MR imaging of injuries to the small joints.

This article describes MR imaging of acute and chronic injuries of the ankle and foot, elbow, and hand and wrist. Conditions discussed include ligament and tendon injuries, fractures and bone bruises, osteochondral defects, foreign bodies, and posttraumatic ganglions. Other topics covered include fasciitis, nerve and muscle injuries about the elbow, and triangular fibrocartilage tears.

Quadriceps femoris muscle angle: normal values and relationships with gender and selected skeletal measures.

The quadriceps femoris angle ("Q angle") has been implicated as a source of several knee disorders, but values for normal knees have not been adequately documented in the literature. This study was designed to provide clinicians with normal values and information regarding the relationships between Q angle, gender, and selected anatomical measurements. The Q angles of 100 individuals (50 men, 50 women), who had no history of knee disorders, were measured goniometrically. The hip widths and femur lengths of all subjects were measured with calipers. The mean Q angle for women was 15.8 +/- 4.5 degrees and for men was 11.2 +/- 3.0 degrees. Using a point biserial correlation, we found a relationship between gender and Q angle (r = -.517) that remained significant (p less than .01) when the effects of femur length and hip width were controlled. The relationships identified between Q angle and the anatomical measurements were no longer significant when the effect of gender was eliminated. The results substantiate the belief that women have larger Q angles than men, but they fail to provide clinicians with an anatomical explanation or new predictor of Q angle.

Relationship between static muscle strength deficits and spasticity in stroke patients with hemiparesis.

The purpose of this retrospective investigation was to determine whether a relationship exists between static strength deficits in the shoulder medial (internal) rotator and elbow flexor muscles and spasticity in these muscles or their antagonists. We reviewed the records of the first 50 stroke patients with hemiparesis who met the entry criteria for the study and who were admitted over a four-month period of time. Static muscle strength was measured by hand-held dynamometry. Spasticity was graded on the Ashworth scale. Kendall's tau correlations were calculated between static muscle strength deficits and spasticity. Static strength deficits of the shoulder medial rotator and elbow flexor muscles were correlated (p less than .01) with the agonist muscles' spasticity, but not with the antagonist muscles' spasticity. Muscle group spasticity and strength deficits, therefore, appear to be covarying manifestations of cerebrovascular accidents. Clinicians, thus, may interpret an agonist muscle's capacity for force production in light of its own tone rather than that of its antagonist.

Shoulder pain in hemiplegia: statistical relationship with five variables.

The incidence of shoulder pain and the statistical relationship between it and five other variables (patient age, time since onset of hemiplegia, range of hemiplegic shoulder external rotation, spasticity and weakness) were investigated retrospectively. Of 50 consecutive hemiplegic patients whose records were reviewed, 36 had shoulder pain. The variables significantly (p less than 0.01) correlated with shoulder pain were: time since onset of hemiplegia (r = 0.45) and ROSER (r = -0.61). The relationship between shoulder pain and range of shoulder motion remained significant when other factors were partialled out. The relationship between shoulder pain and time since onset was not significant when the affect of range of shoulder motion was partialled out. Therefore, range of shoulder external rotation was considered the factor related most significantly to shoulder pain. This finding suggests that shoulder pain demonstrated by hemiplegia patients may be, in part, a manifestation of adhesive capsulitis.