ABSTRACT
We present here a case of synovial osteochondroid metaplasia of the elbow joint that was almost mistaken for a fracture. A 21-year-old military recruit complained of pain at the elbow after a minor direct injury. Since the imaging studies, including simple radiographs and CT scans, showed a small bony fragment, an operation was performed under the impression of fracture of the elbow joint. There was no evidence of acute injury such as bleeding or swelling, and excisional biopsy was done. The histopathological findings of osteochondroid metaplasia surrounded by fibrous tissue and synovium led to the pathologic diagnosis of synovial osteochondroid metaplasia. Clinicians should include this tumorous entity in differential diagnosis when a bony fragment is seen on the radiographs of an acutely injured subject.
Subject(s)
Humans , Young Adult , Biopsy , Diagnosis, Differential , Elbow , Elbow Joint , Hemorrhage , Metaplasia , Military Personnel , Synovial MembraneABSTRACT
The acromioclavicular separation (AC separation) is a common injury, which is often accompanied by the rupture of the coracoclavicular ligament (CC ligament) in severe occasions. In rare forms of AC separation, the fracture of the coracoid process would occur rather than the rupture of the CC ligament. Only 31 cases of such injury have been reported in the English literature. We present 2 additional cases with literature review. The fracture of the coracoid process is not readily seen on anteroposterior shoulder radiograms. Severe AC separation without widening of CC distance on anteroposterior shoulder radiogram heralds the fracture of the coracoid process.
Subject(s)
Ligaments , Rupture , ShoulderABSTRACT
PURPOSE: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. MATERIALS AND METHODS: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. RESULTS: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. CONCLUSION: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.
Subject(s)
Humans , Classification , Curettage , Follow-Up Studies , Joints , Knee , Magnetic Resonance Imaging , Radiography , Talus , TransplantsABSTRACT
We encountered a rare case of diffuse idiopathic skeletal hyperostosis (DISH) associated with dysphonia and dysphagia. An 80 year-old man developed progressive dysphonia and dysphagia. The radiology study, esophagogram and nasopharyngoscopic exam revealed the esophagus and the posterior wall of the nasopharynx to be severely compressed by the unfused osteophyte of the 3rd and 4th cervical intervertebral space. It was thought that the osteophyte formation was caused by not merely DISH but degenerative changes due to a concentration of stress around the unfused hyperostosis. A resection of the osteophyte was performed, which resolved the clinical symptoms. The follow-up radiology study, esophagogram and nasopharyngoscopic exam showed that the osteophyte had disappeared.