• 제목/요약/키워드: Joint capsule

검색결과 88건 처리시간 0.023초

측두하악관절의 초음파영상과 자기공명영상에서 하악과두 외측면과 관절낭간 거리 측정치 비교 (Comparison of the capsular width measured on ultrasonogrape and MR image of the temporomandibular joint)

  • 이태완;유동수;한원정;김은경
    • Imaging Science in Dentistry
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    • 제36권1호
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    • pp.41-48
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    • 2006
  • Purpose : To evaluate the reliability and clinical usefulness of ultrasonography in the temporomandibular joint (TMJ). Materials and Methods : Parasagittal and paracoronal 1.5 T MR images and 7.5 MHz ultrasonographs of 40 TMJs in 20 asymptomatic volunteers were obtained. Disc position using MR imaging was evaluated and the distance between the lateral surface of mandibular condyle and the articular capsule using MR image and ultrasonograph of 27 TMJs with normal disc position was measured and compared. Intraobserver and interobserver measurements reliability was evaluated by using interclass correlation coefficients (ICC) and measurement error. Also, the distance measured on ultrasonographs was compared, according to mouth position and disc postion. Results : The normal disc position was found in 27 of 40 asymptomatic joints. At the intraobserver reliability of measurement, ICC at the closed and open mouth position were 0.89 and 0.91. The measurement error was 0.4% and 0.5%. At the interobserver reliability, ICC at the closed and open mouth position were 0.92 and 0.81. The measurement error was 0.4% and 0.7%. At the TMJ with normal disc position, the distances between the lateral surface of mandibular condyle and the articular capsule measured on MR images and ultrasonographs were $2.0{\pm}0.7mm,\;1.8{\pm}0.5mm$, respectively (p<0.05). On the ultrasonographs, the distances at open mouth position were $1.2{\pm}0.5mm$ (p<0.05). At the TMJ with medially displaced disc, the distances at the closed and open mouth position were $1.3{\pm}0.3\;mm\;and\;0.9{\pm}0.2\;mm$ (p<0.05). Conclusion : The results suggest ultrasonography of TMJ is a reliable imaging technique for assessment of normal disc position.

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Bipolar Intra-articular Radiofrequency Thermocoagulation of the Thoracic Facet Joints: A Case Series of a New Technique

  • Kim, David
    • The Korean Journal of Pain
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    • 제27권1호
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    • pp.43-48
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    • 2014
  • Background: This study tests the hypothesis that of bipolar radiofrequency thermocoagulation of the thoracic facet joint capsule may provide a safe and effect method of pain control from thoracic facet origin. Methods: Among patients suffering from localized mid back pain, nine patients with thoracic facet disease confirmed by magnetic resonance image and diagnostic thoracic facet block were enrolled. Bipolar radiofrequency ablation in the inferior aspect of the thoracic facet joint was done. Visual Analog Scale (VAS) was measured pre-intervention and 1 month post-intervention. Any complications and changes in amount of pain medication were recorded. Results: Significant 47.6% reduction in VAS was noted at 1 month. There were no serious complications. Conclusions: Intra-articular bipolar radiofrequency thermocoagulation of the thoracic facet joint may be a technically easier and valid method of treating mid back pain of thoracic facet origin.

Chronic dislocation of temporomandibular joint persisting for 6 months: a case report

  • Kim, Chul-Hwan;Kim, Dae-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권5호
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    • pp.305-309
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    • 2012
  • Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

An unusual complication during arthrocentesis: N. facialis paralysis, with N. lingualis and N. alveolaris inferior anesthesia

  • Aliyev, Toghrul;Berdeli, Eynar;Sahin, Onur
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제19권2호
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    • pp.115-118
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    • 2019
  • This case report aims to review complications that can occur during arthrocentesis and report an unusual complication observed in a 55-year-old man. The patient received arthrocentesis in an attempt to treat painful locking episodes of his right temporomandibular joint (TMJ). One hour after the operation, the patient experienced temporary facial paralysis in the area of the facial nerve and anesthesia of the lingual and alveolar inferior nerves. No persistent complications were detected during the postoperative follow-up. We suspected this complication occurred after anesthetic solution overflowed from a traumatic perforation in the joint capsule to the infratemporal area during the operation. To our knowledge, this complication has not been previously reported in the literature.

약화된 내측 관절낭을 가진 중증 무지 외반증에 대해 Internal Brace를 이용한 보강술의 수술적 치료 결과 (Surgical Outcomes of the Reinforcing Technique of a Weakened Medial Capsule in Severe Hallux Valgus Using Internal Brace)

  • 이정길;강찬;황득수;이기수;황정모;서강원;김동환
    • 대한족부족관절학회지
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    • 제23권4호
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    • pp.166-172
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    • 2019
  • Purpose: This study evaluated the clinical and radiological results after reinforcement of the weakened medial joint capsule using Internal Brace (Arthrex) for treating severe hallux valgus. Materials and Methods: This study reviewed 56 cases of 50 patients that were followed-up postoperatively for at least 12 months, from September 2017 until August 2018. An extended distal chevron osteotomy combined with a distal soft-tissue release was performed by a single surgeon to treat severe hallux valgus. Internal Brace was applied in 12 cases (group A) who had weakened medial joint capsules, and capsulorrhaphy was performed in 44 cases (group B), and these two groups were compared postoperatively for the clinical and radiological results. The postoperative complications were also investigated. Results: No significant differences at 1-year follow-up on the Manchester-Oxford Foot Questionnaire and the patients' satisfaction scores were found between the two groups (p=0.905 and p=0.668, respectively). For the radiology, the changes of the values between before surgery and at 1-year follow-up according to the group showed no significant differences in the hallux valgus angle, intermetatarsal angle, and the hallux interphalangeal angle (p=0.986, p=0.516, p=0.754, respectively). Recurrence of hallux valgus was reported in two cases in group A, and in three cases in group B. Transfer metatarsalgia occurred in 4 cases in group B. Conclusion: Based on these results, we recommend the capsule reinforcing technique using Internal Brace as a successful operative option for treating a weakened medial capsule in patients with severe hallux valgus.

