OBJECTIVE: To evaluate the validity of Sharp-Purser test in the assessment of anterior atlantoaxial subluxation in rheumatoid arthritis patients. METHOD: We assessed the validity of the Sharp-Purser test in 38 rheumatoid arthritis patients who were subjected to stabilization surgery. All patients were evaluated using manual laxity test and re-evaluated radiologically. RESULTS: In 31 out of 38 patients (81.6%) Sharp-Purser test was positive in spite of anterior displacement of C1 over C2 on radiograms, while the tests were negative in 7. Among those 7 patients with negative test, 4 (10.5%) were acute cases and 3 (7.9%) were chronic cases with high grade hypomobile slip. Among the 31 patients with positive Sharp-Purser test, ADI (atlantodental interval) was 4 mm in 4 patients, 5 mm in 9, and greater than 5 mm in 18 patients. Among the 7 patients with negative Sharp-Purser test, ADI was 4 mm in 4 patients and greater than 5 mm in 3 patients. CONCLUSION: Our results show that the Sharp-Purser test is a useful clinical examination to diagnose atlantoaxial instability.
Arthritis, Rheumatoid ; Displacement (Psychology) ; Humans

PURPOSE: To evaluate the classification and treatment results about the injury of carpometacarpal (CMC) joint with the fracture of hamate. MATERIALS AND METHODS: The authors categorized into 3 types (I, II, III) according to the location of injured CMC joint and type II was subdivided into 2 type (a, b) according to the size of coronal fragment of hamate fracture-type I: fracture-dislocation of 5th CMC joint with small-sized fragment or avulsion fracture of hamate, type IIa: fracture-dislocation of 4th and 5th CMC joint with small-sized fragment or avulsion fracture of hamate, type IIb: fracture-dislocation of 4th and 5th CMC joint with coronal fracture of hamate body presenting an oblique or coronal splitting fracture, and type III: type II injury associated with injury of 3rd CMC joint or coronal plane fracture of capitate. All cases were carried out the operative treatment. And radiologic results and clinical results were evaluated. RESULTS: Type I were 2 cases, type IIa 4, type IIb 5, and type III 3. Twelve of 14 cases were excellent or good results, 1 case (type III) was fair, and 1 case (type IIa) was poor. All cases obtained anatomic reduction of CMC joint. But, the posttraumatic arthritis was observed in 1 case (poor) and the displacement of non-fixed hamate fragment was observed in 1 case (fair). CONCLUSION: We think that it may get more favorable outcomes by the fixation of the relative large fragment of hamate with anatomical reduction of CMC joint.
Arthritis ; Carpometacarpal Joints ; Displacement (Psychology) ; Joints

Many arthritis patients experience physical and psychological impairment. The influence of psychological factors on physical functioning beyond disease & demographic factors had been investigated. Unlike others studied the relationship between just two variables(i. e., depression & helplessness or self-efficacy & depression), the relationships among several variables such as depression, helplessness and self-efficacy were examined altogether. Forty-two patients were examined to identify the relationship between the variables. It was found that ADL is significantly negatively related to depression and helplessness, and positively related to self-efficacy. And ADL was more strongly correlated with self-efficacy and helplessness than depression, Contrary to ADL, pain was significantly negatively related to self-efficacy, and positively related to depression and helplessness. Then stepwise regression analysis was performed to identify the variables to predict ADL. It revealed that helplessness was the only significant predictor of ADL. Finally, it is suggested that the inclusion of the method to increase self-efficacy & to decrease helplessness in any nursing intervention is very important.
Activities of Daily Living ; Arthritis ; Arthritis, Rheumatoid* ; Demography ; Depression ; Humans ; Nursing ; Psychology*

