• Title/Summary/Keyword: Crepitus

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UNUSUAL OSSIFICATION IN TMJ OSTEOARTHRITIS (측두하악관절염에서 발생한 희귀한 골화현상)

  • Ahn, Sang-Hun;Kim, Jong-Pil;Chang, Heon-Soo;Park, Jae-Bum;Ann, Jye-Jynn;Shin, Mi-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.2
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    • pp.308-315
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    • 1996
  • Osteoarthritis is a noninflammatory degenerative disease affecting the articular surfaces and is accompanied by remodeling of the underlying bone. The sympotms of osteoarthritis of the temporomandibular joint are pain in the joint and muscles of mastication, limitation. Osteoarthritis is generally accepted that several factors can contribute to the trauma, aging process, internal derangement and MPDS. Radiographic features of the osteoarthritis are seen flattening of joint, sclerosis on flattened area and osteophyte or anterior lipping. In the past, osteoarthritis was considered to self-limiting disease. Currently, synovial chondromembrane is part of the process of osteoarthritis secondary to trauma. Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. The pathogenesis is more an active metaplastic than a neoplastic process. The cause of synovial chondromatosis is unknown. Although trauma and inflammation have all been cited as possible factors in tis pathogenesis. The clinical sign and symptoms are unilateral swelling of the joint region, pain in the joint area and crepitus seem to be the most reliable signs and symptoms. Radiographic evidence of loose bodies may or may not be present. This is a case report of 66 year old female with synovial chondromatosis, that is advanced disease of the osteoarthrits. We treated patient with surgical excision of lose bodies, diskectomy and synovectomy. The defected articular fossa area was reconstructed with temporalis fascia flap. The result was satisfactory.

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The Relationship between Clinical Sign and Radiographic Findings in Temporomandibular Disorders (측두하악장애의 임상적 증상과 방사선적 소견과의 관계)

  • Byung-Il Park;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.14 no.1
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    • pp.57-66
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    • 1989
  • 66 patients with temporomandibular disorders were selected for experimental group, and 45 normal subjects who were Dental students were selected for control group. Average age of experimental group was 30.5 years, Male to Female ratio was 2 : 3, and their age distribution were teen-ages to seventh decades. Transcranial radiography (TR) with Denar Accurad 100 was used for each group to get the values of width in joint spaces and to investigate the bony changes of articular surfaces and relative condylar position to articular fossa. In addition to TR, clinical interview and routine charting about amount of mandibular movements and occlusal variations were carried out in experimental group. The obtained results were as follows : 1. The mean values of joint space with in control group were 2.15mm to anterior, 2.98mm to superior and 2.29mm to posterior and the value of relative condylar position to the deepest portion of articular fossa was 0.21mm to anterior. In experimental group, those values were 2.01mm, 2.14mm 2.22mm and 0.12mm to posterior in sequence, respectively. Joint spaces in experimental group, therefore, were inclined to decreased, and relative condylar position was inclined to retrude. Joint space in control group showed symmetric condylar position, but in experimental group showed asymmetry. 2. Non-affected joints with no bony changes in experimental group showed the narrowest joint spaces which were thought to manifest the abnormal stress to non-affected side to dysfunctional state of contralateral affected joints. 3. Amount of mandibular movements in experimental group were within normal values in lateral movements and in protrusive movement but in opening movement with or without passive stretch, those were lower than normal values. Frequency of occlusal variation, for example, protrusive posterior contacts, open bite, median line shift to lateral side were inclined to increase with bony changes and with crepitus.

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Total Hip Replacement in a Jindo Dog with Dorsal Acetabular Rim Deficiency: a Case Report (등쪽 관골절구 결손을 가진 진도견의 인공 대퇴 관절 전치환술)

  • Heo, Su-Young;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.121-124
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    • 2014
  • A 7-year-old, intact female Jindo dog was presented for assessment of weight-bearing lameness of the right hindlimb. On physical examination, crepitus and pain was noted in the right coxofemoral joint upon extension. Radiographs revealed a craniodorsal luxation of the right coxofemoral joint and degenerative joint disease (DJD) of both coxofemoral joints. Total hip replacement (THR) was performed for the right coxofemoral joint. Intraoperatively, dorsal acetabular rim (DAR) deficiency was noted, which can be related to a high risk for acetabular cup implant dislocation. Deficiency of the dorsal acetabular rim realigned with the acetabular cup using universal locking plate (ULP) and polymethylmethacrylate (PMMA) bone cement. After surgery, the patient had an uneventful course and a successful outcome. The ROM and thigh girth were dramatically improved. There were no complications associated with prosthesis implants. Hip luxation with dorsal acetabular rim deficiency in a dog was successfully repaired with THR and dorsal acetabular rim augmentation using ULP and PMMA bone cement. This technique should be considered when conventional THR is precluded by dorsal acetabular rim deficiency.

