• Journal of Yeungnam Medical Science
• /
• 제15권2호
• /
• pp.263-274
• /
• 1998

이 연구에서 저자들은 다음과 같은 결론을 얻었다. 1. 고관절 조영술은 수술전에 미리 유용한 정보를 줌으로써 수술전 계획을 세우고 수술을 체계적으로할 수 있을것으로 사료된다. 따라서 고관절 조영술은 도수정복 혹은 수술적 정복전에 필수적으로 시행하여야 할 것으로 사료된다. 2. 고관절 조영술은 비구 관절순, 원형인대의 평가에 매우 유용하였으며, 횡비구인대에 대한 정보는 제한적이었다. 3. 고관절 조영술은 단순 방사선 촬영에 비하여 중앙연각의 평가에 훨씬 유용하고 실제 병리적 소견에 합당한 정보를 주었다.

• 치과방사선
• /
• 제23권1호
• /
• pp.7-14
• /
• 1993

The Internal derangement of temporomandibular joint disc was evaluated by using magnetic resonance imaging and arthrogram in 5 patients having reciprocal clicking or locking and in 5 normal subjects. Parasagittal multisections on both closed and open mouth were serially obtained by using a 1.5 Tesla MR system and surface coil with CSMEMP, MPGR. MR images obtained were analized by correlating with images of arthrograms. The obtained results were as follows: 1. Displaced meniscus was clearly delineated as dark structure on MR images other than on arthrograms of closed mouth view of patient having clicking or locking. 2. The deltoid white images of synovial fluid were identified in the glenoid fossa and on the posterior surface of condyle on open mouth view and partly depicted on closed mouth view, of parasagittal sections by MPGR. 3. The greyish image of joint fluid was identified on the posterior surface of condyle on the open mouth view of parasagittal sections by CSMEMP. 4. The structural relationship among condyle, meniscus, and fluid showed the variety of images on each parasagitta1 view.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2005년도 제13차 춘계학술대회
• /
• pp.14-15
• /
• 2005

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 1997년도 학술대회
• /
• pp.164-166
• /
• 1997

MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex(LOLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalis in image interpretation related to evaluation of the LOLC. MR Arthrogram of 56 shoulders in 41 asymptomatic young, active volunteers were prospectively reviewed to evaluate the labral shapes. capsular insertions and images which may mimic the lesions of glenohumoral instability. The anterior and posterior parts of the labra. respectively. varied in shape: triangular$(72\%,\; 36\%)$. round $(13\%,\; 35\%)$. cleaved$(8\%,\; 1\%)$. notched$(2\%,\; 0\%)$. flat$(5\%,\; 24\%)$ and absent$(0\%,\; 4\%)$. The anterior and posterior capsular insertions. respectively. varied in sites: Mosely and Oevergaard type I$(82\%,\;62\%)$, type II$(13\%,\; 3\%)$ and type III $(5\%,\; 2\%)$. A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum$(29\%)$ and middle glenohumoral ligament in proximity to anterior labrum $(5\%)$ simulated a labral tear. Joint fluid interposed in the central. superior portion of the sublabral sulci$(25\%)$ simulated a SLAP lesion. Synovial fold$(38\%)$ in axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral capsular - ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.

• Clinics in Shoulder and Elbow
• /
• 제2권2호
• /
• pp.199-203
• /
• 1999

It is well known that the essential pathology in traumatic anterior dislocation of the shoulder is the avulsion of the glenohumeral ligament complex from the glenoid rim, However, there were some reports that the avulsion can occur from the humeral attachment site. We have experienced a 42-year-old man who had complained of persistent shoul­der pain after traffic accident and showed the instability on physical examination. The MR arthrogram and arthro­scopic surgery revealed the avulsion of glenohumeral ligament from the humeral attachment site. We repaired the lesion using the suture anchor through the anterior axillary approach and had a good result after 1 year.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권2호
• /
• pp.191-196
• /
• 2000

