Abstracts 113

ligamentous instability involve a large number of falsely positive and falsely negative diagnoses. The greatest uncertainty is attached to the examination of the anterior cruciate ligament and menisci. The diagnostic specificity and the diagnostic sensitivity of the clinical examination of the anterior cruciate ligament are 0.75 and 0.62 respectively. The corresponding values for examinations under anaesthesia are 0.86 and 0.76 respectively.

Two-thirds of the patients without intra-articular effusion. whose clinical examination gives rise to suspicion of ligamentous instability. however, have subclinical intra- articular haemorrhage and have as many cruciate and combined lesions as the whole series. viz. respectively 63 and 37 per cent. On the basis of this we conclude that arthroscopy should be carried out in all patients with a traumatic haemarthrosis or indication of ligamentous instability.

Simonsen 0. Jensen J. Mouritsen P. Lauritzen J. Injury IY84: 16: 96-101

MEDICAL SCIENCES

The pathomorphology of spinal stenosis as seen on CT scans of the lumbar spine This study examines different morphologic measurements in the evaluation of patients with lumbar spinal stenosis. Preoperative CT scans from 7-t patients who underwent surgery for central lumbar stenosis were analyzed. No correlation was observed between the size of the bony spinal canal and the size of the dural sac. A new measurement. the transverse area of the dural sac, is introduced. Normal values are provided. Correlation between the cross-sectional area of the dural sac and the anteroposterior diameter of the dural sac was excellent.

Schonstrom NSR. Bolender N-F. Spengler DM. Spine lY)xS: IO: x06-1 I

Anatomy of the normal knee as seen by magnetic resonance imaging Nuclear magnetic resonance imaging (M RI) was used to study the normal knee. As well as revealing hone quality. MRI provided useful information on intra-articular and extra- articular soft tissues. Mid-sagittal views gave clear images 01 the cruciate ligaments. and of the patcllar and quadriceps tendons. Parasagittal views were the best for delineating the menisci which. like ligaments and tendons. are of loo intensity: the semimembranosus tendon and its inbcrtion to the proximal tibia were also seen clearly in these views. The cruciate ligaments and menisci. though visible in the coronal view also. were better seen in the sagittal view. Axial views provided information on the structure of the patclla. its cartilage. the patellofemoral joint and posterior soft-tissue structures.

Soudry M. Lanir A. Angel D, Roffman M. Kaplan N.

Mendes DG, J Bone Joint Surg 1986; 68B: 117-20

The relationships of functional capacity, pain, and isometric and isokinetic torque in osteoarthrosis of the knee Thirty-nine patients suffering from osteoarthrosis of the knee were repeatedly measured. The relationship was studied for two groups of variables. The first group consisted of subjective assessments of functional capacity and pain and a

walking test. The second group consisted of isometric knee extension torque and isokinetic knee flexion and extension torque at W/set. 6O”/sec, lW/sec and IXO”/sec. High correlations between each of the static and dynamic torque values were found. Multiple regression analysis showed that isometric and isokinetic torque measures are unsatisfactory predictors of functional capacity. since only 23-35X of the variation of functional capacity. pain and walking test variables was explained by the variation of torque variables. Dynamic torque measurements had very little advantage over static torque tests. It is concluded that outcome measures in studies of osteoarthrosis should be problem-oriented and include direct assessments of functional capacity, pain and walking ability.

Lankhorst GJ. Van de Stadt RJ. Van der Korst JK. Stand J Rehab Med 1985; 17: 167-72

Stress fractures and bone pain: are they closely associated? The relationship between bone pain and stress fractures diagnosed by bone scintigraphy was investigated in military recruits during active training. In three patients pain appeared in the site of abnormal uptake 7-11 days after the bone scan in a previously asymptomatic site. One hundred and twentv-four sites of stress fractures were found in 6-t patients; 33 (26 per cent) were asymptomatic. In 3S patients (55, per cent) there were multiple stress fractures; .32 (33 per cent) had asymptomatic stress fractures. Fifty-three per cent of the regions vvith abnormal uptake in the femur were painless. compared with I7 per cent in the tibia.

The necessity for imaging all bones susccptihle to stress fractures. even when asymptomatic. is stressed. It is suggested that diagnosis of stress fracture should he made when tvpical abnormal uptake appears on scintigraphv. Bone pain In-such c;~ses may be delayed.

Groshar D. Lam M. Even-Sapir E. Israel 0. Front D. Injury lYS5:Ih:536-8

Stereophotogrammetry of the lumbar spine. A technique for the detection of pseudarthrosis

A computer-assisted photogrammetric method for the detection of pseudarthrosis following spinal fusion is described. This radiologic method is quantitative and noninvasive and requires a minimum of clinician time. Results of tests with a phantom specimen are presented. Preliminary indications are that the method may prove to be a useful adjunct to the clinician in monitoring the postoperative course of patients requiring fusion procedures.

Morris J. Chafetz N. Baumrind S. Genant 13. Korn EL. Spine 19x5: 10: 36875

SPORTS MEDICINE

Distal femoral stress fracture in military basic trainees: a report of three cases The distal femoral stress fracture can be very difficult to diagnose. Complaints include vague hip, thigh, or knee pain, aching at night, increased pain with weightbearing, and swelling about the knee. It is imperative that this stress fracture be diagnosed in a timely manner because it can result in a displaced fracture of the femur.

Schmidt-Brudvig TJ. J Orthop Sports Phys Ther 1985; 7: 20-2