Radiographic measurements are commonly used to quantify the treatment results of hip dysplasia and assess further need of operative treatment. We investigated the interobserver and intraobserver reliability of the commonest radiographic techniques in the assessment of hip dysplasia in skeletally mature adults. Three observers independently analysed 100 hip radiographs of patients with hip dysplasia aged between 16 and 32 years. We measured centre-edge angle of Wiberg, acetabular angle of Sharp, acetabular index of the weightbearing zone, acetabular index of depth to width, ACM-angle, MZ-distance, acetabular head index, lateral subluxation and neck-shaft angle. In addition, the radiographs were reviewed a second time 3 months apart by two of the observers to assess intraobserver reliability. We found a high correlation (intraclass correlation coefficient) for interobserver reliability (0.76-0.87) and intraobserver reliability (0.70-0.92) for all radiographic measurements except acetabular index of depth to width, ACM-angle and MZ-distance. Depending on the clinical question we therefore recommend the use of one of the reliable measurements to assess the radiograph of a dysplastic hip.

Twenty-one healthy males aged 20-36 years were examined for hemodynamic and metabolic parameters such as heart rate, oxygenation, lactate, blood pressure, under isokinetic and ergometric loadings. The healthy volunteers were tested by increased loads and constant times with an identical isokinetic and ergometric power. The important results are: Heart frequency and blood pressure are higher under isokinetic than under ergometric conditions. Oxygenation is equal in both tests. The lactate values show for the isokinetic maximal and for the ergometric submaximal loadings. The definitive factor for this variation is the relation between force and velocity. The higher tension of the muscles and the higher activity of the fast-twitch fibers seem to be responsible for the increasing of sympathicotonia. The clinical impact of this controlled study is: 1. Isokinetic testing might be dangerous for patients with cardiac diseases or circulatory disturbances. 2. Isokinetic training programs have to pay attention to joint and internal diseases at the same level. 3. During the first isokinetic test all precautions for a possible emergency case have to be taken.

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The histologically confirmed calcaneal cysts showed the radiological signs that are supposed to be typical for an intraosseous lipoma. It cannot be decided whether the histologically diagnosed calcaneal lipomas described by others can be interpreted as fatty degeneration of a calcaneal cyst, or whether fatty areas of the bone marrow have given a wrong impression. Since the literature only describes single isolated cases of a pathological fracture of the calcaneal cyst or lipoma, asymptomatic patients should be treated non-operatively.