• Title/Summary/Keyword: joint effusion

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Relationship between Temporomandibular Joint Disorders and Horizontal Morphology of Lateral Pterygoid Muscle (외측 익돌근의 수평적 형태와 측두하악관절장애 간의 상관성)

  • Jung, Jae-Kwang;Kwon, Choonik;Byun, Jin-Seok;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.149-159
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    • 2013
  • The purpose of this study was to investigate the relationship between horizontal morphology of lateral pterygoid muscle and onset of temporomandibular joint disorders. Randomly selected 150 subjects, assigned with equal number in terms of gender and age group, were included. The axial and sagittal images in their magnetic resonance images of the temporomandibular joints were used to measure the morphologic characteristics of lateral pterygoid muscles and temporomandibular joints. The measurement variables were maximal horizontal width and insertion angle to the condyle, position of the articular disc, condylar deformity, and joint effusion. In addition, presence or absence of the temporomandibular joint pain was examined through history and palpation of the joints. The relationships among measurement variables were analyzed and the results were as follow. The insertion angle of the lateral pterygoid muscle to the condyle was higher in the joint of anterior disc displacement without reduction than that in the joint of normal disc position. In addition, the maximal horizontal width of the lateral pterygoid muscle was significantly increased in joints with pain than those without pain. Also, the insertion angle was significantly higher in younger age group and the maximal width was significantly greater in male than in female. These results suggest that high insertion angle of lateral pterygoid muscle might be an important anatomic predisposing factor for anterior disc displacement in temporomandibular joint and muscular activity of lateral pterygoid muscle might be affected by preauricular pain. In conclusion, there might be a bi-directional interaction between lateral pterygoid muscle and joint in the progression of anterior disc displacement in temporomandibular joint.

Arthroscopic Synovectomy of the Knee in Rheumatoid Arthritis (류마토이드 관절염에서 슬관절의 관절경적 활액막 절제술)

  • Chung, Jae-Hoon;Park, Il-Sung;Yang, Dong-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.91-97
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    • 1997
  • There has been a controversy about the effectiveness of the synovectomy of the knee in the rheumatoid arthritis. So we studied to determine if the arthroscopic synovectomy of the knee was of benefit in the rheumatoid arthritis. We ana lysed 25 knees of 15 patients who underwent the arthroscopic synovectomy of the knee joint for their rheumatoid arthritis from Jun. 1995 to Oct. 1996. The average follow-up period was 20.1 months($12\~28$ months). The results were as follows; 1. Satisfactory results were obtained in 20 knees $(80\%)$ for the pain and the effusion each, 23 $(92\%)$ for the range of motion and 19 $(76\%)$ for the functional capacity. 2. In the overall results for the pain. effusion. range of motion and the functional capacity. we obtained excellent results in 14 knees $(56\%)$ and satisfactory results in 9 knees $(32\%)$. 3. In the patient's self assessment, 11 patients $(44\%)$ were delighted and 10 patients $(40\%)$ were satisfactory. 4. In the overall results according to the articular cartilage damage, satisfactory results were obtained in 15 $(93\%)$ out of 16 knees in Grade I and II, and 6 $(75\%)$ out of 8 knees in Grade III and IV. In conclusion, arthroscopic synovectomy could be one of very useful treatments for the rheumatoid knee. But further study is needed to get the long-term results of the synovectomy because there's many reports saying gradual decrease of good results with increasing time. And continuous and proper medical treatment including DMARDs, is needed to effectively control the rheumatoid arthritis even after the synovectomy.

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Pericardial Window Operation in Oncology Patients: Analysis of Long-Term Survival and Prognostic Factors

