Search

An eight-year-old girl was presented with painful swelling of the sternoclavicular joint. Radiological and scintigraphic examinations lead to a diagnosis of Friedrich's disease, aseptic necrosis of the sternal end of the clavicle. It is a rare condition which is to be differentiated from osteomyelitis, arthritis, or tumor. Because it is a self-resolving, benign condition, awareness of this disease will save the patient from unnecessary surgery.

We performed arthroscopy in nine hips in 8 patients with hip pain of unknown origin. Of them, 5 patients had a rupture in the posterior or posterosuperior labrum, not seen by arthrography. On physical examination the patients complained of pain on both passive flexion and internal rotation of the hip, and when the thigh was pushed backwards at 90 degrees of flexion.

Two hundred thirty-four hips of 117 babies from one day to 18 months of age were examined ultrasonographically for congenital dislocation of the hip joint. Ten hips in eight babies were dislocated or subluxated and there were 11 hip dysplasias in seven babies. In the normal hip, the adaptation between the acetabulum and the femoral head is well demonstrated, and there is no apparent interposition of the limbus between the acetabular roof and the cartilaginous head. In the dislocated hip, the protrusion of the acetabular rim is not so clear as that of the normal hip, and the limbus is seen to be interpositioned between the acetabular roof and the cartilaginous head. In severe cases, the acetabular rim is hidden under the shade of the femoral head. Ultrasonography is an effective method of determining the incidence of dislocation and of diagnosing hip subluxation as well as dysplasia and does not have the hazards of x-ray examination.

Eleven patients with Legg-Calvé-Perthes disease (LCP) were examined ultrasonographically for their femoral head deformity. The outline of the cartilaginous femoral head was well demonstrated, and the image obtained corresponded to that observed by arthrography. Using ultrasonography, a simple method was developed to determine the rate of deformity due to LCP. Ultrasonography does not have the hazards of x-ray and is useful for the diagnosis of LCP.

Stress fracture of the fourth vertebral arch occurred in a 21-year-old woman with a benign osteopetrosis. The fracture healed in three months after application of a body cast. It seems likely that the osteopetrotic bone resists force, in parallel with the cortical layer, but is fragile to forces at right angles to the plane of the cortical layer.