The widespread use of diagnostic radiography, especially using magnetic resonance imaging, has helped to increase the diagnosis of paralabral cysts in patients with chronic shoulder pain. These paralabral cysts are frequent in the anterior, the superior, and the posterior compartment of the shoulder joint but are rare in the inferior compartment. Paralabral cysts in the shoulder appear particularly in men in their third and fourth decades but rarely in elderly patients. We report a case of an inferior paralabral cyst in an elderly patient whom we treated through arthroscopic decompression. The increased use of diagnostic magnetic resonance imaging (MRI) in patients with chronic shoulder pain has correlated with the increase in the diagnosis of paralabral cysts. Paralabral cysts are commonly associated with labral or capsule tears through which synovial fluid seeps out into the extra-articular space; the labral or the capsule tear essentially becomes a 'one-wayvalve'.1,2) Paralabral cysts are present in 2% to 4% of the population, most of whom are 30-to 40-year-old men. They are rarely present in the elderly population. Generally, the cysts are located in the posterior, the superior, or the anterior compartment of the shoulder and are rarely located in the inferior compartment.3)The symptoms of pain and dysfunction can vary according to the position of the cysts. In this study, we present a case of a paralabral cyst in the inferior compartment of the shoulder in a 79-year-old man whom we treated using arthroscopic decompression. Case ReportThe 79-year-old man admitted to our hospital presented with a chief complaint of left shoulder pain that began and deteriorated without particular trauma from a month before. Specifically, he complained of pain around the posterior compartment of the shoulder, and without particular reason he complained that the pain exacerbated at night. At the time of admittance, the patient scored a visual analogue scale for pain of 6 points. Through physical examination, we found that the range of motion of the left shoulder showed a forward elevation of 160 ; the patient displayed slight restriction in motion. We did not observe other physical or neurological abnormalities that indicated instability. Visually, we could not find evidence for atrophy of the muscles, and muscle strength was within the normal range. Because symptoms prevailed with drug therapy, we carried out plain radiography and MRI. At the preoperative MRI, we found and diagnosed a ganglion cyst, which was fused to the articular surface, with a dimension of 2.5×1.5×2 cm at the inferior labrum, and an inferior labral tear (Fig. 1). Despite conservative treatment of the paralabral cyst through drug therapy, rest, and modified activity for 3 months, the symptoms did not improve; thus, we decided to treat the patient surgically.Under general anesthesia, we placed the patient in the right
Department of Orthopaedic Surgery, Gwangju Bohun Hospital, Gwangju, Korea Gout often occurs in the first metatarsophalyngeal joint, and also in the ankle joint and posterior foot. Knee joint gouty arthritis is commonly reported, but gouty tophi in bilateral popliteal cysts, such as this case, are rare. We report on a case treated by cystectomy of gouty tophi in bilateral popliteal cysts and review.
Purpose: Cementless total hip arthroplasty was performed to treat primary osteoarthritis of the hip and avascular necrosis of the femoral head. The clinical and radiological results of the acetabular cups and femoral stems were compared. Materials and Methods:The subjects were 84 cases who underwent primary cementless total hip arthroplasty from The radiological results revealed 9 and 15 cases of acetabular osteolysis (p=0.671) and 1 and 3 cases of vertical migration of the acetabular cups in the group A and B, respectively. Eight and 7 complications (p=0.572) were encountered in group A and B, respectively. Among these, 4 and 5 cases of revisional total hip arthroplasty were performed in group A and B, respectively. The results of survival analysis were similar in the two groups (p=0.969). Conclusion:The clinical and radiological features of the acetabular cups and stems were similar in the two groups.Nevertheless, further studies will be needed due to the high rate of polyethylene liner wear and osteolysis around the acetabular cups or femoral stems.
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