Hallux rigidus describes the osteoarthritis of the firstmetatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaint...Hallux rigidus describes the osteoarthritis of the firstmetatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaints are pain especially during movement and a limited range of motion. Radiographically the typical signs of osteoarthritis can be observed starting at the dorsal portion of the joint. Numerous classifications make the comparison of the different studies difficult. If non-operative treatment fails to resolve the symptoms operative treatment is indicated. The most studied procedure with reproducible results is the arthrodesis. Nevertheless, many patients refuse this treatment option, favouring a procedure preserving motion. Different motion preserving and joint sacrificing operations such as arthroplasty are available. In this review we focus on motion and joint preserving procedures. Numer-ous joint preserving osteotomies have been described. Most of them try to relocate the viable plantar cartilage more dorsally, to decompress the joint and to increase dorsiflexion of the first metatarsal bone. Multiple studies are available investigating these procedures. Most of them suffer from low quality, short follow up and small patient numbers. Consequently the grade of recommendation is low. Nonetheless, joint preserving procedures are appealing because if they fail to relief the symptoms an arthrodesis or arthroplasty can still be performed thereafter.展开更多
MRI can provide clinically useful information in detecting and characterizingpartial-thickness tears in a non-invasive fashion with low accuracy, sensitivity and specificity.Compared with MRI assessment, ultrasonograp...MRI can provide clinically useful information in detecting and characterizingpartial-thickness tears in a non-invasive fashion with low accuracy, sensitivity and specificity.Compared with MRI assessment, ultrasonography is cheaper than MRI and arthrography and moreadvantageous with respect to the possibility of a dynamic exploration of the rotator cuff withenhanced visualization of the tendons during internal and external rotation. MRA image isparticularly well suited to the diagnosis of partial-thickness tears, but is invasive and moreexpensive. Others, such as clinical examination, arthrography, contrast computerized tomographicarthrography and radiograph, are good methods to evaluate the partial-thickness tears.展开更多
文摘Hallux rigidus describes the osteoarthritis of the firstmetatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaints are pain especially during movement and a limited range of motion. Radiographically the typical signs of osteoarthritis can be observed starting at the dorsal portion of the joint. Numerous classifications make the comparison of the different studies difficult. If non-operative treatment fails to resolve the symptoms operative treatment is indicated. The most studied procedure with reproducible results is the arthrodesis. Nevertheless, many patients refuse this treatment option, favouring a procedure preserving motion. Different motion preserving and joint sacrificing operations such as arthroplasty are available. In this review we focus on motion and joint preserving procedures. Numer-ous joint preserving osteotomies have been described. Most of them try to relocate the viable plantar cartilage more dorsally, to decompress the joint and to increase dorsiflexion of the first metatarsal bone. Multiple studies are available investigating these procedures. Most of them suffer from low quality, short follow up and small patient numbers. Consequently the grade of recommendation is low. Nonetheless, joint preserving procedures are appealing because if they fail to relief the symptoms an arthrodesis or arthroplasty can still be performed thereafter.
文摘MRI can provide clinically useful information in detecting and characterizingpartial-thickness tears in a non-invasive fashion with low accuracy, sensitivity and specificity.Compared with MRI assessment, ultrasonography is cheaper than MRI and arthrography and moreadvantageous with respect to the possibility of a dynamic exploration of the rotator cuff withenhanced visualization of the tendons during internal and external rotation. MRA image isparticularly well suited to the diagnosis of partial-thickness tears, but is invasive and moreexpensive. Others, such as clinical examination, arthrography, contrast computerized tomographicarthrography and radiograph, are good methods to evaluate the partial-thickness tears.
