Nine pedunculated benign synoviomata causing mechanical symptoms similar to those of a torn meniscus are described. The average age of the patients was 34.4 years. During the period of study, 2254 meniscal lesions causing mechanical symptoms were identified, giving an incidence of one benign synovioma for every 250 meniscal lesions. All the lesions were removed arthroscopically with relief of symptoms

1 . A personal series of twenty-nine discoid menisci is reviewed. 2. Three anatomical types are recognised and described. 3. The characteristic lesions incurred by each type is recorded. 4. The anatomical and pathological features of the specimens are compared with those of cases previously recorded. 5. A discoid medial meniscus is described, and compared with the only other specimen known to be recorded in the literature

Aims

To report our experience with trunnion corrosion following metal-on-polyethylene total hip arthroplasty, in particular to report the spectrum of presentation and determine the mean time to presentation.

This paper presents four patients with injuries to the thoracolumbar spine assessed by computerised tomography. This technique enabled an easy, quick and accurate diagnosis to be made, avoiding dangerous manipulation of the patient. The scans were analysed using the anatomical classification of Louis to evaluate the instability of the lesions. Control CT scans were used to monitor progress and to provide an accurate prognosis within acceptable limits of irradiation

1. A case of ulnar nerve compression at the wrist caused by rheumatoid arthritis producing motor and sensory changes is presented. 2. The diagnosis from compression at the elbow can be determined by electromyography. 3. It may be that lesions of the deep branch leading to motor changes only occur in rheumatoid arthritis more often than is suspected, their effects being hidden by the concomitant disease and its associated muscle wasting

1. A clinical, radiological and pathological study of sixty-nine cases of epiphysial chondroblastoma has been made. 2. The nature of the tumour is discussed and its clinical and radiographic features are described. A special type is described, for which the name "cystic chondroblastoma" is suggested. 3. The results of treatment are described and the generally benign behaviourof the lesion is noted. 4. The occurrence of malignant change is noted and discussed

1. Seventeen cases of knee injury are described in which the predominant lesion was rupture of the posterior cruciate ligament. Seven were treated conservatively and ten by surgical repair. 2. Most cases occurred in motor cyclists. 3. The extent of the rupture should be determined by examination under anaesthesia. 4. Early surgical repair is indicated for complete rupture. 5. An effective method of repair is described

Osteofibrous dysplasia is a rare condition usually affecting the tibiae and fibulae of males in the first two decades of life. Involvement at the ulna has also been reported in some cases. We describe an extensive, rapidly progressive lesion of the ulna in a three-year-old girl. The progression of the disease accelerated after a local marginal removal, and required extensive resection of the ulna with reconstruction using a fibular autograft. The particular features of this case are the change in the aggressive nature of the condition, which has not been previously reported. We believe that this is only the second recorded case of histologically proven involvement of the ulna

This is a retrospective study of 612 cases of iatropathic injury to peripheral nerves seen in one tertiary referral unit between 1991 and 1998. A total of 291 patients was subsequently operated on to explore the nerve lesion. The most common presenting symptom was pain, which often masked underlying loss of function. The delay in diagnosis was up to 40 months. The findings at operation were analysed according to the type of nerve damaged, the nature of the injury and the referring specialty. Some of the more common causal operations and procedures are discussed. Preventive measures are listed, and early diagnosis and treatment are recommended

We report the arthroscopic drilling of classical lesions of osteochondritis dissecans in 11 knees in 10 children with at least six months history and no sign of clinical or radiological improvement. There were eight boys and two girls and the average age at operation was 12 years 11 months. Relief of pain was noticed within days of operation; radiological healing occurred within 12 months in nine of the 11 knees

We present a method of visualising spinal deformities in three dimensions using conventional radiographs and computer graphics. The shape of the spinal column can be determined from the anteroposterior and lateral radiographs and displayed in any projection. In patients with adolescent idiopathic scoliosis, the fundamental lesion, an abnormal lordosis, can be demonstrated without the need for additional views. The method is applicable to other spinal deformities and may help to elucidate their three-dimensional shape

En-bloc resection, extracorporeal irradiation and re-implantation of the irradiated bone have been used to treat 15 patients suffering from primary malignant tumours of bone or cartilage and two with benign lesions. This treatment is an alternative to replacement by prosthesis or allograft bridging techniques. After a mean follow-up of over five years results are encouraging, despite some complications and the relatively long period before weight-bearing is allowed

In the necropsy material presented there were, among 100 spinal injuries occurring during the past eight years, twelve in juveniles up to eighteen years of age. In all cases, the growth zone of the cartilaginous end-plate of the spine was fractured. The special histological architecture of the growth zones with their loosened fibrous lamellae might play a decisive role in the localisation of the lesions. The clinical importance of this type of injury and the radiological findings are discussed

1. A series of six traction lesions of the common peroneal nerve in association with a severe adduction force to knee is described. 2. The reasons for failure of the nerve repair are discussed. 3. A new system of radiological marking of the anastomosis is described. 4. A less pessimistic view of the prognosis is taken than heretofore, and the management of the injury is discussed with a recommendation that a more conservative resection be done three months after the injury

1. The case histories of four siblings affected by osteogenic sarcoma are described. 2. The lesions appeared over a period of twelve years. The ages of the patients at the onset of symptoms were fifteen, twenty, eleven and twenty-two years. 3. The diagnosis of osteogenic sarcoma was in each case established by radiological and histological methods. 4. Two patients survived for eight and sixteen years after treatment and both are still alive and well

1. A case is described of fatigue fractures occurring in the lowest thirds of the right tibia and fibula simultaneously. 2. The fibular fracture was a runner's fracture. 3. The tibial fracture was ascribed to the application of a below-knee walking plaster to treat the fibular lesion. 4. Both fractures were slow in uniting. 5. The fractures occurred in a rapidly growing youth but no clinical evidence of an endocrine dysfunction was found

1. A case of Fanconi's syndrome, with evidence of renal tubular dysfunction, is reported. 2. Healing of the rachitic lesions followed massive doses of calciferol. There was simultaneous improvement in the biochemical state. This case is probably unique in that the amino-aciduria disappeared. 3. Two-stage osteotomies were undertaken for the correction of severe bowing of the tibiae. 4. No toxic symptoms have developed so far from the calciferol therapy

We report six patients with isolated paralysis of the infraspinatus and discuss the diagnosis, pathology, treatment, and outcome over a mean follow-up period of 33 months. Four patients were shown to have space-occupying lesions at the spinoglenoid notch by MRI or ultrasonography or both, and ganglia were confirmed and removed surgically in three, with good results. Ganglia at this site are not uncommon and should be included in the differential diagnosis of patients presenting with shoulder pain and weakness

Five patients known to be HIV (human immunodeficiency virus)-positive--that is, susceptible to AIDS--presented with symptoms initially thought to be indicative of lumbar disc lesions. Signs of nerve root or cauda equina compression were found in all five patients. Lumbar radiculography and, in one patient, computerised tomography produced no evidence of compressive pathology. We recommend that orthopaedic surgeons exercise caution in diagnosing nerve root compression in patients who may be HIV-positive

The existence of pulmonary metastases in patients presenting with osteosarcoma is known to indicate a poor prognosis. Lung resection of solitary lesions is now a standard treatment approach, but with limited successful long-term results. We report the progress of a 16-year-old girl with osteosarcoma of the proximal tibia who underwent 11 lung resections for pulmonary metastases over a two-year period, and who has since then been free of disease for seven years