At present the newer computerized tomography scanners provide a means for direct measurement of the size of normal and abnormal body structures from monitor. In orthopedics and rheumatology, CT is very important and useful means to make correct diagnosis and treatment modalities. In spite of its increasing importance in orthopedic field, reports about accuracy of CT are not common. We reviewed several reports that described about anatomical measurement using CT or similar experiments to our study. But there are few statements that have directly compared CT and caliper measurements in spine or other bones. So, authors performed experiments with 36 vertebrae of 8 pig spines to know the difference of CT measurement from actual measurement. The results were as follow: 1. In CT, bony portions including diameter of body and both pedicles were overestimated about 5% than actual ones. 2. In CT, AP and lateral diameters of spinal canal were 6~7% smaller than actual measurement and canal area, estimated by the products of AP and lateral diameter of spinal canal, is about 13% smaller than actual size. 3. It is the result of cortical overestimation around canal that spinal canal area was estimated less than actual size. 4. Main cause of this differences was partial volume effect that developed during CT scanning. In conclusion, CT scanner is the useful means and gives many useful informations to diagnose the spinal disease, but the physicians must understand mechanical, physical and mathematical limitations of CT and discrepancy of measurement data.
Diagnosis ; Orthopedics ; Rheumatology ; Spinal Canal ; Spinal Diseases ; Spine ; Tomography, X-Ray Computed

No abstract available.
Bile Ducts/physiopathology ; Biliary Tract Diseases/*diagnosis/radiography/therapy ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic/therapy ; Hepatitis B, Chronic/diagnosis ; Humans ; Liver Neoplasms/diagnosis/therapy ; Liver Transplantation ; Male ; Middle Aged ; *Stents

STUDY DESIGN: Case report OBJECTIVES: To report a case of sacral stress fracture that developed after lumbosacral fusion. SUMMARY OF LITERATURE REVIEW: Sacral stress fractures rarely develop after lumbosacral fusion, and osteoporosis, female sex, being over 60 years old, and long segment fusion are known risk factors. MATERIALS AND METHODS: A 66-year-old woman with spondylolisthesis at L5 on S1 underwent posterior lumbar interbody fusion and posterior instrumentation. A sacral stress fracture was found 4 weeks after the first operation, and we performed posterior reduction and posterior instrumentation with S2 alar screws. RESULTS: The patient was free from symptoms and no further displacement was found at 3 months after the last operation. CONCLUSIONS: Sacral stress fracture after lumbosacral fusion can be treated with posterior reduction and posterior instrumentation with S2 alar screws.
Aged ; Female ; Fractures, Stress ; Humans ; Osteoporosis ; Risk Factors ; Sacrum ; Spondylolisthesis

Hydatid cysts are caused by an infestation with larval tapeworms of the genus Echinococcus. The disease is endemic in developing countries but has rarely been reported from immigrant workers in Korea. This paper reports a case of hepatic hydatid cyst in a 27-year-old female. She was referred with abdominal pain that had persisted for the past 2 months. The patient was a foreign worker from Mongolia. The physical examination was unremarkable, and blood tests showed peripheral blood eosinophilia and elevated liver enzymes. Abdominal ultrasonography showed a well-circumscribed cystic mass with septation in the liver. A surgical resection was performed for complete removal. After uncomplicated postoperative recovery, the patient was discharged with albendazole 400 mg twice daily. The hydatid cyst is an important disease that should be considered in the differential diagnosis of cystic lesions in the liver, particularly in those who have lived in endemic areas. A correct early diagnosis based on the typical image findings is important for early treatment before the rupture of the cyst, which is associated with low morbidity and mortality. A current surgical resection combined albendazole are effective treatments for hepatic hydatid cysts, associated with low recurrence rates.

Lipoma Arborescens is rarely encountered in hip joint. This term was first used by Mueller in 1838, to describe a fatty trmor of the knee which presented branched villous-like projection. The etiology is unknown, Suggests its probable reationship to tuberculosis, rheumatoid arthitis, trauma, chronic inflammation, diabetes mellitus and degenerative arthritis. It frequently involves knee joint, hand, wrist, foot, ankle, tendon sheath and hip joint. It usually presents bilaterally. Their nonspecific symptoms and signs are mild pain, joint swelling with minimum effusion, festriction of joint motion, redness, local heating and crepitus. We experienced a case of lipoma arborescens of hip joint, which was treated by synovectomy with excision of lesion.
Ankle ; Arthralgia ; Diabetes Mellitus ; Foot ; Hand ; Heating ; Hip Joint ; Hip ; Hot Temperature ; Inflammation ; Joints ; Knee ; Knee Joint ; Lipoma ; Osteoarthritis ; Tendons ; Tuberculosis ; Wrist

In 1971, for purpose of reduction of peak stress occuring in cement and trabecular bone of the acetabulum, Harris reported a series of metal-backed acetabular components with removable polyethylene liners that could be replaced if excessive wear occured. Modular designs of hip prostheses have become popular recently, but they introduce the risk of disassembly of the components postoperatively. And introduce of loosening and infection of femoral or acetabular components by debris of polyethylene liner. We report a case of mechanical disassembly of polyethylene liner in cementless metal backed cup, and review previously reported articles.
Acetabulum ; Hip Prosthesis ; Polyethylene

OBJECTIVES: To report a case of sacral stress fracture that developed after lumbosacral fusion.SUMMARY OF LITERATURE REVIEW: Sacral stress fractures rarely develop after lumbosacral fusion, and osteoporosis, female sex, being over 60 years old, and long segment fusion are known risk factors. MATERIALS AND METHODS: A 66-year-old woman with spondylolisthesis at L5 on S1 underwent posterior lumbar interbody fusion and posterior instrumentation. A sacral stress fracture was found 4 weeks after the first operation, and we performed posterior reduction and posterior instrumentation with S2 alar screws. RESULTS: The patient was free from symptoms and no further displacement was found at 3 months after the last operation. CONCLUSIONS Sacral stress fracture after lumbosacral fusion can be treated with posterior reduction and posterior instrumentation with S2 alar screws.

