No abstract

Pain drawings were obtained from three groups of patients: 51 with lumbar disc herniation; 55 with lumbar stenosis, and 42 with benign low back pain. On grid assessment, patients with disc herniation and stenosis who complained of radiating pain or intermittent claudication had a significantly larger number of grids for the extremities than those with benign low back pain. In studies of the relation between the characteristics of the pain drawing and the outcome of treatment, most patients with 19 grids or less, or a score of 3 points or less, had a satisfactory outcome. Those with more grids or a higher score tended to be unsatisfactory. Pain drawing permits differentiation of the three patterns of pain and is useful for predicting the outcome of treatment.

Apabetalone favorably modulated ultrasonic measures of plaque vulnerability in the population studied, which may relate to an increase in HDL particle concentrations. The clinical implications are currently being investigated in the phase 3 major adverse cardiac event outcomes trial BETonMACE.

We present the case of a 39-year-old man with bilateral piriformis syndrome 4 and 6 years after two cementless total hip arthroplasties, respectively. During surgical exploration, each sciatic nerve was found to be entrapped by a tense piriformis muscle and hypertrophic posterior hip capsule. The sciatic-type pain was relieved after sectioning each piriformis muscle with external neurolysis. This is the first reported case of piriformis syndrome after total hip arthroplasty.

Eleven patients with high-standing greater trochanter (13 joints) aged 13-36 years underwent surgery. Distal transfer of the greater trochanter (group T) was performed in 4 patients (5 joints) and lateral displacement osteotomy (group L) in 7 (8 joints). The average follow-up duration was 13.4 years in group T and 5.9 years in group L. Clinical results were evaluated by the hip score according to Merle d'Aubigne. The mean hip score in group T was 13.4 points before operation and 15.4 points after operation, and in group L, 12.8 and 17.4 points, respectively. The postoperative clinical results of group L were significantly better than those of group T (P = 0.0494). In radiological evaluation, although the articulo-trochanteric distance (ATD) increased in both groups in group L it improved remarkably from 9.8 to 24.3, indicating a large descending distance of the greater trochanter. The lever arm ratio (LAR) did not change significantly in group T, but it decreased from 1.97 to 1.60 in group L (P = 0.004). This means that the lever arm of the abductors can certainly be extended by lateral displacement osteotomy. Lateral displacement osteotomy is the most effective procedure for high-standing greater trochanter.