While clavicular injuries are fairly common, bipolar clavicular injuries are not. They may involve dislocations at both ends of the clavicle, or a fracture at one end and a dislocation at the other. We present two cases; a patient with a bipolar clavicular dislocation, and another with a fracture in both medial and lateral ends of the clavicle with anterior dislocation of the sternoclavicular joint. Both were treated conservatively, with fairly good range of motion and return to normal activity.
Accidental Falls ; Accidents, Traffic ; Clavicle/*injuries ; Clavicle/radiography ; Dislocations/radiography ; Dislocations/*therapy

Prompt and accurate diagnosis of cervical spine injury is important to prevent the catastrophic results that can be caused by undetected lesions. Delayed or missed diagnosis of cervical spine injury occurs with an incidence of 5 to 20% according to previous studies. In this study, we report four cases of cervical instability without initial radiologic evidence. These cases demonstrate that dynamic flexion and extension radiographies can be a proper choice of modality to diagnose and exclude the possibility of cervical instability in a patient with a suspicious ligament injury on the static radiographies following acute cervical trauma.
Cervical Vertebrae ; Diagnosis* ; Dislocations ; Female ; Humans ; Incidence ; Ligaments ; Radiography ; Spine

Adult ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Metatarsophalangeal Joint ; injuries ; physiopathology ; Radiography ; Range of Motion, Articular

Secondary osteoarthritis of hip joints is a common disease and is frequently followed by chronic sublexation and dislocation. Twenty four case of the secondary osteoarthritis associated with chronic subluxation and dislocation of the hip joints were evaluated with plain radiography and computed tomography. We retrospectively analyzed 1) the ossification and calcification of the acetabular labrum, 2) the thickeness of the quadrilateral plate of the ilium, and 3) anteroposterior diameter of the acetabulum. The changes of the hip joints in subluxation (n=14) revealed ossification of the acetabular labrum in 12 cases (86%), thickening of the quadrilateral plate of the ilium in 11 cases (78%) but anteroposterior diameter of the acetabulum was not changed. The changes of the hip joints in dislocation (n=10) revealed no evidence of the ossification of the acetabular labrum, thickening of the quadrilateral plate of the ilium in 10 cases (100%) and decreased anteroposterior diameter of the acetabulum. We conclude that CT findings of subluxation and dislocation of the hip joints can be helpful in the evaluation of the secondary osteoarthritis of the hip joints.
Acetabulum ; Dislocations* ; Hip Joint* ; Hip* ; Ilium ; Joints ; Osteoarthritis ; Osteoarthritis, Hip ; Radiography ; Retrospective Studies

Posterior shoulder dislocation is a relatively uncommon event, with an incidence of 1~4% of all shoulder dislocations. Because this condition is rare and because accurately interpreting the radiography is difficult, the diagnosis is often missed. In such a case, significant complications, such as chronic posterior dislocation and degenerative disease of the shoulder, can occur. We experienced the case of a patient in whom bilateral posterior shoulder dislocation occurred following an accidental fall a height of 10m. Fortunately, he had no neurovascular injury of the shoulder and fully recovered after closed reduction, but early diagnosis was missed because other injuries were significant and his vital signs were unstable. A careful history and physical examination, complete radiographic evaluation, and a high level of suspicion are required to identify posterior shoulder dislocation. This case may be helpful for diagnosis of posterior shoulder dislocation.
Accidental Falls* ; Diagnosis ; Dislocations ; Early Diagnosis ; Humans ; Incidence ; Physical Examination ; Radiography ; Shoulder Dislocation* ; Shoulder* ; Vital Signs

Lunate and perilunate dislocations are uncommon, but they have clinical importance because complications, such as median neuropathy and avascular necrosis of the lunate, can occur. Although early diagnosis enabling early surgical treatment is crucial for preventing long-term sequelae, these dislocations are frequently missed in the initial assessment. Imaging tools, such as plain radiography, magnetic resonance imaging, ultrasonography, and electrodiagnostic studies, have been used for diagnosis. The proper choice of initial evaluation tools is important for making an accurate early diagnosis. Here we present a case of lunate dislocation associated with median neuropathy in which ultrasonography, along with the electrodiagnostic study and plain radiography, played an important diagnostic role in detecting structural abnormalities. This case report reveals the complementary diagnostic role of ultrasonography in initial assessment and provides ultrasonographic images of lunate dislocation as a cause of median neuropathy.
Diagnosis ; Dislocations* ; Early Diagnosis ; Lunate Bone ; Magnetic Resonance Imaging ; Median Neuropathy* ; Necrosis ; Radiography ; Ultrasonography*

