The effect of open and closed chain exercise and knee joint position on patellar tracking in lateral patellar compression syndrome.

There are numerous rehabilitation protocols for patellofemoral problems, but there is little objective data to determine the most effective exercise program to conservatively treat this disorder. The purpose of this study was to determine the effect of open and closed chain exercise and knee joint position on patellar tracking in lateral patellar compression syndrome. Computed tomography scans of the patellofemoral joint were performed with the leg in three muscle conditions and at five knee angles in 16 subjects with lateral patellar compression syndrome. Patellar tracking was evaluated by measuring congruence angle. Relaxed and closed chain conditions demonstrated improved congruence as compared with the open chain condition at 0, 10, and 20 degrees of knee flexion (p < .0001). Open chain strengthening techniques appear to be most appropriate after 30 degrees of knee flexion. The three muscle conditions demonstrated progressively improved patellar congruence from 0 to 40 degrees of knee flexion.

Radiographic findings of pulmonary coccidioidomycosis in neonates and infants.

Radiographic findings in four recent cases of pulmonary coccidioidomycosis are reported. Focal consolidation and diffuse nodular densities were observed at one point during the course of the illness in all four patients. Pleural effusion or mediastinal adenopathy was not seen. Hilar adenopathy developed in one patient after 61/2 months. Hyperaeration was noted in all patients. One patient survived the pneumonia and had subsequent clearing of the infiltrates. Cavitation was not seen in any of the patients. The insidious onset and nonspecific and often misleading clinical and laboratory findings in pulmonary coccidioidomycosis infection in neonates and infants may seriously delay the correct diagnosis in this highly fatal disease. A knowledge of the characteristic radiographic manifestations of this pulmonary disease may be helpful to the clinician.