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This study shows a case of a patient with synovial chondromatosis of the hip misdiagnosed as rice body bursitis. The patient complained of pain and limited activity in his left hip. He was diagnosed with synovial chondromatosis of the hip by medical history, physical examination, imaging examination and postoperative pathology. Based on literature review, the characteristics and differential diagnosis of the disease in epidemiology, imaging and pathology were discussed in detail, so as to improve the understanding of the disease and avoid misdiagnosis. He was treated with hip arthroscopy and obtained satisfactory therapeutic effect. The patient was followed up for 1 year without recurrence.
ABSTRACT
The pelvic incidence (PI) is a key anatomical parameter for vertebral-pelvic sagittal plane stabilization, that is, the angle between the perpendicular to the sacral plate at its midpoint and the line connecting this point to the middle axis of the femoral head, which fully reflects the compensatory ability of the pelvis and it does not change with age, gender and position, but is closely related to race. The measurement result of PI varies with the measurement method. The measurement on the standing lumbosacral lateral radiographs is a classic measurement method, which is easy to operate and has strong practicability. Later, the improved three-dimensional CT measurement and measurement methods on bone specimens are based on this, which reduces the error in X-ray measurement. Early research focused on PI and spine-related diseases. Compared with normal people, a small PI value is likely to cause intervertebral disc degeneration or even herniation, a high PI can cause lumbar spondylolisthesis. The measurement of PI can predict the risk of disc degeneration and lumbar spondylolisthesis progression, providing an important reference for spinal sagittal orthopedic reconstruction. The influence of PI in hip joint diseases cannot be ignored. PI also has a predictive effect on the development of certain hip joint diseases, and has guiding significance for the treatment of diseases. The relationship between PI and hip osteoarthritis, hip dysplasia, femur acetabular impingement, and non-traumatic necrosis of the femoral head was reviewed through literature review. The results showed that the relationship between hip osteoarthritis and PI was still controversial. The higher pelvic incidence was observed in Crowe I patients with hip dysplasia, and the lower PI was observed in patients with femur acetabular impingement. The higher PI was associated with a greater likelihood of femoral head collapse in patients with non-traumatic necrosis of the femoral head.
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Objective To study the influence of resolving phlegm and relaxing bowels decoction(Huatan Tongfu decoction)on plasma tissue type plasminogen activator(t-PA),plasminogen activator inhibitor(PAI)and homocysteine(Hcy)in patients with acute cerebral infarction. Methods With randomized and controlled clinical research,78 inpatients from 2010 to 2012 in Traditional Chinese Medicine(TCM)Department of Beijing Chaoyang Hospital,Capital Medical University were chosen,including 40 patients in observation group and 38 patients in control group. The patients in control and observation groups were treated by conventional treatment,and additionally the patients in observation group received Huatan Tongfu decoction(ingredients:Trichosanthis 30 g,Arisaema with bile 6 g,Magnolia bark 10 g,Fried rice sprout 15 g),and the rhubarb decoction was made alone,each 20 mL decoction containing crude drug 6 g. 1-4 days after the beginning of the study,the two decoctions were mixed,and the patients took the lukewarm mixture orally twice daily(once 1/2 the dosage);5-12 days after the start of the study, the patients took 200 mL lukewarm mixed decoction daily,being divided into 2 times to administer,and according to the patient defecation situation,the dosage of rhubarb decoction was adjusted individually,the therapeutic course being 12 days. The t-PA,PAI and Hcy were detected before treatment and on the 7th day after treatment. TCM syndrome scores(phlegm syndrome,fire-heat syndrome and sthenic-fu syndrome)were recorded before and on the 12th day after treatment,and the scores of National Institute of Health Stroke Scale(NIHSS)were recorded at the same time. Results Before treatment,the differences in t-PA,PAI,Hcy levels and NIHSS score and phlegm syndrome,fire-heat syndrome and sthenic-fu syndrome scores were not statistically significant;all the indicators improved significantly after treatment compared with those before treatment,and the changes in observation group were more remarkable〔t-PA(mg/L):13.03±2.15 vs. 12.95±2.16,PAI(mg/L):23.64±9.07 vs. 26.81±10.00, Hcy(μmol/L):9.13±1.15 vs. 11.52±3.17,phlegm syndrome:9.16±1.71 vs. 11.17±2.89,fire-heat syndrome:7.51±1.59 vs. 8.81±2.26, sthenic-fu syndrome:0.61±0.87 vs. 1.19±1.14, NIHSS score:5.70±3.16 vs. 5.90±2.97〕. Conclusion The mechanism of Huatan Tongfu decoction in treatment of patients with acute cerebral infarction accompanied by TCM syndromes of phlegm heat and sthenic-fu may be related to the reduction of plasma PAI and Hcy levels,protection of vascular endothelium and promotion of fibrinolysis,thereby the decoction can improve the clinical efficacy.
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BACKGROUND: In vivo and in vitro experiments have demonstrated that polyetheretherketone (PEEK) polymer is the best cervical fusion cage material due to its good biocompatibility, elastic modulus similar to human bone, and satisfactory plasticity and hardness.OBJECTIVE: To assess the outcomes of polyetheretherketone (PEEK) cage filled with nano-artificial bone following anterior cervical discectomy and fusion (ACDF) in patients with cervical spondylotic myelopathy.METHODS: In total 17 patients with cervical spondylotic myelopathy were collected from the Department of Orthopedics, First Affiliated Hospital of Harbin Medical University between May 2007 and September 2009. There were 12 males and 5 females,averaging 55 (range 42-67) years of age. All patients underwent ACDF using PEEK cage filled with nano-artificial bone. Patients'neurological functions were assessed on the basis of Japanese Orthopaedic Association (JOA) scoring system. The distance between the midpoint of the upper end plate and lower end plate was measured as interboby height. Radiographs with the neck in lateral flexion and extension were obtained to evaluate fusion results.RESULTS AND CONCLUSIONS: Seventeen patients with cervical spondylotic myelopathy participated in the final analysis.Almost all patients had symptomatic improvement. Within postoperative several days, muscle strength of lower limb was increased, and limb was more flexible after surgery than prior to surgery. At 3 months after surgery, JOA scores were significantly increased compared to prior to surgery, the operated segments were stable and disc space height was satisfactory. In addition, no complications were found, and all cases achieved solid fusion, as confirmed by radiographs. These findings suggest that the immediate stability of the operated segments can be obtained by anchoring PEEK cage, and the nano-artificial bone-filled PEEK cage is safe, simple, and with relatively few complications. It is therefore a good choice for patients with cervical spondylotic myelopathy.
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Objective To evaluate the role of IL-2 dendritic cell in chronic hepatitis B,peri-dendritic cells were cultured,cytokins CD4O,CD86,CD80,CD83 and IL-2 were measured by ELLISA.Methods 20 chronic hepatitis B patients were selected,each one donated 15ml blood.dentritic cells were cultured,and IL-4 1000u/ml rhGM-CSF 1000u/ml was given each well,while IL-2 100u/ml was given each control well.CD40,CD86,CD80 and CD83 were measured by FLSC at 9th day.IL-2 was detected by ELISA at 12th day.Results The level of CD40,CD86,CD80 and CD83 in increased when using IL-2,and dentritic cell secreted IL-2 in chronic hepatitis.Conclusion The results suggest that IL-2 can promote the phenotypic and functional maturation of PC.