• 제목/요약/키워드: chronic arthritis of ankle

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원위 경비 인대 결합의 단독 손상 (Isolated Syndesmotic Injury)

  • 김용태;김형년;박용욱
    • 대한족부족관절학회지
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    • 제20권3호
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    • pp.100-105
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    • 2016
  • Syndesmotic injury can either be isolated or associated with bony or ligamentous ankle injury. When it is not associated with an ankle fracture, it may not be easy to diagnose, especially when there is no franck diastasis on a plain radiograph. Without proper treatment, syndesmotic injury can lead to chronic pain due to impingement of scar tissues and instability. It may further lead to ankle arthritis. Early diagnosis with appropriate management is a prerequisite to avoid these problems. Herein, we review and discuss the mechanism of injury, classification, diagnosis, and treatment of isolated syndesmotic injury.

재발성 결핵성 관절염의 항결핵제 치료 중 진단된 만성 다발성 통풍성 관절염: 증례 보고 (Chronic Multiple Gouty Arthritis Diagnosed during Anti-Tuberculosis Treatment of Recurrent Tuberculous Arthritis: A Case Report)

  • 오현철;최윤정;하중원;박상훈;김상희;윤한국
    • 대한족부족관절학회지
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    • 제22권3호
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    • pp.116-119
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    • 2018
  • Gout occurs mainly in monoarthritis and is found in more than 50% of cases in hallux of the foot. In addition, symptoms sometimes begin in the hand, wrist, and elbow, but they are rarely observed in the spine. The patient was referred for tuberculous polyarthritis due to antituberculosis drug failure. Inflammatory findings were observed in the lumbar, elbow, wrist, hand and foot areas. Surgery was performed on the foot area and a pathology diagnosis revealed gouty arthritis. We report this case with a review of the relevant literature.

봉약침을 이용한 류마토이드 관절염의 임상적 연구 (Clinical research of Bee-venom Acupuncture effects on Rheumatoid arthritis)

  • 황유진;이건목;황우준;서은미;장종덕;양귀비;이승훈;이병철
    • Journal of Acupuncture Research
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    • 제18권5호
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    • pp.33-42
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    • 2001
  • Objective : To evaluate the effect of treatment for Rheumatoid arthritis by using Bee-venom Acupuncture that is well known for anti-inflammatory effect and function of activating immune system. Methods : Evaluated the result of Bee-venom Acupuncture treatment twice in a week for patients who diagnosised as rheumatoid arthritis by 7 criteria of US Rheumatism Academy. Results : 1. If you see the distribution chart, sexual rate of male and female was 1:2.75 and age distribution shows as age ascend it shows high. 2. If you see the duration distribution, it shows chronic tendency in order of more than 6 months (59.5%), 2 to 5 months, and 1 month. 3. If you see the invaded region distribution, it shows chronic tendency in order of finger(17 cases), wrist joint(16 cases), knee joint(16 cases), ankle joint(10 cases), elbow joint(8 cases), shoulder joint(7 cases), feet(7 cases), hip joint(5 cases), low back(3 cases) and neck(2 cases). 4. If you see the result of duration distribution treatment, the improvement index is rising in order of within a month, 2 to 5 months, and over 6 months. So it shows that it has good result of treatment within a month. 5. If you see the invaded region, it shows high improvement index in order of low back, hop joint, shoulder joint, wrist joint, feet, knee joint, finger, elbow joint, ankle joint and neck. 6. If you see the result of morning stiffness time before treatment, it shows good effect of treatment in order of 2-3hrs, 30min.-an hr, an hr to 2hrs, and 0-30min. 7. If you see the patients satisfaction after Bee-venom Acupuncture treatment, Excellent is 6 cases, Good is 7 cases, and Moderate 2 cases. Conclusions : It will have greater treatment effect if herbal medicine, moxibustion, and acupuncture are used together as patients whole body condition and symptoms with Bee-venom Acupuncture for rheumatoid arthritis that is chronic inflammatory disease.