Treatment of Recurrent Coxofemoral Joint Luxation by Total Hip Replacement in a Dog (대퇴관절 전치환술을 이용하여 개의 재발되는 대퇴관절 탈구증의 치료)

  • Kim, Jooho;Heo, Su-Young;Kim, Minsu;Lee, Kichang;Kim, Namsoo;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.125-128
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    • 2014
  • A 7-year-old, intact female Golden Retriever weighing 38 kg was referred for left coxofemoral joint luxation. On physical examination, pain and crepitus were noted atthe left hip joint during joint extension. Radiological examination revealed coxofemoral joint luxation and mild degenerative bone changes in the left hip joint. We performed minimally invasive arthroscopy-assisted reduction with TightRope$^{(R)}$ as a treatment option; however, the left coxofemoral joint was reluxated after one month postoperatively. We performed cementless total hip replacement (THR) of the luxated left coxofemoral joint. At tenmonths after surgery, the dog could sit, stand, walk normally and jump comfortably without lameness. The thigh girth measurement of the operated limb was 108.6% of the contralateral limb. Based on the present case, THR can be a successful treatment for coxofemoral joint luxation in dogs with failed coxofemoral joint reduction.

Relationship between Temporomandibular Disorders and Occlusal States Dental Students (측두하악장애와 교합상태와의 관계에 대한 연구)

  • Ji-Hee Kim;Ji-Won Lee;Sung-Chang Chung
    • Journal of Oral Medicine and Pain
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    • v.16 no.1
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    • pp.85-93
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    • 1991
  • In this study, 88 dental students were examined to evaluate the relationship between occlusal states and TM disorders for the epidemiologic study of TM disorders. The clinical evaluation were composed of mandibular movement, TMJ noise, occlusal states and muscle palpation. The following results were disclosed. 1. The frequencies of pain on mandibular movement were 3.4% on maximum opening, 1.13% on protrusion and no pain on laterotrusion. 2. The frequencies on TMJ sound were 21.6% in click, 1.13% in crepitus. 3. The frequency of tenderness on palpation was 12.5% on extra oral, intraoral and neck muscles, tenderness on palpation of TMJ capsule were reported 5 cases, and 4 of them were female. 4. The distribution of Angle's classification was found 79.5% in class I, 4.5% in clasII-div.1 and 15.9% in class III. There was no significant differences on TM disorders between Angles classifications. 5. There was no significant differences on TM disorders between the subjects of canine guided occlusion and group function occlusion, and also for the differences between the subjects of nonworking side interferences and no interferences on laterotrusion. 6. There was no significant differences on TM disorders between the subjects of anterior teeth trauma in C.C. and no anterior teeth trauma, but there were significant differences between the subjects of posterior protrusive contact and no posterior protrusive contact.

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A 3D-printing Bone Model for Surgical Planning of Total Hip Replacement after Failed Triple Pelvic Osteotomy

  • Han, Kyungjin;Park, Jiyoung;Yoon, Jangwon;Lee, Young-Won;Choi, Ho-Jung;Jeong, SeongMok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.463-466
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    • 2017
  • A 3-year-old, 26 kg, castrated male Chow Chow was presented for assessment of weight-bearing lameness of the left hind limb. The patient had a history of triple pelvic osteotomy on the left side to correct hip dysplasia 2 years prior to his presentation of clinical signs and underwent total hip replacement on the right coxofemoral joint 1 year later. Upon physical examination, pain and crepitus were noted on the left hip joint during extension. Radiological examination revealed coxofemoral joint subluxation and moderate degenerative bone changes on the left hip joint and pelvic axis, which relates to acetabular angles that were changed after triple pelvic osteotomy (TPO). Preoperative computed tomography was used for 3-dimensional printing to establish an accurate surgical plan. The changed angles of the acetabulum after TPO were evaluated, and rehearsal surgery was performed using a 3-demensional printing bone model. Three months after the THR surgery, the function of the affected limb had improved, with no lameness. Complications, such as luxation and implant failure, were not observed until 6 months after the operation. Accurate evaluation of acetabulum angles and rehearsal surgery using a 3D-printed bone model is effective for total hip replacement after unsuccessful TPO.

Micro Total Hip Replacement in Two Dogs with Legg-Calvé-Perthes Disease

  • Roh, Yoon-seok;Heo, Su-Young;Yoon, Jang-won;Park, Jiyoung;Jeong, Seong-Mok;Lee, Hae-beom
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.454-458
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    • 2017
  • A Maltese (case 1) and a Pomeranian (case 2) presented with acute right and left hind limb weight-bearing lameness. On physical examination, they exhibited severe pain and crepitus on the coxofemoral joint of affected hind limb. In addition, decreased thigh girth measurements were noted compared with the opposite leg. Radiological exam revealed necrotic areas in the femoral head of affected hind limb. These dogs were diagnosed with Legg-$Calv{\acute{e}}$-Perthes disease (LCPD). The dogs underwent micro total hip replacement (THR). After surgery, at 3 years (case 1) and 7 months (case 2), both dogs recovered normal activity. The thigh girth and lameness scores were apparently improved in the affected limbs of both dogs. No complications of prosthesis implants, such as loosening, were noted. The clinical outcomes of these cases indicate that dogs with LCPD can be successfully treated with micro THR and have a good prognosis immediately after surgery.

