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PubMedDate not supplied

[Reproducibility in the roentgenological assessment of coxarthritis].

The "German Society of Orthopaedic Surgery and Traumatology (DGOT)" is trying to support the application of standardized and reproducible criteria in diagnosis and therapy of osteoarthritis. As radiographs are a primary measure of outcome at present, the objective of this study was to investigate the reproducibility of radiologic assessment in hip osteoarthritis using different radiographic variables. 3 investigators read 100 hip joints on 50 pelvis radiographs at two time-points for the presence and severity of individual radiographic features: joint space narrowing (JSN), osteophytes, sklerosis, subchondral cysts and deformity of the femoral head. Additionally the summary grade of Kellgren and Lawrence (1963) and Scott et al (1992) was assessed. Intra- and inter-rater-reliability were calculated by intra-class-correlation-co-efficient (ICC). The results regarding intra- and inter-rater-reliability show excellent values for superior JSN, femoral head deformity and the summary score. The radiologic assessment of medial JSN, osteophytes and acetabular sklerosis depends on the level of the investigator's experience. Perifoveal osteophytes and subchondral cysts do not seem to be have sufficient reproducibility. The results of our investigation show, that a reliable radiological classification of the severity of hip osteoarthritis is possible by assessment of certain individual radiographic features or a summary grade.

Adult↗
PubMedDate not supplied

[Sub-Achilles bursitis--a biomechanical analysis and clinical study].

Chronic inflammations of the distal Achilles tendon correspond frequently to a mechanical irritation of the subcalcaneal bursa. On grounds of the biomechanical analysis an excessive inward bending of the hindfoot is postulated as the reason. So a conception for the clinical therapy is detected. The first measure will be a statics correction of the foot and a local application of antalgics. In case of unsuccessfulness after 3 months the surgical resection of the calcaneus exostosis is performed. After 3 months of conservative treatment 15 of 24 athletic patients are free of pain. The other 9 patients are free of pain 3 months after the surgical treatment. In either case all patients return to their former sports activity 6 months after the beginning of the treatment.

Achilles Tendon↗
PubMedDate not supplied

[Atypical Achilles tendon rupture in Haglund exostosis--a case report].

We report about an unusual case of a rupture of the Achilles tendon in a patient with Haglund's exostosis and long term achillodynia. Intraoperatively, we found a fresh superficial typically located tendon-rupture and an old deep round shaped rupture which was located directly over the cranial edge of the calcaneous bone spur. We presume that the sharp edge of Haglund's deformity was the cause of the deep tendon rupture, because the location of the round shaped rupture was near the exostosis. The additional superficial rupture, caused by an inadequate trauma, induced operative revision consisting of double layer transosseous suturing. In conclusion early operative resection of Haglund's deformity in cases of repeated irritations of the Achilles tendon should be performed to avoid mechanical damage, including the risk of rupture by the hypomochlion-like effect of the exostosis.

Achilles Tendon↗
PubMed1991

[Autosome dominant vitreoretinal dystrophy with skeletal dysplasia in one generation].

We report on ten patients of four generations with autosomal dominant vitreoretinal dystrophy with different manifestation. The ophthalmological findings are retinal detachment, retinal holes, retinoschisis, lattice and snowflake degeneration, vitreoretinal adhesions, chorioretinal atrophy and peripheral pigment epithelial changes. Two sisters show growth retardation with skeletal anomalies most likely brachyolmia.

Amblyopia↗
PubMedDate not supplied

[Hyperostosis of the sterno-clavicular joint - an enthesopathy?].

Erosion of the insertions of tendons and ligaments in bone (i.e. of the enthesis) due to chronic aseptic inflammation causes reparative ossification. With regard to our clinical and radiological findings in ten patients hyperostosis of the sterno-clavicular joint seems to be the late stage of such an enthesopathy. Pain and swelling of the soft tissues and an elevated erythrocyte sedimentation rate are characteristics of this seronegative rheumatic disease. For visualizing the extraarticular changes in the sterno-costo-clavicular region tomography is necessary. Early diagnosis and consequent antiphlogistic therapy should remit pain and help avoid hyperostosis.

Adult↗
PubMedDate not supplied

[The significance of bone spurs at the base of the 2d metacarpal bone in the pathogenesis of joint arthrosis of the base of the thumb].