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심장이식 후 부신피질호르몬 투여로 인한 거골의 무혈성 괴사 - 1예 보고 - (Corticosteroid-induced Avascular Necrosis of Talus after Cardiac Transplantation)

  • 박홍기;엄기석
    • 대한족부족관절학회지
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    • 제4권2호
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    • pp.83-86
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    • 2000
  • A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

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분쇄가 심한 Ruedi-Allgower II, III형의 개방성 경골 천정 골절에서 단계적 수술의 결과 (Result of Staged Operation in Ruedi-Allgower Type II and III Open Tibia Pilon Fractures with Severe Comminution)

  • 최귀연;이준영;장현웅;김영욱
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.110-115
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    • 2019
  • Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

외측 거골 골연골 병변에 대한 자가 골연골 이식술 후의 중기 추시 임상결과 (Intermediate-Term Clinical Outcomes after Autologous Osteochondral Transplantation for Lateral Osteochondral Lesions of the Talus)

  • 김성후;조병기
    • 대한족부족관절학회지
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    • 제27권4호
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    • pp.137-143
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    • 2023
  • Purpose: Autologous osteochondral transplantation (AOT) is indicated for patients with a large osteochondral lesion of the talus (OLT), accompanying subchondral cyst, and the failure of bone marrow stimulation (BMS) procedures. Despite the many reports on the clinical results of surgical treatment for medial osteochondral lesions, those of lateral lesions are rare. This paper reports the intermediate-term clinical outcomes after AOT for lateral OLTs. Materials and Methods: Twenty-one patients with lateral OLTs were followed up for at least three years after AOT. The clinical evaluations comprised the Foot and Ankle Outcome Score (FAOS) and Foot and Ankle Ability Measure (FAAM). The radiographic assessment included the irregularity of the articular surface (subchondral plate), the progression of degenerative arthritis, and the changes in talar tilt angle and anterior talar translation. Results: The mean FAOS and FAAM scores improved significantly from 42.1 to 89.5 and 39.5 to 90.6 points, respectively, at the final follow-up (p<0.001). The radiological evaluation revealed two cases (9.5%) of articular step-off ≥2 mm and 1 case (4.8%) of progressive arthritis. The mean talar tilt angle and anterior talar translation improved significantly. As postoperative complications, there was one case of a local wound problem, one case of superficial peroneal nerve injury, and one case of donor site morbidity. At a mean follow-up of 62.3 months, no patient showed a recurrence of instability or required reoperation for OLT. Conclusion: AOT for the lateral OLTs demonstrated satisfactory intermediate-term clinical outcomes, including daily and sports activity abilities. Most OLT could be accessed through lateral ligament division and capsulotomy, and the incidence of iatrogenic complications, such as recurrent sprains or chronic instability, was minimal. AOT appears to be an effective and relatively safe treatment for patients with large lateral osteochondral lesions unresponsive to conservative therapy, with subchondral cysts, or with failed primary BMS.

Initial experience with intra-articular 188Re-tin colloid as a "radiation synovectomy" agent in various joints

  • Shinto, Ajit S;Indira, VU;Kamaleshwaran, KK;Banka, Vinay Kumar;Aswathy, KK;Thirumalaisamy, SG;Rajamani, V;Mallia, Madhav;Banerjee, Sharmila
    • 대한방사성의약품학회지
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    • 제1권2호
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    • pp.109-117
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    • 2015
  • Radiation synovectomy has been proposed as a promising palliative therapy for recurrent joint effusions for the last two or three decades. Ionizing radiations emitted by intrarticularly administered radiolabelled colloids. The aim of this study was to assess the effectiveness of radiation synovectomy (RSV) using $^{188}Re$-tin colloid in the treatment of recurrent joint effusions and chronic synovitis of knee joints. Three phase bone scan was acquired for the concerned joint prior to radiosynovectomy. $^{188}Re$-tin colloid was prepared as per the reported protocol. 9 patients, diagnosed with rheumatoid arthritis and suffering from chronic resistant synovitis of the knee, ankle or elbow joints were administered the radiopharmaceuticals, checked for radiochemical purity >95% by intraarticular route. A whole body scan was acquired 2 h post-radiosynovectomy. In all the 9 treatments, no leakage to non-target organs was visible in the whole body scan. Static scans of the joint revealed complete retention of $^{188}Re$-tin colloid in the joints post administration of the agent. Clinically all patients exhibited a complete or partial response. RSV with $^{188}Re$-tin colloid was safe and effective in patients with chronic synovitis of rheumatoid origin.

