The risk of osteoarthritis with running and aging: a 5-year longitudinal study.

Our purpose was to determine the 5-year longitudinal effects of running and aging on the development of radiographic and clinical osteoarthritis (OA) of the knees, hands and lumbar spine. Thirty-five running subjects and 38 controls, with a mean age of 63 years, were matched for age (+/- 2 years), years of education, and occupation; 33 matched pairs were constructed. All subjects underwent rheumatologic examination, completed questionnaires, and had radiographs taken of the hands, lateral lumbar spine, and knees in 1984 and in 1989.

Estimating lumbar bone mineral density from routine radiographs of the lumbar spine.

To evaluate the information content of lateral lumbar films with respect to bone mineral content, we compared reading criteria with values obtained by quantitative computed tomography (CT) of L1 at baseline and after 5 years. The highest correlations with mineral content were found for the criteria "overall assessment of the vertebra", "vertebral bone density versus soft tissue", and "amount of trabeculations". These three reading criteria yielded higher correlations with CT scores in subjects with lower body mass index.

Size of osteonecrosis of the knee.

In the Swedish Multicenter Study of Knee Arthroplasty, 115 knees in 110 patients with knee osteonecrosis represented all reported cases treated with knee arthroplasty in the period from 1975 to 1986. Primary medial femoral condyle osteonecrosis was the most common osteonecrosis reported (89%). Preoperative roentgenograms were staged according to the type of osteonecrosis and classified according to the grade of arthrosis.

Impact of running on lumbar bone density: a 5-year longitudinal study.

Our study was designed to examine associations of longterm physical impact (running) with changes in lumbar bone mineralization. Study subjects were a volunteer sample of 14 members of a running club now aged 55 to 77 years and 14 matched controls undergoing computerized scans of the first lumbar vertebra both at baseline and after 5 years. Separate analyses included data from 23 runners available over the entire 5-year period.

Rheumatologic and skeletal changes in acromegaly.

The anabolic functions of growth hormone (GH) and insulin-like growth factor-I (IGF-I) in cartilage and bone metabolism are important in the normal physiology of these tissues. The effects of chronic elevation of GH and IGF-I levels on bony structures produce the typical physical changes associated with acromegaly, whereas the effects on cartilage result in arthropathy, which is usually degenerative. This article presents an overview of the physiologic roles of GH and IGF-I in cartilage and bone metabolism, the clinical features of the degenerative arthropathy and other rheumatologic syndromes associated with acromegaly, effects of acromegaly on bone and mineral metabolism, and an unusual bone disease that is occasionally associated with acromegaly, the McCune-Albright syndrome.

Primary osteonecrosis in the knee evaluated by histopathology and specimen scintimetry related to clinical radiography, scintimetry and MR.

Arthroplasty for primary osteonecrosis of the femoral condyle of the knee was performed in 5 patients and the resected pieces of bone were studied histologically. The patients had been given 99 mm-Tc-MDP preoperatively and the scintimetric uptake in the resected bone pieces was determined. All patients had changes typical for osteonecrosis preoperatively on radiographs and scintimetry.

Osteonecrosis of the knee. Diagnosis and outcome in 40 patients.

Clinically suspected primary osteonecrosis of the knee was studied in 40 patients with repeated plain radiography and scintimetry, and the patients were followed for 1-7 years. Thirty-three patients had typical scintimetric and radiographic signs of osteonecrosis of either one of the femoral condyles, whereas 7 patients had only typical scintimetric findings, but never developed an osteonecrosis based on plain radiography. Because the scintimetric findings were identical to the other 33 knees and because there is no other well-known localized disease in this region of the femoral condyle, we deemed that these 7 patients had probable osteonecrosis, but in an abortive form.

MR imaging of the knee in acute rheumatoid arthritis: synovial uptake of gadolinium-DOTA.

In patients with rheumatoid arthritis, the presence of acute synovial inflammation is an indication of the activity of the disease. It is an important finding because it often influences therapeutic decisions. However, acute synovitis may be difficult to detect by clinical examination, especially if a joint effusion also is present.

Insufficiency fracture of the sternum caused by osteopenia: plain film findings in seven patients.

Sternal insufficiency fractures, whether nonbuckling (displaced or nondisplaced) or buckling, are rare and have been described in elderly osteopenic patients with accentuated kyphosis of the thoracic spine. We retrospectively analyzed the radiographs and clinical records in seven osteopenic patients with sternal insufficiency fractures and correlated the type of insufficiency fracture with the presence and degree of dorsal kyphosis, as well as the presence of chest pain, soft-tissue mass, and osteolysis. We found that displaced or nondisplaced nonbuckling fractures (five patients) may be associated with chest pain localized to the sternum (three patients), and may be present with (three patients) or without (two patients) associated thoracic kyphosis.

Three-phase scintimetry in osteonecrosis of the knee.

Three-phase scintimetry with 99mTc MDP was analyzed in 40 patients with a clinical history of spontaneous onset of knee pain and a focal static isotope uptake in the femoral condyle indicating osteonecrosis. A strong correlation was found between pool-phase ratios and the static ratios. The pool-phase study did not add to the information obtained from the flow phase and static studies.

