• 제목/요약/키워드: synovitis

검색결과 116건 처리시간 0.028초

$^{99m}Tc$-labelled HIG 스캔을 이용한 류마티스 관절염 환자에서 활막염증의 평가 : 조영증강 자기공명영상과의 전향적인 비교 (Assessment of the Synovial Inflammation in Rheumatoid Arthritis with $^{99m}Tc$-labelled Polyclonal Human IgG(HIG): Prospective Comparison with Gadolinium Enhanced MRI)

  • 유영훈;이종두;서진석;박창윤;전평;나재범;이수곤
    • 대한핵의학회지
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    • 제29권1호
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    • pp.84-91
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    • 1995
  • 지금까지 류마티스 관절염의 염증 정도의 평가를 위하여 많은 검사들이 사용되어져 왔다. $^{99m}Tc$-labelled HIG 스캔은 동물실험과 사람에서도 염증이나 감염병소에 집적되는 것으로 알려져 있다. 본 연구의 목적은 $^{99m}Tc$-labelled HIG 스캔을 이용하여 류마티스 관절염 환자에서 활동성 염증이 있는 군과 없는 군을 구별해 보고자 하였고 이러한 결과를 다른 임상인자와 조영증강 자기공명영상과 비교해 보았다. 11명의 활동성 염증이 있는 류마티스 관절염 환자와 활동성 염증이 없는 류마티스 관절염 환자 1명, 강직성 척수염 환자 2명 그리고 퇴행성관절염 환자 1명을 대상으로 하였다. 활동성 염증(active synovitis)은 ESR의 상당한 증가와 조영증강 자기공명영상에서 조영증강을 보이는 경우로 정의하였다. $^{99m}Tc$-labelled HIG를 정맥주사후 4시간후에 전신 및 국소영상을 얻었다. 섭취정도의 평가는 3명의 전문의에 의하여 3단계로 나누어 시각적으로 평가하였다. 모든 환자에 있어서 조영증강 자기공명영상을 같이 시행하였다. 활동성 염증이 있는 11명의 류마티스 관절염 환자중 10명에서 상당한 정도의 섭취증가를 보인 반면 활동성 염증이 없는 나머지 환자에서는 정상 또는 미미한 정도의 섭취증가만을 보였다. 본 연구에서 $^{99m}Tc$-labelled HIG 스캔을 이용하여 류마티스 관절염에 이환된 관절들의 전반적인 국소화가 가능하였고 $^{99m}Tc$-labelled HIG의 섭취정도가 다른 임상적이나 자기공명영상의 활동성 염증을 시사하는 인자들과 잘 연관되었다. 결론적으로 $^{99m}Tc$-labelled HIG 스캔은 류마티스 관절염 환자에 있어서 염증 정도를 평가해 볼 수 있는 유용한 방법이 될 수 있을 것으로 생각한다.

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소아에서의 이물질에 의한 슬관절 활액막염 - 증례보고 - (Foreign Body Synovitis of a Child's Knee - A Case Report -)

  • 김성재;이수찬;이영수;이윤태
    • 대한관절경학회지
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    • 제3권1호
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    • pp.51-53
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    • 1999
  • 특별한 외상을 알 수 없이 슬관절 동통을 호소하는 4세 된 남아에서 방사선사진상 슬관절 내측에 이물질이 보였다. 저자들은 관절경으로 찢어진 반월판 연골 및 골연골의 변연절제술과 동시에 유리조각을 제거함으로써 성공적으로 치료하였기에 보고하고자 한다.

