• Hip & pelvis
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• v.35 no.2
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• pp.88-98
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• 2023

Purpose: The objectives of this study were to examine the prevalence and risk factors for development of periprosthetic occult femoral fractures during primary cementless total hip arthroplasty (THA) and to assess the clinical consequences of these fractures. Materials and Methods: A total of 199 hips were examined. Periprosthetic occult femoral fractures were defined as fractures not detected intraoperatively and on postoperative radiographs, but only observed on postoperative computed tomography (CT). Clinical, surgical, and radiographic analysis of variables was performed for identification of risk factors for periprosthetic occult femoral fractures. A comparison of stem subsidence, stem alignment, and thigh pain between the occult fracture group and the non-fracture group was also performed. Results: Periprosthetic occult femoral fractures were detected during the operation in 21 (10.6%) of 199 hips. Of eight hips with periprosthetic occult femoral fractures that were detected around the lesser trochanter, concurrent periprosthetic occult femoral fractures located at different levels were detected in six hips (75.0%). Only the female sex showed significant association with an increased risk of periprosthetic occult femoral fractures (odds ratio for males, 0.38; 95% confidence interval, 0.15-1.01; P=0.04). A significant difference in the incidence of thigh pain was observed between the occult fracture group and the non-fracture group (P<0.05). Conclusion: Occurrence of periprosthetic occult femoral fractures is relatively common during primary THA using tapered wedge stems. We recommend CT referral for female patients who report unexplained early postoperative thigh pain or developed periprosthetic intraoperative femoral fractures around the lesser trochanter during primary THA using tapered wedge stems.

• The Korean Journal of Pain
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• v.7 no.2
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• pp.292-298
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• 1994

The common disorder called facet syndrome exhibits lower back pain, with or without, radiating pain to buttock and thigh due to facet joint arthropathy. Many physicians have believed that the usual lesion of facet syndrome was an anatomical impairments of facet joint itself. So facet joint block has been known only as a therapeutic and diagnostic modality of facet syndrome. Based on clinical experience and anatomical study, we have concluded varying opinions from common sense about facet syndrome. Pain in the facet joint is supposedly the secondary effect of narrowing of joint space by sustained muscle contracture around joints. We therefore conclude that spasmolytic treatment of muscles connecting the two vertebral articular space would be better for treatment and diagnosis of facet syndrome rather than facet block with local anesthetic and steroid only.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.78-82
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• 2009

Obturator nerve block has been used for analgesia of hip pain, relaxation of adductor muscle spasm related to cerebral palsy or paraplegia and in urologic surgery to prevent inadvertent obturator activity during lateral wall cystoscopy. Recently, ultrasound guidance has gained popularity in the field of peripheral nerve block and have been reported in some benefits. We describe here successfully performed both obturator nerve block under ultrasound guidance.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.100-105
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• 1994

This is a study of decrease in both stump pain and unidentified complaints after removal of neuroma on an amputated left thigh. The patient was a 44 year old woman who received an operation after a motorcycle accident 20th of March, 1991. She started a rehabilitation program in early June of the same year. How ever the patient complained of a squeezing pain on the amputated area. This symptom became more severe after the removal of the nails in September. The pain was perceived as a mental problem and the patient was released from the previous hospital. The pain continued and on the 9th of March, 1992, the patient was introduced to our pain clinic. The patient complained about the cold sensation and pressure pain of the amputated area at the beginning. Later she also expressed various unidentified complaints. No improvement resulted after conducting an epidural block and a lumbar sympathetic ganglion block. MMPI test showed psychological instability. Local injection showed some positive effects, which led to considerations concerning the possibility of neuroma. After confirming the existence of neuroma through CT and MRI, neuromectomy was performed. After the removal of neuroma, the unidentified complaints as well as the stump pain decreased.

• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.151-153
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• 2011

We describe a rare case of pulsed radiofrequency treatment for pain relief associated with meralgia paresthetica. A 58-year-old female presented with pain in the left anterior lateral thigh. An imaging study revealed no acute lesions compared with a previous imaging study, and diagnosis of meralgia paresthetica was made. She received temporary pain relief with lateral femoral cutaneous nerve blocks twice. We performed pulsed radiofrequency treatment, and the pain declined to 25% of the maximal pain intensity. At 4 months after the procedure, the pain intensity did not aggravate without medication. Pulsed radiofrequency neuromodulation treatment on the lateral femoral cutaneous nerve may offer an effective, low risk treatment in patients with meralgia paresthetica who are refractory to conservative medical treatment.

