Now that ankylosing spondylitis is known to be relatively common, it is important that mild cases should be diagnosed earlier to avoid inappropriate investigation and unhelpful non-specific therapy and to improve social rehabilitation. However, difficulties in the diagnosis of ankylosing spondylitis are often encountered. To establish the clinical values of SPECT in ankylosing spondylitis, a study of radiologic evaluation, quantitative bone scan and SPECT have been carried out in 34 patients who were firmly suspected as having ankylosing spondylitis by other tests. This study showed that SPECT could improve the applicability of the imaging modality in the diagnosis and the assessment of disease activity and the capacity of early diagnosis in patients with ankylosing spondylitis. We believe that improved three dimensional localization in and around the sacroiliac joints by SPECT might overcome several diagnostic difficulties. Especially when radiographic abnormalities are not present in the early period, the diagnostic values of SPECT may be more potential.
Diagnosis ; Early Diagnosis ; Evaluation Studies as Topic ; Humans ; Rehabilitation ; Sacroiliac Joint ; Spondylitis, Ankylosing* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Calcaneus* ; Intra-Articular Fractures*

PURPOSE: To show the results of treatment of ipsilateral unstable femoral fracture during postoperative period of total hip arthroplasty. MATERIAL AND METHOD: We analyzed eight cases of ipsilateral unstable femoral fractures during the postoperative period of total hip arthroplasty, which were treated operatively from November 1992 to November 1995. The follow-up period ranged from 2 years to 3 years and 8 months (average, 2 years 8 months). There were seven cases of type B2 fractures and one case of type B3 fracture according to the Duncan's8) classification. All showed femoral stem loosening. One case was treated with revision of new femoral stem and internal fixation using wire. Six cases were treated with revision of long femoral stem and internal fixation using wire or Parham band. One case was treated with revision of long femoral stem and internal fixation using plate and wire. All cases had bone graft performed at the fracture site of femur. RESULTS: The results of treatment of periprosthetic fractures showed that seven cases were satisfactory and one case was unsatisfactory. The complications were as follows: nonunion in one, heterotopic ossification in two, and one case of limb shortening. CONCLUSION: The treatment of ipsilateral femoral fractures during postoperative period of total hip arthroplasty can be complex and difficult but revision arthroplasty with a new femoral stem prosthesis, combined with internal fixation and bone graft, may be satisfactory, if the femoral stem is displaced or loosened.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Classification ; Extremities ; Femoral Fractures* ; Femur ; Follow-Up Studies ; Ossification, Heterotopic ; Periprosthetic Fractures ; Postoperative Period ; Prostheses and Implants ; Transplants

Diseases involving hip may influence on the anatomy of the proximal femur, especially on the endosteal canal shape. The simple radiographic comparative study was performed between normal and diseased hips. For the diseasd hip group, 74 hips ol' femoral head AVN(avascular necrosis) (average age: 49.3 years old, patients were all male) who had limped for average l9 months were selected and 77 male hips (average age: 48.9 years old) who had no prior hip disease were selected for the normal hip group. The external shape of both group showed no significant differences except for the femoral head dimensions. Statistically significant differences were ohserved hetween two groups in the proximal endosteal canal shape and cortical thickness. The femur of the diseased hip group had wider canal from the level of distal to lesser trochanter to the level of isthmus, with a significant reduction in the metaphyseal index (the ratio hetween the canal width proximal to lesser trochanter and distal to lesser trochanter) and the canal flare index (p<0.001). Theoretically this study suggests that the optimal fit and fill to the proximal endostcal canals of normal and diseased hips cannot be obtained by oneshape cementless femoral stcms.
Femur* ; Head ; Hip* ; Humans ; Male

The purpose of this study is to compare 76 cases of fractures of the proximal humerus both clinically and radiologically which were treated at Pusan National University Hospital from January 1987 to December 1996. According to Neers classification, among the 76 patients, there were nine one-part fractures (11.8%), forty two-part fractures (52.6%), eighteen three-part fractures (23.7%), four four-part fractures (5.3%), and five head-splitting fractures (6.6%). In terms of treatment method, among the 76 patients, 49 patients (64.5%) were treated conservatively. Thirty seven patients (75.5%) of one-part and two-part fractures were treated conservatively, and twelve patients (54.5%) of three-part and four-part fractures were treated operatively. The results of the cases were rated by the Neer s assessment, 42 patients (85.7%) had excellent or satisfactory results in one-part and two-part fracture, and 7 patients (31.8%) had unsatisfactory or failed results in three-part and four-part fracture. Total cases with complications were 14 cases (18.4%). From the viewpoint of the type of fracture, the results in two-part and three-part fractures were much better than those of fourpart fractures. The joint stiffness which was the most common complication must be prevented by allowing the early motion of the joint to obtain a better result.
Busan ; Classification ; Humans ; Humerus* ; Joints

