• Clinics in Shoulder and Elbow
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• 제9권1호
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• pp.68-72
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• 2006

Purpose: To demonstrate arthroscopically the presence of bilateral shoulder "mirror lesions" due to overhead work. Materials and Methods: A cross-sectional study was performed in a historical cohort of 10 male tire plant workers who underwent MRI studies of both shoulders. Bilateral intraarticular shoulder pathology was diagnosed by magnetic resonance imaging and confirmed by arthroscopy. "Mirror lesions" were defined as similar pathology between an individual patient's two shoulders. Results: We report on ten patients who had bilateral "mirror lesions." The most common mirror lesions were tears of the rotator cuff. Most patients (7 of 10) had more than one mirror lesion in their shoulders. There were two bilateral full thickness tears involving the supraspinatus and infraspinatus, four bilateral partial thickness supraspinatus tears, six bilateral partial or upper corner lesion complete subscapularis tears, and one bilateral complete supraspinatus tear. Conclusion: Occupational overhead work with simultaneous use of both arms is associated with bilateral shoulder lesions verified by arthroscopy. By demonstrating the work-related bilateral shoulder involvement, this study suggests an etiopathogenesis for these lesions and provides rational for developing worksite prevention strategies.

• Clinics in Shoulder and Elbow
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• 제3권1호
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• pp.33-38
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• 2000

Objectives: The purpose of this study was to grading the severity of intra-articular lesions and evaluate the effects of arthroscopic surgery after manipulation of the resistant frozen shoulder. Materials and Methods : Forty-eight cases from 44 subjects, median age of 53, who underwent arthroscopic surgery after manipulation with minimum follow-up of 12 months were chosen. The UCLA shoulder rating scale was applied, and average scale was 18.2 points. Results: Twelve cases out of our series showed as rotator cuff tear which could produce secondary frozen shoulder. In postoperative follow up, 34 subjects complained of no pain or noctalgia, 5 showed mild degree of pain, 8 with mild degree of remained limited range of motion, and only 1 with no improvement. When viewed with UCLA shoulder rating scale, the most improved aspect was pain, and satisfaction of patient was following. And final average scale was 31.9 points. Conclusion: Our study revealed that arthroscopic surgery after manipulation showed favorably high final scale and patient's satisfaction. Therefore, we recommend this modality for treatment of resistant frozen shoulder in a point of view that the diagnosis and treatment can be done simultaneously.

• Tuberculosis and Respiratory Diseases
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• 제72권5호
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• pp.448-451
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• 2012

Invasive pulmonary aspergillosis (IPA) has emerged as a severe infection in patients with immunocompromised hosts. However, recently, several IPA cases, without an apparent predisposition to immunodeficiency, has been reported. A 72-year-old woman was admitted for evaluation of general weakness and poor oral intake. She reported no medical history, except for intraarticular injection of a corticosteroid for joint pain for the duration of two months. A chest radiography revealed multiple cavitary nodules in both lungs. Examination of specimens, obtained by percutaneous needle biopsy, led to a diagnosis of invasive aspergillosis. Brain magnetic resonance imagining revealed numerous peripheral thin enhancing cystic nodules in both cerebral hemispheres. We initiated intravenous administration of amphotercin B. However, the patient died after nine days. Here, we report an invasive aspergillosis case, which involves the lungs and brain after a short period of steroid injection.

• Nuclear Medicine and Molecular Imaging
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• 제40권2호
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• pp.127-131
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• 2006

Radiosynovectomy has been used as an effective treatment in patients with resistant synovitis after failure of long-term medication and intraarticular steroid injection. Although $^{90}Y$ silicate/citrate, $^{186}Re$ sulfide, and $^{169}Er$ citrate were approved in Europe for the appropriate radiopharmaceuticals for radiosynovectomy other radionuclides such as $^{32}P$-chromic phosphate, $^{165}Dy$-ferric hydroxide macroaggregate, $^{188}Rh$-microspheres, $^{153}Sm-particulate, and $^{166}Ho$-ferric hydroxide macroaggregate have been used in many countries. Reported success rates range from 40% to 90% for the different joints and underlying disease. In Korea, $^{188}Re$-tin-colloid and $^{166}Ho$-chitosan complex are now using as the major radionuclides in radiosynovectomy with good clinical results. A study on radiation synovectomy using $^{188}Re$-tin-colloid for patients with Korean rheumatoid arthritis shows the treatment resulted in the improvement of arthritis and well tolerated in our study, the radiosynovectomy with $^{166}Ho$-chitosan complex in 53 hemophilic patients markedly decreased intra-articular bleeding frequency and need for coagulation factor. This review inculdes general priciples in the application of radiosynovectomy and the clinical experience in Korea.

