关节镜治疗难治性髌前滑囊炎30例临床分析

目的探讨改进关节镜下治疗难治性髌前滑囊炎的疗效。方法自2009年6月~2014年5月对我院30例复发髌前滑囊炎患者,男22例,女8例。囊肿最大为8cm×12cm,最小为4cm×5cm,全部病例均在关节镜下手术治疗,平均手术时间为30分钟,术后固定2周。膝关节疼痛评价按采用视觉模拟评分法(visual analogue scale,VAS)评分、膝关节关节活动度(ROM)对术前、术后3、6、12、24、36个月随访时功能进行评价。结果术后随访,全部患者均无感染,无肿胀,关节活动正常,全部病例术后膝关节疼痛显著缓解,活动显著改善。仅有1例患者残留有膝前疼痛,1例患者局部皮肤有麻木感。结论关节镜下保守治疗髌前滑囊炎,美容效果和功能效果满意,适合临床开展。     

Bilateral deep infrapatellar bursitis associated with tibial tuberosity enthesopathy in a case of juvenile ankylosing spondylitis

Summary A case of bilateral deep infrapatellar bursitis is reported in a 19-year-old man suffering from juvenile ankylosing spondylitis and surgically treated for bilateral tibial tuberosity enthesopathy. In addition to erosive nonspecific bone remodelling the excised specimens showed, in the bursa, synovial layer hyperplasia with mild subintimal inflammatory cell infiltration, i.e. changes similar to those of synovitis in ankylosing spondylitis. The respective roles of the inflammatory terrain and of local shearing stress are discussed.     

新生儿泪囊炎治疗的护理观察

目的:观察庆大霉素针行泪道探通冲洗疗效.方法:新生儿泪囊炎58例,其中男 40例,女 18例年龄2月至9个月用庆大霉素针4万单位加生理盐水4ml行泪道探通冲洗,次日再冲洗一次,结果:显效率为72%,有效率为26%,总有效率为98%.结论:庆大霉素针治疗新生儿泪囊炎疗效好.     

Clinical approach to hip pain

Hip joint pain occurs not uncommonly in clinical practice. Arthritis of the hip joint, ligament strain and bursitis are some of the common causes of hip joint pain encountered by physicians. This article dwells on relevant clinical anatomy of the hip and the diagnostic approach to hip pain in rheumatology clinic.     

Abductor muscle necrosis due to iliopsoas bursal mass after total hip arthroplasty

Background

While symptomatic iliopsoas bursal lesions have been reported after total hip arthroplasty (THA), mass effect of the collection causing abductor muscle damage has not been reported in the literature.

Methods and Results

This report discusses the presentation, clinical findings, and operative management of a patient, status post metal-on-polyethylene THA, with a large psoas bursal collection with resulting abductor muscle injury and deep venous thrombosis from compression of the femoral vein. Despite the improved wear characteristics of modern-generation THA implants, physicians must be aware of the possibility of soft tissue irritation of the iliopsoas as a cause of soft tissue swelling, persistent pain, and potential adverse complications. It is also important to recognize the variety of effects and spectrum of severity for associated lesions, including muscle damage.

Conclusions

This report highlights the rare findings of abductor muscle necrosis, as well as acute thrombosis, related to iliopsoas bursitis. It also highlights a review of the available literature.     

Physiotherapist survey: Increasing thoracic spine movement within the management of chronic subacromial impingement syndrome

AimsThis study's primary aim is to address two questions. Firstly; what evidence exists regarding the inclusion of increasing thoracic movement within the management of subacromial impingement syndrome SIS?; and secondly, what proportion of Society of Musculoskeletal Medicine (SOMM) physiotherapists use this form of treatment within SIS management?MethodsAn online survey was conducted using a questionnaire incorporating a vignette describing a patient with chronic SIS. The SOMM physiotherapy members were sampled using convenience sampling.FindingsThis study has identified some evidence supporting increasing movement of the thoracic spine in the management of patients with SIS. No study or guideline protocols have been identified that advocate the use of this form of treatment, nor research identified that investigates physiotherapists’ use of this form of treatment within SIS management. Of the 1340 physiotherapists surveyed, 52 responded of which 79% stated that they would use treatment aimed at increasing movement of the thoracic spine within SIS management. Chi Square analysis suggests no significant association between using this treatment and number of years experience (p value = 0.15) or courses attended (p = 0.62).ConclusionsEvidence suggests it is beneficial to include treatment to increase thoracic spine mobility within SIS management. This study highlights the need for the clinician to be aware of the role of the thoracic spine in relation to the biomechanics of the shoulder complex. Of the sample of SOMM physiotherapists obtained, the majority stated that they would use this form of treatment. Further research is recommended.     

膝部囊肿的B超诊断

本文报告70例膝部囊肿的B超检查结果，69例B超表现为无回声液性暗区，1例为低回声区，边界清楚、后方回声增强。其中40例为腘窝囊肿，16例为膝部腱鞘囊肿，10例为半月板囊肿，4例为髌前滑囊炎。所有病例均经穿刺细胞学检查或手术及病理证实，结果表明：B超能准确诊断膝部囊肿，并能进行囊肿定位和随访。