• Title/Summary/Keyword: joint effusion

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Avascular Necrosis of Femoral Head on Bone Scan (대퇴골두 무혈성 괴사의 뼈스캔상의 병기)

  • Yang, Hyung-In;Kim, Eui-Jong;Kim, Deog-Yoon;Ryu, Kyung-Nam;Cho, Kyung-Sam
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.206-213
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    • 1994
  • We studied 90 patients(179 femoral heads) with avascular necrosis of femoral head, who had been performed X-ray, bone scan and MRI to compare of the findings of AVN on bone scan between each other, retrospectively. The patients were 82 males and 9 females, their mean age was 45 years. Radiographic stages were classified by Steinberg modification, radionuclide stages were classified as followed; stage o(or type 0) : normal, stage 1 : faint ring like uptake around the femoral head, stage 2: intense ring like uptake, stage 3: irregular increased uptake with central photon defect, stage 4 : Intense diffuse increased uptake at femoral head and stage 5 : hip joint deformity with relatively mild increased uptake. The findings of MRI were classified according to extent, location, early or advanced lesion, signal intensity of the lesion and joint effusion. 156(87%) of 179 femoral heads had avascular necrosis, 68(75.5%) of 90 patients had bilateral AVN, 35 femoral heads had early stage and 120 had advanced stage. The detection rate of AVN by X-ray and bone scan were 85% (134), 91.6% (143), respectively. Early AVN with atypical types of bone scan showed larger extent, moderate to large amount of joint effusion, soft tissue hypertrophy within joint, and secondary degenerative changes. Bone scan had relatively high detection rate in the diagnosis of AVN of femoral head, and demonstrated various types depending on the disease stage.

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Case Study of Shoulder Impingement Syndrome with Synovial Joint Effusion Improved as Sweet BV acupuncture (Sweet BV를 이용하여 윤활관절의 삼출액을 동반한 어깨 충돌증후군 치험 1례)

  • Yang, Mi-Sung;Chu, Min-Gyu;Cho, Hee-Geun;Park, Su-Gon;Kim, Min-Jung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.4
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    • pp.914-918
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    • 2009
  • Recently, according to increasing population to enjoy sports, Shoulder Impingement Syndrome occurred frequently. In this report, we introduce a case suffered from chronic shoulder pain, ROM restriction because of Shoulder Impingement Syndrome treated by Sweet BV acupuncture. Sweet BV acupuncture maintains the BV acupuncture effects and restricts allergic reaction at the same time. In this report, Sweet BV acupuncture is a new therapy that have a safety and efficiency simultaneously.

Effect of Achyrantis Radixs and Ultrasound in Osteoarthritis Rats Articular Cartilage (우슬과 초음파가 퇴행성관절염 백서의 관절 연골에 미치는 영향)

  • Kim, Eun-Jung;Chung, Hun-Woo;Kim, Gye-Yeop
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.2
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    • pp.390-396
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    • 2008
  • Osteoarthritis(OA) diseases are characterized by joint pain, tenderness, limitation of movement, crepitus, occasional effusion, and variable degrees of inflammation without systemic effects. We investigated the effects of Achyrantis radixs cream treatment and low intensity ultrasound in monosodium iodoacetate(MIA) induced experimental osteoarthritis rat. Sprague-Dawley 40 rats of 7-8 weeks, weight $250\;{\pm}\;50$ g were divided into four groups including the control group and ostoarthritis group(30 rats). Histopathological examination, Mankin's score, and immunohistochemical were performed. Histological findings in control group that are similar to those observed in human osteoarthritis, such as disorganization of chondrocytes, erosion and fibrillation of cartilage surface, and subchondral bone exposure. Safranin O-fast green staining revealed that marked diffuse reduction of proteoglycans and chondrocyte treated with MIA. The Mankin's score were closely correlated to the grade of histological findings. The level of Bax and caspase-3 expression decreased experimental groups. This study shows that a Acyranthes Radix cream treatment and low intensity ultrasound exerts a beneficial influence on the severity of chondral lesion in osteoarthritis rats. This treatments could related to a reduced level of chondrocyte apoptosis through anti-apoptotoc capacities of MIA-induced apoptotic protein overexpression.

