Apophyseolysis and osteochondrosis of the ischial tuberosity. Criteria of differential diagnosis.

The authors describe three pathological entities affecting the apophysis of the ischial tuberosity observed in young athletes. Acute and chronic apophyseolysis and osteochondrosis are studied separately in terms of their clinical characteristics, radiographic aspects, and treatment. A rare case of bilateral apophyseolysis is also reported. Unless correctly diagnosed and treated, these lesions may in the long term affect the sporting activity of the patient. Six cases are presented illustrating each of these syndromes.

Osteosynthesis of subtrochanteric fractures. A review of different methods.

The authors analysed the long-term results of 72 subtrochanteric fractures treated surgically over a period of 13 years. The case material was subdivided according to type of fracture and method of osteosynthesis and the results were evaluated with a view to ascertaining the best method of treatment in each type of fracture. The best results were obtained with osteosynthesis using an angled nail plate.

Rotatory subluxation of the atlanto-axial joint.

Twelve cases of rotatory subluxation of the atlanto-axial joint are presented. The pathogenesis of this lesion is discussed, in particular why it is prevalent in children. The radiographic and clinical features are described. The long-term results emphasize the importance of early diagnosis and treatment, which are essential if the best results are to be obtained.

Arthrography in the investigation of persistent pain after meniscectomy.

The authors report 62 patients in whom arthrography of the knee had been performed because of persistent pain after menisectomy. In about 60% of the cases the interval between operation and arthrography was less than 18 months. The causes of residual pain identified by arthrography were divided into meniscal and extra meniscal. The most frequent findings were remnants of pathological meniscal tissue; lesions of the anterior cruciate ligament; synovial and chondral pathology. Thirty patients were checked by arthroscopy and were subjected to further operation. In 80% of these cases the arthrographic findings corresponded exactly with the operative findings. The writers confirm that arthrography is still a valid method of investigation in patients affected by persisting pain after meniscectomy.

Evaluation of double contrast arthrography in pigmented villonodular synovitis of the knee.

The authors report the arthrographic findings in 9 cases of diffuse villonodular pigmented synovitis of the knee in various phases of development before and after synovectomy. Arthrography was negative in only one case, while in the other cases the findings were significant but not pathognomonic.