• Title/Summary/Keyword: Joint Pain

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Clinical Features and Radiological Differential Diagnoses of Symptomatic Sesamoid Bones and Accessory Ossicles: A Pictorial Essay (증상이 있는 종자골과 부골의 임상적 소견과 영상적 감별진단: 임상화보)

  • Hyun Gun Kim;Hee Young Choi;Ji Seon Park;Kyung Nam Ryu;So Young Park;Wook Jin
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.82-98
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    • 2021
  • Sesamoid bones and accessory ossicles are normal anatomic variants with varying morphological appearances and incidences. They are usually small osseous fragments with well-corticated margins located adjacent to the joint space and bone. Patients with sesamoid bones and accessory ossicles are usually asymptomatic and commonly encountered in clinical practice. These sesamoids and accessory bones are occasionally painful because of fractures, dislocations, degenerative changes, avascular necrosis, accessory bone infections, or abnormalities of the adjacent tissue, such as nerve entrapment, tenosynovitis, or soft tissue impingement. This article aimed to illustrate the imaging features of symptomatic sesamoids bones and accessory ossicles at various anatomic locations and describe their clinical features and radiological differential diagnosis.

Direct MR Arthrography of the Hip: Diagnosis and Pitfalls of Acetabular Labral Lesions (고관절 직접 자기공명관절조영술: 비구순 병변의 진단 및 함정)

  • Eun Sol Lim; Yong Kyun Kim;Hye Mi Park;Seung Jin Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1140-1162
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    • 2021
  • Tearing of the acetabular labrum is a common cause of chronic hip pain. MR arthrography (MRA) of the hip is the imaging procedure of choice for the evaluation of acetabular labrum. Familiarity with the various imaging findings of MRA of the hip allows recognition of normal variants and differentiation from true pathologic conditions. This article comprehensively reviews the technical aspects and interpretation of MRA of the hip. The appearances of normal and abnormal labra in MRA are discussed. Potential pitfalls in labral tear interpretation, such as sulci around the hip, normal variants of the labrum and plicae, and osseocartilaginous and soft tissue lesions identified on MRA of the hip are also described.

Rice Bodies Presenting as Intra-Articular Masses in Pediatric Idiopathic Arthritis: A Case Report (소아기 특발성 관절염 환자에서 관절 내 종양형태로 나타난 쌀소체: 증례 보고)

  • Dong Hyeon Kim;Ji Hae Lee;Myeong Ja Jeong;Soung Hee Kim;Ji-Young Kim;Soo Hyun Kim;Mi-Jin Kang
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.731-735
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    • 2023
  • Rice bodies are commonly detected in adults with rheumatoid arthritis and rarely occur in children. An 11-year-old female adolescent who visited our hospital for evaluation of knee pain underwent a MRI scan, which revealed an intra-articular mass. Arthroscopic examination of the mass confirmed conglomerated rice bodies. We report a case of rice bodies that clinically presented as intra-articular masses.

A Study on the Relationship between Stress and Climacteric Symptoms of Midlife Men (중년기 남성의 스트레스와 갱년기 증상)