원위경비인대결합의 손상 (Syndesmotic Injury)

  • 안정태;박문수;정비오
    • 대한족부족관절학회지
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    • 제26권1호
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    • pp.9-15
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    • 2022
  • Syndesmotic injuries are found frequently in clinical practice, and they remain controversial because of the variety of diagnostic techniques and management options. Bony avulsions or malleolar fractures are commonly associated with syndesmotic disruptions. Even unstable isolated syndesmosis injuries are associated with a latent or frank tibiofibular diastasis and should not be ignored in the early phase. A relevant instability of the syndesmosis with diastasis results from collateral ligaments tears and requires operative stabilization. The treatment involves an anatomic reduction of the distal tibiofibular articulations followed by stable fixation. Syndesmotic transfixation screws or suture button implants are being proposed as a means of fixation. Recently, suture button fixation has shown more favorable outcomes, but the outcomes can still be controversial. Syndesmotic malreduction can lead to hardware failure, adhesions, heterotopic ossification, tibiofibular synostosis, chronic instability, and posttraumatic arthritis. In particular, the correct diagnosis and evidence-based treatment options for unstable syndesmotic injury should be considered.

Anti-arthritic activity of D-carvone against complete Freund's adjuvant-induced arthritis in rats through modulation of inflammatory cytokines

  • Chen, Guifang;Song, Yuxiu;Ma, Fang;Ma, Yuxia
    • The Korean Journal of Physiology and Pharmacology
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    • 제24권6호
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    • pp.453-462
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    • 2020
  • Chronic joint pain due to loss of cartilage function, degradation of subchondral bone, and related conditions are common plights of an arthritis patient. Antioxidant compounds could solve the problems in arthritic condition. The objective of this study was to evaluate the anti-arthritic activity of D-carvone against complete Freund's adjuvant (CFA)-induced arthritis in rats. D-carvone was orally administered for 25 days at the doses of 30 and 60 mg/kg against CFA-induced arthritic rats. Changes in body weight, paw swelling, organ index, hematological parameters, oxidative stress markers, inflammatory cytokines, and histopathology were recorded. Oral treatment of D-carvone significantly improved the body weight, reduced the paw swelling, edema formation, and organ index in arthritic rats. The levels of white blood cells were reduced, red blood cells and hemoglobin levels were improved in D-carvone treated arthritic rats. Lipid peroxidation levels were lowered whereas enzymatic and non-enzymatic antioxidants were significantly elevated by D-carvone administration against arthritic rats. D-carvone significantly modulated inflammatory cytokine levels and improved the ankle joint pathology against CFA-induced arthritic inflammation. In conclusion, D-carvone proved significant anti-arthritic activity against CFA-induced arthritis in rats.

상완골외측상과염(上腕骨外側上顆炎)에 대한 봉약침(峰藥鍼) 요법이 미치는 영향(影響) (A Clinical Study of Bee Venom Acupuncture Therapy on External Epicondylitis)

  • 김경태;송호섭
    • 대한약침학회지
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    • 제9권2호
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    • pp.93-97
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    • 2006
  • Objective : This study was to evaluate the effectiveness of Bee Venom acupuncture therapy on external epicondylitis. Methods : We divided chronic arthritis of ankle patient into 2 groups; one group combined bee venom acupuncture therapy and acupuncture therapy, another group was only acupuncture therapy. To estimate the effectiveness of treatment that applied for two groups, we used visual analog scale(VAS). We compared the VAS score of two groups statistically. Results : 1. As a result of evaluation by using visual analog scale(VAS), treatment score at final was marked more higher than score before treatment on each groups. 2. treatment at final, acupuncture and bee venom acupuncture therapy group had significant result on visual analog scale(VAS) compared with acupuncture therapy group. Conclusion : Bee Venom acupuncture therapy can be used with acupuncture therapy for highly effective treatment for external epicondylitis.