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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Juvenile rheumatoid arthritis or, more correctly, juvenile chronic polyarthritis with its many clinical manifestations can be separated into the Still-syndrome with acute beginning, high fever and a high percentage of extra-articulalar, i.e. visceral symptoms, and the chronic polyarthritis in the more strict sense with non-visceral symptoms. The subsepsis allergica should be regarded as a subseptic first stage of the Still syndrome. The Still-syndrome implies a systemic disease mainly of the reticulo-endothelial system, with carditis, nephropathy, recurrent erythemas, and a progressing polyarthritis. Later symptoms are amyloidosis, chronic nephritis, myo- and pericarditis, and artheriitis necroticans. Predominanly the involvement of the kidneys is the reasons for the high mortality rate of 13%. Chronic polyarthritis in the strict sense is similar in children and adults, though in children rheumatic factors are rarely detected. The exsudative form of arthritis tends to cause early deterioration. Joint symptoms are distributed asymmetrically and show locally inflammed growth otherwise less common in Still-syndrome. Spondylitis cervicalis rapidly causes ankylosis. Atlanto-axial-arthritis with consequent atlanto-axial dislocation can be the reason for neurological disturbances. Juvenile mono- or oligo-arthritis often turns into polyarthritis; but for joints the prognosis is more favourable. In contrast, rheumatoid iridocyclitis as found in 22% of the cases causes unfavourable complications because symptoms are not noticed in time so that treatment is often too late. Juvenile spondylitis ankylosans begins with a peripheral arthritic stage which is not easily distinguished from chronic polyarthritis. The male sex, mono- or oligoarthritis of the outer extremities, pain in the heel, atlanto-axial-arthritis, iridocyclitis, and a positive HLA of 27 give a diagnostic clue. -- Characteristics of the therapy will be discussed.
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PMID:[Juvenile rheumatoid arthritis and related collagen diseases. Clinical aspects (author's transl)]. 1 66

The incidence of radiographically visible ectopic ossification around the hip joint was redorded in 145 hip joints of 132 patients treated by endoprosthetic replacement. There were 56 total hip replacements with a McKee-Farrar and 39 with a Brunswik type of endoprosthesis; in a further 50 hips the femoral head was replaced with a Moore or Thompson prosthesis. An identical antero-lateral surgical approach was used in all, without detachment of the greater torchanter. The patients were re-examined 3, 6, and12 months after the operation. The extent of ectopic ossification was graded from 0 to III and correlated with pain and with the function and mobility of the operated hip. Ectopic ossification of varied extent was recorded in 37 % after total hip replacement and in 38 % after replacement of the femoral head. Of these ossifications 95 % were recognizable within 3 months; they did not increase in size, but often in density during the following months. One case of bony ankylosis was noted. Ectopic ossification of slight (grade I) to moderate (grade II) degree did not cause pain or affect the function of the operated hip, but reduced the mobility of the affected hip. The difference in mobility between grade I and grade II was significant (p less than 0.05), and between grade 0 and grade II highly significant (p less than 0.001).
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PMID:Ectopic ossification after hip arthroplasty. 9 71

The principle of hip joint resurfacing is replacement of diseased joint surfaces and simultaneous restoration of the normal anatomy and biomechanical function to the maximal degree possible. This concept offers several theoretical advantages over conventional total hip joint replacement and the clinical results in this series of 426 cases appears to confirm the value of both the method and the concept. Successful joint resurfacing surgery with attention to detail. Most problems can be anticipated and handled appropriately. Complications are few. The operation should only be done in cases of severe hip disability, when the patient's level of suffering demands operative intervention and when the only reasonable alternatives are fusion, total joint replacement or head and neck resection. It is an operation designed and recommended as an "in-between" procedure to gain time against the progressive disease. Resurfacing should not be performed if conservative measures or classic hip osteotomies offer significant benefit. The principal advantages of this procedure relate directly to the prosthetic design. Only the joint surfaces are removed during surgery, most of the normal bone is preserved, the medullary canal is not opened, and the implants utilized are of small volume. As a result the risk of infection is low compared to other implant arthroplasty techniques and clinical statistics confirm this anticipated advantage. The operation is designed to interfere minimally with the normal joint mechanics so it is also anticipated that prosthesis longevity will be greater than when rigid stem prostheses are placed in elastic bone. As yet follow-up is too short to make valid judgments on this point. The technique is applicable to younger patients, however, because if it should, in time, fail and other surgical treatment becomes necessary the original alternatives of total hip replacement, arthrodesis, or head and neck resection remain available. Relief of pain is predictable and almost all patients have experienced significant improvement in function. The procedure has a broader indication in cases of prior bone or joint infection and is definitely a preferable procedure in young individuals with severe hip disability.
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PMID:Surface replacement arthroplasty of the hip. 10 69

