We report 11 patients who, over a five-year period, were treated for pyogenic infection of the sacro-iliac joint. This condition is uncommon and difficult to assess, so that diagnosis is liable to be delayed and morbidity increased. Skeletal scintigraphy, with perfusion phase imaging, is usually positive in early lesions and prompt antibiotic treatment reduces complications

Osteotomies are commonly carried out in orthopaedic surgery, particularly in limb reconstruction. Complications are uncommon provided that sufficient care is taken and a sound technique used. We describe three cases of formation of false aneurysm after osteotomy, with acute, delayed and asymptomatic onset. The diagnosis was supported by ultrasound investigation, and confirmed by angiography. Embolisation with coils was a successful method of treatment. We recommend a safe method of osteotomy with good bone exposure and adequate soft-tissue protection

1. A farmer who owned cattle infected with brucellosis presented with a painful, swollen wrist. Osteolytic lesions were seen radiologically. The wrist was explored. Histological features were those of a subacute granuloma. Brucella abortus biotype I was grown. 2. The clinical diagnosis, bone and joint radiology, pathology and microbiology are discussed

1. Clinical and histological features in ten patients with smooth muscle tumours of the limbs are described. 2. Severe pain and tenderness and the radiographic demonstration of calcification are useful pointers to the diagnosis. 3. Local recurrence of the tumour occurred in four patients despite apparently adequate excision. In three of these the tumours were shown histologically to be benign

1. Cases are presented to show that blackthorn inflammation is not uncommon in the West Midlands. 2. The pathology is that of a chronic non-suppurative inflammation. 3. Cases are divisible into three groups on the basis of their history. In the third group, with no history of blackthorn trauma, diagnosis may be very difficult. 4. Removal of the blackthorn fragments causes prompt resolution of the inflammation

We report a patient with a subperiosteal ganglion cyst of the tibia which was imaged by radiography, arthrography, CT and MRI. The images were correlated with the arthroscopic surgical and histological findings. Spiculated formation of periosteal new bone on plain radiographs led to the initial suspicion of a malignant tumour. Demonstration of the cystic nature of the tumour using cross-sectional imaging was important for the precise diagnosis. Communication between the ganglion cyst and the knee was shown by a delayed arthrographic technique, and the presence of this communication was confirmed at arthroscopy and surgically

Between 1980 and 1984 nine adult patients in the renal unit of Guy's Hospital developed bone and joint infection. The commonest site of infection was the spine. In this series two patients died, a mortality of 22%. The purpose of this paper is to illustrate the pitfalls in the diagnosis and management of bone and joint infection in patients with renal failure and renal transplants

Two cases are reported of the late diagnosis of compartment syndrome secondary to alcohol and drug overdose. Surgical decompression at two and a half days and at six days, respectively, produced worthwhile recovery. Other reports are reviewed and a case is made for the value of decompression even when performed late, and for delayed and minimal excision of apparently necrotic muscle

We report eight patients with prominent cystic changes in the head of the fibula. Seven of these had osteoarthritis of the adjacent knee, and five had evidence of local deposition of calcium pyrophosphate dihydrate crystals. A radiographic survey of 470 knees in 254 patients with osteoarthritis suggested that such cysts are rare, but should be considered in the differential diagnosis of such changes before expensive or invasive investigations are performed

The case histories and investigations for five adolescent girls with a presumed diagnosis of either primary acetabular protrusio or acute idiopathic chondrolysis are presented. The follow-up ranged from three to nine years. All were treated by extensive soft-tissue release but in no case did this improve movement of the affected hip and permanent stiffness was the inevitable result. The literature is reviewed and methods of treatment are discussed in the light of the CT findings

A chart is presented to assist with the assessment and treatment of patients with growth-related deformities. It is based on anthropometric values from five published sources and relates sitting height to stature, limb length, the radiographic lengths of the leg bones and the lengths of the feet and hands. It has proved useful in the prediction of leg-length discrepancies, in the diagnosis of cases of short stature, and in the assessment of spinal shortening from scoliosis

Four military recruits with complete distraction-type stress fractures of the femoral neck were treated conservatively. The radiographic diagnosis was made within two weeks of the onset of symptoms and the activities of the patients were matched to the clinical and radiographic progress of fracture healing. None of the fractures displaced and union occurred uneventfully. Our experience suggests that prophylactic internal fixation of these fractures is not necessary

1. Six patients are reported in whom ischaemic muscle contractures followed prolonged external pressure. 2. Systemic hypoxaemia may be a predisposing factor in patients with overdoses of central nervous system depressants. 3. If treatment is to be successful, early diagnosis is required, and the most important factor is an awareness of the condition. 4. The treatment of the late case is discussed

1. Attention is drawn to the importance of taking tangential radiographs of the patella in all cases of injury to the knee, especially when there is difficulty in distinguishing between recurrent dislocation of the patella and tear of a meniscus. 2. New bone formation along the medial side of the patella confirms a diagnosis of recurrent dislocation. 3. The importance of Coleman's original observations is stressed

1. The clinical and radiological features of thirty-two feet with congenital vertical talus are described and subdivided into groups determined by the presence or absence of associated abnormalities. 2. The differential diagnosis of congenital vertical talus from flat foot, talipes calcaneus and uncorrected club foot is discussed. 3. No benefit came from either non-operative treatment or tenotomy of the tibialis anterior

1) A case is reported of paraplegia with normal radiographic appearances in which cervical cord damage was shown at autopsy to have been due to hyperextension injury. 2) The mechanism of such injuries is discussed, together with the differential diagnosis from acute prolapse of an intervertebral disc. 3) The grave dangers of using the fully extended position of the cervical spine in the management of these cases is noted

Needle biopsies, performed on 208 consecutive patients and interpreted at the London Bone Tumour Service over a two-year period, were reviewed. A correct diagnosis was reached in 97% (133 out of 137) using this technique alone. Needle biopsy is safe and accurate when undertaken in consultation within a bone tumour service; it offers considerable advantages to both patient and surgeon over conventional open biopsy

1. A series of patients with recent ligamentous injuries of the ankle is presented. Stress radiography and arthrography were carried out in all cases, with surgical exploration where indicated. The findings are correlated. 2. Both stress radiography and arthrography are unreliable in the diagnosis of injuries to the "lateral ligament" of the ankle. 3. Arthrography may be useful in the demonstration of injury of the inferior tibio-fibular joint and of the medial ligament