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MR imaging is not routinely used for the evaluation of tophaceous gout. However, gout may have atypical clinical and radiologic findings. It should be considered in the differential diagnosis when a mass reveals heterogeneous and low signal intensity on T2 weighted images. We present MR imaging characteristics of gout tophi and arthritis in two patients.
Today, bunion surgery is still very controversial. Considering that a bunion deformity is actually a result of multiple possible causes, the rationale of the currently applied techniques has not been conclusively demonstrated. Multiple techniques are still applied with uncertain outcome, as shown by the not insignificant recurrence rate. The tarsometatarsal reorientation arthrodesis addresses the deficient anteromedial buttress which is due to the most often concomittent hypermobile first ray. This is an important aspect of treating hallux valgus deformity and includes the sagittal alignment besides the horizontal reposition of the metatarsal over the sesamoid complex. Since in hallux valgus, the first metatarsal looses its position also by the insufficiency of the intrinsic musculature and the ligamento-capsular structures, the arthrodesis regulates the elasticity of the multiarticular first ray within the sagittal plane. Recurrences are less likely after this operation, even when performed on the adolescent hallux which is known as very difficult to be treated successfully.
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This paper reviews 79 cases of diagnostic ankle arthroscopy. Primary diagnoses and the effects of arthroscopy in relieving the preoperative symptoms are evaluated. In addition to the ankle, arthroscopy of the subtalar and first metatarsophalangeal joints is discussed.
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The medical literature demonstrates numerous documented cases of post-traumatic arthrosis following comminuted fracture-dislocations at the tarsometatarsal joint(s). Conventionally described reductions and methods of fixation, therefore, lend themselves to less than acceptable results. A newly devised, alternative method of approach to this disabling injury was indicated, and is presented by the authors in the hope of preventing the long-term sequelae commonly seen with this type of injury. After open reduction and remodeling of a severely comminuted fracture-dislocation at the second metatarsal-cuneiform articulation, a modified, double-stemmed Swanson Silastic implant was utilized in order to maintain second ray length and attempt prevention of the usual postinjury osseous consequences, i.e., fusion and arthritic changes. The case presented demonstrates that, after her last clinical evaluation 19 months postoperatively, the patient returned to her normal occupation, and at that time her foot was normal in appearance with no sign of traumatic arthritic change. This procedure thus far has proved to be very rewarding to the patient, and the authors believe it should be considered as an alternative approach in patients who present with injuries of this magnitude.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fifty-three ankles of 29 normal volunteers were examined with Magnetic Resonance Imaging (MRI) to improve the anatomical MR knowledge of tibiotalar and subtalar joints. The aim of our study was therefore to assess the visibility of articular cartilages, tendons and ligaments of the ankle and to define the best scan plane for their visualization. MR studies were performed with SE T1-weighted sequences on the sagittal, coronal and axial planes. The visibility of articular cartilages was 70.8% for the tibiotalar joint and 56.3% for the subtalar joint. All ankle tendons and four of the eight ankle ligaments considered in our study were assessed, at least on one of the sagittal, coronal or axial planes, with over 70% visibility. The deltoid ligament was detected in 95% of the cases on coronal images, the anterior and the posterior talofibular ligaments were seen respectively in 82% and in 75% of the cases on axial images, while the interosseous ligament was detected in 87.5% of the cases on sagittal images. Our study assessed both the capabilities and the limitations of MRI in the detection of anatomical structures of the tibiotalar and subtalar joints and defined the best scan plane for their visualization.
A young woman presented with recurrent dorsal subluxation of the fifth metatarsal-cuboid joint secondary to trauma. The injury was treated by metatarsal-cuboid fusion without functional residual disability.
A case report of a 28-year-old man with associated dislocations of the tarsometatarsal (Lisfranc) and metatarsophalangeal joints is presented. The potential for disability after these injuries is very high when the diagnosis or treatment is delayed, the reduction is incomplete, or the dislocation recurs. Relevant aspects of diagnosis and treatment are discussed.