A Study on Osteoarthritis of the Knee (슬관절(膝關節)의 퇴행성 관절염에 대한 고찰)

  • Jang Jun-Huk;Kim Kyeng-Ho
    • Journal of Acupuncture Research
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    • v.15 no.2
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    • pp.493-509
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    • 1998
  • Osteoarthritis(degenerative joint disease), the most common arthropathy affecting the aged people, is characterized by degeneration of articular cartilage with proliferation and remodeling of subchondral bone. Osteoarthritis of the knee, which probably has greater social cost and more associated disability than osteoarthritis of any other joint, prevalence is known to increase with age, and females have higher rates than males; radiographic abnormalities are present in more than 30% of persons more than 65 years old, with approximately 40% of these persons symptomatic. Though the etiology of osteoarthritis is not entirely understood, much information is available regarding risk factors for the development of knee osteoarthritis that permit some reasonable guideline for preventive strategies. Traumatic damage or occupational or recreational overuse of knee joint may result in osteoarthritis, and obesity also is related to osteoarthritis of the knee. A variety of other possible risk factors for the development of knee osteoarthritis have been proposed, including increased bone mass, smoking, diseases such as diabetes or elevated serum uric acid, and some metabolic factors, but the contribustions of these and other factors such as smoking or race and diseases such as diabetes are as yet undetermined. The usual clinical manifestations include pain, stiffnesss, crepitus and loss of function. In oriental medicine, osteoarthritis of the knee is very similar to diseases such as Bijung(痺症), Haksulpung(鶴膝風), Youkjeolpung(歷節風) in symptoms. The diseases such as Bijung(痺症), Haksuipung(鶴膝風), Youkjeolpung(歷節風) is related to the of function liver(肝) and kidney(腎) and risk factors are regarded as Pung(風), Han(寒), sub(濕). The diagnosis of osteoarthritis of the knee has often been based on radiographic appearance and clinical manifestations. The acupuncture therapy of osteoarthritis of the knee has often been based on Stomach meridian(ST), Spleen meridian(SP), Kidney meridian(KI), Liver meridian(LR).

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Medical Imaging of Tracheal laceration in a Young Alaskan Malamute Dog (어린 알래스카 말라뮤트견에서 기관열상의 영상의학증례)

  • Choi, Ho-Jung;Lee, Young-Won;Ha, Ji-Young;Kim, Jae-Hwan;Park, Ki-Tae;Yeon, Seong-Chan;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.190-193
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    • 2012
  • A 2-month-old, intact female Alaskan Malamute was presented for evaluation of dyspnea and subcutaneous emphysema of the neck following biting wound. Two small punctured skin lesions and crepitus on the neck were found during physical examination. Radiographs revealed pneumomediastinum and subcutaneous emphysema. Confirmative diagnosis of tracheal laceration was made by identifying the tracheal wall discontinuity on the computed tomography. CT is a valuable tool to diagnose an external traumatic tracheal injury, and more specifically, to assess the location and the extent of laceration, and it leads to early definitive treatment and reduction of the incidence of complications.

Reduction of Bowed Tibia Fracture by Fixation with Kirschner and Cerclage Wires in a Dog: A Case Report (Kirschner 철사와 원형 철사를 이용하여 개의 휘어진 경골 골절을 정복한 증례)

  • Uhm, Mi-Young;Kim, Young-Ki;Wang, Ji-Hwan;Lee, Hee-Chun;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.408-410
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    • 2008
  • A four months old, 3.6 kg intact female Miniature Dachshund dog was referred for non-weight bearing lameness at right hind limb due to car accident. On physical examination, the patient was non-weight bearing on the right hind leg and had moderate swelling in the proximal to middle tibia region. There was palpable crepitus. Radiographs revealed a slightly displaced, spiral, oblique fracture involving the proximal diaphyseal region of the right tibia. Fibular fracture was also noted. Internal fixation was performed to repair the fracture. Due to bowed shape of fractured tibia, it was not possible to apply K-wire, containing appropriate diameter ($60{\sim}80%$ of bone marrow diameter) for intramedullary fixation. We fixed the bowed tibia fracture using a smaller diameter (30% of bone marrow diameter) K-wire with cross pins and cerclage wires. Four weeks after the operation, radiographs demonstrated healing of the tibia fracture as well as the fibular fracture.