[Objective] We analyzed the clinical findings in 5 patients with osteonecrosis in the medial condyle of the tibia. We also evaluated the usefulness of a tibial percussion test that we developed for examination of differences between the healthy and affected sides in percussion caused by knocking on the tibial rough surface.
[Methods] The subjects were 5 females, who consulted our hospital with a chief complaint of gonalgia and in whom conditions such as osteonecrosis in the medial condyle of the tibia were confirmed by MRI in 4 limbs. In addition to X-p, MRI findings, medical findings by interview, and findings by physical examination were evaluated as clinical findings. Furthermore, the tibial percussion test was performed.
[Results] The causes of pain in the knee joint were unclear in all patients. Pain was severe in 3 patients and marked in 2 patients. Physical examination showed marked tenderness in the medial articular gap and tenderness in the medial condyle of the tibia. In all patients, a difference in the percussion findings between the healthy and affected sides was confirmed by the tibial percussion test.
[Conclusions] These findings indicated that the tibia percussion test in addition to confirmation of characteristic clinical conditions, such as the initial condition of the disease and the severity of tenderness, is useful for the evaluation of conditions of this disease.

[Purpose] Elderly patients with chronic low back pain have often been treated by acupuncture andmoxibustion therapy, using the traditional acupoints for low back pain. But there are some patients who do not get a clinical effect. Therefore, we tried to treat three such patients with three sessions of trigger point acupuncture therapy, instead of using the traditional acupoints for low back pain.
[Methods] The patients were aged 74, 71 and 66, and had low back pain for at least 6 months. They hadround backs, but there were no extraordinary findings in their neurological examinations.
[Results] During and after the previous therapy using the traditional acupoints for low back pain, there wereno remarkable clinical effects on low back pain. But during and after the present therapy using trigger points, there were remarkable clinical effects on low back pain, as evaluated by the visual analogue scale (VAS) and the pain disability assessment scale (PDAS).
[Conclusion] These results suggest that the trigger point acupuncture therapy may be more effective on lowback pain in elderly patients than acupuncture therapy which uses the traditional acupoints.

[Objective] To examine the effect of moxibustion treatment for reducedpain during activity due to hallux valgus.
[Methods] The subjects were five young females with pain due to hallux valgus. Indirect moxibustion treat-ment was carried out on the region of maximum pain to relieve pain. Moxibustion was performed once per day for 2 weeks, for a total of 14 times. Evaluation used the number of side steps performed and the pain (Numerical Rating Scale) at the time of a side step.
[Results] After moxibustion treatment, pain improvement was observed in all subjects at the time of a side step. At the same time, the number of side steps increased. Repeated measurements before and after moxibustion indicated that there was no significant learning effect.
[Discussion and Conclusion] It became clear that the pain due to hallux valgus is mitigated by moxibustion over a fixed period, while athletic ability with respect to side steps is also improved. These results suggested the pain during activity due to hallux valgus is controllable with moxibustion treatment. By controlling pain, moxibustion treatment also temporarily improves athletic ability.