Purpose This study is to report presurgical magnetic resonance imaging(MRI) findings of the temporomandibular joint which had perforation in the disc or its surrounding tissues and to improve its diagnostic rate using MRI. Patients and Methods The sample consisted of patients who visited the TMJ clinic at Yongdong Severance Hospital, Yonsei University, during the years, 1992 and 1997. They were diagnosed as TMJ internal derangement and received surgical treatment. We divided them into two groups. The first group comprised of 85 joints with perforated disc or its surrounding tissues and which were confirmed surgically. The second group of 62 joints which only had disc displacement without perforation, hyperemia or adhesion served as control. Results The preoperative diagnostic sensitivity of TMJ perforation using MRI was 74.1%. The MRI findings for diagnosis of the TMJ perforation were degenerative change of the condyle head or the articular fossa, bone to bone contact between the condyle head and the articular eminence or the articular fossa, bony spurring or osteophytosis of the condyle head, flattening of articular surface of the condyle head or the articular eminence, discontinuity of the disc and the arthrographic effect due to joint effusion. Conclusion The preoperative diagnostic sensitivity of TMJ perforation using MRI in this study was 74.1% which was lower than the diagnostic rate using the arthrogram. Further investigations are needed to improve the diagnostic accuracy of TMJ perforation using MRI.

• Clinics in Shoulder and Elbow
• /
• 제9권1호
• /
• pp.42-49
• /
• 2006

Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.

• Clinics in Shoulder and Elbow
• /
• 제25권2호
• /
• pp.93-100
• /
• 2022

Background: Subscapularis tendon insertion at the first facet has separate layers (deep and superficial). The purpose of this study is to evaluate postoperative clinical outcomes and radiological healing according to each layer of detachment in the first facet involving subscapularis tendon tear. Methods: Eighty-three patients who underwent arthroscopic repair due to First facet involving the scapularis tendon tear accompanying small to medium sized posterosuperior cuff tear were classified into three groups (group A: deep layer partial detachment, group B: deep layer complete detachment, but no superficial layer detachment, and group C: deep layer and superficial layer complete detachment). Subscapularis tendon healing was evaluated using computed tomography arthrogram and clinical result was evaluated using American Shoulder and Elbow Surgeons (ASES) shoulder score, Constant score and University of California Los Angeles (UCLA) shoulder score. Results: Retear rate of the subscapularis tendon was 2.2%, 18.2%, and 33.3% in group A, group B, and group C, respectively. These rates showed statistically significant difference among the three groups, which were classified by deep and superficial layer detachment in the first facet (p=0.003). Group A showed significant difference in subscapularis tendon healing compared with group B and group C (p=0.018 and p<0.001, respectively), but there was no statistical difference between group B and group C (p=0.292). Regarding clinical outcomes, there was no significant difference among three groups in ASES and UCLA score at final follow-up (p=0.070 and p=0.106, respectively). Conclusions: Complete detachment of deep layer may be related with retear occurrence regardless with detachment of superficial layer, but clinical outcome may not be related with each layer detachment in the first facet involving subscapularis tendon tear.