  • Sung Min Kim;Jun Ho Lee;Su Ryeun Chung;Kiick Sung;Wook Sung Kim;Yang Hyun Cho
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.169-177
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    • 2024
  • Background: Pericardial effusion (PE) is a serious condition in cancer patients, primarily arising from malignant dissemination. Pericardial window formation is a surgical intervention for refractory PE. However, the long-term outcomes and factors associated with postoperative survival remain unclear. Methods: We retrospectively analyzed data from 166 oncology patients who underwent pericardial window formation at Samsung Medical Center between 2011 and 2023. We analyzed survival and PE recurrence regarding surgical approach, cancer type, and cytopathological findings. To identify factors associated with survival, we utilized Cox proportional-hazards regression. Results: All patients had tumors documented in accordance with the American Joint Committee on Cancer staging manual, including lung (61.4%), breast (9.6%), gastrointestinal (9.0%), hematologic (3.6%), and other cancers (16.4%). Surgical approaches included mini-thoracotomy (67.5%) and thoracoscopy (32.5%). Postsurgical cytopathology confirmed malignancy in 94 cases (56.6%). Over a median follow-up duration of 50.0 months, 142 deaths and 16 PE recurrences occurred. The 1-year overall and PE recurrence-free survival rates were 31.4% and 28.6%, respectively. One-year survival rates were significantly higher for thoracoscopy recipients (43.7% vs. 25.6%, p=0.031) and patients with negative cytopathology results (45.1% vs. 20.6%, p<0.001). No significant survival difference was observed between lung cancer and other types (p=0.129). Multivariate analysis identified New York Heart Association class, cancer stage, and cytopathology as independent prognostic factors. Conclusion: This series is the largest to date concerning window formation among cancer patients with PE. Patients' long-term survival after surgery was generally unfavorable. However, cases with negative cytopathology or earlier tumor stage demonstrated comparatively high survival rates.

Tibial Tuberosity Advancement for Partial Rupture of Cranial Cruciate Ligament in Two Dogs (경골조면 전이동술을 이용한 개에서의 부분 전십자인대 단열치료 2례)

  • Heo, Su-Young;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.141-144
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    • 2014
  • Two dogs (Case 1 weighing 27 kg, Case 2 weighing 42 kg) were referred with hindlimb lameness. On physical examination, there was moderate pain on stifle joint testing and mild cranial translation on cranial drawer testing in Case 1. This translation was obvious when the patient was under general anesthesia. Case 2 showed discomfort during hyperextension of the stifle joint, but no significant cranial translation under general anesthesia. Joint effusion was detected on radiography in both cases. Based on physiologic and radiographic examinations, cranial cruciate deficiency was suspected, so exploratory arthroscopy was performed. Arthroscopy revealed partial rupture of the cranial cruciate ligament (CrCL) in both cases. Case 1 showed unstable partial CrCL rupture, while Case 2 had stable CrCL rupture. Tibial tuberosity advancement (TTA) was carried out as planned. Seroma occurred one week postoperatively in Case 2, and was removed surgically. The patients returned to satisfactory weight-bearing ambulation 5 months after initial surgery. Based on the results of these cases, TTA appears to be a useful procedure in the treatment of CrCL partial rupture.

Rapidly Destructive Arthrosis of Knee Following Treatment of Crizotinib in a Patient with Non-Small-Cell Lung Cancer (비소세포폐암 환자에서 크리조티닙 치료 후 발생한 급속 파괴형 슬관절증)

  • Hwang, Jin Tae;Choi, Jae-Hyeong;Park, Chul-Hyun;Yoon, Kyung Jae;Lee, Yong-Taek;Do, Jong Geol
    • Clinical Pain
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    • v.19 no.2
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    • pp.120-123
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    • 2020
  • Rapidly destructive arthrosis is a rare syndrome characterized by narrowing of the joint space and rapid joint destruction within 6~12 months. A 62-year-old woman with anaplastic lymphoma kinase rearranged non-small-cell lung cancer presented with both knee pain and varus deformity. She was treated with crizotinib 500 mg/day for more than 2 years, with partial tumor response. Initial plain radiography showed Kellgren and Lawrence (K-L) grade 1. After 10 months, varus deformity was worsened and plain radiography aggravated to K-L grade 4 despite conservative treatment including activity modification. Diffuse synovitis with massive joint effusion and destruction of anterior cruciate ligament, medial meniscus, medial collateral ligament, and lateral collateral ligament were shown in magnetic resonance imaging. The patient was diagnosed with rapidly destructive arthrosis of knee and underwent a both total knee arthroplasty.