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아시아 지역의 닭마이코플라즈마병 상황

  • 강민수
    • 월간양계
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    • 제33권7호통권381호
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    • pp.100-105
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    • 2001
  • 마이코플라즈마 갈리셉티쿰(Mycoplasma gallisepticum, MG)및 마이코플라즈마 시노비에(M. synoviae,MS)에 의한 감염증은 아시아지역 뿐만 아니라 전세계적으로 닭에서 흔히 발생하는 질병이다. MG 감염은 흔히 닭에서 기낭염을 수반하는 만성호흡기병(chronic respiratory disease, CRD)과 칠면조의 전염성부비동염(infectious sinusitis)을 일으킨다. MS는 처음에 육계에서 전염성활막염(infectious synovitis)을 유발하는 병원체로만 알려졌으나, MG에 감염되지 않은 육계의 기낭염 병변부에서 빈번히 분리됨으로 인해 최근에는 원래의 전염성활막염보다 기낭염과 관련하여 많은 관심이 고조되고 있다. 아시아지역의 마이코플라즈마 감염상황을 대변하는 많은 문헌자료가 있으나, 대부분이 자국의 언어로 출판되어 있는 관계로 자료분석에 많은 애로가 있어 주로 해독이 가능한 영문자료를 근거로 하여 각국의 닭에서의 MG 및 MS 감염증의 발생상황과 방제현황에 대하여 언급하고자 한다. 비록 개략적이 나마 이를 토대로 국내 마이코플라즈마 방역상황을 되돌아볼 수 있는 계기가 되었으면 한다.

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거골하 관절경술 (Subtalar Arthroscopy)

  • 서진수
    • 대한족부족관절학회지
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    • 제16권1호
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    • pp.26-30
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    • 2012
  • The subtalar joint is a complex joint that is functionally responsible for inversion and eversion of the hindfoot. Advances in optical technology and surgical instrumentation have allowed the arthorscocpic surgeon to investiagate the small joints including the subtalar joint. Indications for subtalar arthroscopy include pain, swelling, stiffness and locking. Therapeutic indications include treatment of chondromalacia, osteophytes, arthrofibrosis, synovitis, loose bodies, osteochondral lesions, excision of a painful os trigonum, arthrodesis, and FHL tendinopathy. Contraindications to subtalar arthroscopy include infection, advanced osteoarthritis with deformity, severe edema, poor vascularity and poor skin quality. Subtalar arthroscopy is a technically demanding and difficult procedure that should only be performed by experienced surgeons. With proper instrumentation and careful operative techniques, satisfactory results may be obtained with minimal morbidity.

족근 관절 연부조직 충돌 증후군에서 MRI의 진단적 의의 및 관절경적 치료 결과 (Diagnostic efficacy of specialized MRI & clinical results of arthroscopic treatment in ankle soft tissue impingement syndrome)

  • 이진우;문은수;김성재;한수봉;강응식
    • 대한족부족관절학회지
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    • 제7권2호
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    • pp.208-217
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    • 2003
  • Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

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감염성 척추염과 감별질환의 병태생리와 MRI 소견 (Pathophysiology and MRI Findings of Infectious Spondylitis and the Differential Diagnosis)

  • 유선진;김여주;이승훈;류정아;박성훈;홍정의
    • 대한영상의학회지
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    • 제82권6호
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    • pp.1413-1440
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    • 2021
  • MRI에서 추간판의 이상 신호와 위, 아래 척추체 종판의 파괴, 종판 주변의 골수부종 등은 감염성 척추염의 전형적인 소견으로 여겨지나 퇴행성 척추질환, acute Schmorl's node, 척추관절병증, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO)/chronic recurrent multifocal osteomyelitis, 척추신경관절병증, calcium pyrophosphate dehydrate 결절침착질환 등 다양한 비감염성 척추질환에서도 나타날 수 있다. MRI에서 이러한 비감염성 척추질환과 감별되는 감염성 척추염의 영상 소견은 추간판의 고신호와 농양, 척추 연부조직의의 농양, 그리고 T1 강조영상에서 저신호로 보이는 종판의 경계가 불명확해지는 점 등이다. 그러나 이러한 감별점이 항상 적용되는 것은 아니며 감염성, 비감염성 질환의 영상 소견에 유사점이 많기 때문에 정확한 진단을 위해서는 감염성 척추염뿐만 아니라 감염과 감별해야 하는 다양한 질환의 병태생리와 연관된 영상학적 특징을 아는 것이 중요하다.

외상성 악관절 손상 (TRAUMATIC TMJ INJURY)

  • 김영균
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제19권2호
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    • pp.191-199
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    • 1997
  • Mandibular trauma is developed due to traffic accident, fall down, industrial injury, and others. TMJ disorder is usually also developed after facial traumatic injury. Many authors suggested that disc displacement or tearing, acute synovitis, TMJ ankylosis, traumatic arthritis, or effusion are developed after facial trauma. It is still very controversible what is the best treatment of TMJ injury such as condylar fracture and meniscal injury. In TMJ injury, synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukotriene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and meniscal injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ can be obtained. And I think that the initial surgical management of meniscus of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.

