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We have studied 35 patients (25 female and 10 male) with low-back pain who were managed with aquatic exercises after an appropriate period of treatment for their condition in the medical institution. The exercises employed consisted of strengthening exercises for the abdominal, gluteal, and leg muscles, stretching of the back, hip, hamstrings, and calf muscles, walking in water, and swimming. All the patients had been participating in the exercise program for more than 6 months. The frequency of performing exercises was once a week for 7 patients, twice a week for 19, and 3 or more times a week for the remaining patients. The method used in this study was a survey questionnaire which was composed of questions about the patient's physical and psychological condition. Those patients who had performed exercises twice or more in a week showed a more significant improvement in the physical score than those who performed exercises only once a week. More than 90% of the patients felt they had improved after 6 months of participation in the program. The improvement in physical score was independent of the initial ability in swimming. The results obtained suggested that exercises in water may be one of the most useful modes of exercise for a patient with low-back pain.

We present five patients with acute traumatic hemarthrosis of the knee who also had hemorrhage within the bone marrow around the knee detected by magnetic resonance imaging. No additional bony, ligamentous, meniscal or osteochondral injuries were evident from clinical examination, initial and repeated plain radiographs, or magnetic resonance imaging. The main symptoms were sharply localized pain and tenderness of the contused area. When hemarthrosis was demonstrated at the first office visit, three cases had fat droplets in the blood. Two patients with hemarthrosis of the knee undergoing arthroscopy showed no obvious lesions of intra-articular structures. Instead they showed congestion of the joint capsule located in accordance with the traumatic episode. Magnetic resonance imaging demonstrated marrow abnormalities as diffusely low and high signal intensity areas in T1-weighted and T2-weighted images, respectively, in locations consistent with the traumatic episode and the symptoms. These disappeared within an average of 13 weeks (range in 4 cases, 12 to 16 weeks). These findings were considered diagnostic of bone contusion. Symptom duration was about 2 weeks in all cases. In conclusion the clinician should consider the possibility of coexisting bone contusion in cases of acute traumatic hemarthrosis of the knee with no evidence of bone or intra-articular lesions on clinical examination and conventional radiographs.

Stress fractures of the tarsal navicular bone are rare injury and assessing its healing is difficult. Tenderness over the tarsal navicular on physical examination is the most reliable sign for assessing fracture healing. However, it is desirable to assess fracture healing with some imaging method. We used serial magnetic resonance imaging (MRI) to assess healing in a patient with a tarsal navicular stress fracture. MRI was useful for the assessment of fracture healing of tarsal navicular stress fracture in our case.