Italian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint disease.

In a double-blind study, the efficacy and tolerability of S-adenosylmethionine (SAMe) were evaluated in comparison with those of placebo and naproxen in the treatment of osteoarthritis of the hip, knee, spine, and hand. Thirty-three centers, 18 rheumatologic and 15 orthopedic, participated in this study. A total of 734 subjects, including 582 with coxarthrosis (hip osteoarthritis) or gonarthrosis (knee osteoarthritis), were enrolled.

Ultrasonography in the early diagnosis of congenital dysplasia of the hip.

The authors discuss the feasibility of using ultrasonography in the early diagnosis of congenital dysplasia of the hip. Having used the methods of Graf and Harcke, they devised a new scan which always reveals the state of the limbus in neonatal congenital dysplasia. This has been used for two years as an additional technique in neonates with a positive Ortolani click to demonstrate the presence of an inverted limbus, which is not revealed in the Graf and Harcke scans although they give a very good overall picture of the femoral head and acetabulum.

Scintigraphy with Tc99m-MDP in the diagnosis of stress lesions in bone.

Scintigraphy with Technetium methylene diphosphate gives a positive result in bone tissue in a state of raised metabolic activity. This can be used in the diagnosis of mechanical stress lesions in bone. The authors present several clinical examples confirming the usefulness of this method.

Clinical investigations of tolerance to materials and acrylic cement in patients with hip prostheses.

In forty-two patients with prostheses of the hip followed up after an interval, the authors carried out skin allergy tests against the metals of which the prostheses were composed, and against methacrylate. They found that the tests gave positive results in about 25 per cent of cases. They also investigated whether this finding showed any relationship with loosening or movement of the prostheses.

A new method for the quantitative determination of osteoporosis in man.

The authors studied a technique based on the use of a radiographic negative in antero-posterior projection of the third lumbar vertebra, from which the index of osteoporosis was obtained quantitatively by spectrophotometric examination. This index is about 0.50 in normal cases and approaches unity in cases of osteoporosis.

Role of synovectomy in hemophilic arthropathy.

Fifteen knee synovectomies performed in severe hemophiliacs between 1969 and 1971 were reevaluated after a follow-up period ranging from five to seven years. In the majority of cases (53%) there was no recurrence of hemarthrosis; in the others the condition was reduced (40%) or unchanged (7%) and joint scintiscans carried out with 99mTc showed a significant uptake of the tracer. Joint motion was markedly impaired in eight cases despite prolonged and intensive physiotherapy.

Short-term evaluation of synovectomy in haemophilia.

Twenty-three operations of synovectomy (15 on the knee, 5 on the ankle, and 3 on the elbow) were carried out over a three-year period in 19 patients with severe haemophilia A and B who were followed for an average period of 15 months postoperatively. Short-term evaluation of the results was mainly based on the postoperative incidence of haemarthrosis and on the range of joint motion, which were compared with the preoperative findings. Synovectomy reduced, but did not abolish, the occurrence of haemarthrosis; however, after the operation bleeding episodes were usually less severe and incapacitating.