No abstract

A comprehensive anatomic, pathologic and radiographic study of the adult hip was undertaken to define bony landmarks which, when altered, are reliable indicators of disease. Methodology included radiography of cadaveric specimens and analysis of over 300 anteroposterior (AP) radiographs of "normal" adult hips. This information was applied to clinical situations with the following conclusions: (a) The diagnosis of protrusio acetabuli is warranted if the acetabular line projects medial to the ilioischial line by 3 mm or more in men and by 6 mm or more in women. (b) In acetabular trauma, an AP and two oblique radiographs (30 degrees anterior oblique and 30--45 degrees posterior oblique) are required for complete evaluation. (c) Characteristic alterations in the joint space allow accurate diagnosis of disease.

A comprehensive anatomic, pathologic, and radiographic study was undertaken to define reliable soft-tissue landmarks about the hip. Methodology included an analysis of 300 "normal" adult hip radiographs, tissue maceration, cadaveric intra-articular injection studies and review of selected clinical cases. Results, when applied to clinical situations, indicate: (a) The iliopsoas and "capsular" fat planes are poor indicators of small to moderate amounts of intra-articular fluid in the adult. (b) The "capsular" fat plane is not associated with the joint capsule, but in fact is a fat plane between two muscle bundles anterior to the articulation. (c) Distinct soft-tissue planes are available for dissemination of fluid from the hip joint. These include the iliopsoas bursa, which may distend in association with articular disease, and the fat plane of the obturator externus muscle.

Seven patients (eight shoulders) with sepsis of the glenohumeral joint were studied clinically and radiographically. Despite the advanced age of the patients, the presence of gram-negative organisms, and multiple risk factors in each patient (including serious chronic underlying diseases), needle drainage and parenteral antibiotics were all that were required for successful management, provided early diagnosis with prompt institution of antibiotics and drainage occurred. Contrast arthrography safely guided therapy and revealed rotator cuff tears in four of six shoulders as well as frequent extra-articular extensions of the disease. A nonleukemic patient with Aeromonus hydrophifiu sepsis and arthritis is reported who survived with eradication of infection and preservation of joint function. A poor prognosis for shoulder sepsis is not substantiated.Despite numerous general reviews of the subject of septic arthritis (I-lo), there is a paucity of specific