동통을 동반한 제2 중족 족지 관절 불안정성의 치료경험 - 1예 보고 - (Surgical Treatment for Painful Instability of the Second Metatarsophalangeal Joint - 1 Case Report -)

  • 서동현;박용욱;김도영;이상수;서영진;박현철;강승완
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.204-207
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    • 2004
  • An unstable second metatarsophalangeal joint may produce pain in the forefoot. Plication of stretched lateral ligament and capsule and transfer of the extensor digitorum brevis under the transverse intermetatarsal ligament performed as the primary procedure to stabilize this painful joint. But the pain was not subsided and the proximal phalanx was resubluxated. So, we osteotomized the second metatarsal to restore a normal alignment of the second toe. Then the symptom was subsided. We report a case of painful instability of the metatarsophalangeal joint of the second toe.

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주관절 관절경을 이용한 구축의 치료 (Arthroscopic Treatment of Stiff Elbow)

  • 이광진;김경천;홍창화;송호섭;신현대
    • Clinics in Shoulder and Elbow
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    • 제8권1호
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    • pp.14-18
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    • 2005
  • Purpose: Limitation of motion of the elbow joint due to stiffness affect on life quality of the patients. So contracture of the elbow should be treated as soon as possible. Among the many treatment modalities, we described the result of arthroscopic treatment. Materials and Methods: From Mar. 2000 to Mar. 2003, 40 patients, who received the arthroscopic treatment by author for contracted elbow, were the subjects. We estimated the range of motion (ROM) of elbow joint before and after surgery by goniometer. The clinical result was evaluated by Severance elbow scoring system. The final ROM was evaluated at the point of no further increasement of joint motion. Male ware 30 cases, female ware 7 cases, average 42.6 years old and mean follow up period were 31 months. During arthroscopic treatment we had done release of the joint capsule or resection, synovectomy, removal of loose bodies. We used traditional portals. Results: The avarage preoperative ROM of elbow joint was 72.5 degree(range, 5 - 132 degree) and the increasement of ROM was totally 49.3 degree in flexion 26.5 degree and extension 22.8 degree. There was no other complication. Conclusion: Arthroscopic treatment for contracted elbow permit early joint ROM and it decrease the secondary injury to the elbow joint. Also there are few complications. It is thought to be a good treatment modality in contracted elbow joint.

무지 중수지 관절의 외상성 탈구 치료 (Treatment of Traumatic DislocationofMetacarpophalangeal Joint of the Thumb)

  • 이승구;송석환;이화성;정진화;정도현;이원희
    • 대한정형외과스포츠의학회지
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    • 제1권2호
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    • pp.143-148
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    • 2002
  • 목적: 임상적으로드물며, 발생시도수정복이잘안되는무지중수지관절복합탈구의임상적결과를알아보고자하였다.대상및방법: 무지중수지관절의외상성탈구11예(10예후방탈구, 1예전방탈구)를대상으로초기에탈구의정복가능성,도수정복을방해하는해부학적요인, 수술적접근법에관하여조사하였다.결과: 모든증례에서초기에도수정복을시도하였으나, 2예에서만이정복이되었다. 8 례는전방도달법으로관혈정복을하였고, 1예는만성적인소견을보여관절고정술을시행하였다. 정복방해요인은파열된수장판내로근위부에서단무지굴건과요측종자골이감입되어있었고, 중수골두는파열된인대와단무지굴건사이에형성된간격사이로빠져나와있었다.결론: 과신전에의한중수지관절의후방복합탈구는드물지만, 정복이쉽지않아서주로관혈정복이요구되며, 이때정복방해요인인파열된수장판과관절막, 단무지굴건과종자골등에관심을갖고치료에임하여야한다.

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주관절의 이학적 검사 (Physical Examination of the Elbow)

  • 김풍택;경희수;전인호
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2003년도 연수강좌
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    • pp.51-56
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    • 2003
  • The trained examiner can gain considerable information from visual inspections of the elbow joint, Because much of the joint is subcutaneous, any appreciable alteration in the skeletal anatomy often is detectable. Gross soft tissue swelling or muscle atrophy is also early observed. Inspection and palpation of the medial and lateral epicondyles and the tip of the otecranon from an equilateral triangle with the elbow is flexed. Normally, the arc of flexion extension, although variable, ranges from about O to 140 degrees plus or minus 10 degrees. The posterolateral rotatory instability(PLRI) of the elbow is most common pattern of elbow instability. The lateral collateral ligament complex also includes a narrow but stout band of ligamentous tissue blending with the distal and proterior fibers of the capsule to insert distally on the crista supinatoris of the ulna. This is the lateral ulnar collateral ligament(LUCL). A clinical elbow pivot shift test confirms the PLRI. There are also two active apprehension signs.

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