Joint fluid after aspiration. A disturbing factor in knee arthrography

The amount of fluid in the knee after aspirating any effusion was investigated and averaged 6.8 ml, being independent of the presence of a lesion. Because it causes dilution of the contrast medium, it is suggested that small amounts of a relatively high-concentrated non-ionic contrast agent should be preferred for double-contrast knee arthrography.     

How to read a postoperative knee replacement radiograph

Knee replacement surgery is the most common joint replacement surgery in England and Wales. Postoperative radiographs are associated with long-term outcome at both early and late stages, and their correct interpretation is therefore vital. These radiographs will commonly be assessed by surgical trainees, emergency doctors, orthopaedic surgeons, nurse practitioners, and radiologists. The aim of this paper is to provide the reader with a systematic approach to assessing these radiographs, whether it be in the immediate postoperative period or during subsequent follow-ups, and to provide sufficient knowledge to critique the procedure. An outline of prostheses and their indications alongside a comprehensive review of the assessment of important angles, alignment, and correct positioning of femoral and tibial components is presented.     

Outcomes of the operatively treated knee dislocation

Despite being a serious injury with early complications associated with a high degree of morbidity, the outcomes of knee dislocations have improved dramatically since the days of Sir Astley Cooper. Currently, most authors favor early surgical reconstruction of the injured ligamentous structures. With modern surgical techniques and rehabilitation protocols, most patients are able to achieve functional range of motion and stability necessary for everyday life. Despite improvements in treatment, stiffness and pain, rather than instability, can be a problem. Patients continue to have difficulty returning to pre-injury levels of athletic competition and manual labor, although a significant number of patients have achieved these goals. As physicians, we must be knowledgeable in the current surgical techniques and rehabilitation protocols used in the treatment of knee dislocations, and the typical prognosis of the injury. By informing our patients of hurdles that they will be forced to overcome, in their path to recovery, before initiating treatment, patients will better understand the seriousness of the injury, which, it is hoped, will lead to compliance with their rehabilitation and thus better outcomes.     

Snapping knee due to the biceps femoris tendon treated with repositioning of the anomalous tibial insertion

Snapping knee associated with biceps femoris tendon that caused lateral knee pain is reported. The long head of the biceps femoris tendon had an anomalous tibial insertion in addition to the direct arm and anterior arm on the fibular head. Resection of both the anomalous tibial insertion and the anterior arm was necessary to resolve the snapping. Level of evidence IV.     

立体定向多电极射频热固化治疗中晚期原发性肝癌的护理

立体定向多电极射频热固化治疗系统是近年引进的治疗晚期肝癌的新技术。 1 999- 1 2～ 2 0 0 1 - 1 2 ,我院应用该系统治疗中晚期原发性肝癌 2 1 3例 ,近期疗效满意。现就应用该系统治疗原发性肝癌的护理报告如下 :1　临床资料1 1　一般资料　本组 2 1 3例 ,男 1 54例 ,女 59例 ;年龄最大79岁 ,最小 35岁 ,平均年龄 45 5岁。均经Ｂ超及ＣＴ等明确诊断为原发性肝癌。1 2　治疗方法　在持续硬膜外麻醉和Ｂ超引导下 ,采用立体定向技术 ,选择穿刺点和进针角度 ,将带鞘治疗针插入肝癌组织 ,然后由小电极发出高能射频波使癌组织蛋白发生固化而死…     

Decreased eccentric muscle endurance in the conservatively treated anterior cruciate-deficient knee

Concentric (CON) and eccentric (ECC) isokinetic knee extensor endurance, during 100 repetitive isokinetic contractions, were analysed in 32 consecutive patients with conservatively treated unilateral anterior cruciate ligament ruptured knees. There were 20 men and 12 women (mean age 34 years). The test was performed 6.8 years after the injury (range 4–14). The uninjured leg in each patient served as control. Lysholm subjective score, Tegner activity score and IKDC grading were used to relate the subjective knee function to muscle performance. Knee extensor endurance for concentric as well as for eccentric contractions were significantly lower in the injured side than the uninjured side. The magnitude of decrease in muscle performance was 7.6% for concentric (range-12 to 27%) and 15.3% for eccentric (range -9 to 50%) endurance. The eccentric injured/uninjured endurance ratio correlated significantly to the Lysholm subjective score. We conclude that the knee extensor endurance is decreased in patients with conservatively treated anterior cruciate ligament-ruptured knees. The eccentric endurance test seems to reflect the patients' subjective knee functioning.     

