Nerve palsy as a complication of hematoma following total hip arthroplasty (THA) is a rare development. Although rare, this complication can cause permanent nerve palsy. The authors experienced a case of recovery from sciatic nerve palsy after emergency evacuation of a hematoma. The expanding thigh hematoma was due to anticoagulation treatment for prevention of venous thromboembolism after total hip arthroplasty. After 10 months from the operation, the patient regained complete motor power and leads an ordinary life. The authors would like to emphasize the danger of hematoma following anticoagulation therapy for prevention of venous thromboembolism after total hip arthroplasty.
Arthroplasty ; Emergencies ; Hematoma ; Hip ; Humans ; Paralysis ; Sciatic Nerve ; Sciatic Neuropathy ; Thigh ; Venous Thromboembolism

PURPOSE: The purpose of this study is to assess the usefulness of magnetic resonance imaging (MRI) in diagnosis, planning of treatment methods for suspected acute septic arthritis in children, and evaluation of the clinical results of the operations with the help of magnetic resonance imaging as a diagnostic modality. MATERIALS AND METHODS: Between March 2003 and May 2007, 20 patients suspected of having acute septic arthritis of the hip underwent MRI. The mean age of the patients was 3 years and 5 months (range: 10 days-14 years). The average follow-up was 2 years and 2 months (range: 1 year-3 years 6 months). Assessment of MRI findings and final results with recurrence of the infection and post-infectious radiographic sequelae was performed retrospectively. RESULTS: Among the 20 cases, 17 cases(85%) showed joint effusion. Among these 17 cases, accompanying signal changes were observed in the meta-epiphyseal region in seven cases, and accompanying signal changes were observed in surrounding soft tissue in three cases. Accompanying abscess formation was observed in one case. The remaining three cases(15%), which had no joint effusion, showed an intramuscular abscess pocket around the joint, which mimicked septic arthritis. At final follow up, two cases showed unsatisfactory results, with limited joint motion and radiographic sequelae. CONCLUSION: In children who are suspected of having acute septic arthritis of the hip, MRI can provide useful information about the location and extent of infection and even the differential diagnosis of acute septic arthritis. MRI was considered to be a useful method for diagnosis of suspected acute septic arthritis in children.
Abscess ; Arthritis, Infectious ; Child ; Diagnosis, Differential ; Follow-Up Studies ; Hip ; Hip Joint ; Humans ; Joints ; Magnetic Resonance Imaging ; Recurrence

PURPOSE: This study evaluated mid-term clinical and radiological results of autologous bone marrow transplantation (BMT) for early stage osteonecrosis of the femoral head (ONFH) and analyzed prognostic factors. MATERIALS AND METHODS: From November 2003 to April 2008, 101 hips of 93 patients with early stage ONFH who underwent autologous BMT were followed for at least five years. For clinical results, preoperative and postoperative Harris hip scores (HHS) were evaluated and survival rate was obtained at the point of performing total hip arthroplasty or femoral head collapse progression. Radiologic results were assessed by changes in necrosis size on magnetic resonance imaging performed preoperative and postoperatively. For evaluation of prognostic factors, survival rate was analyzed according to age, gender, etiology, stage, necrosis size, and location. RESULTS: Averaged HHS at latest follow up showed no significant change in comparison with preoperative HHS. Of 101 hips, 35 hips required arthroplasty and six hips were running head collapse. Groups with use of steroid, lateral location of necrosis, large size of necrosis, or large necrotic angles showed lower survival rate. However, age, gender, and stage had no effect. CONCLUSION: In early days, autologous BMT for early ONFH can be considered as a treatment for improvement of clinical features and delay of radiologic progress. However, after some years, there was no effect compared with the natural course of ONFH.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Bone Marrow Transplantation* ; Follow-Up Studies ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging ; Necrosis ; Osteonecrosis* ; Risk Factors ; Running ; Survival Rate

Cubital tunnel syndrome is compressive neuropathy, entrapment of the ulnar nerve around the medial epicondyle of the elbow joint, and the second most common neuropathy after carpal tunnel syndrome. Patients complain of hypoesthesia or paresthesia in the ulnar half of the ring and small fingers early in the disease. Advanced disease is complicated by irreversible muscle weakness or atrophy and claw hand deformity of the ring and small fingers. Although traditional decompression and anterior transposition of the ulnar nerve is known as standard treatment, according to recent reports only simple decompression has a good outcome. So, variety of surgical treatment options are available. In this paper, we purpose to describe the causes, clinical features and recent surgical treatments of cubital tunnel syndrome.
Animals ; Atrophy ; Carpal Tunnel Syndrome ; Cubital Tunnel Syndrome* ; Decompression ; Elbow Joint ; Fingers ; Hand Deformities ; Hoof and Claw ; Humans ; Hypesthesia ; Muscle Weakness ; Nerve Compression Syndromes ; Paresthesia ; Ulnar Nerve

BACKGROUND: Increasing evidence suggests a pivotal role for neuronal inflammation in response to replicating varicella zoster virus in the development of postherpetic neuralgia (PHN). OBJECTIVE: In this study, we investigated the value of serum levels of various inflammatory markers in acute herpes zoster (HZ) as predictors for the development of PHN. METHODS: A total of 116 patients with acute HZ were enrolled in this study. We measured scores on the pain visual analogue scale (VAS) at baseline and at 1, 3, and 6 months after diagnosis of HZ. We defined PHN as pain greater than 1 on the VAS lasting for more than 6 months. Serum samples for laboratory assay, including complete blood count were obtained at the initial visit. Correlations between the levels of each inflammatory marker and the development of PHN were evaluated. RESULTS: Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte count, and albumin showed significant correlations with development of PHN in univariate analysis. Levels of ESR, CRP, and lymphocyte count also showed significant correlations in multivariate analysis. ESR level showed stronger correlations with development of PHN than levels of CRP and lymphocyte count. CONCLUSION: In this study, we confirmed that elevated ESR was an independent and significant predictor of PHN in patients with acute HZ. To validate these results, further well-designed, randomized clinical trials are needed.
Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Diagnosis ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Inflammation ; Lymphocyte Count ; Multivariate Analysis ; Neuralgia, Postherpetic* ; Neurons

A 59-year-old man presented to the emergency department with a chief complaint of sore throat after swallowing sodium picosulfate/magnesium citrate powder for bowel preparation, without first dissolving it in water. The initial evaluation showed significant mucosal injury involving the oral cavity, pharynx, and epiglottis. Endotracheal intubation was performed for airway protection in the emergency department, because the mucosal swelling resulted in upper airway compromise. After conservative treatment in the intensive care unit, he underwent tracheostomy because stenosis of the supraglottic and subglottic areas was not relieved. The tracheostomy tube was successfully removed after confirming recovery, and he was discharged 3 weeks after admission.
Airway Obstruction* ; Cathartics ; Caustics ; Citric Acid* ; Colonoscopy ; Constriction, Pathologic ; Deglutition ; Eating* ; Emergency Service, Hospital ; Epiglottis ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Middle Aged ; Mouth ; Pharyngitis ; Pharynx ; Sodium* ; Tracheostomy ; Water