Diagnosis of plant-thorn synovitis by high-resolution ultrasonography: a case report and literature review.

Plant-thorn synovitis is an uncommon cause of arthritis and has not been reported in Asian countries. Zanthoxylum ailanthoides, an aromatic plant distributed in East Asia, is used as a spice in Taiwan. We reported a case of acute monoarthritis over the third metacarpo-phalangeal joint of the right hand after an injury by the thorn of the Zanthoxylum ailanthoides. A thorn foreign body of 2.7 mm in length was detected in the joint by high-resolution ultrasonography and led to a surgical synovectomy. The patient recovered completely after synovectomy. Plant-thorn synovitis is easily negligible. Early diagnosis is difficult and frequently delayed. The removal of thorn by synovectomy is the only curative treatment for plant-thorn synovitis. Compared to CT and MRI, ultrasonography is inexpensive, nonradioactive, repeatable, and easily accessible. It could detect foreign bodies that are smaller than 0.5 mm. High-resolution ultrasonography is a useful tool for detecting plant thorn and could promote early diagnosis.

The feasibility of a video-based motion analysis system in measuring the segmental movements between upper and lower cervical spine.

The evaluation of the range of motion (ROM) and static posture in the cervical spine are important in physical examination. Despite offering dynamic assessment without radiation, the video-based motion analysis system has not yet been applied to measure the cervical segmental movements. The purposes of this study were to develop a neck model to differentiate the movements and posture between upper and lower cervical spine, and to examine the reliability of measuring cervical motion with surface markers and the aid of videofluoroscopy. Sixteen healthy adult subjects (eight males and eight females) participated in this study. Ten surface markers were used to estimate the discrepancies in cervical vertebral angles compared with corresponding bony landmarks throughout the ROM. The average intraclass correlation coefficients (ICCs) of the paired vertebral angles between surface markers and bony landmarks ranged from 0.844 to 0.975 and the mean absolute difference (MAD) averaged 2.96 degrees. Our results indicate high consistency between surface markers and bony landmarks throughout the cervical movements. The mean upper (C0-C2) and lower (C2-C7) cervical joint angles in the neutral position were 18.59+/-4.33 degrees and 23.98+/-6.15 degrees, respectively. Furthermore, the reliability of the digitizing procedure within raters (ICC=0.850-0.999; MAD=0.58-2.42 degrees) and between raters (ICC=0.759-0.988; MAD=0.59-2.66 degrees) suggests that the neck motion analysis model is a feasible method for investigating static neck posture or dynamic motion between upper and lower cervical spine.