ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Low back pain is a very common and significant problem in our society, and there are both mechanical and psychosocial aspects to its etiology. This paper presents a systematic approach to the treatment of common types of low back pain. Treatment, beginning with conservative care, is outlined in this paper in the form of an algorithm. Current research directed at both the diagnostic and treatment aspects of low back pain is addressed.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Patients with arthritis often want more information about their disease and surgery than physicians realize. They turn to the popular press, which focuses on recent, often untested innovations that capture the imagination. This information is not always consistent with the longer, more mundane perspective of science. There has been promising progress in uncemented arthroplasty, but conventional techniques remain useful. Revolutionary change awaits new materials. Particularly significant advances have enabled surgeons to prevent or rectify complications of reconstructive joint surgery.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Although total joint arthroplasty is the most commonly performed procedure for the treatment of advanced stages of degenerative joint diseases, alternatives to joint replacement remain essential to the armamentarium of the clinician. For the hip, knee, and ankle, alternatives such as synovectomy, osteotomy, and fusion should be considered when contraindications to joint replacement exist. The indications and results of these procedures are discussed as reflected by a review of the recent literature.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Pathologic conditions of the metatarsophalangeal joints comprise the majority of painful conditions of the forefoot. Clinical manifestations commonly include hallux valgus (bunion), bunionette (“tailor's bunion”), and metatarsalgia. Conservative treatment remains the hallmark of initial management of these disorders. Conservative measures emphasize the adequate accommodation of the forefoot within the toe box of the shoe and the even distribution of plantar pressures by various metatarsal pads or bars and soft insoles. Numerous and sometimes controversial surgical procedures have been developed when conservative measures fail to achieve significant pain relief. In general, these procedures can be grouped as 1) soft tissue realignment procedures, 2) bony realignment procedures, 3) combined bony and soft tissue realignment procedures (osteotomy), 4) bony and joint resection, 5) arthrodesis techniques, and 6) Silastic joint replacement techniques.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This is a review of current concepts of rheumatoid collapse deformities, and the current treatment options available to those caring for the rheumatoid wrist and hand. It presents an overview to familiarize the clinician with the deformities and their causes, and the techniques and materials available to restore function to the rheumatoid hand.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Amyloidosis is a disease involving the fibrillar deposition of proteins in a manner that uniformly leads to the presence of green birefringence on polarization microscopy after staining the involved tissues with Congo red. In the year summarized, a wide range of new information has accumulated about this disease. In this article, attention has been paid to several newly described proteins now known to precipitate into amyloid deposits, including the proteins transthyretin, apolipoprotein A-I, cystatin C, gelsolin, amyloid 3 protein, β2-microglobulin, scrapie protein, and islet amyloid polypeptide. The number of these amyloid-related proteins has resulted in the need for a revised nomenclature and classification scheme. The results of a recent international symposium addressing this issue are summarized in table form. The varied clinical manifestations of amyloidosis are described according to organ system, with unusual or unique areas of involvement noted. Finally, the treatment of amyloidosis and its prognosis are addressed, and new areas of possible intervention suggested.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Recent studies emphasize the adverse effects of endocrine disorders on bone mass. Successful surgery for hyperparathyroidism results in an increase in bone mass, although impact on future fracture rates in these patients is unknown. The etiology of reduced bone mass in diabetes is still unclear, and the adverse effects of thyroxine replacement treatment on bone mass need to be carefully balanced against beneficial effects on hypercholesterolemia. Musculoskeletal problems in chronic renal failure are common, but investigations into their pathogenesis are complicated by the coexistence of renal endocrine failure and β2-microglobulin-related amyloid deposition in long-term dialysis patients. An improved definition of dialysis arthropathy is needed. The type of dialysis membrane does not appear to be important in the pathogenesis of this condition.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Neoplasia in an important cause of rheumatic disease. The mechanisms are either direct infiltration of the bone and joint, or indirect infiltration with manifestations distant from the site of neoplastic involvement. Many of the reports reviewed in this article center on direct associations. In particular, there is a report on polymyositis and dermatomyositis and the link with neoplasia. Cases of reflex sympathetic dystrophy are also described in association with neoplasia. There is further discussion on the link of hairy cell leukemia and vasculitis. Other case reports highlight the multiple associations of musculoskeletal disease and neoplasia. These reports include patients with subcutaneous sarcoidosis, ankylosing spondylitis, polychondritis, and systemic sclerosis. Articular manifestations of benign pleural fibromas are described. The existence of these reports, however, does not constitute proof of a causal relationship and the possibility of chance occurrences of two conditions must be considered. Finally, various therapies for cancer are associated with rheumatologic manifestations. Intravesical bacillus Calmette-Guerin has been found to cause an inflammatory polyarthritis. This form of arthritis is similar to experimentally induced adjuvant arthritis in rats that follows immunization with Freund's adjuvant containingMycobacterium tuberculosis.

ISSN:1040-8711    

出版商:OVID    

年代:1991

数据来源: OVID