Quite high prevalence of acute and chronic complications of calcaneal fractures has been reported. Acute complications include blisters, wound necrosis or infection. Late complications include subtalar arthritis, calcaneal malunion, lateral subfibular impingement, tendon problems, sural nerve complications. There are many surgical or nonsurgical treatment modalities to manage those complications. However strategic initial surgical approach with gentle soft tissue handling accompanied by comprehensive understanding about numerous complications might be the best tool to achieve pain free and functional heel after treating calcaneal fractures.
Arthritis ; Blister ; Calcaneus ; Handling (Psychology) ; Heel ; Necrosis ; Organic Chemicals ; Prevalence ; Sural Nerve ; Tendons

PURPOSE: End-stage ankle arthritis is frequently combined with ankle-hindfoot deformity or ankle instability and therefore additional surgical procedures are often required when performing total ankle arthroplasty. We report the short term clinical and radiographic results of the total ankle arthroplasty with/without the combined adjunctive surgical procedures. MATERIALS AND METHODS:The study is based on the 17 ankles (16 patients) of end-stage ankle arthritis that were treated with HINTEGRA(R)Total ankle prosthesis (Newdeal, Lyons, France) total ankle arthroplasty (TAA) from 2004 to 2007 with at least 12 months follow-up. The combined adjunctive procedures as well as the VAS pain score, AOFAS score, radiographic measurements and patient satisfactions were evaluated. RESULTS:Average follow-up period was 29 months (13~55 months) , and the age was average 62 years (39~75 years) old. Among total of 17 ankles, varus deformity and lateral ankle instability were found in 4 cases and 3 cases respectively. Twenty additional procedures such as Achilles triple hemisection (9), calcaneal displacement osteotomy (4) and lateral ankle ligament reconstruction (3) were performed in adjunct to TAA in 13 ankles. VAS pain score improved from preoperative average 8.4 (7~10) to 2.0 (0~5) and the AOFAS functional score improved from 41.8 points (13~71 points) to 90.6 (77~100 points) at final follow-up. Ninety-four percent of the patients were satisfied with the surgery. CONCLUSION: We confirmed that many adjunctive combined surgical procedures are often necessary in addressing the end-stage ankle arthritis (74%) with total ankle arthroplasty. We also achieved quite good clinical and radiographic short term results, although the long term follow-up study with larger number of cases are needed in the future.
Animals ; Ankle ; Arthritis ; Arthroplasty ; Congenital Abnormalities ; Displacement (Psychology) ; Follow-Up Studies ; Humans ; Ligaments ; Osteotomy ; Prostheses and Implants

PURPOSE: To evaluate the optimal pulse sequences in the detection of erosions and for the discrimination of theeffusion from pannus. MATERIALS AND METHODS: MR studies were performed in thirteen patients with clinical diagnosis of rheumatoid arthritis. We used a 1.5T MR unit with single or dual 3 inch coil. We compared coronal images at the same location, obtained with pulse sequences of T2, T2 with fat saturation, and postcontrast T1 with fat suppression. Erosions were assessed by comparing the count of the numbers of erosions depending on each imaging method. A four point scoring systems was used for the comparison of conspicuitof lesion. RESULTS: T2WI with fat suppression and postcontreat T1WI with fat suppresison were better than conventional T2WI in the detection of erosions. The pannus had a heterogeneous signal on T2WI, some of which were enhanced after the intravenous injection of MR contrast a gents. CONCLUSION: We suggest that the fat suppression TIWI with enhacnement or the fat suppression T2WI were better than conventional T2WI for detecting both bone erosion and pannus. The postcontrast MR imaging may often be helpul in distinguishing pannus from the effusion.
Arthritis, Rheumatoid* ; Diagnosis ; Discrimination (Psychology) ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging* ; Wrist*

PURPOSE: The purpose of this study was to examine the effects of a six week self-help empowerment strategy program on the empowerment status, pain intensity, physical function, joint flexibility and depression status in rheumatoid arthritis patients. METHOD: The subjects of the study consisted of a convenience sample thirteen rheumatoid arthritis patients. Data was collected from July to November, 2001. All patient received a self-help empowerment strategy program, once a week for six weeks. RESULT: After receiving the self-help empowerment strategy program, the empowerment status increased significantly, the pain intensity and the depression score decreased significantly and the level of physical function significantly improved but the flexibilities of shoulders, knees and ankles were not significantly changed. CONCLUSION: Further studies need to be done to determine the feasibility of implementing empowerment strategy and its possibility as an effective intervention program for decreasing pain intensity and depression score and improving the physical function.
Ankle ; Arthritis, Rheumatoid* ; Depression ; Humans ; Knee ; Power (Psychology)* ; Range of Motion, Articular ; Self-Help Groups ; Shoulder