Discography appears to be the only means to give radiological, strictly anatomical and clear visual data on the nucleus of a disc. It is a comparatively simple and technically easy technique as long as one has the right tools and personnel. While it is disagreeable for the patient, it is not dangerous if strict asepsis can be applied. Discography gives an uncomplicated and unequivocal interpretation with sufficiently precise discometric and sensory signs which enable us to identify the lesion reliably. Tolerance and harmlessness of the technique are by now established. The indications refer to disc pathology and are indispensable before any arthrodesis carried out for pain in the lumbar spine or spondylolisthesis. These indications are now being extended to all problems of reports or difficult diagnosis of vertebral pathology. Discography also has a special and essential place with sciatica, particularly when radiculography is negative.
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PMID:[Lumbar discography (author's transl)]. 13 51

Persistent pain at the site of injection is the most common complication of local anesthesia in the oral cavity. The complication of trismus after local anesthetic injection is rare and may be prevented by the use of short needles for maxillary posterior injections, and by the avoidance of multiple injections in a short period time. Once trismus develops, its progression to chronic hypomobility and fibrous ankylosis may be prevented by the early institution of treatment consisting of heat, analgesics, muscle relaxants, and exercises.
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PMID:Trismus after injection of local anesthetic. 28 83

The authors studied the results of surgery for lombosacral spondylolisthesis with gross displacement. The technique of arthrodesis makes intersomatic fusion easy in displacement of grades II and III. This fusion, without reduction of the displacement, leads to good functional rsults climating low back pain, and most sciatic pain without which time would be necessary for posterior liberation at the olisthetic stage. The authors also believe that preliminary correction of displacement, although satisfying in orthopaedic terms but still difficult to achieve with current techniques, is at present rarely indicated.
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PMID:[Surgical treatment of lumbosacral spondylolisthesis with gross displacement]. 32 55

A method of triple arthrodesis is described which involves inlay of the subtalar and midtarsal joints. It is applicable to the undeformed and valgus foot as is encountered in poliomyelitis, spasmodic flat foot, cerebral palsy and spina bifida. The operation was successful in controlling deformity and pain. The only significant complication was failure of fusion of the midtarsal joint which occurred in three of eighty-five feet (3-5%).
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PMID:Triple arthrodesis by inlay grafting--a method suitable for the undeformed or valgus foot. 33 May 42

At the beginning of this century and during World War I psychogenic contractures were very common; later on they became rare.--The author reports and demonstrates 3 cases of psychogenic supination contractures of the foot (functional clubfeet) following a slight trauma of the ankle, the treatment of which was carried out in 1946, 1974 and 1976. All of these patients were women. The deformity of the foot was caused by a permanent contraction of the tibialis-muscles without an underlying organic disease. The therapy consisted of an arthrodesis of the midtarsal joints along with a transfer of the tibialis-anterior-tendon to metatarsus V. In all three cases both deformity and pain disappeared. The quantity and quality of the patients' mobility improved to near normal.--With this article the author intends to remind the orthopedic surgeons and the neurologists of this functional contracture.
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PMID:[The psychogenic clubfoot. A rare posttraumatic condition (author's transl)]. 41 Mar 95

Twenty-seven patients have been operated on for total replacement of the temporomandibular joint because of ankylosis due to trauma, arthritis, neoplasm, infection, or pain. One prosthesis had to be taken out because of gross infection due to Staphylococcus albus, 2 more were removed for pain and dislocation of the prosthesis, and 1 was removed because of erosion through the skin. The remaining 23 had no complications.
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PMID:Total prosthetic replacement of the temporomandibular joint. 42 Apr 87

Forty-three patients with a fifth lumbar-first sacral spondylolisthesis of 50 per cent or greater were reviewed. Four had been treated non-operatively; eleven, by arthrodesis; eighteen, by decompression and arthrodesis; and ten, by reduction and arthrodesis. The angle of slipping (measurement of the kyphotic relationship of the fifth lumbar to the first sacral vertebra) was found to be as important a measurement as the percentage of slipping in measuring instability and progression of slipping. Hamstring tightness did not correlate with neural deficit. Arthrodesis alone, even in the presence of minor neural deficits, tight hamstrings, or both, gave relief of pain and resolution of neural deficits and tight hamstrings. Our experience with a limited number of patients suggests that management by postoperative extension casts may achieve a significant reduction in percentage of slipping and in angle of slipping. Progression of the spondylolisthesis may occur following a solid arthrodesis.
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PMID:Management of severe spondylolisthesis in children and adolescents. 43 34


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