Clinical Study of Osteoid Osteoma / 대한정형외과학회잡지

Osteoid osteoma is a small, oval or roundish, nidus like neoplasm of bone. The lesion usually does not exceed a centimenter in its greatest dimension, and it consists of osteoid, trabeculae of newly formed osseous tissues and a substratum of highly vascularized osteogenic connective tissue. In a differential diagnosis, consideration should be given to Brodies abscess, sclerosing osteomyelitis of Garre, Fibrous dysplasia and healing fractures. From Janua 1960 to December 1980, we have seen and studied 18 cases of osteoid osteoma and the results obtained from this study were follows: l. Eleven cases were found in second decade and 17 cases were developed before thirty years old. 2. The sex ratio was nearly equal and duration of disease from onset was average 16 months. 3. Location of lesions were predominantly in lower extremities, 9 in tibia and 3 in femur. 4. Pain was noted in 16 cases and aspirin affected in 8 cases. 5. Nidus was found in 11 cases. 6. All cases were treated by radical excision of lesions with disappearance of pain and satisfactory results.

Fibrous Dysplasia: Report of Four Cases / 대한정형외과학회잡지

Fibrous dysplasia of bone is a condition affecting one or more bones, usually not disabling, of slow progress, and showing a tendency to become arrested. The etiology of fibrous dysplaia is unknown but it is now believed to be a developmental error in which primitive fibrous tissue proliferates within the bony medulIa and encroaches upon the cortex from within, often producing expansion. The process may be localized to a small segment or may involve almost the entire shaft of the bone, and it may be monostotic, monomelic or polyostotic. In the latter form some patients exhibit a remarkable combination of skin pigmentation and endocrine disturbances. This paper reports the one case of polyostic and three cases of monostotic fibrous dysplasia. The disgnosis was made by clinical, radiological and histological findings.

Synovial Fluid Analysis as a Diagnostic Aid in Arthritis / 대한정형외과학회잡지

Extensive knowlege of the characteristics of synovial fluid has been available for at least the past 30 years, when a Monograph on the subject by Kling first appeared in 1938. Since that time, Ropes, Bauer(1953) and Hollander (1960, 1961, 1965) have published classic. Monographs on their extensive studies and findings of synovial fluid. Specific laboratory tests for diagnosis of various forms of arthritis are usually lacking. For example, the test for the rheumatoid factor in serum may be helpful in establishing the diagnosis of rheumatoid arthritis, but these are often negative in early cases and L. E. phenomenon is often negative in the early stage or between severe exacerbations of the Systemic lupus erythematosus. It has become increasingly clear during the past 10 years that synovial fluid analysis is both the most valuable and yet the most neglected differential diagnostic test for arthritis. Studies of synovial fluid have presented a virtually unexplored frontier in the investigation of arthritis. So, we studied the synovial fluid from 100 cases of various forms of arthritis in the Department of Orthopedic Surgery, Severance Hospital from May, 1968 to May, 1969. 100 cases of arthritis are; 30 cases of Osteoarthritis, 20 cases of Traumatic athritis, 25 cases of Rheumatoid arthritis, 10 cases of Septic arthritis, 5 cases of Tuberculous arthritis, and 10 cases of Non-specific bursitis. The synovial fluid were aspirated from the involved joints in aseptic conditions and follwing studies were done. 1) General appearance. 2) Mucin content by Acetic acid PPT. or Ropes test. 3) Viscosity by Drop test. 4) Cell count by Wright s stain. WBC: Total and differential count. RBC count. 5) Synovial sugar by Folin Wu method. 6) Fasting blood sugar by Folin Wu method. 7) Sugar difference between synovial sugar and Fasting blood sugar. 8) Total protein by Kingsley s Biuret method. 9) Bacterial culture in Septic arthritis. 10) Microscopic examination. RA cells by Sternheimer-Malbin stain in Rheumatoid arthritis. Cartilage fragments with simple wet preparations in Osteoarthritis. 6 kinds of arthritides were grouped into 3 categories based on the degree of inflammation of the synovial membrane as reflected by synovial fluid changes according to Ropes and Bauer s classification(1953). The first group, consisting of Osteoarthritis and Traumatic arthritis, was associated with mild inflammatory reactions and increased amount of fluid, but no significant changes in the number of WBC, sugar concentration, or quality of mucin. The second group was characterized by more sever inflammation of the synovial membrane and included Rheumatoid arthritis, Septic arthritis and Tuberculous arthritis. The second group was associated with decreased mucin content, increased WBC, polymorphonuclear leucocytes, RBC and protein and decreased amount of synovial sugar. RA cells were found in all cases of Rheumatoid arthritis and cartilage fragments in Osteoarthritis under the light microscope. The third group, an intermediate group-Non specific bursitis might have some distinguishing characteristics of synovial fluid but these were not usually diagnostic.

A Case of McKee-Farrar Prosthetic Replacement of the Hip / 대한정형외과학회잡지

A case of severe osteoarthritic patient of both hip treated with McKee-Farrar total endoprosthesis on one hip is reported. The introduction, indication, procedure of the surgery and the use of the self curing acrylic cement were reviewed briefly. The hip following the surgery, even though the follow-up duration is short, showed exceIlent result.

A Case of Unusual Lung Abscess Induced by Psoas Abscess in Tuberculosis of the Spine / 대한정형외과학회잡지

A case of unusual lung abscess induced by psoas abscess in tuberculosis of the thoracolumbar spine complicated with complete spastic paraplegia is reported. Usually the tuberculous psoas abscess drains out along the fascia and ligament by it's own gravity. The common site of drainage of the tuberculous psoas abscess are the Petit triangle, the femoral triangle, the sciatic notch, the adductor region of the thigh and the lumbar region. In the reported case the left psoas abscess penetrated into the diaphragm and induced a lung abscess. This was confirmed by operation as no communication was inspected between the paravertebral abscess. The abscess was completely evacuated through thoracotomy and the tuberculous lesion in T-11,12 was operated by complete removal of focus and simultaneous anterior spinal fusion, another lesion in the lumbar spine was operated by radical operation three weeks after first operation. The paraplegia was recovered three months after first operation with satisfactory bony union and the patient was allowed to be up and about. A satisfactory result was obtained by radical ressection and anterior interbody fusiao of T-11,12 of the diseased vertebrae through the left extrapleural approach. This was followed by focal deberidement of right psoas abscess.