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: 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 efficacy of intra-articular hyaluronic acid and steroid injection in osteoarthritis of the knee. METHOD: Among 653 patients with osteoarthritis, 531 patients were participated in this study. They were divided to three groups; A, treated with hyaluronic acid 2.5 ml intra-articular injection once a week for 5 times; B, hyaluronic acid 2.5 ml once a week for 5 times with triamcinolone 20 mg once at the first time; C, only triamcinolone 20 mg at the first time. Before injection, X-ray with standing view were checked and divided according to Kellgren's grade of osteoarthritis. The amount of pain relief was assessed by pain rating score (PRS) and visual analogue scale (VAS) 1 week before and 1 month after the treatment. RESULTS: The degree of pain relief by PRS and VAS were all improved at 1 month after injection compared with pre-injection status (p<0.001). Intra-articular hyaluronic acid injection was more effective in Kellgren's grade I, II than in III, IV in pain relief and hyaluronic acid with steroid injection was more effective in III, IV. CONCLUSION: The results suggest that intra-articular hyaluronic acid injection would be effective for the treatment of patients with osteoarthritis.
Humans ; Hyaluronic Acid* ; Injections, Intra-Articular ; Knee* ; Osteoarthritis* ; Triamcinolone

OBJECTIVE: The purpose of this study was to evaluate the ultrasonographic (US) findings in the shoulder impingement syndrome and to correlate them with the Hawkins and Kennedy's clinical stages. METHOD: 41 patients with suspected shoulder impingement syndrome were evaluated. All patients were divided into 3 clinical groups according to Hawkins and Kennedy and US examination was done in each group. RESULTS: US findings were as follows. In stage I, there were 3 normal findings, 5 tendinitis of the rotator cuff (RC), 2 partial thickness tear of RC, and 0 full thickness tear of RC. In stage II, 6 normal findings, 13 tendinitis of RC, 3 partial thickness tear of RC and 2 full thickness tear of RC. In stage III, 0 normal findings, 1 tendinitids of RC, 1 partial thickness tear of RC, and 5 full thickness tear of RC. The most common findings in the tendinits of RC were tendon thickness, focal hypoechogenicity and calcification. In partial thickness tear of RC, focal hypoechogenicity and impingement in abduction were most common findings. In full thickness tear of RC, the irregular humeral head surface and the biceps tendon effusion were most common findings CONCLUSION: The ultrasonography is a valuable means of evaluating the shoulder impingement syndrome and its findings have good correlation with clinical stages
Humans ; Humeral Head ; Rotator Cuff ; Shoulder Impingement Syndrome* ; Shoulder* ; Tendinopathy ; Tendons ; Ultrasonography*

OBJECTIVE: The purpose of this study was to investigate the serum and synovial IGF-I levels in 30 patients with knee osteoarthritis (OA) and the relationships among the IGF-I level, pain intensity and severity of knee OA. METHOD: Thirty patients who met criteria of knee OA of American Rheumatology Association participated in this study. Samples of serum and synovial fluid were obtained from all patients. The levels of IGF-I were determined by radioimmunoassay (RIA). The intensity of pain was assessed by Pain Rating Score (PRS) and Visual Analogue Scale (VAS). The severity of knee OA was evaluated by Kellgren's grade of knee OA. RESULTS: The mean serum and synovial IGF-I level was 231.66+/-86.15 ng/ml and 122.42+/-37.79 ng/ml, respectively. There was no correlation between pain intensity and IGF-I levels. Neither was there statistically significant correlation between Kellgren's grade and IGF-I levels. CONCLUSION: The serum and synovial IGF-I levels were not related with pain intensity and severity of knee OA.
Humans ; Insulin-Like Growth Factor I* ; Knee* ; Osteoarthritis, Knee* ; Radioimmunoassay ; Rheumatology ; Synovial Fluid

OBJECTIVE: This study was aimed to demonstrate definite diagnostic radiologic criteria between normal and flatfoot. METHOD: Sixty healthy subjects and fifty two flatfoot cases were evaluated by radiologic measurements. We evaluated criteria for longitudinal arch curve by measuring of calcaneal pitch, talocalcaneal angle, talometatarsal angle, metatarsal angle and navicular height I and II. RESULTS: Over 10 years old, there was significant correlation between normal group and flatfoot in calcaneal pitch, talocacaneal angle, difference angle, metatarsal angle, navicular height I and II. But below 10 years old, there was difference in only talometatarsal angle and metatarsal angle. Therefore talometatarsal angle and metartarsal angle are valuable in diagnosis of flatfoot in all age group. CONCLUSION: In diagnosis of flatfoot, variable radiologic measurement are clinically significant.
Child ; Diagnosis ; Flatfoot* ; Humans ; Metatarsal Bones

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*

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: 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

OBJECTIVE: To compare the Madopar(R) (Levodopa Benserazide) test with Insulin Tolerance Test (ITT) as a provocation test for growth hormone (GH). METHOD: One hundred eighty-seven subjects who had not organic disease such as hypothalamic-pituitary disease were studied. Seventy-one subjects underwent an ITT by injection of 0.1 U/kg of regular insulin and blood samples for GH assay were taken at 0, 30, 60 and 120 minutes. One hundred sixteen subjects underwent a Madopar(R) test by administration of Madopar(R) and blood samples for GH assay were taken at 0, 60, 120 and 180 minutes. RESULTS: The GH mean peak response in ITT was significantly higher than that of the Madopar(R) test. Below 50 years, 18 of ITT and 24 of Madopar(R) test showd a GH peak response of less than 5 ng/ml. Above 50 years, 14 of ITT and 53 of Madopar(R) test showd a GH peak response of less than 5 ng/ml. CONCLUSION: The results suggested that the GH response to the Madopar(R) test was much less than that of the ITT. The Madopar(R) test was limited in diagnosis of the adult GH deficiency in normal adults.
Adult* ; Diagnosis* ; Growth Hormone* ; Humans ; Insulin