This article presents a detailed review of the 49 reported cases of emphysematous osteomyelitis. Infection of the bones and joints usually developed in various locations of patients with concomitant diseases. The treatment includes antibiotic therapy and minor surgery, usually drainage.
Background. Clinically, functional instability (FI) of metacarpophalangeal joints (MCPJ) is not considered to represent a pathology. This excessive mobility can be detected by the application of external forces to a MCPJ at different angles. Our study aimed to measure the FI of 2nd to 5th MCPJ.
Materials and methods. A group of 36 healthy right-handed individuals were enrolled. The value of FI was measured in millimeters and verified by a CT scan. Statistical calculations was made in Statistica v.10.0.
Results. The largest values of the right and left-hand finger posterior displacement (FI) in the second to fifth MCPJ were obtained in the neutral position 0° (p<0.05). Measurements of volar displacement of the proximal phalanx second to fifth MCPJs in both hands revealed higher values at position 0° (p<0.05).
Conclusions. 1. FI of the second to fifth MCPJs is determined by anatomical configuration and dynamic stabilizers. 2. Instability measurements show that posterior displacement of the proximal phalanges is greater by at least 1 mm in the 0° neutral position.
Early references of emphysematous osteomyelitis (EO) in the literature trace back to 1981, when the presence of intraosseous gas was mentioned in a paper of Ram et al.. Subsequently, 48 cases of EO were described. A significant underlying comorbidity was reported in most EO cases, especially diabetes and malignancy. This report presents a 37-year-old male with undiagnosed diabetes mellitus which was accompanied by emphysematous osteomyelitis of both femoral heads.
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