  • Chung, Yeon-Kang;Lee, Jae-On;Han, Kyung-Lim
    • Research in Community and Public Health Nursing
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    • v.13 no.3
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    • pp.513-522
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    • 2002
  • This study investigated stress and the extent of climacteric symptoms in mid-life men, and examined their relationship in order to better understand the stress and climacteric symptom experiences of mid-life men, and thereby attempted to offer basic materials for the development of a health improvement program that may help increase the quality of life of mid-life men. Three hundred mid-life men whose ages were between 40 and 59 and resided in the Seoul area were subjects of this study. The data were analyzed with the SAS PC program using descriptive statistics to analyze subjects' general characteristics and variables of stress and the extent of climacteric symptoms of the subjects. The relationship between stress and climacteric symptoms were examined by the Pearson Correlation Coefficient, and stress and the extent of climacteric symptoms in relation to the general characteristics were analyzed by T-test and ANOVA. The study conclusions are as follows: 1. Subjects general characteristics The average, age of the subjects was 46 and 47.0% of them reported ages between 40 and 45. Of the subjects, 98% were married. In marriage satisfaction, those who were generally satisfied with their married life comprised 62.0% of the subjects. In terms of level of education, 95.7% were educated above the high school level. In occupational background, 59.7% had occupations related to technologies. As for religion, 42.7% had no religion. In number of children, 67.3% had 2 children. In residential status, 79,3% were living in their own homes. In terms of living arrangements, 87.7% of the subjects were living in the form of nuclear families. 2. Stress and the extent of climacteric symptoms The level of stress was scored as $2.94{\pm}0.74$, and considering that the overall examination score is $27.16{\pm}1.32$, the subjects' stress level was not viewed as particularly high. The average score of the extent of climacteric symptoms was $35.37{\pm}0.27$. The extent of sub-domains of climacteric symptoms included skeleton symptoms ($39.37{\pm}2.81$), joint pain ($39.16{\pm}3.66$), vasomotor symptoms ($35.39{\pm}3.01$), other symptoms ($36.99{\pm}3.02$), psychological symptoms ($34.68{\pm}3.01$), urogenic symptoms ($35.03{\pm}3.27$), and cardiovascular symptoms ($33.70{\pm}2.78$). 3. General characteristics in relation to the stress level The subjects' general characteristics that were significantly related to the level of stress were marriage status (F=4.38, p=.001), marriage satisfaction (F=4.56, p=.001), educational background (F=2.68, p=.012), and age (F=2.48, p=.033). 4. General characteristics in relation to the level of climacteric symptoms The subjects' general characteristics that were significantly related to the level of climacteric symptoms were educational background (F=3.26, p=.007), age (F=2.58, p=.027), marriage status (F=2.62, p=.025), and marriage satisfaction (F=2.78. p=.032). 5. The correlation between stress and climacteric symptoms The subjects' level of stress and climacteric symptoms were significantly related to each other (r=0.578, p=0.000). The subjects' level of stress was correlated with sub-domains of the climacteric symptoms including psychological symptoms (r=0.579, p=0.000), joint pain (r=0.479, p=0.000), skeleton symptoms (r=0.477, p=0.000), other symptoms (r=0.467, p=0.000), vasomotor symptoms (r=0.4615, p=0.000), cardiovascular symptoms (r=0.458, p=0.000), urogenic symptoms (r=0.401. p=0.000). In summary, the climacteric symptoms suffered by mid-life men are positively correlated with their level of stress. In addition, the climacteric symptoms were affected by the level of stress.

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Relationship of Subjective Oral Health Status to Subjective Oral Symptoms for the Elderly in Some Seoul Area (서울 일부 지역 노인의 주관적 구강건강상태와 주관적 구강증상과의 관련성)

  • Won, Young-soon;Kim, Ji-Hyun;Kim, Soo-Kyung
    • Journal of dental hygiene science
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    • v.9 no.4
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    • pp.375-380
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    • 2009
  • The purpose of this study was to help improve oral health care planning for the elderly in an effort to promote the oral health of elderly people in preparation for aging society. The subjects in this study were 200 elderly people who were selected by random sampling from senior centers in Seoul. An interview was conducted to gather data from June to September 2008, and the data collected were analyzed.: 1. The mean number of residual tooth was 13.71. 2. Concerning connections between gender and subjective oral symptoms, gender had a statistically significant relationship to temporomandibular joint dysfunction(p=0.000), dry mouth(p=0.001) and halitosis(p=0.006). The men underwent more oral symptoms than the women. 3. As for the relationship of mastication(p=0.000), oral pain(p=0.010), temporomandibular joint dysfunction(p=0.010) and dry mouth(p=0.001) to subjective oral health state, the elderly people who were not in a good oral health suffered more oral symptoms, and the gap between them and the others was statistically significant. 4. A larger number of tooth led to less mastication difficulties, less dry mouth and more gingival diseases, and the relationship between the factors was statistically significant. A better oral health state led to less mastication difficulties, less oral pain, less dry mouth and less bad breath, and the relationship between the factors was statistically significant. Through this study the oral health the elderly people perceive wss concerned with oral symptom, and the number of residual teeth also had links to subjective oral symptoms. Therefore, to maintain original teeth of the elderly people, the management system of oral health and the education program for oral health in order to prevent disease relateded with oral and enhance the perception standard of oral state are indispensably necessary to the elderly people.