Effect of Trachelospermi Caulis Herbal-acupuncture on the Collagen-induced Arthritis in Rats (낙석등(絡石藤)약침이 Collagen 유발 관절염에 미치는 영향)

  • Lee, Tae-Ho;Lee, Eun-Young
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.51-65
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    • 2009
  • Objectives : This study was built to investigate the effect of Trachelospermi Caulis herbal-acupuncture on the Collagen-induced arthritis(CIA) in rats. Methods : Arthritis was induced by intradermal injection of Bovine type II collagen solution into base of tail. Experimental group were divided into 5 groups ; Normal(N) group, Control(C) group, Trachelospermi Caulis high(TH) group, Trachelospermi Caulis low(TL) group, Saline(S) group(n=7 for each group). Normal group was had no management. Control group was injected with Bovine type II collagen solution and taken no treatment. Trachelospermi Caulis high group was injected with Bovine type II collagen solution and taken high-intensity(10mg/kg) herbal-acupuncture treatment on $ST_{36}$. Trachelospermi Caulis low group was injected with Bovine type II collagen solution and taken low-intensity(5mg/kg) herbal-acupuncture treatment on $ST_{36}$. Saline group was injected with Bovine type II collagen solution and taken saline injection on $ST_{36}$. Body weight, paw edema volume and ankle joint thickness were measured during experimental day. On the last experimental day, we analyzed WBC count, TNF-$\alpha$ & IL-$1{\beta}$ concentration, c-fos immunohistochemistry and NADPH-d histochemistry for evaluating the effect of Trachelospermi Caulis herbal-acupuncture. Results : The results were as follows ; 1. In the change of paw edema volume, TH group only has significant difference compared with C group. 2. In the change of ankle joint thickness, TH group only has significant difference compared with C group. 3. In WBC count of serum, TH, TL groups have significant decrease compared with C group. 4. In TNF-$\alpha$ concentration of effusion, TH, TL groups have significant decrease compared with C group. and TH group has significant decrease compared with TL group. 5. In IL-$1{\beta}$ concentration of effusion, TH, TL groups have significant decrease compared with C group. and TH group has significant decrease compared with TL group. 6. In c-fos positive neurons of S1S2(cortex) region, TH, TL, S groups have significant decrease compared with C group. 7. In NADPH-d positive neurons of CPu(caudate putamen) region, TH, TL groups have significant decrease compared with C group. 8. In NADPH-d positive neurons of Tfp(transverse fibers of pons) region, TH, TL, S groups have significant decrease compared with C group. and TH group has significant decrease compared with S group. Conclusions : According to above results, we hope that Trachelospermi Caulis herbal-acupuncture may have the effect that decreases progression and development of CIA. And it can be suggested that Trachelospermi Caulis herbal-acupuncture may reduce the expression of c-fos and NOS.

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Operative Treatment of the Tuberculous Arthritis on the Sternoclavicular Joint - A Report of Two Cases- (흉쇄 관절에 발생된 결핵성 관절염의 수술적 치료 - 2예 보고 -)

  • Park, Jin-Young;Kim, Jeong-Woo;Chun, Churl-Hong;Kwon, Seok-Hyun;Choi, Yun-Hong;Lee, Seok-Jung
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.57-61
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    • 2008
  • Tuberculous arthritis on the sternoclavicular joint is an uncommon disease and a delayed diagnosis can be due to the obscure clinical symptoms. We should suspect tuberculous arthritis in patients with slowly progressive pain, swelling, mild fever and a previous history of tuberculosis. Early diagnosis is important through conducting a thorough physical examination and performing laboratory tests and radiologic study. Tuberculous arthritis on the sternoclavicular joint should be treated with a combination of systemic antituberculous agents and thorough surgical debridement in marked damaged joints. When performing this operation, it is important not only to minimized the injury of the costoclavicular ligament, but also to avoid injury to the surrounding the vital structures such as the mediastinum and pleura after aggressive resection or radical debridement. We describe here 2 cases of the tuberculous arthritis on the sternoclavicular joint: one case had a good result after surgical debridement with using an anti-tuberculous agent, and the other had fatal complications such as mediastinal abscess and pleural effusion after the operation.