The major cause of early dislocation after total hip arthroplasty is malposition of acetabular cup. Therefore, radiographic evaluation of acetabular cup placement is essential in determining the postsurgical prognosis. The purpose of this study was to establish principles which would aid in checking the radiography. We evaluated 33 patients who were treated with total hip arthroplasty between Jan. 1988 and Aug. 1993 and investigated the methods of measuring the position of the acetabular cup on radiography using pelvic skeleton and acetabular cup. The results were analyzed as followings. l. After the total hip arthroplasty, the inclination of the acetabular cup shows average 37.1 degress in pelvis AP, 36.4 degrees in hip AP and 43.4 degrees in femur AP. This result means that the more X-ray beam focus is far from the acetabular cup, the more inclination of acetabular cup on radiography is incerased. 2. After the total hip arthroplasty, the difference of acetabular cup angle between pelvis AP and hip AP is average 0.7 degree, 6.4 degrees between pelvis AP and femur AP and 7.1 degrees between hip AP and femur AP. This result means that the more X-ray beam focus is far from acetabular cup, the larger difference between acetabular cup angle on radiography is.3. In experimental study with pelvic rotation, acetabular cup angle on radiography is average 45.7 degrees in neutral position, 42.8 degrees in 10 degree rotation, and 39.6 degrees in 20 degree rotation. This result means that the more rotation of pelvic bone is increased, acetabular cup angle on radiography is reversely diminished. 4. In experimental study with pelvic flexion-extension, acetabular cup angle on radiography is average 45.7 degrees in neutral position, 56.4 degrees in 20 degree pelvic flexion, and 32.3 degrees in 20 degree pelvic extension. This result means that when the pelvis is flexed, acetabular cup angle on radiography is increased, and when the pelvis is extended, acetabular cup angle is decreased than normal acetabular cup angle. 5. In experimental study with X-ray beams, acetabular cup angle on radiography is average 45.7 degrees in pelvis AP, 45.5 degrees in femur AP and 50.4 degrees femur AP. This result means that the more X-ray beam focus is far from acetabular cup, the more inclination of acetabular cup on radiography is increased. As the result of the study, radiographs which focus centered on hip demonstrated a nearly true representation of acetabular cup angle.
Acetabulum ; Arthroplasty, Replacement, Hip ; Dislocations ; Femur ; Hip ; Humans ; Pelvic Bones ; Pelvis ; Prognosis ; Radiography ; Skeleton

CT has been advocated as an adjunct to conventional radiography in the evaluation of pelvic bone fractures andtraumatic dislocations of the femoral head. Author compared and analysed the CT and plain radiographic findings of3 consecutive adult patients in whom acetabular or femoral head injuries were suspected or demonstrated on initialradiographs. The results were as follows; 1. CT was convenient and precise method in evaluation the patient withhip trauma. 2. CT was helpful in detecting intraaraticular osseous fragment, interposed soft tissue, and wideningof the joint space which was not evident on plain radiographs. 3. CT permitted better evaluation of asociatedinjuries in soft tissue and viscera in the plevic and retroperitoneal cavity, and also gave information aboutother associated fractures. 4. CT was superior for the evaluation of posterior acetabular rim and medial portionof the acetabulum. 5. CT was helpful for evaluating the presence or absence of intraarticular osseous fragmentsafter reduction of the dislocated hip.
Acetabulum ; Adult ; Craniocerebral Trauma ; Dislocations ; Head ; Hip ; Humans ; Joints ; Methods ; Pelvic Bones ; Radiography ; Viscera

PURPOSE: To establish modality of diagnosis and treatment in pisiform injuries by analysis of its clinical experiences. Materials & Methods : Twelve fractures and one dislocation of the pisiform that were followed up for more than twelve months were reviewed retrospectively. RESULTS: Eight cases had associated injuries on the wrist or hand of ipsilateral side. Eight cases were diagnosed by routine radiography and three cases required additional special radiography such as the supinated oblique view or carpal tunnel view. One case was diagnosed by computed tomography. Cast immobilization was performed in nine cases and three cases underwent internal fixation. Pisiform was excised in one chronic dislocation case. The results were usually satisfactory but two cases showed pisotriquetral arthritis and one of them underwent excision of pisiform. CONCLUSION: The diagnosis of pisiform injury may accompany some difficulties due to associated carpal injuries. Routine radiography is sufficient for the screening of it if attention is paid and specific radiography such as supinated oblique view or carpal tunnel view may be very useful for confirmation. As conservative treatment alone shows good result, operative fixation is recommended for limited cases. The excision of pisiform is required in case of pisotriquetral arthritis or neglected chronic dislocation.
Arthritis ; Diagnosis* ; Dislocations ; Hand ; Immobilization ; Mass Screening ; Radiography ; Retrospective Studies ; Wrist

Finger Joint ; diagnostic imaging ; pathology ; Humans ; Joint Dislocations ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Radiography