OBJECTIVE: To determine valuable radiologic criteria in diagnosis of pes cavus. METHOD: Thirty eight healthy subjects and twenty seven pes cavus cases were evaluated by radiologic measurements. We evaluated the criteria for longitudinal arch curve by measuring the calcaneal pitch, talocalcaneal angle, talometatarsal angle, metatarsal angle and navicular height I and II. RESULTS: By comparing the pes cavus with the control group, no significant differences in the talocalcaneal angle, metatarsal angle and navicular height I and II were found. Whereas we found a significant difference between the talometatarsal angle and calcaneal pitch. Talometatarsal angle is more sensitive and specific compared to the calcaneal pitch. CONCLUSION: In diagnosis of idiopathic pes cavus, talometa tarsal angle is more reliable in the diagnosis of pes cavus. The ultimate diagnostic value of talometatarsal angle in pes cavus is 6degrees.
Diagnosis ; Foot Deformities* ; Metatarsal Bones

OBJECTIVE: This study was conducted to compare the effects of low frequency needle transcutaneous electrical nerve stimulation (TENS) and high frequency needle TENS on experimental pain threshold. METHOD: Twenty two healthy adult subjects were assigned randomly to a low-TENS group or to a high-TENS group. Experimental pain threshold at forearm was determined with pain threshold of electrical simulation using surface electrode and needle electrode. RESULTS: Low-TENS group showed that pain relief was developed after 10 minutes and persisted 3 hours after treatment cessation. Low-TENS group showed a significant increase in experimental pain threshold opposing to high TENS group. CONCLUSION: This results suggest that effect of low frequency needle TENS therapy is better and longer than high frequency needle TENS therapy.
Adult* ; Electrodes ; Forearm ; Humans ; Needles* ; Pain Threshold* ; Transcutaneous Electric Nerve Stimulation* ; Withholding Treatment

OBJECTIVE: To know the clinically meaningful findings of ultrasonography in plantar fasciitis. METHOD: Thirty one feet of 24 patients who had clinical diagnosis of plantar fasciitis and 70 feet of 35 healthy volunteers were evaluated with ultrasound. Sagittal sonograms were obtained in the prone position, and the plantar fascia thickness (PFT) was measured at proximal end near its insertion into the calcaneus. Hypoechogenecity, perifascial fluid collection, tendon rupture, calcaneal spur and calcification were also evaluated. RESULTS: The plantar fascia thickness (PFT) of the symptomatic heels (SH) of patients group (4.83+/-0.86 mm) was significantly greater than that of their asymtomatic heels (ASH) (2.95+/-0.57 mm)(p<0.05) and it was also greater than that of control group (2.63+/-0.41 mm)(p<0.05). The range of difference of both PFT was 0.7~3.2 mm in patients group and 0~0.8 mm in control group. Hypoechogenecity was found in 22 SH (71%), perifascial fluid collection in 5 SH (16%) and calcification in 2 SH (6%). Calcaneal bony spur was identified in 7 SH (26%) on simple radiography. CONCLUSION: Increased thickness (>3.8 mm), difference of thickness between SH and ASH (>1.0 mm) and hypoecho genecity of plantar fascia were clinically meaningful ultrasonographic findings of plantar fasciitis, and ultrasonogrphy can be used as the inital imaging modality for the diagnosis.
Calcaneus ; Diagnosis ; Fascia ; Fasciitis, Plantar* ; Foot ; Healthy Volunteers ; Heel ; Heel Spur ; Humans ; Prone Position ; Radiography ; Rupture ; Tendons ; Ultrasonography

OBJECTIVE: To evaluate the effect of extracorporeal shock wave therapy (ESWT) in plantar fasciitis with visual analog scale score and thickness of fascia by ultrasonography. METHOD: The subjects consisted of 32 feet (24 patients) with established diagnosis of chronic plantar fasciitis, including 17 feet in the ESWT group and 15 feet in the control group. In the ESWT group, three session of ESWT (0.24 mJ/mm2 FED, 1,200 impulse, weekly) were performed. The visual analog scale (VAS) score and thickness of the plantar fascia were measured by ultrasound before therapy and at the 6-week and 6-month follow-up. Patients in the control group were treated with medication, orthotics, physical therapy and exercise program. VAS and thickness of plantar fascia was evaluated at the same time as ESWT group. RESULTS: In the ESWT group, thickness of plantar fascia decreased significantly at 6-week follow-up (p <0.05) and 6-month follow-up (p <0.05). Control group showed no significant difference at follow-up (>0.05). Visual analog scale score showed no significantly difference at 6-week follow-up (>0.05), but decreased at 6-month follow-up. On the other hand, in the control group, thickness of plantar fascia did not change significantly at 6-week follow-up (>0.05) and 6-month follow-up (>0.05). VAS score was not significant different at the 6-week follow-up (>0.05), but decreased at the 6-month follow-up (p <0.05). CONCLUSION: ESWT in plantar fasciitis is effective in relieving subjective pain and reducing thickness of plantar fascia at 6-month follow-up.
Fascia ; Fasciitis, Plantar ; Follow-Up Studies ; Foot ; Hand ; Humans ; Shock

Patients with ankylosing spondylitis are more susceptible to spine fractures than healthy people. Because of their underlying back pain, vertebral fracture induced pain is not easily controlled by bed rest, physical therapy and medications. Thus, new treatment methods should be introduced. We report a 63 year-old man with ankylosing spondylitis who fell down 4 weeks ago and suffered a fracture of T6 spine. He complained of a mid thoracic pain. Although he was treated with bed rest, physical therapy, second-line bisphosphonate agents, the pain persisted. Therefore, intravenous zoledronate which was approved for palliative treatment of bone metastases in patients with breast cancer, 4 mg was administrated. The severity of pain was decreased by half within 2 days and sustained over 4 weeks.
Back Pain ; Bed Rest ; Breast Neoplasms ; Humans ; Middle Aged ; Neoplasm Metastasis ; Palliative Care ; Spine ; Spondylitis, Ankylosing*