BACKGROUND: Tissue injury by surgical manipulation or trauma may cause pain hypersensitivity secondary to central sensitization. The aim of this study was to evaluate the postoperative effect of gabapentin on incisional pain in rat pretreated with pentylenetetrazole. METHODS: Thirty rats were divided into 5 groups, a control group (n = 10), PTZ 10 group (n = 5), PTZ 20 group (n = 5), PTZ 30 group (n = 5), and a PG 30 group (n = 5). To evaluate postoperative mechanical hyperalgesia in injured feet, withdrawal thresholds were measured by calibrated von Frey filaments at 2 hr, 1 day, 2 days, 3 days, 4 days, and 5 days after the incision. RESULTS: The PTZ 10, 20, and 30 groups showed no significant difference in withdrawal thresholds when compared with the control group during 5 days postoperatively. There were no significant differences in withdrawal thresholds among the PTZ 10, 20, and 30 groups. However, the PG 30 group showed a significantly lower withdrawal threshold compared with the control group at postoperative days 3, 4 (p < 0.05), and 5 (p < 0.01). CONCLUSIONS: Intraperitoneal pentylenetetrazole administered before an incision had no effect on postoperative pain in the incisional pain model. However, gabapentin injection after an incision in rats pretreated with pentylenetetrazole caused hyperalgesia during 5 days postoperatively.
Animals ; Central Nervous System Sensitization ; Foot ; Hyperalgesia ; Hypersensitivity ; Pain, Postoperative ; Pentylenetetrazole* ; Rats*

PURPOSE: To report a case of anterior uveitis secondary to Listeria monocytogenes infection. CASE SUMMARY: A 57-year-old male presented to our clinic with ocular pain and decreased vision in the right eye for 2 days. The patient had a history of liver transplantation 2 years prior and used immunosuppressive agents. Listeria monocytogenes was identified in blood cultures 1 month before his visit. At presentation, best-corrected visual acuity (BCVA) of the right eye was counting fingers at 20 cm and the intraocular pressure (IOP) was 50 mmHg. Conjunctival hyperemia, corneal edema, keratic precipitates, and cells in the anterior chamber were observed in the right eye. The patient was diagnosed as anterior uveitis in the right eye. Conventional uveitis treatment was initiated but clinical features did not improve and black hypopyon appeared. The possibility of anterior uveitis caused by Listeria monocytogenes infection was considered. An anterior chamber tap and culture were conducted to identify pathogens. Anterior chamber antibiotic injections and systemic antibiotic injections were performed. One week after injection, the BCVA of the right eye improved to 0.4 and the IOP decreased to 14 mmHg. One month after injection, the BCVA of the right eye improved to 1.0 and the IOP decreased to 16 mmHg. No inflammation of the anterior chamber was observed. CONCLUSIONS: When nonspecific uveitis occurs in immunosuppressed patients, cultures and appropriate antibiotics should be considered because of the possibility of infection.
Anterior Chamber ; Anti-Bacterial Agents ; Corneal Edema ; Endophthalmitis ; Fingers ; Humans ; Hyperemia ; Immunosuppressive Agents ; Inflammation ; Intraocular Pressure ; Listeria monocytogenes ; Listeria ; Liver Transplantation ; Male ; Middle Aged ; Uveitis ; Uveitis, Anterior ; Visual Acuity

PURPOSE: To report a case of choroidal neovascularization in a Best disease patient treated with intravitreal bevacizumab injection and followed up with optical coherence tomography angiography (OCTA). CASE SUMMARY: A 20-year-old female visited our clinic with decreased visual acuity of the left eye for 6 months. On optical coherence tomography (OCT), subretinal fluid and hyperreflective subretinal clumps were observed in the macula of the right eye. Subretinal hemorrhage and subretinal fluid were observed in the left eye. Choroidal neovascularization in the left eye was observed using OCTA, fluorescein angiography, and indocyanine green angiography. A full-field electroretinogram was normal in both eyes, but an electrooculogram revealed that the Arden ratio was 1.564 in the right eye and 1.081 in the left eye. Intravitreal bevacizumab injection was performed in the left eye. At 6 months after the intravitreal injection, the best-corrected visual acuity of the left eye had recovered to 20/20. OCT revealed that subretinal fluid reduced and choroidal neovascularization was stable. After 12 months, visual acuity of the left eye was maintained at 20/20, but OCTA revealed that choroidal neovascularization had increased. CONCLUSIONS: Choroidal neovascularization associated with Best disease can improve by intravitreal bevacizumab injection, and the changes in choroidal neovascularization can be followed using OCTA.
Angiography ; Bevacizumab ; Choroid ; Choroidal Neovascularization ; Electrooculography ; Female ; Fluorescein Angiography ; Hemorrhage ; Humans ; Indocyanine Green ; Intravitreal Injections ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity ; Vitelliform Macular Dystrophy ; Young Adult