Measurement of Capsular Thickness in Magnetic Resonance Arthrography in Idiopathic Adhesive Capsulitis of Hip / 대한고관절학회지

PURPOSE: The clinical suspicion of idiopathic adhesive capsulitis of the hip (IACH) involves restricted range of motion and normal hip radiographs. The purpose of this study was to delineate the characteristic findings observed on magnetic resonance arthrography (MRA) by identifying the anatomical structures involved and their significance on clinical presentation of restricted range of motion. MATERIALS AND METHODS: We retrospectively evaluated MRA's of 46 hips (44 patients) who suffered hip pain from September 2006 to August 2012 in our hospital. Of those, 10 cases (8 patients) with clinical suspicion of IACH were compared to 20 normal hip cases (control group). To identify anatomical evidence of adhesive capsulitis in the MRA's of the IACH group, capsular thickness was measured superiorly, inferiorly, anteriorly and posteriorly, and compared to that of the randomly selected control group. RESULTS: Comparison of the MRA findings of the control group to that of the IACH group showed that there was a statistically significant increase in the mean thickness of the joint capsule superiorly and posteriorly (P<0.01), while comparison of examination findings revealed a statistically significant decrease in the mean range of motion (flexion 122.5degrees+/-5.5degrees/abduction 28.0degrees+/-2.8degrees/adduction 26.5degrees+/-2.4degrees/external rotation 30.5degrees+/-3.8degrees/internal rotation 25.5degrees+/-2.4degrees) in the IACH group. CONCLUSION: A change in the capsular thickness on MRA is a common finding in IACH patients with the increase more evident in the posterior and superior capsules than the anterior and inferior capsules.

Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography / 대한족부족관절학회지

PURPOSE: We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures. MATERIALS AND METHODS: The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, Bohler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement. RESULTS: The average postoperative AOFAS score and VAS score was 84.1+/-8.5 and 2.2+/-2.2. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average Bohler angle was restored from 11.1degrees to 24.7degrees (p0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular step-off and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, Bohler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score. CONCLUSION: The clinical outcome did not show correlation with Bohler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.