[Clinical investigation of scapulohumeral periarthritis with arthrography].
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The preoperative or postoperative painful hip can present a difficult diagnostic problem. In a series of 46 aspirations on such hips, one instance of Staphylococcus aureus, three instances of Staphylococcus albus, one instance of Escherichia coli and one instance of tuberculous infections were diagnosed. In addition, in a series of 22 fluoroscopically controlled arthrograms performed on patients with painful total hip replacements, six instances of loose acetabular components and one instance of a broken femoral stem were found.
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After a review of the methods employed for arthrographic visualization of cruciate ligaments (CL), the authors present a new technique to separately study the anterior and posterior CL during traction. This technique enables to obtain a good visualization of CL and a good diagnostic accuracy; it can radiographically demonstrate a pathologic sagittal instability of the knee; it is easy to perform and is easily repeatable in different patients.
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A ligament rupture is found in some 60% of patients with ankle distortion. The rupture usually involves the anterior talofibular ligament, and there may be associated ruptures of other ankle ligaments. Clinical findings and conventional radiological examination (including stress exposures) are insufficiently reliable for demonstration or exclusion of a ligament lesion. Ankle arthography is a relatively simple method of investigation; interpretation of the images obtained is generally no problem. Surgical exploration has nearly always confirmed the arthrographic diagnosis 'ligament lesion'.
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For assessment of the value of computed tomography (CT) as a method for evaluating the cartilage of the patellofemoral joint, 100 knees were examined in 91 patients. With the patient in a supine position with the knee flexed at a 30 degree angle, a sufficient quantity of air and positive contrast material was required to obtain an accurate CT picture of the cartilage. Normal cartilage images of 53 knees and abnormal images of 47 knees were obtained by use of CT. The latter group was classified into eight types. When the CT findings of 70 knees were compared with arthroscopy and/or arthrotomy, the results showed that CT diagnosis was accurate in 68 of 70 knees, with a coincidence rate of 97.1%. Cartilage thickness at an arbitrary site and the extent of the ulcer within the deep layers were observed easily by CT. Although examination exclusively with arthroscopy had distinct disadvantages (e.g., the inability to assess either the specific thickness of the cartilage or the extent of the ulcers within deep layers), the combined use of arthroscopy with CT provided a precise three-dimensional image of the cartilage. CT was found to be a valuable noninvasive imaging method for patellofemoral joint cartilage evaluation.
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