A Case Report on Bee Venom Acupuncture for Patient with Osteo-Arthritis of Knee Joint, Diabetic Mellitus, and No Response for Steroid Injection (관절강내 Steroid injection에 호전되지 않은 DM을 가진 OA환자에 대한 봉독요법 치험1례)

  • Han, Soon-Hyun;Youn, You-Suk;Kim, Sung-Soo;Chung, Won-Suk
    • The Journal of Korea CHUNA Manual Medicine
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    • v.4 no.1
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    • pp.17-28
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    • 2003
  • We experienced a patient(53-year-old female) with knee joint effusion, pain and stiffness who had not responded to steroid injection therapy, significantly improved by bee venom acupuncture in clinical symptom. And for a opinion that prohibited bee venom acupuncture on DM because of increasing serum glucose level by increasing serum cortisol level, we also experienced that serum glucose level of DM patient stabilized by bee Venom acupuncture treatments, so we report this case with literature review of articles.

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Ultrasonographic Findings of Both Knee in Hemiplegic Ambulators with Recent Stroke (초기 편마비 보행 환자에서 양측 무릎의 초음파 검사 소견)

  • Park, Soon-Ah;Yang, Chung-Yong;Kim, Ji-Hee;Lee, Kang-Keun;Shin, Byung-Cheul;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.4
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    • pp.539-545
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    • 2012
  • To evaluate of the ultrasonographic changes in hemiplegic and unaffected knee joints of hemiplegic ambulators with recent onset stroke. Twenty patients (40 knees) with prevalence duration of 14-39 weeks (mean 24.70 weeks) after a stroke insult were included. All participants were walking independently without leg dragging, had no previous knee injury. There were significant differences in intercondylar cartilage thickness and pes anserinous tendinopathy (PAT) between hemiplegic and unaffected knees (p<0.05). There were no differences in cartilage thickness of medial condyle and lateral condyle, patellar tendinitis/bursitis, suprapatellar effusion, synovitis, joint space narrowing, and Baker's cyst of ultrasonographic findings and x-ray findings in hemiplegic knee compared to the control except PAT (p<0.05). In hemiplegic knee, medial or lateral condylar cartilage thickness was significantly correlated with body weight, intercondylar cartilage thickness, and PAT (p<0.05). PAT was significantly correlated with Brunnnstrom stage and condylar cartilage thickness (p<0.05). Knee pain was significantly correlated with lateral condylar cartilage thickness (p<0.1). The hemiplegic knee had more ultrasonographic abnormalities including PAT and more cartilage thickness preservation in patient with recent onset stroke. Intraarticular sonographic findings including cartilage thickness was significantly correlated with extraarticular findings including PAT and a symptom of knee pain.

The Comparison of Sonographic Features of Ankle Ligament and Tendon in Affected Side With Non-Affected Side Ambulatory of Hemiplegic Patients (보행 가능한 편마비 환자에서 편측 및 건측 하지 발목 관절의 인대와 힘줄의 초음파 비교)

  • Park, Ji-Woong;An, Jae-Ki;Park, Yong-Bum;Bae, Won-Sik
    • Physical Therapy Korea
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    • v.17 no.2
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    • pp.60-66
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    • 2010
  • In chronic ambulatory hemiplegic patients, structural changes might be developed at both ankles possibly due to unequal and repetitive weight bearing on tendons and ligaments. We examined ankles by sonography to find out structural changes of tendons and ligaments of both ankles in ambulatory hemiplegic patients. Nineteen ambulatory hemiplegic patients over 1 year were included as study subjects. All subjects had no previous trauma or disease history in their ankle joints and they were able to walk independently or with supervision but had spastic ankles with equinovarus tendency. We examined both ankle joints by sonography to see joint effusion and measure width, thickness, and area of tendons of the tibialis anterior, tibialis posterior, and Achilles, and also ligaments of the anterior talofibular and calcaneofibular. We compared sonographic features of the hemi-side ankle with the sound-side ankle. There were no significant differences between hemi-side and sound-side ankles in almost all measured parameters of tendons and ligaments. However, the width of the hemi-side tibialis posterior tendon ($7.24{\pm}1.52$ mm) was narrower than the sound-side tendon ($8.61{\pm}1.37$ mm). With the amount of active joint motion and weight bearing possibly preventing ligament and tendon atrophy even though marked weakness, spasticity occurred during the chronic hemiplegic phase.