<strong>Background:</strong> Plain radiography usual method to detect degeneration in the subtalar and talonavicluar joints. MRI is a better way to fully characterise non-ossified structures, such as artic...<strong>Background:</strong> Plain radiography usual method to detect degeneration in the subtalar and talonavicluar joints. MRI is a better way to fully characterise non-ossified structures, such as articular cartilage, marrow tissue and synovial fluid and therefore detect changes of arthritis. The motivation behind this study was to develop a quantitative way to score arthritic changes to the subtalar and talonavicular joints using MRI. The developed system will then be used as a research tool and in the close assessment and monitoring of patients with hindfoot degenerative disease. <strong>Methods:</strong> The MRI scans of thirty consecutive subjects with foot and ankle pain were retrospectively evaluated. Images were interpreted independently by three musculoskeletal radiologists in order to determine intra-observer reliability as well as the inter-observer reliability of the score. Five features of osteoarthritis were scored in the Subtalar joint and the Talonavicular joint. These were cartilage morphology, subarticular marrow, subarticular cyst, marginal osteophytes and synovitis. <strong>Results:</strong> For the 30 MRI scans the mean score for the Subtalar joint ranged from 11.7 to 14.4 and for the Talonavicular joint ranged from 3.7 to 5.6. The inter-observer correlation for the Subtalar joint between the three readers ranged between 0.53 and 0.83 for the individual features but overall was excellent at 0.76. For the Talonavicular joint the total correlation was good at 0.67. The inter-observer ICC for the total score was 0.75 which showed excellent agreement between the three readers. The total intra-observer correlation was excellent. <strong>Conclusions:</strong> The current work has shown excellent reliability for the scoring system. It will be a useful tool to diagnose and monitor disease progression of the Subtalar and Talonavicluar joints.展开更多
Benign Giant Cell Tumor is a relatively common benign lesion which usually appears as an enlarging painless mass and has a synovial origin. Although benign giant cell tumors generally involve tendon sheaths, they are ...Benign Giant Cell Tumor is a relatively common benign lesion which usually appears as an enlarging painless mass and has a synovial origin. Although benign giant cell tumors generally involve tendon sheaths, they are infrequently documented in the foot. A 45 years old female presented with a complaint of a lump on the top of her left foot. Under general anesthesia with a pneumatic tourtniquet the mass excised with great care not to leave any residual tumor tissue that can cause recurrence. Benign giant cell tumor of the foot can be associated with talonavicular joint capsule which can be detected with MRI imaging and total excision of the lesion is mandatory to prevent recurrence.展开更多
目的探讨距舟楔关节融合治疗Müller-Weiss病的临床疗效。方法回顾性分析2012年1月至2015年11月于我院行距舟楔关节融合治疗的Müller-Weiss病患者19例,22足的术前及术后资料。患者术中在足内侧柱得到复位重建后,凿除舟骨外侧...目的探讨距舟楔关节融合治疗Müller-Weiss病的临床疗效。方法回顾性分析2012年1月至2015年11月于我院行距舟楔关节融合治疗的Müller-Weiss病患者19例,22足的术前及术后资料。患者术中在足内侧柱得到复位重建后,凿除舟骨外侧部分并进行清理,取适当大小的髂骨骨块进行植骨,足背侧进行锁定钢板固定,轴向予空心螺钉固定。术前及术后的疼痛模拟评分(visual analog scale,VAS评分)和美国矫形外科足踝协会踝与后足评分(American Orthopaedic Foot and Ankle Society,AOFAS评分)进行比较。结果所有患者均获得随访,平均随访时间为28个月(13~57个月),平均融合时间为15周(13~17周),4例严重的跟骰关节炎患者行骨赘清理手术,1例患者术后15个月时出现螺钉松脱,予内固定拆除。术后疼痛模拟评分及AOFAS评分均较术前明显改善(P=0.000)。结论距舟楔关节融合结合自体髂骨取骨植骨治疗Müller Weiss病疗效可靠,足内侧柱的复位重建对于恢复足部的解剖形态及术后功能具有重要意义。展开更多
文摘<strong>Background:</strong> Plain radiography usual method to detect degeneration in the subtalar and talonavicluar joints. MRI is a better way to fully characterise non-ossified structures, such as articular cartilage, marrow tissue and synovial fluid and therefore detect changes of arthritis. The motivation behind this study was to develop a quantitative way to score arthritic changes to the subtalar and talonavicular joints using MRI. The developed system will then be used as a research tool and in the close assessment and monitoring of patients with hindfoot degenerative disease. <strong>Methods:</strong> The MRI scans of thirty consecutive subjects with foot and ankle pain were retrospectively evaluated. Images were interpreted independently by three musculoskeletal radiologists in order to determine intra-observer reliability as well as the inter-observer reliability of the score. Five features of osteoarthritis were scored in the Subtalar joint and the Talonavicular joint. These were cartilage morphology, subarticular marrow, subarticular cyst, marginal osteophytes and synovitis. <strong>Results:</strong> For the 30 MRI scans the mean score for the Subtalar joint ranged from 11.7 to 14.4 and for the Talonavicular joint ranged from 3.7 to 5.6. The inter-observer correlation for the Subtalar joint between the three readers ranged between 0.53 and 0.83 for the individual features but overall was excellent at 0.76. For the Talonavicular joint the total correlation was good at 0.67. The inter-observer ICC for the total score was 0.75 which showed excellent agreement between the three readers. The total intra-observer correlation was excellent. <strong>Conclusions:</strong> The current work has shown excellent reliability for the scoring system. It will be a useful tool to diagnose and monitor disease progression of the Subtalar and Talonavicluar joints.
文摘Benign Giant Cell Tumor is a relatively common benign lesion which usually appears as an enlarging painless mass and has a synovial origin. Although benign giant cell tumors generally involve tendon sheaths, they are infrequently documented in the foot. A 45 years old female presented with a complaint of a lump on the top of her left foot. Under general anesthesia with a pneumatic tourtniquet the mass excised with great care not to leave any residual tumor tissue that can cause recurrence. Benign giant cell tumor of the foot can be associated with talonavicular joint capsule which can be detected with MRI imaging and total excision of the lesion is mandatory to prevent recurrence.
文摘目的探讨距舟楔关节融合治疗Müller-Weiss病的临床疗效。方法回顾性分析2012年1月至2015年11月于我院行距舟楔关节融合治疗的Müller-Weiss病患者19例,22足的术前及术后资料。患者术中在足内侧柱得到复位重建后,凿除舟骨外侧部分并进行清理,取适当大小的髂骨骨块进行植骨,足背侧进行锁定钢板固定,轴向予空心螺钉固定。术前及术后的疼痛模拟评分(visual analog scale,VAS评分)和美国矫形外科足踝协会踝与后足评分(American Orthopaedic Foot and Ankle Society,AOFAS评分)进行比较。结果所有患者均获得随访,平均随访时间为28个月(13~57个月),平均融合时间为15周(13~17周),4例严重的跟骰关节炎患者行骨赘清理手术,1例患者术后15个月时出现螺钉松脱,予内固定拆除。术后疼痛模拟评分及AOFAS评分均较术前明显改善(P=0.000)。结论距舟楔关节融合结合自体髂骨取骨植骨治疗Müller Weiss病疗效可靠,足内侧柱的复位重建对于恢复足部的解剖形态及术后功能具有重要意义。
