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The incidence and the aetiology of chronic carpal tunnel syndrome in black South Africans was evaluated. This study showed that the incidence of idiopathic carpal tunnel syndrome was very low in this population group and that most patients who presented with symptoms and signs of chronic carpal tunnel syndrome had a specific pathology. A rare case of tumoral calcinosis causing carpal tunnel syndrome is presented. A case of perineural lipofibroma causing carpal tunnel syndrome is also described.

The incidence and the aetiology of chronic carpal tunnel syndrome in black South Africans was evaluated. This study showed that the incidence of idiopathic carpal tunnel syndrome was very low in this population group and that most patients who presented with symptoms and signs of chronic carpal tunnel syndrome had a specific pathology. A rare case of tumoral calcinosis causing carpal tunnel syndrome is presented. A case of perineural lipofibroma causing carpal tunnel syndrome is also described.

Introduction: Numerous national joint registries demonstrate a trend towards the use of uncemented femoral components in total hip arthroplasty. While the results of first-generation uncemented, and some of the second-generation uncemented implants have been unacceptably poor, others, including the fully hydroxyapatite (HA) coated femoral stems, have been excellent with survival rates of greater than 95% at 20 years. Component longevity is largely related to robust stem fixation to native bone. Adequate stem fixation to the native bone can be determined by clinical assessment and radiological signs of osteointegration. The absence of these radiological signs might be an indication of early loosening. With this in mind, we performed a radiological analysis of the osteointegration of uncemented fully HA-coated femoral stems inserted at our arthroplasty unit.

Penicillin resistance amongst gonococcal strains causing disseminated gonococcal infection (DGI) has been infrequently reported worldwide. The clinical records of 34 patients with gonococcal arthritis seen over a 53-month period were reviewed. The study population consisted of 32 blacks and two Indians with a mean age of 23.5 yr (range 14-46 yr) and a female to male ratio of 2.8:1. The diagnosis of gonococcal arthritis was made on the basis of isolation of Neisseria gonorrhoeae from the SF alone in 20 patients, SF and genital site in nine genital site alone in two and genital site and synovial tissue in one patient and synovial tissue alone in two patients. Eighteen of the 32 (56%) synovial isolates were penicillinase-producing strains of N. gonorrhoeae (PPNG). Monoarthritis was the commonest mode of presentation and seen in 73% of patients. The joints most frequently involved were the wrist (44%), knee (41%), ankle (15%) and shoulder (12%). None of the patients had cutaneous lesions. The occurrence of DGI is usually associated with protein 1-A serotype and arginine, hypoxanthine and uracil requiring auxotype, but all isolates available for auxotyping in this study were prototrophic. This study shows a very high prevalence of PPNG strains causing DGI, an observation which has important therapeutic implications.