OBJECTIVE: Although minimally invasive posterior cervical foraminotomy (MI-PCF) is an established approach for motion preservation, the outcomes are variable among patients. The objective of this study was to identify significant factors that influence motion preservation after MI-PCF. METHODS: Forty-eight patients who had undergone MI-PCF between 2004 and 2012 on a total of 70 levels were studied. Cervical parameters measured using plain radiography included C2–7 plumb line, C2–7 Cobb angle, T1 slope, thoracic outlet angle, neck tilt, and disc height before and 24 months after surgery. The ratios of the remaining facet joints after MI-PCF were calculated postoperatively using computed tomography. Changes in the distance between interspinous processes (DISP) and the segmental angle (SA) before and after surgery were also measured. We determined successful motion preservation with changes in DISP of ≤3 mm and in SA of ≤2°. RESULTS: The differences in preoperative and postoperative DISP and SA after MI-PCF were 0.03±3.95 mm and 0.34±4.46°, respectively, fulfilling the criteria for successful motion preservation. However, the appropriate level of motion preservation is achieved in cases in which changes in preoperative and postoperative DISP and SA motions are 55.7 and 57.1%, respectively. Based on preoperative and postoperative DISP, patients were divided into three groups, and the characteristics of each group were compared. Among these, the only statistically significant factor in motion preservation was preoperative disc height (Pearson’s correlation coefficient=0.658, p<0.001). The optimal disc height for motion preservation in regard to DISP ranges from 4.18 to 7.08 mm. CONCLUSION: MI-PCF is a widely accepted approach for motion preservation, although desirable radiographic outcomes were only achieved in approximately half of the patients who had undergone the procedure. Since disc height appears to be a significant factor in motion preservation, surgeons should consider disc height before performing MI-PCF.
Foraminotomy* ; Humans ; Neck ; Radiography ; Surgeons ; Zygapophyseal Joint

In spite of recent development in fixation technique we still have lots of complication including avascular necrosis of femoral head. For many years, orthopaedic surgeon have been searching for a simple, safe, accurate and reliable clinical test to asses the vascular status of the femoral head. In early detection of viability of the femoral head, nothing is more certain than bone scan at the moment. Bone scan can detect or predict the viability of the femoral head. Subramanian and McAfee introduced 99mTc-Sn-polyphosphate as a bone seeking agents. We applied serial bone scan in 19 cases of femur neck fractures from 1982 to 1985 at the department of orthopaedic surgery, National Medical Center. The results were as follows; 1. The uptake ratio of displaced and undisplaced group based on preoperative radiography was 1.ZO, 1.46, 1.52, 1.55, and 0.63, 1.23, 1.81, 1.58 in average in postoperative bone scan interval 1–2 wks, 3 months, 6 months, 12 months. The bone scan uptake ratio was lower in the former than the latter, but after 3 months, there was no remarkable difference between them. 2. At the time of 1 to 2 weeks, 3 months, 6 months and 12 months, uneventful group was 0.74, 1.27, 1.72, 1.62 and avascular necrosis group 0.13, 0.18, 0.30, 0.67 in the uptake ratio. In 2 cases of avascular necrosis, the uptake ratio was markedly decreased. 3. There was no difference between the group operated within 48 hour after injury and the group delayed later.
Equidae ; Femoral Neck Fractures ; Femur Neck ; Femur ; Head ; Necrosis ; Radiography

OBJECTIVE: To retrospectively compare the imaging characteristics of retropharyngeal density and associated findings for Kawasaki disease with those for non-Kawasaki disease, and identify the distinguishing features which aid the CT diagnosis of Kawasaki disease with retropharyngeal low density. MATERIALS AND METHODS: Among the enhanced neck CT performed in children less than 8-years old with clinical presentation of fever and cervical lymphadenopathy over a 6-year period, only cases with retropharyngeal low density (RLD) were included in this study. The 56 cases of RLD were divided into two groups; group A included cases diagnosed as Kawasaki disease (n = 34) and group B included cases diagnosed as non-Kawasaki disease (n = 22). We evaluated the CT features including the thickness of RLD and its extent into the deep neck spaces, as well as soft tissue change in the adjacent structure. We also scored the extent of RLD into the deep neck spaces and the soft tissue changes in the adjacent structure. RESULTS: The thickness of RLD was greater in group A than in group B (group A, 6.0 +/- 2.1; group B, 4.6 +/- 1.5, p = 0.01). The score of the RLD extent into the deep neck spaces was significantly greater in group A than in group B (group A, 2.3 +/- 1.3; group B, 0.8 +/- 1.0, p < 0.01). Also, the score of the adjacent soft tissue changes was greater in group A than in group B (group A, 2.0 +/- 1.1; group B, 1.0 +/- 1.0, p < 0.01). CONCLUSION: If children present with fever and cervical lymphadenopathy that display retropharyngeal low density with extension into more deep neck spaces as well as changes in more adjacent soft tissue, the possibility of Kawasaki disease should be considered.
Child ; Child, Preschool ; Female ; Humans ; Lymphatic Diseases/complications/radiography ; Male ; Mucocutaneous Lymph Node Syndrome/complications/*radiography ; Neck/*radiography ; Pharyngeal Diseases/complications/*radiography ; Pharynx/*radiography ; *Tomography, X-Ray Computed

