Archives of orthopaedic and trauma surgery
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The growing propagation of hip-joint sonography and its increasing use as a screening method make it important to point out some potential mistakes. Good image quality, three-dimensional evaluation with real-time technique, consideration of form variants, correct estimation of angle parameters, consideration of medical history, and clinical evaluation as well as the necessity of follow-up examinations are inevitable requirements for reliable diagnostic sonography of the hip joint.
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Arch Orthop Trauma Surg · Jan 1990
The importance of functional magnetic resonance imaging (MRI) in the planning of stabilizing operations on the cervical spine in rheumatoid patients.
Chronic inflammatory diseases, such as chronic polyarthritis or spondylarthritis ankylopoietica, can occasionally lead to vertebral instabilities of the occipitoatlantal or atlantoaxial level, requiring some form of stabilizing operation. By means of functional magnetic resonance imaging, i.e., with the cervical spine at its maximal range of flexion and extension, performed on 11 patients suffering from an instability at the above level, it was possible to demonstrate not only the extent of synovial tissue, but also how this sometimes excessive soft-tissue growth hinders an adequate reduction of the subluxated vertebrae. The importance of this investigation lies in the fact that the necessary operation can be planned appropriately. As such, three patients required a decompressing operation entailing resection of the posterior arch of the atlas, widening of the foremen magnum, or both.
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Kienböck's disease with onset after 50 years of age was studied. Of 127 patients with Kineböck's disease seen over the past 30 years, the cases of 15 (12 female, 3 male) were analyzed. The average age of onset was 58.3 years. ⋯ Moreover, it was noteworthy that the variance among aged controls (group C) was higher than among the young controls (group D). The metacarpal index of the patients with aged-onset Kienböck's disease was markedly lower than that of the young. Considering the increase of ulnar variance with age, the persistence of minus variance and the presence of osteoporosis might make the lunate bone susceptible to injury.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsSimultaneous dislocation of both interphalangeal joints in a finger.
Unlike dislocations of the distal or proximal interphalangeal joints, the simultaneous dislocation in a single finger of both seems to be a rare occurrence. Reduction and checking of the collateral ligament, extensor tendon, and volar plate, followed by 3 weeks of splinting in the intrinsic plus position seems to be the treatment of choice.
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Arch Orthop Trauma Surg · Jan 1990
Case ReportsDigital subtraction angiography in musculoskeletal tumors and other conditions.
One hundred and forty consecutive DSA examinations of various musculoskeletal diseases were analyzed with respect to the contributions and/or limits of this modern diagnostic imaging modality. Angiography remains the imaging tool of choice for many benign and malignant orthopedic conditions of bones and soft tissues, mainly when MRI is still not generally available. ⋯ DSA has the advantage of being less invasive and it also surpasses analog arteriography in better visualization of vascular patterns hidden in hyperostosis, sclerosis, and metallic shadows. Angiographic investigations, when necessary, should therefore start with DSA.