We examined the usefulness of neutrophil CD64 expression in detecting local musculoskeletal infection and the impact of antibiotics on its expression. Of 141 patients suspected of musculoskeletal infection, 46 were confirmed by microbiological culture to be infected and 95 had infection excluded. The median CD64 count of patients with localised infection was 2230 molecules per cell (interquartile range (IQR) 918 to 4592) and that of the patients without infection was 937 molecules per cell (IQR 648 to 1309) (p < 0.001). The level of CD64 correlated with the CRP level in patients with infection, but not in those without infection (r = 0.59, p < 0.01). Receiver operator characteristic curve analysis revealed that CD64 was a good predictor of local infection. When the patients were subdivided into two groups based on the administration of antibiotics at the time of CD64 sampling, the sensitivity for detecting infection was better in those who had not received antibiotics.

These results suggest that measurement of CD64 expression is a useful marker for local musculoskeletal infection.

To clarify the normal range of articular cartilage volumes of the patella and femur in the human knee joints of healthy adults using three-dimensional magnetic resonance imaging and to analyze the correlation of the articular volumes with the background characteristics.

Fifty seven knees of 57 healthy volunteers aged from twenties to forties (30 males and 27 females), who had no past history of joint disease or trauma in the legs, were imaged by a fat-suppressed three-dimensional sequence (SPGR; 1.5T GE; Horizon LX 8.2.5) The obtained data were analyzed by 4 examiners independently with a computer workstation, and a average of the four was adopted as the articular volume. Analyzed characteristics factors of the volunteers were: age, body weight, height, leg length, foot size, circumference of the thigh and lower leg, quadriceps angle, foot angle, body-mass index, and general laxity.

The mean articular cartilage volume was 7.2 +- 1.6 ml. It was significantly larger in males than in females. Concerning the relationship between the volume and the characteristic factors, there was a significant correlation of the cartilage volume with the foot size in males (r=0.47), and with height, leg length and foot size in females (r=0.53, 0.60, 0.60, respectively), but no significant correlation with the other factors.

Conclusion. The articular cartilage volumes of the patella and femur was 7.2+- 1.6 ml. The size of skeletal structure, especially the skeletal size of the lower extremity, were assumed to be important factors in estimating cartilage volume.

Percutaneous nucleotomy is a relatively new technique for treating lumbar disc herniation. There is no agreement as to the volume of disc material to be removed. A long-term study of clinical and radiological data from patients treated by percutaneous nucleotomy was designed to identify the factors associated with favourable and unfavourable outcomes. We studied 42 patients for at least ten years; the mean follow-up was 10.9 years. They were divided into two subgroups to assess the value of preserving the nucleus pulposus in the central area of the disc.

The overall success rate for both subgroups was 50%. A decrease in disc height on plain radiography and a decrease in signal intensity on MRI were observed more infrequently in patients in whom the nucleus pulposus in the central area of the disc had been preserved, than in those in whom it had been extensively removed. These adverse radiological findings correlated closely with increased low back pain during the first one to two years after operation and a poorer overall outcome.

We conclude that percutaneous nucleotomy is most likely to be successful when the central area of the disc is preserved.