Rare Disease Entity of Dorsolateral Foot Pain: Lateral Branch of Deep Peroneal Nerve Entrapment Syndrome (외측 심부 비골신경 포착 증후군의 증례 보고)

  • Na, Yoonju;Yeo, Seung Mi;Park, Jin Ho;Hwang, Ji Hye
    • Clinical Pain
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    • v.20 no.2
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    • pp.122-126
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    • 2021
  • When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.

Evolving Indication of Meniscal Allograft Transplantation (진화하고 있는 동종 반월연골판 이식술의 적응증)

  • Lee, Bum-Sik;Bin, Seong-Il;Kim, Taehyung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.200-209
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    • 2020
  • The first human meniscal allograft transplantations (MATs) were performed 30 years ago. In the early era, candidates were limited to patients who have favorable joint conditions. MAT is currently indicated for patients with post-meniscectomy symptoms, such as compartmental pain or effusion after a subtotal or total meniscectomy. The current indication for MAT is being expanded to other patients who were not indicated previously. The present article reviews how the indications of MAT have changed over the years.

Failure of Cross-Pin Femoral Fixation after Anterior Cruciate Ligament Reconstruction - A Case Report - (전방십자인대 재건술후 대퇴골 경골핀 고정의 실패 - 증례보고 -)

  • Lee Kee-Byoung;Kwon Duck-Joo;Ji Yong-Nam
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.92-95
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    • 2003
  • A 34-year-old man with ACL total rupture due to slip down injury, had received ACL reconstruction using autogenous hamstrings tendon with cross-pin femoral fixation. Postoperative course was as usual. But postoperative 3 months later, he complained posterolateral knee pain, recurrent effusion and mild instability. He was managed repeatitive aspiration and nonsteroid antiinflammatory drugs but was failed to relieve symptoms & signs. In CT scans, perforation of posteromedial femoral cortex of lateral femoral condyle was found. In second look arthroscopy, two pieces of broken femoral cross pin were found in between tibiofemoral Joint which was badly injured cartilage. We considered malposition of pins was the main cause of failure. We propose that femoral tunnel must be made more acute angle and femoral cross-pin guide must be positioned more external rotation 10-20 degree than transepicondylar axis made confirm the cross-pin tunnel position in order to avoid posterior cortex perforation and early failure.

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Bilateral Lipoma Arborescens of the Knee in an Adolescent Patient (청소년에서 양측 슬관절에 발생한 수지상 지방종)

  • Kim, Hee-June;Kim, Jeong-Woo;Lee, Hyun-Joo;Kyung, Hee-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.354-358
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    • 2020
  • Lipoma arborescens (LA) is a rare lesion that causes joint effusion and pain. LA usually presents as a unilateral knee lesion, and bilateral lesions are extremely rare. LA among adolescent patients is also extremely rare with the disorder having a much higher incidence among adults. This paper reports a 14-year-old boy who was treated for bilateral knee LA. X-rays revealed the characteristic features of LA in both knees, and arthroscopic synovectomy was performed to resect the lesions. Postoperative recovery progressed smoothly, and the patient was eventually relieved of pain and swelling. LA should be considered when adolescent patients present with bilateral pain and swelling, even though this condition is rare in this age group. Furthermore, surgical synovectomy for a complete resection is an appropriate treatment option.

Arthroscopy for the Diagnosis and Treatment of Failed Trochleoplasty in a Dog (활차구 성형술이 실패한 개에서 관절경을 이용한 진단과 치료)

