment is reported. The patient was successfully treated by a sagittal split mandibular osteotomy with bi-cortical screw fixation. The report discusses the shortcomings of the current classification of TMJ dislocation and ...

We present a rare case of carpal perilunate fracture-dislocation, with volar displacement of the distal carpal row and a proximal row location of the triquetrum. A pre-existing abnormal radio-luno-capitate alignment might have contributed to both the unusual volar direction and the difficulty encountered in its treatment, which caused us to ...

A rare case of bilateral atlantoaxial rotatory dislocation (Fielding type V) in an adult is presented. The diagnosis was rapidly made by computed axial tomography. Prior reports of this entity have not clearly defined the pathoanatomy, which in our case was confirmed by three-dimensional tomographic reconstruction. We offer a clarification ...

This paper presents the diagnosis of effusion of the knee by ultrasound. 140 patients with pain and swelling of the knee were detected to have suprapatellar effusion by ultrasound. The antero-posterior distances of the suprapatellar effusion were 0.2-3.4 cm with a mean of 1.2 cm. The effusion was revealed as ...

Traumatic facet dislocation of the lumbosacral joint is uncommon. This report of a bilateral L5-S1 facet dislocation is compared with prior reported unilateral and bilateral cases with respect to mechanism of injury, neurologic injury, surgical reduction and fixation, and clinical outcome. Attention to the disk injury is recognized as essential ...

Isolated dislocation of the trapezoid is a rare injury. The case of a 21-year-old woman who sustained an isolated dislocation of the trapezoid in a motor vehicle accident is presented. Treatment consisted of a closed reduction. One-year follow-up revealed normal range of motion with no residual pain.

A 25-year-old man presented to the emergency department with simultaneous right anterior and left posterior hip dislocations resulting from a motor vehicle accident. Simultaneous bilateral traumatic hip dislocation is an uncommon occurrence. More rare is asymmetric simultaneous bilateral hip dislocation, with only ten cases documented in the English-language literature. The ...

Two cases are described of anterior dislocation of the proximal interphalangeal joint which could not be reduced because of interposition of the central slip of the extensor mechanism. In common with previously reported cases the injuries were sustained in a spin drier. The literature on anterior dislocation of the proximal ...

Ehlers-Danlos syndrome (EDS) has been associated with irreparable arterial disruption, spontaneous and traumatic, necessitating amputation. Recurrent and chronic joint dislocation is a common component. Because of the very thin, hypermobile skin and "tissue paper scars," these patients would be expected to be poor candidates for the use of lower extremity ...

The radiologic appearances of 70 lunotriquetral coalitions in 52 patients were evaluated to determine whether a wide scapholunate joint space in subjects with this congenital abnormality reflects a scapholunate ligament disruption or is a normal variant. When the middle of the scapholunate joint space was larger than the capitolunate or ...

Two cases of physeal fracture dislocation of the distal phalanx are reviewed. Each injury occurred in a toddler, was originally undiagnosed, and appeared years later as a dorsal mass in a fore-shortened digit with decreased distal interphalangeal joint motion. In each case x-ray films revealed a dislocated epiphysis, accounting for ...

We describe a 33-year-old woman with acute calcific periarthritis (ACP) of the interphalangeal joint of the thumb and review 42 reported cases of ACP involving the finger joints. A computer assisted literature search for reported cases of ACP involving the finger joints was performed. Clinical features of our case and ...

We report three athletes with symptomatic isolated ganglion of the anterior cruciate ligament. The symptoms consisted of anteromedial knee pain, worse when changing direction while running, and on squatting. All gave a history of repeated minor knee trauma without a single episode of serious injury. At day-case arthroscopy, a unilobulated ...

The Dundee Limb Fitting Centre has provided an integrated rehabilitation programme for the amputee since 1965. A review of 1846 primary amputees is discussed. During this period a dramatic change in the above-knee/below-knee (AK/BK) ratio has been achieved with 71% BK and 26% AK occurring in 1989. Over 80% of ...

Pyarthrosis of the knee with Nocardia asteroides occurred concomitantly with thorn synovitis in an 11-year-old boy who was otherwise healthy. A review of the orthopedic and infectious disease literatures did not disclose a similar report. Contrary to common teaching, effusions from joints violated by thorns should not be presumed sterile. ...