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Effects of 12 weeks of home-based exercise program in patients with ankylosing spondylitis (강직성 척추염 환자에 대한 12주간의 가정기반 운동 프로그램의 효과)

  • Cho, Kyoung-Hwan;Jeon, Yunah
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.3
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    • pp.771-785
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    • 2021
  • This study was performed to provide detailed and comprehensive information on inflammation-related blood indicators, joint range of motion, pain scale, and psychological indicators by patient characteristics by performing a 12-week home-based exercise program for ankylosing spondylitis patients. For the purpose of this study, 10 patients with ankylosing spondylitis were selected by age (30s vs. 40s vs. 50s), gender (male vs. female), and duration (less than 5 years vs. 5 years or more). The home-based exercise program was a combination of aerobic exercise and Pilates-based resistance exercise, and was performed 4 times a week for 12 weeks at an intensity of 50-70% of maximal heart rate (MHR). As a result, after 12 weeks of home-based exercise intervention, the blood C-reactive protein (CRP) concentration of patients with ankylosing spondylitis decreased (-35.6%, p=.002), and the blood inflammation level was improved, and each joint (hip, lumbar, cervical) improved mobility (p<.05). In addition, the bath ankylosing spondylitis disease activity index (BASDAI) was decreased by -67% (p=.001) and the visual analogue scale (VAS) was decreased by -64.8% (p=.001), stiffness and pain has been alleviated. In particular, as the degree of depression decreased by -65.5% (p=.001) and the degree of anxiety by -55.2% (p=.003), 12 weeks of home-based exercise improved not only physical changes but also psychological factors. On the other hand, there was no difference in exercise effect according to age, gender, and disease duration in ankylosing spondylitis patients (p>.05). These results suggest that the 12-week home-based exercise applied in this study can be an effective exercise program that can be universally used for ankylosing spondylitis patients regardless of patient characteristics.

Initial Symptoms of Malignant Bone Tumors (악성 골 종양의 초기 증상)

  • Oh, Joo-Han;Lee, Sang-Hoon;Suh, Sung-Wook;Lee, Ho-Kyoo;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.18-23
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    • 2003
  • Purpose: Delay in the diagnosis of the primary malignant bone tumors may critically influence the chance of the patients' survival and the limb sparing, but the primary malignant bone tumors are so rare that most doctors have little experience in these challenging diseases. The purpose of the current study is to examine the initial symptoms of osteosarcoma and chondrosarcoma, and to shorten the delay of diagnosis. Materials and Methods: The data was based on the questionnaires and the medical records from 139 patients whose histological diagnoses were confirmed in the authors' institution. There were 108 patients of osteosarcoma and 31 patients of chondrosarcoma. Eighty-six were male and fifty-three were female. The mean age of the patients was 20.2 years in osteosarcoma, and 42.4 years in chondrosarcoma. Results: The most common symptom that the patient consult the doctor was pain (93.5% of osteosarcoma patients and 61.3% of chondrosarcoma patients). Among them, 76.2% of osteosarcoma and 57.8% of chondrosarcoma patients complained the night pain. The history of trauma was evident in 48.5% of osteosarcoma patients and one patient of chondrosarcoma. At the first medical visit, the malignant bone tumor was suspected in 61.1% of osteosarcoma and 64.5% of chondrosarcoma patients. Fracture was the most common misdiagnosis in osteosarcoma (16.7%), and the osteomyelitis in chondrosarcoma (19.4%). Initial radiographic examination and the adult age were shown to increase the rate of correct diagnosis of both diseases (p<0.05). Patient's delay and doctor's delay were significantly longer in chondrosarcoma patients than in osteosarcoma. Initial radiography led to shorten the doctor's delay, and the axial location of the tumor lengthened the doctor's delay. Trauma and the young age were believed to shorten the patient's delay. Conclusion: Careful history taking, including the night pain and trauma, would be mandatory for the early diagnosis of the primary malignant bone tumors, and the initial radiographic examination and periodic follow-up can increase the rate of correct diagnosis.