Spontaneous osteonecrosis of the knee: value of MR imaging in determining prognosis.

Sixteen patients with early and late stages of spontaneous osteonecrosis of the knee were studied to evaluate if MR imaging can be used to determine the prognosis of the disease. All patients had sequential conventional radiographs and clinical examinations, one or more 99mTc-methylene diphosphonate bone scintigrams, and an MR examination. The duration of the disease at the time of the MR examination ranged from 1 to 58 months (mean, 18 months).

Isolated dislocation of the tarsal navicular: a case report.

Isolated dislocation of the tarsal navicular is a rare injury that is not mentioned in standard orthopedic textbooks and described only once in the English literature. Because of the rarity of this condition, the best means of treatment has not been established. A patient with this unusual dislocation was recently diagnosed and treated.

Neuroarthropathy associated with chronic alcoholism.

Neuroarthropathy involving the feet is seen most commonly in patients with diabetes mellitus. Chronic alcoholism has been implicated as a cause of neuroarthropathy, but many alcoholics have coexistent diabetes mellitus, which may not be detected by measuring blood glucose levels alone. We report five chronic alcoholic patients with neuroarthropathic alterations of the feet in whom coexistent diabetes mellitus was excluded by using laboratory methods that are more sensitive than those employed in previously reported series of alcoholic neuroarthropathy.

Rheumatoid arthritis: similarity of radiographic abnormalities in men and women.

To test the hypothesis that there are significant differences in the radiographic appearance of rheumatoid arthritis between men and women, the authors blindly evaluated bilateral hand and wrist radiographs in 32 men with definite rheumatoid arthritis and 32 age- and disease duration-matched women (mean age, 56.4 years; mean disease duration, 10.5 years).

Patterns of femoral head migration in osteoarthritis of the hip: a reappraisal with CT and pathologic correlation.

Although medial, superior, and axial patterns of migration of the femoral head in osteoarthritis of the hip have been well described, it is not clear what anatomic and biomechanical factors determine the direction of migration. The authors studied 22 patients with bilateral (11 patients) or unilateral (11 patients) osteoarthritis by means of conventional radiography and computed tomography (CT) to define any relationships between migration in the coronal plane and that in the transverse plane and to determine whether femoral anteversion, acetabular anteversion, femoral neck-shaft angle, or acetabular inclination were related to particular migration patterns. Anterior migration was evident in 14 of the 19 hips with a superior migration pattern, whereas posterior migration was present in five of the seven hips with a medial migration pattern.

Destructive spondyloarthropathy in hemodialysis patients. Report of four cases and prospective study.

A destructive spondyloarthropathy is reported in four patients undergoing maintenance hemodialysis for chronic renal disease. In a separate investigation a controlled, prospective radiographic study of the cervical spine revealed this spondyloarthropathy in 4 (15%) of 26 long-term dialysis patients. A single disc level was involved in three patients, and two disc levels were involved in one patient.

Carpal alterations in adult-onset Still disease, juvenile chronic arthritis, and adult-onset rheumatoid arthritis: comparative study.

A specific pattern of pericapitate involvement of the wrist has been described in the rheumatologic literature as characteristic of adult-onset Still disease (AOSD), a relatively rare disorder that is often diagnosed by exclusion after extensive and frequently invasive tests. To evaluate the potential diagnostic value of carpal radiography in suspected cases of AOSD, a retrospective blinded analysis of 48 patients (16 each with AOSD, juvenile chronic arthritis, and adult-onset rheumatoid arthritis) was performed. Pericapitate articular alterations without radiocarpal involvement were found to be distinctly unusual among patients with rheumatoid arthritis but frequent in the setting of AOSD.

Stress fractures of the distal tibia and calcaneus subsequent to acute fractures of the tibia and fibula.

Stress fractures (two in the calcaneus and four in the distal tibia) occurring distal to the site of a healing fracture of the tibia or fibula were discovered in five patients. Three of these fractures were identified radiographically at the time of their occurrence, and three were identified only after retrospective review of the radiographs of 74 patients with previous tibial or fibular fractures. Three of the patients were less than 10 years old.

Symptomatic intraspinal synovial cysts: opacification and treatment by percutaneous injection.

Intraspinal synovial cysts are usually located in the lower lumbar spine in association with osteoarthritis of the facet joints, and they are most accurately diagnosed by using CT. Surgical removal of intraspinal synovial cysts implicated in the development of radiculopathy has resulted in symptomatic relief. A nonoperative method of treatment consists of CT-guided needle placement into the facet joint adjacent to the cyst, followed by injection of contrast material to show communication between the joint and the cyst and injection of corticosteroids.

Patterns of paravertebral ossification in the prehistoric saber-toothed cat.

In cases of paravertebral ossification in humans, the radiographic characteristics usually lead to a specific diagnosis. Similar manifestations are sometimes described in other species. We applied knowledge of the radiographic appearance of spinal alterations in modern humans to the evaluation of 48 fused thoracic and lumbar fossilized spine specimens from the prehistoric saber-toothed cat (Smilodon californicus), in which prominent paravertebral ossification is frequently found.