• Title/Summary/Keyword: 대퇴 골두 괴사증

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Early Stage Legg-Calve-Perthes Disease in a Dog: Clinical, Surgical, Radiological, Computed Tomography and Histological Findings (초기 허혈성 대퇴골두 괴사증을 보이는 개에서 임상학적, 수술적, 방사선학적, 컴퓨터단층촬영, 조직학적 소견)

  • Thak, Min-Ae;Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.366-370
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    • 2013
  • A 7-month-old Pomeranian presented with non-weight bearing lameness on the right pelvic limb. Physical examination revealed pain on extension of the right hip joint, and serum chemistry results showed an increased concentration of creatine kinase. Radiographic findings at admission included a weak radiolucent line on the right femoral head and widening of the right hip joint space, and mild displacement of the right capital femoral epiphysis was additionally identified on day 14. Computed tomography (CT) showed a decreased Hounsfield Unit measurement and a fracture line on the right femoral head. Early stage Legg-Calve-Perthes disease (LCPD) was diagnosed and femoral head and neck ostectomy was performed on the right femur. A fracture fissure and osteophytes at the epiphyseal plate of the femoral head were identified surgically. Necrosis in the femoral metaphysis and epiphysis was observed histologically. This case report describes the radiography, CT images, and surgical and histological findings in a dog with early stage LCPD.

Initial Plain Radiographs versus MR Imaging: Comparison of Prognostic Efficacy in Legg-Calve-Perthes Disease (초기의 단순 X선 촬영술 대 자기공명영상: 소아성 대퇴골두 무혈성 괴사증에서 예후 예측성 비교)

  • Lee, Sun-Jin;Jee, Won-Hee;Cho, Song-Mee;Jeong, Chang-Hoon;Ok, In-Young
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.153-160
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    • 2008
  • Purpose : To evaluate if at the time of diagnosis of Legg-Calve-Perthes disease, MR imaging is superior to radiographs for identifying patients with a favorable long term prognosis as determined by maintenance of a spherical configuration of the femoral head epiphysis on follow-up radiographs. Materials and Methods : We retrospectively analyzed plain radiographs and MR images of 48 femoral heads in 41 patients with Legg-Calve-Perthes disease at time of diagnosis. Femoral head involvement was estimated on initial plain radiographs and MR images using the Catterall classification. Prognosis as determined by maximum femoral head deformity was determined on follow-up radiographs evaluated according to Stulberg classification. Results: Catterall classification of greater than 1 at MR imaging had 100% sensitivity (14/14) for detecting patients with a poor prognosis as indicated by deformity of the femoral head on follow-up radiographs (Stulberg class > 2). Initial radiographs had a lower sensitivity of 57% (8/14) for detecting patients with poor prognosis. Specificity for MR imaging was 21% (7/34) which was not significantly different from 32% (11/34) specificity for initial radiographs. Conclusion: Catterall group 1 at initial MR imaging indicates favorable prognosis for Legg-Calve-Perthes disease. Patients with more extensive involvement of the femoral head can have a good outcome, however they are at risk for loss of spherical configuration of the femoral head and subsequent osteoarthritis in adulthood. MR imaging may be superior to radiographs for identifying a subgroup of patients with favorable prognosis.

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Rapidly Destructive Coxarthrosis Mimicking a Malignant Bone Tumor - A Case Report - (악성 골 종양으로 오인된 급속 파괴형 고관절증 - 증례 보고 -)

  • Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.203-207
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    • 2008
  • Rapid destructive hip osteoarthritis is a rare subset of osteoarthritis with rapid destruction of the hip joint within months of the onset of symptoms. The entity simulates rheumatoid arthritis, septic arthritis, neuropathy or malignant bone tumor. We report a case of rapidly destructive coxarthrosis of the right hip joint initially misdiagnosed as a malignant bone tumor at outside hospital in a 80-year-old woman.

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Pediatric Hip Disorders (소아 고관절 질환)

  • Seunghyun Lee;Young Hun Choi;Jung-Eun Cheon;Seul Bi Lee;Yeon Jin Cho
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.531-548
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    • 2024
  • Developmental dysplasia of the hip is a condition characterized by hip joint instability due to acetabular dysplasia in infancy, necessitating precise ultrasound examination. Legg-Calvé-Perthes disease is caused by a temporary disruption in blood flow to the femoral head during childhood, progressing through avascular, fragmentation, re-ossification, and residual stages. Slipped capital femoral epiphysis is a condition where the femoral head shifts medially along the epiphyseal line during adolescence due to stress, such as weight-bearing. Differentiating between transient hip synovitis and septic arthritis may require joint fluid aspiration. Osteomyelitis can be associated with soft tissue edema and osteolysis. When multiple lesions are present, it is essential to distinguish between Langerhans cell histiocytosis and metastatic neuroblastoma. This review will introduce imaging techniques and typical findings for these conditions.

