SAPHO syndrome had different clinical and radiological aspects. The clinical features were not remarkable, except the dermatological manifestations and the involvement of the anterior chest. Bone lesions including hyperostosis and osteitis were found radiographically in the majority of patients with SAPHO syndrome. These are the characteristics of the SAPHO syndrome, with the exclusion of other bone diseases.

BackgroundMuch controversy exists as to the management of full-thickness tears of the rotator cuff. Not all patients with rotator cuff tears require surgical treatment. We have little information whether there are factors that are related to successful outcome of conservative treatment.AimThe purpose of this study was to determine the factors related to the successful outcome following conservative treatment.MethodsThis study included 123 shoulders in 118 patients with full-thickness tears of the rotator cuff diagnosed by high-resolution magnetic resonance imaging with a microscopy coil. All patients were treated conservatively for at least 3 months. Clinical symptoms improved in 65 shoulders in 62 patients by conservative treatment (conservative group), but remained unchanged or aggravated in 58 shoulders in 56 patients, who eventually underwent surgical repair (surgical group).ResultsThe following parameters showed significant differences: 1) integrity of the intramuscular tendon of the supraspinatus (24.1% in the surgical group and 58.4% in the conservative group showed an intact intramuscular tendon); 2) supraspinatus muscle atrophy (occupancy ratio was 69.8% in the surgical group and 78.0% in the conservative group); 3) impingement sign (positive in 79.3% in the surgical group and 30.7% in the conservative group); and 4) external rotation angle (35.0 degrees in the surgical group and 52.2 degrees in the conservative group). The success rate of conservative treatment was 87% in the cases with at least three of these four factors.ConclusionThese four factors are useful in selecting patients who will respond well to conservative treatment before initiating the treatment.

In computed tomography (CT)-guided interventions (CTIs), physicians are close to a source of scattered radiation. The physician and staff are at high risk of radiation-induced injury (cataracts). Thus, dose-reducing measures for physicians are important. However, few previous reports have examined radiation doses to physicians in CTIs. This study evaluated the radiation dose to the physician and medical staff using multi detector (MD)CT-fluoroscopy, and attempted to understand radiation-protection and -reduction methods. The procedures were performed using an interventional radiology (IVR)-CT system. We measured the occupational radiation dose (physician and nurse) using a personal dosimeter in real-time, gathered CT-related parameters (fluoroscopy time, mAs, CT dose index (CTDI), and dose length product (DLP)), and performed consecutive 232 procedures in CT-guided biopsy. Physician doses (eye lens, neck, and hand; μSv, average ± SD) in our CTIs were 39.1 ± 36.3, 23.1 ± 23.7, and 28.6 ± 31.0, respectively. Nurse doses (neck and chest) were lower (2.3 ± 5.0 and 2.4 ± 4.4, respectively) than the physician doses. There were significant correlations between the physician doses (eye and neck) and related factors, such as CT-fluoroscopy mAs (eye dose: r = 0.90 and neck dose: r = 0.83). We need to understand the importance of reducing/optimizing the dose to the physician and medical staff in CTIs. Our study suggests that physician and staff doses were not significant when the procedures were performed with the appropriate radiation protection and low-dose techniques.

Abducting the shoulder during immobilization in external rotation is demonstrated to improve the reduction of the Bankart lesion. Therefore, this position is expected to reduce the recurrence rate after initial dislocation of the shoulder. Future clinical trials are necessary.

Osteoid osteoma (OO) apparent in the intra-articular region of the elbow is very rare. Although computed tomography-guided excision and radiofrequency ablation have been recognized as useful treatment options, arthroscopic excision has recently received focus as an alternative strategy for lesions close to neurovascular structures or intra- and juxta-articular lesions. We herein report a 17-year-old female who underwent arthroscopic treatment for intra-articular OO located at the olecranon/coronoid fossa. Her symptoms included elbow pain that was exacerbated at night and contracture of elbow flexion-extension, and she was diagnosed with intra-articular OO after 12 months of symptomatic history. Arthroscopically, thorough synovectomy for both the anterior and posterior aspects of the joint enabled definition of the tumor margin with hyperemic alteration and excision of the lesion as an en bloc specimen. At the 12-month follow-up, the patient had no recurrence of elbow limitation or pain. This case report describes the advantages of arthroscopic treatment, including a low-invasive approach and easy accessibility to the whole intra-articular space, which can provide clear visualization of the tumorous lesion.