• Korean Journal of Acupuncture
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• v.37 no.3
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• pp.191-197
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• 2020

This case study reports the clinical response to Korean Medicine (KM) treatments including capsaicin-containing (CP) pharmacopuncture in three patients with acute low back and hip pain. Three patients were diagnosed with acute lumbar sprain, and were treated with CP pharmacopuncture, and other KM treatments including acupuncture, cupping, and herbal medicine. Numeric Rating Scale (NRS), Oswestry Disablility Index (ODI), and Clinical Evaluation Grade (CEG) were used to evaluate symptom changes. After one or two treatments, acute pain with limited range of motion in the low back and thigh region improved with a decrease in NRS, ODI, and CEG. These results suggest that further studies on KM treatments including CP pharmacopuncture for acute low back and hip pain are warranted.

• Investigative Magnetic Resonance Imaging
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• v.26 no.1
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• pp.71-75
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• 2022

Tuberculous epididymo-orchitis, a rare form of extrapulmonary tuberculosis, results from hematogenous dissemination or retrograde extension from the lower urinary tract. Herein, we studied the case of a 22-year-old male patient who presented with refractory left scrotal pain and inflammation. The patient also complained of multifocal pain involving the right buttock, posterior thigh, and right wrist, without trauma history. The patient was diagnosed with multifocal tuberculosis by sputum AFB study and right sacroiliac joint biopsy.

• The Korean Journal of Pain
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• v.24 no.4
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• pp.226-230
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• 2011

Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.

• Journal of Korean Physical Therapy Science
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• v.1 no.2
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• pp.235-241
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• 1994

Myofascial pain syndrome is a common cause of physical disability and reduces the activity of the patient. The purpose of this study was review and analysis efficiency of myofascial pain syndrome with low back pain on 50 case who were treated at the Tae Jon Nam, Myung Ho rehabilitation clinic, from January 1, 1994 to May 31, 1994. The results of this study are as follows : 1. of the 50 cases, 24(48.0%) were male and 26(52.0 %) were female. The most common age group was 40 to 30 years old. 2. The most common duration of the treatment and onset were more than 25 months with 22(44.0 %) and less : 3. As for a major causative disease of low back pain with myofascial pain sndrome, without known cause(30.0 %), lifting object(16.0 %), post exercise(14.0 %) and heavy work(12.0 %). 4. Involved muscle with low back pain reviewed I. C. L(31.0 %), Q. L, Gluteus and others muscle(23.0 %). 5. Disease history and treatment duration were proportioned. 6. Involved muscle distribution for causative disease was 26.0 % post exercise to I. C. L, 33.5 % lifting object to Q. L, 40.0 % without known to gluteus. 7. Low back pain with syndrome was buttock and thigh Pain with 44.0 %, only low back pain with 36.0 %. 8. The improvement by physical therapy on the low back pain was good 24.0 %, fair 56.0 % etc respectively. * I.C.L : Iliocostalis lumborum * Q.L : Quadratus lumborum.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.258-262
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• 1999

Sacral meningeal cyst is usually asymtomatic, but may be responsible for sciatic pain syndromes and other clinical symptoms. Sacral meningeal cyst might be suspected when definite explanation for the clinical symptom, such as herniation of the intervertebral disc or spinal stenosis is not found. Plain films and CT may suggest the presence of sacral meningeal cyst, but MR is the current imaging study of choice. Evaluation of the correlation between the symptom and the cyst is as important as detection of it. We have experienced a case of sacral meningeal cyst detected during caudal epidural block. The patient complained of low back pain radiating to thigh. Plain films and lumbar spine CT showed no remarkable finding except disc bulging. During caudal epidural needle insertion, there was leakage of clear CSF, and intrasacral cystic shadow was visualized by dye injection. MR confirmed sacral meningeal cyst.