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The Effect of Placing Biomembrane cover following Microfracture on Cartilage Repair: Comparison with Conventional Microfracture Technique in a Prospective Randomized Trial (미세골절술 후 생체막 덮개가 연골 재생에 미치는 영향 : 고식적인 미세골절술과의 전향적 비교 연구)

  • Son, Kwang-Hyun;Kim, Jin-Ho;Kwak, Kyu-Sung;Park, Jang-Won;Yoon, Kyoung Ho;Min, Byoung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.83-91
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    • 2011
  • Purpose: Microfracture has been used as a first-line treatment to repair articular cartilage defects. In this study, a new technique using an extracelluar matrix biomembrane to cover the cartilage lesions after microfracture was evaluated in terms of cartilage repairability and clinical outcome compared with conventional microfracture technique in a prospective randomized trial. Materials and Methods: A total of 53 patients (59 cases) without osteoarthritis who had focal full thickness articular cartilage lesions were randomly assigned in two group. Seventeen patients (17 cases) underwent conventional microfracture procedure (control group) and thirty-six patients (42 cases) received microfracture and placing biomembrane cover (ArtiFilm$^{TM}$) concomitantly (experimental group). Clinical assessment was done through 6 months postoperatively using the subjective International Knee Documentation Committee IKDC questionnaire, and visual analog scale (VAS) for pain and satisfaction. Magnetic resonance imaging (MRI) was performed at 6 months after the operation in all patients. Results: In clinical outcomes, the significant difference was observed between both groups in IKDC, but not in VAS for pain and for satisfaction (final outcomes of IKDC, p=0.001; VAS for pain, p=0.074; VAS for satisfaction, p=0.194). The MRI showed good to complete defect fill (67 to 100%) in 33 patients (78.6%) of experimental group and 4 patients (23.5%) of control group, respectively. In control group, 9 of 17 patients (52.9%) showed poor defect fill (less than 33%), whereas 5 (11.9%) in experimental group (p=0.001). Assessment of peripheral integration revealed no gap formation in 35 patients (83.3%) in experimental group and 6 patients (35.3%) in control group (p=0.001). No serious complications or adverse effects related to the biomembrane were found. Conclusion: Good short-term follow-up clinical results were obtained in the group whose cartilage defects in the knee joint were covered with biomembrane after the microfracture, with the MRI findings confirming the excellent regeneration of the defective cartilage area. This suggests that the surgery to cover the defective area with biomembrane (ArtiFilm$^{TM}$) after the microfracture procedure is a safe, more effective treatment to induce cartilage regeneration.

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The Effectiveness of Buprenorphine Transdermal Patch on Patients with Shoulder Pain: Short-Term Follow-up Study (견관절 통증을 동반한 동결견 환자에게서 Buprenorphine transdermal patch의 효과: 단기 추시 결과)

  • Hong, Jin Ho;Park, Yong Bok;Ryu, Ho Young;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.7-12
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    • 2014
  • Purpose:The effectiveness of transdermal buprenorphine patch on the patients with frozen state of frozen shoulder was evaluated. Materials and Methods: Between March and September in 2013, 127 patients with pain and limited range of motion in shoulder joint over 6 months were included. Every patient was confirmed the diagnosis through MRI or ultrasonogram and each patient received intra-articular injection of steroid once. After 2~4 weeks, every patient was interviewed via telephone survey and finally 105 patients were included, 54 patients received only oral NSAIDs (NP group) while 51 patients received additional transdermal buprenorphine patch (BP group). Pain and functional visual analog scale (PVAS, FVAS), American Shoulder Elbow Society (ASES) score was checked. Results: Generally, every outcome variables showed improvements in both groups (p<0.001). PVAS score after treatment showed superior result in NP group but it was not significant (p=0.088). In ASES score, NP group had superior result than BP group and it had significant difference. Similarly in FVAS, NP group showed superior result but the data before treatment was significantly different (p=0.028) Conclusion: Transdermal buprenorphine patch didn't show superior treatment result in the patient with frozen state of frozen shoulder which was applied with oral NSAIDs after single intra-articular glenohumeral steroid injection in short-term follow-up.

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A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture (쇄골 간부 골절의 최소 침습적 경피적 금속판 고정술과 관혈적 수술 비교)

  • Yoo, Seong-Ho;Kang, Suk-Woong;Kim, Bu-Hwan;Song, Moo-Ho;Kim, Yeong-Joon;Park, Gyu-Taek;Kwack, Chang-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.1-6
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    • 2017
  • Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.