A Biomechanical Analysis of Stress Transfer Behaviors Within the Necrotic Area of Femoral Head secondary to Changes in Core Placement Direction on Various Distributions of Necrotic Areas in the Osteonecrosis of the Femoral Head (대퇴골두 무혈성 괴사증에 있어서 괴사 영역의 위치와 천공방향의 변화에 따른 대퇴골두 괴사영역에서의 응력 변화 분석에 대한 생체역학적인 고찰)

  • Lim, D.H.;Lee, S.J.;Kim, J.S.;Shin, J.W.;Kim, Y.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1998 no.11
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    • pp.157-158
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    • 1998
  • The purpose of this study was to test the hypothesis that even very small change of the cue direction in the treatment of the early osteonecrosis could affect the outcomes of operation. For this, the changes in stress transfer within the necrotic area of the femoral head were investigated under various directions and placements of the core utilizing finite element method. The loading of 3188N, which represents after-heel-strike, was imposed in cubic cosine pattern. All nodes on the most distal surface of the model were constrained in all directions. All materials included were assumed to have linear-elastic behavior. The result says that the critical stress, which causes collapse of the femoral head, was reduced when the core was oriented toward the posterior side of the femoral head regardless of location of the necrotic area. The same result was obtained either fibular bone grafting or cementation was adopted. As a consequence, the biomechanical study suggests that the core should be directed toward the loading point where the resultant force is applied to get more desirable treatment of the osteonecrosis of the femoral head in the early stage.

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Slipped Capital Femoral Epiphysis(SCFE) (대퇴골두 골단분리증의 치험례)

  • Dan, Jin-Myoung;Kim, Se-Dong
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.245-261
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    • 1997
  • Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

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A Case Report on a Patient with Osteonecrosis of the Femoral Head Treated with Korean Medicine Treatment Including Hwaeo-jeon (대퇴골두 골 괴사증 환자에 대한 화어전을 포함한 한의학적 치료에 대한 증례보고)

  • Bong, Sung Min;Jang, Woo Seok;Kim, Kyung Ho
    • The Journal of Internal Korean Medicine
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    • v.41 no.1
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    • pp.88-96
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    • 2020
  • Objectives: Osteonecrosis of the femoral head (ONFH) is caused by a circulatory disorder. If symptoms are not present, the patient's progress is observed, but if symptoms are present, non-surgical methods or total hip replacement are performed. Several case reports have described the effects of Korean Medicine treatment on ONFH, but the number of cases is still small, and few studies have used blood stasis-based herbal medicines like Hwaeo-jeon (HEJ). This study reports the effectiveness of Korean Medicine treatments, including HEJ, on a case of ONFH. Methods: A patient diagnosed with ONFH by CT and MRI was treated with Korean Medicine treatments consisting of herbal medicine including HEJ, bee venom pharmacopuncture, acupuncture, cupping, and physical therapy. The improvement of pain was assessed using a numerical rating scale. Inflammation levels were determined by blood tests conducted during hospitalization. Results: Korean Medicine treatment, including herbal medicine, resulted in good clinical improvement responses, including reduced pain, improved mobility, and reduced inflammatory levels in the blood tests. Conclusions: Korean Medicine treatments, including HEJ, may be effective for ONFH patients. Further studies are needed to determine the recovery of osteonecrosis and the improvement of post-operative aftereffects using Korean Medicine treatments, as well as the reduction of pre-operative pain.

A Case Report on a Patient of Early Developed Avascular Necrosis of Femur Head with lumbar HIVD(Herniated Intervertebral Disc), Treated by Conservative Oriental Medical Treatment Including Hip Joint MST(Motion Style Treatment) (요추 추간판 탈출증을 동반한 대퇴골두 무혈성 괴사 초기 진단 받은 환자를 대상으로 시행한 고관절 MST 및 한방 보존적 치료 치험 1례)

  • Baek, Sang-Hyun;Park, Min-Woo;Eom, Kwan-Joon;Yang, Seung-Hee;Lee, Seung-Yeol
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.2
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    • pp.141-149
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    • 2013
  • Objectives : The Purpose of this study is to investigate the clinical application of conservative treatment including hip joint MST for lumbar HIVD(Herniated Intervertebral Disc) and early developed avascular necrosis of femur head. Methods : Patient is hospitalized at Dept. of Oriental Internal Medicine, Jaseng Oriental Medicine Hospital, diagnosed as lumbar HIVD(Herniated Intervertebral Disc) and early developed Avascular Necrosis of Femur Head and treated by herbal medicine, acupuncture, moxibustion and hip joint MST. This study was measured by NRS(Numeric Rating Scale), ODI(Oswestry Disability Index) and ROM(range of motion). Results : After conservative treatment, the patient's pain was controlled and NRS score was decreased. ODI and ROM also were improved. Conclusions : As seen in this one case, Oriental conservative treatment including hip joint MST has a positive effect to control pain with lumbar HIVD(Herniated Intervertebral Disc) and early developed avascular necrosis of femur head.

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