• Journal of Yeungnam Medical Science
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• 제38권1호
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• pp.19-26
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• 2021

Adhesive capsulitis of the shoulder joint is a common disease characterized by pain at the insertional area of the deltoid muscle and decreased range of motion. The pathophysiological process involves fibrous inflammation of the capsule and intraarticular adhesion of synovial folds leading to capsular thickening and contracture. Regarding the multidirectional limitation of motion, a limitation in external rotation is especially prominent, which is related to not only global fibrosis but also to a localized tightness of the anterior capsule. Ultrasound and magnetic resonance imaging studies can be applied to rule out other structural lesions in the diagnosis of adhesive capsulitis. Hydraulic distension of the shoulder joint capsule provides pain relief and an immediate improvement in range of motion by directly expanding the capsule along with the infusion of steroids. However, the optimal technique for hydraulic distension is still a matter of controversy, with regards to the infusion volume and rupture of the capsule. By monitoring the real-time pressure-volume profile during hydraulic distension, the largest possible fluid volume can be infused without rupturing the capsule. The improvement in clinical outcomes is shown to be greater in capsule-preserved hydraulic distension than in capsule-ruptured distension. Moreover, repeated distension is possible, which provides additional clinical improvement. Capsule-preserved hydraulic distension with maximal volume is suggested to be an efficacious treatment option for persistent adhesive capsulitis.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.191-204
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• 2023

Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

• 대한영상의학회지
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• 제81권1호
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• pp.2-20
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• 2020

MRI 영상은 관절 내 질환의 평가에 중요한 검사기법이며, 관절 MRI 영상의 해석을 위해선 견고한 해부학적 지식이 바탕이 되어야 한다. 관절의 해부학 분야에서는, 새로운 구조물이 발견되기도 하며, 과거에 보고되었으나 기능을 알지 못하던 구조물이 새롭게 주목을 받기도 한다. 본 종설에서는 최근 십여 년간 활발하게 연구되어온 견관절 회전근개 케이블(rotator cable) 및 상관절막(superior capsule), 슬관절의 후외측(posterolateral corner) 및 전외측 인대 복합(anterolateral ligament complex), 발목관절의 원위부 경비골 인대결합(distal tibiofibular syndesmosis) 등의 최근 연구 결과를 소개하고, 이를 MRI 영상을 통해 확인해 보았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.292-295
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• 2008

활액낭은 측두하악관절에 매우 드물게 나타나는 질환으로 본 증례는 개구제한을 주소로 내원하여 측두하악관절장애로 의심하고 자기공명 영상검사를 시행하였다. T2강조영상에서 좌측 측두하악관절강내에 다량의 활액이 관찰되었으나 전형적인 활액막 연골종증과 달리 상하관절강내의 활액이 격벽에 의해 분리되어 있었으며 수술시 낭성 병변이 관찰되었다. 조직학적으로 낭주위가 활액세포로 이장되어 있는 진성낭이었으며 낭벽내에 신생혈관 및 염증세포의 침윤이 관찰되어 염증성 활액낭으로 최종 진단하였다. 이 증례는 특징적인 자기공명영상소견을 나타내었지만 타 질환과 감별에 많은 어려움이 있었다. 치료는 병소의 적출을 시행하였으며 추적관찰기간 동안 재발은 보이지 않았다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권1호
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• pp.11-20
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• 1993

Bony ankylosis is an intraarticular condition where there is fusion of the bony surfaces of the joint : The condyle and the glenoid fossa. It occurs in both children and adults, unfortunately more frequently in the former, in whom early recognition and correction is particularly critical. Trauma is well proven to be the predominant cause of TMJ ankylosis. Infection, rheumatoid arthritis and neoplasm are another, significant cases of TMJ ankylosis. The necessity for using an interpositional material to prevent TMJ reankylosis has been widely discussed and many interpositional materials have been used, including temporal muscle and fascia, dermis, auricular cartilage, fascia lata, fat, Lyo-dura, Silastic and various metals. The temporal muscle and fascia have been widely used pedicled flap for head and neck reconstruction. The use of a temporal muscle and fascia for reconstruction of the TMJ, particularly in cases of ankylosis is a very reasonable option. Its principle advantages are its autogenous nature, resilience, and proximity to the joint, allowing for a pedicled transfer of vascularized tissue into the joint area. However, the viability of temporal muscle and fascia is a critical question. We treated 2 cases of TMJ ankylosis with temporal muscle and fascia transfer and one case with temporal fascia. We obtained satisfactory results as to functional aspects.

• 대한족부족관절학회지
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• 제1권1호
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• pp.30-37
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• 1997

Pilon fracture is an intraarticular fracture of distal tibia. It is high energy injury with significantly associated soft tissue damage, bone comminution, and articular surface disruption. Until recently, this treatment has followed the AO principles, Because the risk of complications outweighs potential benefits, the principle of a Pilon fracture treatment are changing. Newer techniques using articulated external fixation minimize disturbance of the soft tissue envelope and have decreased these complications. Series of 5 patients with Pilon fracture were treated by articulated external fixator and followed up more than 12 monthes at the Department of orthopaedic surgery, Kang Dong Sacred Heart Hospital, College of medicine, Hallym University. The results were as follows: 1. The type of fracture were type C2(3 cases),type C3(2 cases) according to AO-$M{\ddot{u}}ller$ classification. 2. The clinical results according to functional criteria by Mast and Teipner were good in 4 cases and poor in 1 case, which is an old fracture. 3. Techniques utilizing articulated external fixator were associated with satisfactory results and appeared to significantly decrease the incidence of soft tissue complication, post-traumatic arthritis, osteoporosis, and fibrosis of ankle joint.