• 대한정형외과스포츠의학회지
• /
• 제5권1호
• /
• pp.50-57
• /
• 2006

목적: 견관절 회전근 개 전층 파열시 관절경적 복원술 후 대결절에 부착되어진 회전근 개의 건이 상완골에 어느 정도의 비율로 건-골(tendon to bone)에 치유되는지에 대하여 알아보고자 하였다. 또한 저자들은 극상건 전층 파열된 례에서 관절경적 복원술 후의 기능적 평가를 시행하였다. 대상 및 방법: 연속적 인 30례의 극상건 전층 파열을 19례에서 one row of anchor를, 11례에서는 two rows of anchor를 사용해 관절경적 복원술을 시행하였다. 환자들의 연령은 51세부터 79세로 평균 63세였으며, 평균 추시 기간은 술후 12개월부터 28개월로 평균 16개월이었다. 술전과 마지막 추시에 주관적 및 객관적인 기능적인 평가를 위해 Constant, ASES와 HCLA score를 측정하였다. 해부학적인 건 치유를 확인하기 위해 30례 전례에서 술후 6개월에서 20개월, 평균 10개월째 자기 공명 관절 조영술(25례)이나 자기 공명 술(5례)을 시행하였다. 결과: 관절경적 복원술후 회전근 개의 대결절에 대한 완전 치유는 30례중 21례(70.0%)였고, 부분적인 파열은 3례(10%)였으며, 극상건이 전혀 치유되지 않아 대결절에 부착되지 못한 경우는 6례 (20%)였으나, 그 중 5례에서는 술후 남아있는 결손의 크기가 처음 술전 보다는 작았다. 객관적인 평가로 Constant score는 술전에 평균 $55.7{\pm}7.1$점에서 술후 마지막 추시 관찰시에 $77.7{\pm}9.7$점으로 향상되었고(p<0.001), ASES xcore는 술전 $39.2{\pm}7.4$점에서 $72.4{\pm}12.6$점으로 향상되었고(p<0.001), UCLA score는 술전 $17.9{\pm}2.2$점에서 $26.5{\pm}5.0$점으로 향상되었다(p<0.001). 견관절의 전방 거상시 근력 이 대결절에 치유된 례 $(7.1kgs{\pm}2.4)$에서 전혀 치유되지 않아 완전히 재 파열되었거나, 부분 파열을 보인 례 $(4.5kgs{\pm}1.0)$에서 보다 통계학적으로 의미 있는 향상을 보였다(p<0.05). 건 치유에 결정적인 영향을 미치는 인자는 환자의 나이였다. 65세 이상의 환자에서는 단지 41.7%만이 대결절에 극상건의 완전한 치유율을 보였다(p<0.05). 결론: 회전근 개 중 극상건 전층 파열된 례에서 관절경적 복원술 후 약 70%에서 완전한 치 유를 보였다. 술후 극상건의 부분 파열 및 재파열은 근력 저하와 직접적인 연관을 가졌다. 특히, 노령 환자에서의 회전근 개 상태가 술후 재파열과 밀접한 관련이 있다.

• Journal of Yeungnam Medical Science
• /
• 제13권2호
• /
• pp.211-224
• /
• 1996

1989년 1월부터 1995년 5월까지 영남대학교 의과대학 부속병원 정형외과에서 발달성 고관절 탈구로 진단된 9개월-3세 환자중 치료후 1년이상 추시가 가능했던 환자 16명(17례)을 대상으로 치료결과를 분석하여 다음과 같은 결과를 얻었다. 1. 진단시의 연령은 16.4개월 (9-31개월)이었으며, 8례에서 보존적 치료, 4례에서 수술적 치료를 시행하였으며, 5례에서 보존적 치료에 실패하여 2차로 수술을 시행하였다. 2. Severin의 radiologic grade에 의한 결과는 보존적 치료에서 우수 4례, 양호 3례, 불량 1례, 수술적 치료에서는 양호 2례, 불량 2례이었으며 보존적 치료에 실패하여 2차로 수술적 치료를 받은 경우는 우수 2례， 양호 2례, 불량 1례이었다. 3 합병증으로 무혈성 괴사 3례가 관찰되었다. 4. 고관절 조영술상 도수정복의 정도가 우수(good)인 경우는 보존적 치료를 시행하여 좋은 결과를 얻을 수 있었으며, 불량(poor)인 경우는 도수정복보다는 수술적 치료를 시행하는 것이 좋은 결과를 얻을 수 있다고 사료된다. 이상의 결과 보행기 연령군의 치료방법의 선택에는 정복시 안정성의 유무, 탈구의 정도, 고관절 조영술상 도수정복의 정도가 중요한 것으로 사료되며, 도수정복은 안정대가 넓고, 정복시 안정성이 있는 경우, 탈구의 정도가 심하지 않고 고관절 조영술상 도수정복의 정도가 우수인 경우에 시행한다면 만족스러운 치료결과를 얻을 수 있으며, 안정대가 좁고, 도수정복시 불안정성이 있는 경우, 탈구의 정도가 심하고 고관절 조영술상 도수정복의 정도가 불량인 경우는 수술적 치료를 시행하는 것이 좋은 결과를 얻을 수 있다고 사료된다.