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반월상 연골 손상에 대한 관절강내 봉약침 치료 증례보고 4례 (The Effect of Intra-articular Bee Venom Injection on Meniscal Injury : Four Cases Report)

  • 김동은;유덕선;염승룡;권영달;송용선
    • 한방재활의학과학회지
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    • 제20권1호
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    • pp.219-230
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    • 2010
  • According to previous reports, intra-articular bee venom injection is very effective for synovitis, intra-articular lesions. In this article, we report 4 cases of well-treated meniscal tear with intra-articular bee venom injection. We used intra-articular bee venom injection on meniscal tear diagnosed by MR imaging and prescribed herbal medication, physiotherapy if necessary. Outcomes were measured by Visual Analogue Scale(VAS) and Lysholm Knee Scoring Scale. Patients who are treated by intra-articular bee venom injection had a significant effect on the pain reduction, improved range of motion and knee function. Further well-designed, controlled studies and more cases are needed to define the effect of intra-articular bee venom injection on knee.

흉막강액에서 진단된 류마티스성 흉막염 - 세포학적 소견 1예 보고 - (Cytologic Findings of Rheumatoid Pleuritis in Pleural Effusion - A Case Report -)

  • 차희정;민수기;김준미;주영채
    • 대한세포병리학회지
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    • 제8권1호
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    • pp.47-51
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    • 1997
  • Patients with rheumatoid arthritis of any degree of severity or duration may develop necrotizing granulomatous pleuritis, a morphologic replica of the inflammatory reaction characteristic of rheumatoid synovitis and rheumatoid nodules. The principal feature is the background composed of granular, amorphous, particulate material or debris of various hues. The material is sometimes eosinophilic sometimes more cyanophilic, or even green in the Papanicolaou stain. Within this background are elongated, fibroblast-like epithelioid cells, numerous multinucleated giant cells and degenerating leukocytes. The combination of the debris, spindle epithelioid ceils, and multinucleated giant cells in fluid is pathognomonic for rheumatoid pleuritis. We experienced a hcase of rheumatoid pleuritis showing these characteristic cytologic findings. The patient was a 63 year-old man with positive rheumatoid factor. The pleual fluid specimen revealed elongated epithelioid cells and multinucleated giant cells on a background of amorphous granular material.

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치과치료와 턱관절장애의 연관성에 관한 연구 (The Relationship between Dental Treatment and Temporomandibular Disorder)

  • 김영균;이용인
    • 대한치과의사협회지
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    • 제46권5호
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    • pp.308-314
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    • 2008
  • The risk of temporomandibular joint disorder (TMD) can be increased during dental treatment due to excessive mouth opening and change of occlusion. The aim of this study is to find the relationship between dental treatment and TMD in the patients who developed TMD after dental treatment. The subjects of this study were 21 patients, who developed TMD after dental treatment and were treated with active TMD therapy in Seoul National University Bundang Hospital from June 2003 to February 2007. The subjects were examined with preceding dental treatment, symptom, diagnosis, treatment method of TMD and prognosis of TMD. The obtained results were as follows. 1. Preceding dental treatments were : Implant treatment, 14 cases ; Tooth extraction, 3 cases and others. 2. TMD symptoms were : pain on TMJ, 12cases : Sound on TMJ, 3cases ; Mouth opening limitation, Headache and others. 3. Diagnoses of TMD were : Synovitis and/or capsulitis, 10 cases ; 8 cases of Internal derangement and others. 4. Most TMD were treated by stabilization splint. 5. Prognoses of TMD were : Improvement, 6cases ; sustained 11 cases. In conclusion, the risk of TMD is increased during implant treatment. Prognoses of TMD after dental treatment were bad. It might be that these patients were non-cooperative and have distrust of dental treatment. Because the overloading on TMJ is possible in dental treatment of patients with underlying TMD, prior explanation and knowledge TMJ treatment are very important in these cases.

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