We experienced a case of congenital goiter with congenital hypothyroidism in 45 day-old male, who complained of respiratory difficulty and anterior neck mass. After admission, he was diagnosed congenital hypothyroidism by the clinical manifestations and laboratory tests including biochemistry, radioimmunoassay, radioisotope study, perchlorate discharge test, and bone radiography. We obtained positive finding at the perchlorate discharge test and found that his congenital goiter with congenital hypothyroidism was manifested by organification defect. We started treatment with L-thyroxine orally at 6th hospital day. The case was presented with brief review of literatures.
Biochemistry ; Congenital Hypothyroidism* ; Goiter* ; Humans ; Male ; Neck ; Radiography ; Radioimmunoassay ; Thyroxine

PURPOSE: This study was done to evaluate the absorbed doses in organs of the head and neck for the conventional temporomandibular joint tomography. MATERIALS AND METHODS: Dosimetry was performed with 32 LiF thermoluminescent dosimeters, which were placed in a tissue-equivalent phantom when the temporomandibular joint was examined by both lateral and frontal temporomandibular joint tomography. RESULTS: For lateral tomography, parotid gland and preauricular area towards tube showed relatively high absorbed dose of 1056.9 microGy and 519.9 microGy respectively. For frontal tomography, the two largest absorbed doses were 259.2 microGy in orbit towards tube and 212.0 microGy in lens towards tube. CONCLUSION: Conventional temporomandibular joint tomography showed relatively low absorbed doses on critical organs. Thus, responsible use of it may not be limited.
Head* ; Neck* ; Orbit ; Parotid Gland ; Radiation Dosage ; Radiography ; Temporomandibular Joint*

This report described a case in which diagnostic radiographs showed irregular dense radiopaque strings and curved lines in the head and neck area. These artifacts could lead to misinterpretation since they may obscure anatomical structures and/or mask critical structures/pathologies. A more detailed history of the patient indicated that these strings originated from a facelift procedure in which a gold-wire technique was used. Considering that such intervention may cause a radiodiagnostic burden, it should be included in the anamnesis prior to radiography.
Artifacts* ; Head ; Humans ; Masks ; Neck ; Radiography ; Rhytidoplasty ; Surgery, Plastic

The purpose of this study was to determine whether association exists between temporomandibular joint (TMJ) characteristics in transcranial radiographs and TMJ internal derangement and to evaluate the validity of transcranial radiographs in diagnosis of internal derangement. Transcranial radiographs and magnetic resonance imaging (MRI) of 113 TMJs from 76 subjects were used for this study and all TMJs were classified into 3 groups according to the results of MRI: normal disk position, disk displacement with reduction, and disk displacement without reduction. Transcranial analysis included linear measurement of joint spaces and condylar head angle measurement. To determine any relationship between transcranial measurements according to disk displacement, one-way ANOVA was used. The results showed that condyle-fossa relationship in standard transcranial radiographs had no relationships with disk displacement. And, as disk displacement progressed, condylar angle between head and neck increased significantly. This result can be interpreted that condylar head angle reflects structural hard tissue change according to internal derangement progress. But this is insufficient in the determination of internal derangement. Therefore, although still clinically helpful, the validity of standard transcranial radiographs to diagnose TMJ internal derangement was questioned.
Diagnosis* ; Head ; Joints ; Magnetic Resonance Imaging ; Neck ; Radiography* ; Temporomandibular Joint

