Impingement Syndrome and Labral Tear in Athletes: Differences in Diagnosis and Management with General Population / 대한스포츠의학회지

The pathophysiology of impingement syndrome and labral tear was variable and not clear. In general populations, lesions occur mainly in acute cases. But in athletes, lesions are caused by repetitive exposure to excessive force, resulting in different patterns. For diagnosis, thorough physical examinations and radiologic findings should be combined. In athletes, conservative treatment including posterior capsular stretching and periscapular muscle strengthening is recommended as the first choice of treatment considering chronic progression and adaptive change. When choosing surgical treatment because of failure of conservative treatment, careful attention should be paid to the choice of repair or debridement of the rotator cuff partial tear, and the choice of the labral repair or biceps tenodesis.

Basic Principles and Current Trends of Medial Opening-Wedge High Tibial Osteotomy / 대한정형외과학회잡지

High tibial osteotomy (HTO) is a popular surgical procedure for osteoarthritis of the knee with varus deformity. In general, HTO has shown sufficient clinical outcomes with careful patient selection and correct surgical technique. Among various surgical techniques, medial opening-wedge and lateral closing-wedge HTO are widely used. This report includes basic principles and current trends in patient selection and preoperative evaluations and planning, operative technique, complications, and rehabilitation protocol in medial opening-wedge HTO.

Fibrocartilaginous Intramedullary Bone Forming Tumor of the Distal Femur Mimicking Osteosarcoma

Fibrocartilaginous dysplasia (FCD) has occasionally led to a misdiagnosis and wrong decision which can significantly alter the outcome of the patients. A 9-yr-old boy presented with pain on his left distal thigh for 6 months without any trauma history. Initial radiographs showed moth eaten both osteolytic and osteosclerotic lesions and biopsy findings showed that the lesion revealed many irregular shaped and sclerotic mature and immature bony trabeculae. Initial diagnostic suggestions were varied from the conventional osteosarcoma to low grade central osteosarcoma or benign intramedullary bone forming lesion, but close observation was done. This study demonstrated a case of unusual fibrocartilaginous intramedullary bone forming tumor mimicking osteosarcoma, so that possible misdiagnosis might be made and unnecessary extensive surgical treatment could be performed. In conclusion, the role of orthopaedic oncologist as a decision maker is very important when the diagnosis is uncertain.

FDG-PET/CT Complements Bone Scan with Respect to the Detection of Skip Metastasis of Osteosarcoma: A Case Report / 대한골관절종양학회지

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.