Consistency of the Sonographic Image (Double Contour Sign) in Patients with Gout after Ambulation.

The aim of this study was to know whether or not any crystal shedding occurs after ambulation in patients with gout and how it affects the consistency of the sonographic image of crystal deposition on hyaline cartilage. A total of 18 consecutive patients (29 knees), 11 with early gout (17 knees) and seven with chondrocalcinosis (12 knees), were prospectively scanned by ultrasound. Examination at rest and after ambulation was performed in each patient. Crystal aggregates were measured in a transverse view. Crystal shedding after ambulation was noted in two patients (two knees) with gout. However, crystal deposits on the surface of the articular cartilage in gout kept invariable size. In patients with chondrocalcinosis, crystal shedding by ambulation was absent. The conclusion of this study is that the size of crystal deposits on the hyaline cartilage in gout and chondrocalcinosis assessed by ultrasound is not modifiable by ambulation.

Paleopathological interpretations of hypermobility syndrome in the art from ancient America.

Paleopathological representations of hypermobility syndrome were assumed in pre-Columbian artifacts from different ancient civilizations from America. Anthropomorphic sculptures from several museums and galleries visited on site or thru Internet show the human figure in contorted positions. These positions are only possible within well-trained individuals or persons with hyperextensibility of the joints.

Severe cartilage damage of the knee joint in two young women with hypermobility.

The purpose of this pictorial assay is to show the arthroscopic findings of two patients with hypermobility syndrome and patellofemoral malalignment. Severe chondral damage and recurrent bleeding were common findings in these patients. One patient also had a meniscal impingement syndrome. A dynamic assessment of the patellofemoral joint as well as the evaluation of the lateral and medial retinaculum was performed by arthroscopy. Pictures of damaged area on the articular cartilage were obtained through a 5-mm arthroscope using standard portals. A lack of the patellae retinaculum involvement was proved arthroscopically in both cases. Mechanical complaints and recurrent effusion, even without history of trauma, should alert physicians who manage patients with hypermobility. In patients with joint hypermobility, the damage of the cartilage is real and often a therapeutic challenge.