  • Hwang, Junho;Heo, Suyoung;Kim, Bumseok;Lee, Sanghoon;Jeong, Seongmok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.251-254
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    • 2015
  • A 3-year-old castrated male Spitz dog (8.4 kg) was referred for hindlimb lameness. The dog had undergone corrective surgery for bilateral medial patellar luxation 6 weeks prior to presentation. Intermittent lameness of both hind limbs was evident on general inspection. Physical examination revealed moderate pain and crepitus upon flexion and extension of the stifle joints. Radiography revealed features consistent with distal deviation of the cartilage flaps and effusion in both stifle joints. Detachment and deviation of both osteochondral blocks were suspected based on the physical and radiographic findings. Arthroscopy confirmed failed osteochondral blocks (right $1.5cm{\times}0.9cm{\times}0.2cm$, left $1.3cm{\times}0.9cm{\times}0.1cm$), which were removed. After removal of the osteochondral blocks, the stepped trochlear grooves were located and debrided using an arthroscopic burr, to prevent patellar tracking disorder. The dog resumed normal ambulation without medial patellar luxation 2 weeks postoperatively, and there were no complications. Arthroscopy is an effective surgical modality for the diagnosis and treatment of canine joint disorders. It offers a magnified view of the joint, which allows accurate evaluation of intra-articular structures. In addition, arthroscopic surgery can reduce the postoperative complications associated with surgical wound.

Comparison of MR Findings between Patients with Septic Arthritis and Acute Gouty Arthritis of the Knee (급성 통풍성 슬관절염과 패혈성 슬관절염의 자기공명영상 소견 비교)

  • Su Young Yun;Hye Jung Choo;Hae Woong Jeong;Sun Joo Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1071-1080
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    • 2022
  • Purpose To compare the MR findings of septic and acute gouty arthritis of the knee joint. Materials and Methods This retrospective study included patients who underwent knee MRI for septic or gouty arthritis at our hospital between October 2012 and October 2018. The MR findings were analyzed for the presence of bone marrow edema, soft tissue edema, abscess, pattern of synovial thickening (frondlike, lamellated, diffuse linear), maximum thickness of the synovium, and joint effusion volume. The gouty (n = 5) and septic arthritis (n = 10) groups were compared using the Wilcoxon rank-sum test and Fisher's exact test. Results No statistically significant differences were observed for each item. One patient in the gouty arthritis group and seven in the septic arthritis group had bone marrow edema. Soft tissue abscess formation was only observed in the septic group. The incidence of each synovial thickening pattern was as follows: 100% (diffuse linear) in the gouty arthritis group and 20% (frondlike), 50% (lamellated), and 30% (diffuse linear) in the septic arthritis group. Conclusion Differentiation of gouty arthritis and septic arthritis based on imaging findings is difficult. However, lamellated synovial thickening patterns, bone marrow edema, and soft tissue abscess formation are more commonly observed in patients with septic arthritis than in those with gouty arthritis.

The comparison of two different intraarticular injections using a sonographic anterolateral approach in patients with osteoarthritic knee

  • Choi, Jin Wook;Lee, Jun Ho;Ki, Minjong;Kim, Myung Jong;Kang, Sehrin;Lee, Juhyung;Lee, Jun-Rae;Han, Young-Jin;Son, Ji-Seon
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.289-295
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    • 2018
  • Background: The intraarticular (IA) injection has become popular for the management of the osteoarthritic knee without an effusion. The success rate of IA injection would be better if it was able to be visually confirmed. We hypothesized that an anterolateral approach, which targets the synovial membrane of the lateral condyle using ultrasound, would provide an equivalent alternative to the anterolateral approach, targeting the synovial membrane of the medial condyle for IA injection of the knee. Methods: A total of 96 knees with osteoarthritis were randomized placed into the two groups, which were group I (anterolateral approach to the medial condyle) and group II (anterolateral approach to the lateral condyle). The primary outcome was to compare the success rate of the two methods of IA injection. The required length of the needle for injection was also measured and compared. Pain intensity was assessed using the Numeric Rating Scale in order to evaluate the success of injection. Results: There were no significant differences in the success rate between both groups. The success rate of group I and group II were 87.8% (95%, CI 78.7-97.0) and 91.5% (95%, CI 83.6-99.5), respectively (P = 0.549). The needle depth was $5.0{\pm}0.8$ (3.0 to 6.1 cm) in group I, and $3.0{\pm}0.8$ (1.5 to 5 cm) in group II (P < 0.001). Conclusions: The anterolateral approach to the lateral femoral condyle, using ultrasound, is an alternative method to the approach targeting the medial femoral condyle, using shorter needle.