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A 36-year-old man with abdominal pain presented with a 9-month history of low back pain after traffic accident. He was a chronic daily alcohol drinker, but had any other medical problem. He was diagnosed as a herniation of nucleus pulposus previously and had been treated by acupuncture and pain killer. In spite of treatment, wax and wane pattern low back pain continued, and left ankle pain newly developed. Abdominal pain, which was dominant on the right side, also appeared at 5 months after the accident. Abdominal pain occurred abruptly and disappeared by rest, and it was not associated with meal.We could not find abnormal finding on esophagogastroduodenoscopy, total colonoscopy, abdominal ultrasonography, and laboratory examination. Erythrocyte sedimentation rate (2 mm/ hr) and C-reactive protein (0.113 mg/dL) level were not elevated.Back pain began when he was younger than 40 years old, aggravated at night, and was not improved with rest. Initially, we thought that he might have inflammatory back pain, and ankle pain was one of extra-axial manifestations of spondyloarthropathy. Simple radiography (Fig. 1) showed suspicious cam type femoroacetabular impingement at right. Sacroiliac joint magnetic resonance imaging (Fig. 2) showed avascular necrosis (AVN) of the femoral head, Association Research Circulation Osseous (ARCO) stage II [1]. The T1-weighted image revealed Ewha Med J 2015;38(3):144-145 http://dx. Images and Solution
A 36-year-old man with abdominal pain presented with a 9-month history of low back pain after traffic accident. He was a chronic daily alcohol drinker, but had any other medical problem. He was diagnosed as a herniation of nucleus pulposus previously and had been treated by acupuncture and pain killer. In spite of treatment, wax and wane pattern low back pain continued, and left ankle pain newly developed. Abdominal pain, which was dominant on the right side, also appeared at 5 months after the accident. Abdominal pain occurred abruptly and disappeared by rest, and it was not associated with meal.We could not find abnormal finding on esophagogastroduodenoscopy, total colonoscopy, abdominal ultrasonography, and laboratory examination. Erythrocyte sedimentation rate (2 mm/ hr) and C-reactive protein (0.113 mg/dL) level were not elevated.Back pain began when he was younger than 40 years old, aggravated at night, and was not improved with rest. Initially, we thought that he might have inflammatory back pain, and ankle pain was one of extra-axial manifestations of spondyloarthropathy. Simple radiography (Fig. 1) showed suspicious cam type femoroacetabular impingement at right. Sacroiliac joint magnetic resonance imaging (Fig. 2) showed avascular necrosis (AVN) of the femoral head, Association Research Circulation Osseous (ARCO) stage II [1]. The T1-weighted image revealed Ewha Med J 2015;38(3):144-145 http://dx. Images and Solution
Purpose: Usually, about 25% of the patients treated with corticosteroids after kidney transplantation suffer from the complication of Avascular Necrosis (AVN) of the femoral head. This study aims to compare the effect of Neuromuscular Electric Stimulation (NMES) and traditional treatment (infrared and decrease weight-bearing) on Harris hip score. Methods: Twenty patients who developed AVN of the femoral head after kidney transplantation were divided into two groups. The first group was treated by NMES and stretching and strengthening exercises 3 sessions a week for 3 months. The second group was treated by Traditional Treatment (TT) and stretching and strengthening exercises 3 sessions a week for 3 months. Results: Harris hip score component was measured before the intervention and then three months after the intervention using the t-test. After the intervention, significant differences were found between both groups in pain, support, distance walked, limping, putting on shoes and socks, climbing stairs, sitting, flexion (all P<0.001), external rotation (P=0.014), abduction (P=0.030), adduction (P<0.001), public transportation (P=0.010), and total hip score (P<0.001). Conclusion: TT exercises accompanied by NMES were more effective than TT alone for AVN of femoral head patients and could stop the progressive worsening of hip joint mobility.
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