A causal correlation is proved between an outgrowing osseous spur at the Os metacarpale II and the rhizarthrosis. The midhand bone of the thumb is connected by a ligament with the base of the Os metacarpale II. High tensile stresses elongate the ligament and lead to its partial ossification. The ligament looses its essential function and the thumb subluxates radially.

Exostoses↗
PubMedDate not supplied

[5-years lithotripsy of plantar of plantar heel spur: experiences and results--a follow-up study after 36.9 months].

INTRODUCTION: Effectivity and application as well as possible complications and side effects of extracorporeal shock wave lithotripsy of plantar heel spurs should be evaluated. METHOD: We applied extracorporeal shock wave lithotripsy (ECSL) to treat plantar fasciitis in 54 patients (period from: 3/1/1993 to 3/1/1996). 20 persons were treated with Lithostar plus (group 1) and ultrasound focussing and 34 patients (group 2) were treated by a Lithostar and X-ray focussing. RESULTS: After 6 weeks 14 (70%) of group 1 and 27 (79.4%) of group 2 were free of pain. After 36.9 months 8 (40%) of group 1 and 23 (67.6%) of group 2 were still painfree. We could not recognize any severe complications after 36.9 months. CONCLUSION: ECSL is an effective and noninvasive method of treatment. It is not the method of choice for the first treatment of plantar fasciitis but is an alternative option for operation.

Exostoses↗
PubMed1983

[Different stages of hyperostosis of the heads of the ribs in spondylosis hyperostotica].

Hyperostosis of the heads of the ribs represents a rare pattern and localization of spondylosis hyperostotica. The latter is combined with asymmetric extensions of the costovertebral surfaces, which are different from arthrotic alterations. A distinct preference is given to the upper glenoid surfaces. The scleroses of the heads of the ribs are also more pronounced in their cranial parts. Because of the pattern and different extent of the reported alterations a classification in five degrees of development and severity was possible.

Aged↗
PubMed1981

Short rib-polydactyly syndrome, type Verma-Naumoff.

A case of perinatal lethal dwarfism is described: owing to its clinical, radiological and histologic features the case can be classified as SRP syndrome type III (Verma-Naumoff). On the basis of the radiological features and--particularly--of those of the growing cartilage, stress is laid on the importance of these studies for a proper classification of such rate and not completely known chondrodysplastic dwarfisms.

Dwarfism↗
PubMed1987

[Ankylosing hyperostosis of the sternoclavicular joint].

The rarely occurring ankylosing hyperostosis of the sternoclavicular joints can be taken as a paradigm of chronic seronegative inflammation of tendinous insertion involving the capsular apparatus of the sternoclavicular joints. Etiologically uncertain erosions of the insertion lead to reparative ossifications. There are few symptoms but the course is protracted. If the condition cannot be arrested by anti-inflammatory drugs in its initial stages, there develops a progressive loss of sternoclavicular joint function. The case is described of a 66-year-old woman who has had the condition for 33 years. At wide intervals she has had severe pain. Electromyography a few years after biopsy gave an indication of mild irritation of the roots C 7 and C 8. Resulting from loss of function of the sternoclavicular joint the acromioclavicular joint was dislocated. No specific drug or surgical treatment has so far been necessary.

Aged↗
PubMed2001

Subungual exostosis of the third toe.

Subungual exostosis is a variant of osteochondroma that appears as a pinkish nodule under the free end of the nail plate. It becomes symptomatic when large enough to disrupt the overlying nail on the digit or through mechanical irritation of the exostosis from physical activity. Appropriate workup of such a lesion is important, because many cases of subungual exostosis are initially misdiagnosed by a variety of specialists, including dermatologists. With the use of history and roentgenography, subungual exostosis can be effectively diagnosed or excluded. Appropriate treatment of subungual exostosis can be selected- surgical excision of the lesion with significant cure rates achieved. Although most cases of subungual exostosis are localized to the great toe, we describe a 32-year-old woman who developed a subungual exostosis on her right third toe. Appropriate diagnostic workup and surgical treatment of the right third-toe exostosis has resulted in complete relief of symptoms with no signs of recurrence 7 months after surgery.

Adult↗