Deformity of the forearm is common in patients with hereditary multiple osteochondromas. It produces cosmetic and functional impairment. The deformity of the forearm in hereditary multiple osteochondromas that we described is often associated with osteochondroma of the distal part of ulna causing ulnar longitudinal hypoplasia. This osteochondroma mechanically disturbs the axial alignment of the adjacent joints, either directly or though tension on the interosseous membrane. We reviewed 9 cases of forearm deformity caused by hereditary multiple osteochondromas in 9 patients, in whom ulnar lengthening with excision of osteochondroma was a main procduree. The patients were followed along for a mean of 3 year 6 months. The procedures included ulnar lengthening with excision of osteochondroma in the distal part of the ulna in 6 patients, ulnar lengthening with excision of the osteochondroma and corrective osteotomy of the radius in 2 patients, and stapling of the distal physis of the radius with excision of osteochondroma in 1 patient. Ulnar lengthening was performed by an immediate bone graft and internal fixation in 5 patients, or gradual distraction with and external fixator in 3 patients. The cosmetic results of the surgery were very gratifying and the range of motion of radial deviation at the wrist was increased. Partial recurrence of the deformity was seen during follow up in the skeletally immature patients. However, in general, Ulnar lengthening with excision of osteochondroma was an effective procedure to restore cosmesis as well as function of the wrist.
Congenital Abnormalities ; Exostoses, Multiple Hereditary ; External Fixators ; Follow-Up Studies ; Forearm ; Humans ; Joints ; Membranes ; Osteochondroma ; Osteotomy ; Radius ; Range of Motion, Articular ; Recurrence ; Transplants ; Ulna ; Wrist

No abstract available.
Bone Cysts* ; Fractures, Spontaneous*

No abstract available.
Child* ; Humans ; Humerus*

Osteoid osteoma is a relatively common benign skeletal tumor that usually affects the cortex of the long bone. Despite its common incidence, the diagnosis is often delayed and confused with other entities such as stress fracture, tuberculosis, osteomyelitis and intracortical abscess. Moreover, the diagnosis becomes more difficult when the osteoid osteoma develops in the intra-articular region. Several factors contribute to the difficulty of the diagnosis: First, osteoid osteoma is relatively rare compared to other causes of articular pain. Second, it presents non-specific clinical manifestation in the hip joint much like other intraarticular disorders. Third, plain radiographs sometimes do not represent the characteristic findings. Fourth, MR imaging reveals inconsistent signal intensities, especially in the early stage. Bone scan also lacks specificity for diagnosis. Recently, we experienced four cases of intra-articular osteoid osteoma of the hip joint and presented them with a review of the literatures.
Abscess ; Diagnosis ; Fractures, Stress ; Hip Joint ; Hip* ; Incidence ; Magnetic Resonance Imaging ; Osteoma, Osteoid* ; Osteomyelitis ; Sensitivity and Specificity ; Tuberculosis

PURPOSE: To assess the midterm results of the hydroxyapatite hip system with acetabular cups, with particular emphasis upon cup wear and loosening, using a computer assisted-3 dimensional technique. MATERIALS AND METHODS: From March 1992 to December 1996, 52 patients (61 hips) were available for inclusion in this study after an average duration of follow up of 6 years and 4 months. Clinical evaluation was performed using the Harris hip scoring system. Initial postoperative and long term follow up films were digitized, and 2 dimensional linear and 3 dimensional wear was measured by using a computer assisted-3 dimensional technique. Acetabular bone changes are described using previous published methods. RESULTS: An analysis of the clinical results showed a mean Harris hip score of 47.2 points preoperatively and 89.8 points at the final visit. The mean polyethylene 3D-linear wear rate was 0.26 mm/year and mean volumetric wear rate was 105.9 mm3/year. In 16 hips (26.2%) the linear wear rate was more than 0.3 mm/year (0.30-0.74 mm/year). Osteolytic changes of the acetabulum were recorded in 51% around acetabular cups, in which considerable wear of the acetabular polyethylene was evident by the five-year radiographic findings. CONCLUSION: Midterm results of hydroxyapatite coated acetabular cups were disappointing in terms of acetabular cup and liner wear, despite early accelerated bone remodeling by hydroxyapatite and excellent early clinical results.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Bone Remodeling ; Durapatite* ; Follow-Up Studies ; Hip* ; Humans ; Osteolysis* ; Polyethylene