Posteromedial compartment cement extrusion after unicompartmental knee arthroplasty treated by arthroscopy: a case report

Unicompartmental knee arthroplasty (UKA) with extrusion of cement into the posterior compartment of the knee is uncommon. Various problems after a UKA procedure, such as aseptic loosening, polyethylene wear and progressive arthritis have been reported. This study will report on a patient with extrusion of cement fragments into the posteromedial compartment of the knee after a UKA procedure. This complication was treated successfully with the direct posterior–posterior triangulation arthroscopic visualization method. In cementing the prosthesis, it is of paramount importance to take caution to completely remove extruded cement remnants in order to prevent this complication during UKA.     

穿盖弹射时人体头、膝部的冲击限值

目的探讨穿盖弹射对人体头部、膝部的损伤程度，以提出适宜的生理参数，供工程部门使用。方法用１７具头颅骨在摆锤式冲击台上进行动态冲击试验，在材料试验机上进行准静态压力试验，观察试验后颅骨骨折情况。在落锤式冲击台上进行８具膝部冲击实验。用假人进行地面弹射、火箭滑车实验，测试假人与舱盖碰撞的外力值。结果外力峰值不超过３．５ｋＮ或作用时间不超过３０ｍｓ时颅骨没有发生骨折。颅盖骨可承受６．９ｋＮ以下的缓慢均匀加压，颅底骨只可承受１．５ｋＮ。膝部承受８．０ｋＮ冲击力时无损伤发生。结论穿盖弹射时对人体主要的威胁是头部碰撞伤，颅盖骨承受的破坏力值比颅底骨大得多。破盖器工作时人体与舱盖碰撞的机率很小，且不易发生损伤。膝部可承受较大的穿盖力，不致发生损伤     

Ultrasound-guided aspiration cytology of the spleen.

The cytologic results of ultrasound-guided fine-needle biopsies (FNB) of the spleen in 42 patients were analyzed retrospectively. A focal lesion was punctured in 28 of them, splenomegaly in 12, and an enlarged accessory spleen in 2. Sufficient material was aspirated for cytologic analysis in 41 (97.6%) cases. A final diagnosis of malignancy was made in 16 (38%), and a benign condition diagnosed in 26 (62%) patients. The sensitivity, specificity, and accuracy of the method for differentiating malignancy from benign conditions were 68.8%, 100%, and 88.1%, respectively. No complications occurred. We conclude that ultrasound-guided FNB is a safe, highly specific, but relatively insensitive method of defining splenic pathology.     

How to do it: ultrasound-guided fine-needle aspiration of thyroid nodules that commonly result in inappropriate cytology

Ultrasound (US)-guided fine-needle aspiration (US-FNA) is widely used for the diagnosis of thyroid nodules and other neck masses, and it is now considered the most simple, safe, accurate, and minimally invasive procedure for this purpose. The aim of this article was to present US-FNA for thyroid nodules with difficult or unusual sampling conditions. A better understanding of a wide range of US-FNA techniques will be helpful to the practicing and experienced doctors for diagnosing thyroid nodules or neck masses that are difficult to sample accurately.     

Prostatic carcinoma metastasis to the kidney: diagnosis by thin needle aspiration biopsy

Renal metastasis of prostatic origin is uncommon. The routes of metastatic spread are discussed. The efficacy and safety of thin needle aspiration biopsy in obtaining a premortem diagnosis are stressed.     

影像医学如何为中医“证”求证

中医学的现代研究应从中医证入手,对中医证进行规范化、客观化研究是中医研究的当务之急,也是当前中医理论研究的主要课题之一.如何应用影像医学来发展中医是我们这一代人义不容辞的责任和义务.笔者结合自己的点滴经验提出一些肤浅看法,以期达到抛砖引玉的目的.     

Prostatic carcinoma metastasis to the kidney: Diagnosis by thin needle aspiration biopsy

Renal metastasis of prostatic origin is uncommon. The routes of metastatic spread are discussed. The efficacy and safety of thin needle aspiration biopsy in obtaining a premortem diagnosis are stressed.