OBJECTIVE: To evaluate effects of short stretch bandage and electrical stimulation therapy (EST) for the complex regional pain syndrome (CRPS) in hemiplegic patients METHOD: 10 hemiplegic CRPS patients after stroke or traumatic brain injury were included in the study. We established CRPS from clinical symptoms and triphasic bone scan. Short stretch bandage was applied on affected limb and changed every 24 hours for 2 weeks. EST was tried for 10 minutes twice per day. It was applied at finger and wrist flexor muscles. We measured hand volume of pre-and posttreatment using hand volumeter. Also compared pre-and posttreatment pain-free range of motion (ROM) of metacarpophalangeal (MCP) joint and third proximal interphalangeal (PIP) joint circumference. RESULTS: Mean difference of hand volume between the affected and the unaffected prior to treatment was 20.5+/-4.9 ml (7.9+/-2.3%). After treatment, mean volume change was 15.5+/-4.9 ml (5.5+/-1.8%) (p<0.05). Mean change of pain-free ROM was 8.0+/-4.8 degree (10.9+/-7.1%), mean change of PIP joint circumference was 3.1+/-1.4 mm (5.9+/-2.4%) (p<0.05). CONCLUSION: Short stretch bandage and EST complex therapy is effective for the reduction of paralyzed hand edema and pain in hemiplegic CRPS patients. However further control study is required.
Bandages* ; Brain Injuries ; Edema ; Electric Stimulation Therapy* ; Electric Stimulation* ; Extremities ; Fingers ; Hand ; Humans ; Joints ; Muscles ; Range of Motion, Articular ; Stroke ; Wrist

OBJECTIVE: The purpose of this study was to evaluate the effect of lateral heel and sole wedges on osteoarthritis of knees. METHOD: Sixty patients with knee osteoarthritis were enrolled and divided into the control (n=30) and wedge (n=30) groups. The control group received only conventional therapy for 5 weeks, while the wedge group took lateral wedges with 4 mm height in additional to the same conventional therapy. Intensity of pain and funtional activity were assessed by Western Ontario and Mac-Master Universities Osteoarthritis index (WOMAC index) and Lequesne s index. Scanogram was measured to assess femorotibial anglechange. WOMAC index, Lequesne's index and scanogram were measured before and 6 months after the therapy. RESULTS: For the wedge group, WOMAC index and Lequesne's index were significantly lower at the six month follow up compared to the initial indices (p<0.05). The femorotibial angle showed no significant change in both groups. CONCLUSION: Lateral heel and sole wedges can be used as an effective therapeutic modality for long term management of knee osteoarthritis in combination with conventional therapy.
Follow-Up Studies ; Heel* ; Humans ; Ontario ; Osteoarthritis* ; Osteoarthritis, Knee*

OBJECTIVE: To obtain reference values of early potential latency and amplitude of pudendal SEP in Korean normal women and to correlate those values with height and age. METHOD: Twenty-three normal female with mean age of 45.27 years were evaluated for pudendal SEP. Stimulation was applied on the dorsal aspect of the clitoris with a bar electrode. Onset, P1, N1, P2 latencies and P0-P1, P1-N1, N1-P2 amplitudes were measured and those of both sides were analyzed. RESULTS: The mean latency of P0, P1, N1, P2 were 29.0+/-2.83 msec, 35.5+/-2.91 msec, 45.1+/-4.10 msec, 56.3+/-5.20 msec by the right pudendal nerve, and 28.6+/-3.11 msec, 35.2+/-2.93 msec, 45.0+/-3.83 msec, 56.5+/-5.33 msec by the left pudendal nerve. The amplitude ranges of P0-P1, P1-N1, N1-P2 were 0.31~2.45 uV, 0.11~2.24 uV, 0.21~2.62 uV by the right pudendal nerve, and 0.29~2.46 uV, 0.25~2.21 uV, 0.12~5.07 uV by the left pudendal nerve. There was tendency of prolongation of the latency with increasing the height. There is no difference of amplitude according to the height and the age. There was no significant difference between right and left sides in mean latency and range of amplitude of pudendal nerve SEPs, and between premenopause and postmenopause. CONCLUSION: Normal reference of female pudendal SEP were established. We suggest that pudendal SEP can be used as one of useful diagnostic tools for female urogenital and neurologic disease.
Clitoris ; Electrodes ; Evoked Potentials, Somatosensory* ; Female ; Humans ; Postmenopause ; Premenopause ; Pudendal Nerve ; Reference Values*

OBJECTIVE: There is increasing interest in growth hormone (GH) replacement therapy to improve quality of life (QoL) of elderly with age-related decline in GH level (somatopause). The aim of this study was to evaluate the effect of GH replacement on the QoL in patients with somatopause. METHOD: A prospective study of 56 adults with somatopause was conducted. They were replaced with a GH over a 6-month period. QoL was assessed by using three self-rating questionnaires: the Nottingham Health Profile (NHP), the Psychological General Well-Being Index (PGWBI) and theAssessment of Growth Hormone Deficiency in Adults (AGHDA). RESULTS: Significant impairment in QoL as measured by NHP, PGWBI and AGHDA were noted in patients with somatopause compared with age and sex matched normal population (p<0.05). There was significant improvement in QoL after 6-month of GH replacement (p<0.05). CONCLUSION: Six months GH replacement induced an improvement in the QoL of patients with somatopause.
Adult ; Aged ; Growth Hormone* ; Humans ; Prospective Studies ; Quality of Life* ; Surveys and Questionnaires