The synovitis, acne, pustulosis, hyperostosis, osteitis syndrome is pertinent even in paediatrics since skin involvement is frequent.

Physical job characteristics and psychological aspects of work were more powerful than magnetic resonance imaging-identified disc abnormalities in predicting the need for low back pain-related medical consultation and the resultant work incapacity. However,the conclusions are still preliminary, and replication of the findings in larger and more representative study samples is needed.

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The central trochlea has been considered as the major location of dysplasia. The purpose of this study was to investigate the influence of the lateral trochlea on patellar stability and to establish a new method for measuring the lateral trochlea on sagittal magnetic resonance (MR) images. Twenty-eight knees of 23 patients suffering from lateral patellar subluxation (12 knees with radiological signs of central trochlear dysplasia) and of 46 patients without patellofemoral complaints (without central trochlear dysplasia) were analysed. The lateral condyle index was designed to measure the lateral trochlea by comparing the anterior cartilaginous trochlea (a) and the posterior aspect (p) [(a:p)× 100]. The lateral condyle index showed high interrater reliability (r=.94) and was significantly (p<0.001) lower in symptomatic patients (86%) than in the control group (93%). These results show high clinical relevance of the lateral trochlea as another factor for patellar instability.

Spinal canal dimensions are assumed to play a significant role with regard to the development of symptoms in individuals with disc herniations. The literature is inconclusive on the significance of spinal canal size as a risk factor for sciatica, mainly because of study design problems. The objective of this study, therefore, was to test the hypothesis that spinal canal dimensions are a significant risk factor for the development of sciatica, comparing symptomatic and asymptomatic individuals. Thirty symptomatic patients undergoing lumbar discectomy and 45 asymptomatic volunteers were investigated by clinical and MRI examination. The size of the spinal canal and thecal sac as well as the midsagittal spinal canal diameter were measured using a point counting method and scanner software, respectively. Differences between the groups were compared separately for each level L3/4 to L5/S1. The intra- and inter-observer error ranged between 0.95 and 0.99 for all measurements. In symptomatic patients, the dimensions of the spinal canal and thecal sac as well as the midsagittal spinal canal diameter were smaller at all disc levels. Unpaired t-test demonstrated a significant difference, ranging from P<0.05 to P<0.001. When controlled for age, sex and body height, the odds ratio for a symptomatic disc herniation increased to as high as 35, depending on the spinal level, when the size of the spinal canal was smaller than the mean for controls by two standard deviations or more. In symptomatic patients, spinal canal dimensions are significantly smaller than those in asymptomatic individuals. Spinal canal dimension is an important factor discriminating patients from control subjects. A clinically relevant grading system for disc herniation should therefore be based on the spatial relationship between herniated disc material and neurogenic structures.