OBJECTIVE: To analyze the X-ray characteristics in youth neck type of cervical spondylosis with upper crossed syndrome(UCS). METHODS: The patients who had a neck type of cervical spondylosis with or without UCS were selected from January to October 2017, 20 cases in each group, and 10 normal volunteers were chosen in the study. X-ray examination of lateral and hyperextension-hyperflexion of cervical spine were performed to observe cervical spine angle, angular displacement and adjacent vertebral body slip. RESULTS: The cervical spine angle was (-0.40±9.64)° in the UCS group, significantly less than (14.35±9.01)° in the normal group and (12.34±5.65)° in the non-UCS group(<0.05). The change of angular displacement of the upper cervical vertebra in anterior flexion and posterior extension was (8.18±4.81)° in UCS group, which was also significantly less than (12.14±3.48)° in the normal group and (12.34±5.65)° in the non-UCS group(<0.05). The slippage of the vertebral posterior margin of the lower cervical spine in the anterior flexion was 15.41±2.21 in the UCS group, which was significantly greater than 13.26±2.42 in normal group(<0.05), and was not obviously different from 15.64±2.07 in non-UCS group(>0.05). CONCLUSIONS In young patients who has a neck type of cervical spondylosis with UCS, the cervical curvature prone to straighten or reverse, the upper cervical flexion and extension are limited, while the lower cervical is in a flexion.
Adolescent ; Cervical Vertebrae ; Humans ; Neck ; Radiography ; Spondylosis ; X-Rays

PURPOSE: To investigate the causes of nonunion and its appropriate modality of treatment by a retrospective review of our cases. MATERIALS AND METHODS: Four cases of established nonunion of the femur neck referred from other hospitals were included and the initial fracture was Delbet type 2 in all cases. Three cases were mobile with marked bony resorption at the nonunion site. RESULTS: The causes of nonunion include insufficient fixation which did not cross physis in the state of inaccurate reduction, and also insufficient duration of cast immobilization, and early weight bearing. All cases of nonunion were successfully treated by adequate amount of autogenous cancellous bone graft with minimal pin fixation across physeal plate, and followed by sufficient cast immobilization for more than 12 weeks, reinforced by instituting long-term protective weight bearing for at least 6 months until evidence of union on plain roentgenography is shown. CONCLUSIONS: Based on our experience, we propose the followings instead of subtrochanteric valgus osteotomy in the treatment of mobile, osteopenic nonunion of the femur neck in children. The most important considerations are adequate amount of autogenous cancellous bone graft, and prolonged protective weight bearing until bony union is assured as well as less bulky internal fixation crossing the physis.
Child* ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Humans ; Immobilization ; Osteotomy ; Radiography ; Retrospective Studies ; Transplants ; Weight-Bearing

BACKGROUND: Reports on the relationship between osteoporosis and osteoarthritis (OA) have tended to disagree, especially in non-weight bearing joints such as the hand joints. We aimed to investigate the relationship between bone mineral density (BMD) and hand and knee OA in a general Korean elderly population. METHODS: We evaluated femur neck BMD and the hand and knee radiographs of 143 men and 123 women over 65 years of age who participated in a population-based cohort study. The Kellgren-Lawrence criteria for grading OA were implemented, and grade 2 or higher were categorized as radiographic OA. BMD was compared according to the existence of radiographic OA in the hand and knee using analysis of covariance, and correlation analyses were performed to explore the relationship between BMD and radiographic OA grade. RESULTS: After controlling for age and body mass index, there was no significant difference in BMD between participants with and without hand OA (p = 0.717 in male and p = 0.862 in female), between those with and without knee OA (p = 0.974 in male and p = 0.563 in female), and between those with only hand OA and those with only knee OA (p = 0.920 in male and p = 0.961 in female). Furthermore, there was no significant correlation between BMD and the radiographic OA grade of the hands (p = 0.182 in male and p = 0.897 in female) and knees (p = 0.245 in male and p = 0.098 in female). CONCLUSIONS: In our cohort of the general Korean elderly population, no association was found between osteoporosis and OA, regardless of the weight bearing status of the joints.
Aged ; *Bone Density ; Female ; Femur Neck/*radiography ; Hand/*radiography ; Humans ; Male ; Osteoarthritis, Knee/complications/*radiography ; Osteoporosis/complications/*radiography ; Republic of Korea ; Sex Factors