PURPOSE: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. MATERIALS AND METHODS: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. RESULTS: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. CONCLUSION: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.
Arthritis ; Clavicle ; Debridement ; Edema ; Follow-Up Studies ; Humans ; Osteomyelitis ; Recurrence ; Retention (Psychology) ; Sternoclavicular Joint ; Sternum

BACKGROUND: The class I major histocompatibility complex (MHC) antigen, HLA-B27 appears to be the major genetic susceptibility factor for ankylosing spondylitis (AS), anterior uveitis, and reactive arthritis, but the mechanism underlying the association remains unknown. HLA-B27 consists of eleven closely related alleles (B*2701-B*2711) which differ in a restricted number of nucleotide substitutions. The aim of this study was to investigate the frequency and the contribution of the HLA-B27 subtypes to AS. METHODS: Forty-six patients (36 AS, 4 anterior uveitis, and 2 psoriatic arthritis, 2 reactive arthritis, 1 erythema nodosum, 1 rheumatic valvular disease) were analysed. The polymerase chain reaction with sequence-specific primers (PCR-SSP) method was used to define B27 allele subtypes. The primers were specifically designed for the discrimination of HLA-B*2701-B*2711. RESULTS: Thirty-two out of forty-six patients were typed. Among them, 27 AS patients were typed. Only two subtypes were identified : 88.9% (24 out of 27) were typed as B*2705 and 11.1% (3 out of 27) were typed as B*2704. Other 5 non-AS patients ( 4 anterior uveitis & 1 psoriatic arthritis) were also typed as B*2705. CONCLUSIONS: No difference in the distribution of HLA-B27 subtypes between patients and healthy controls could be found (Fisher's exact test : P= 0.867, P>0.05). Any specific B27 subtypes don't appear to contribute to AS susceptibility.
Alleles ; Arthritis, Psoriatic ; Arthritis, Reactive ; Discrimination (Psychology) ; Erythema Nodosum ; Genetic Predisposition to Disease ; HLA-B27 Antigen* ; Humans ; Major Histocompatibility Complex ; Polymerase Chain Reaction ; Spondylitis, Ankylosing* ; Uveitis, Anterior

PURPOSE: This study was to investigate the prevalence of depressive symptoms and risk factors in elderly people (old vs oldest-old) with arthritis. METHODS: The Korean Longitudinal Study of Aging (KLoSA) was used with a sample of 1,084 elderly people with arthritis aged 65 or above. RESULTS: We found that the prevalence of depressive symptom was greater for oldest-old people (66.7%) compared to old people (56%). Significant differences between old people and oldest-old people were found for education, living with spouse, number of generation, regular exercise, body mass index (BMI), ADL limitation, self-rated health, and depression. Significant differences existed between depression and non-depression in terms of all variables except region and BMI among old people. But, among the oldest people, ADL limitation and self-rated health showed differences. The Logistic regression analysis revealed that religion, medical comorbidity, ADL limitation, self-rated health were significantly associated with depressive symptoms in old people. But, in oldest-old people, none of the variables were associated with depressive symptoms. CONCLUSION: The findings show that there are age differences in depression and related factors in elderly people with arthritis. Longitudinal studies, which covered depressive symptom severity and which are controlled for a large number of potential confounders, will need to complement the results of this study in the future.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Arthritis/*psychology ; Body Mass Index ; Comorbidity ; Depression/*psychology ; Female ; Health Status ; Humans ; Interviews as Topic ; Longitudinal Studies ; Male ; Risk Factors ; Socioeconomic Factors