WordNet

partial displacement of a joint or organ

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/11/16 15:31:08」(JST)

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A subluxation may have different meanings, depending on the medical specialty involved. It implies the presence of an incomplete or partial dislocation of a joint or organ.^[a]

Orthopedics

An orthopedic subluxation of any joint will sometimes require medical attention to help relocate or reduce the joint. Nursemaid's elbow is the subluxation of the head of the radius from the annular ligament. Other joints that are prone to subluxations are the shoulders, fingers, kneecaps, ribs, wrists, ankles, and hips affected by hip dysplasia. A spinal subluxation can sometimes impinge on spinal nerve roots, causing symptoms in the areas served by those roots. In the spine, such a displacement may be caused by a fracture, spondylolisthesis, rheumatoid arthritis,^[2] severe osteoarthritis, falls, accidents, and other traumas. People with frequent subluxations are known as hypermobile. This is common in Ehlers-Danlos Syndrome.

Ophthalmology

An ophthalmologic subluxation is called ectopia lentis, an ocular condition characterized by a displaced or malpositioned lens within the eye.^[3] Subluxated lenses are frequently found in those who have had ocular trauma and those with certain systemic disorders, such as Marfan syndrome, Ehlers–Danlos syndrome, Loeys-Dietz syndrome and homocystinuria. Some subluxated lenses may require removal, as in the case of those that float freely or those that have opacified to form cataracts.

Dentistry

A dental subluxation is a traumatic injury in which the tooth has increased mobility but has not been displaced from the mandible or maxilla. This is a common condition and one of the most common dental traumatic disorders.^[4] Dental subluxation is a non-dental-urgency condition, i.e., unlikely to result in significant morbidity if not seen within 24 hours by a dentist,^[5] and usually treated conservatively: good oral hygiene with 0.12% chlorhexidine gluconate mouthwash, a soft and cold diet, and avoidance of smoking for several days.^[5] In painful situations, a temporary splinting of the injured teeth may relieve the pain.^[6]

Subluxation may also occur in the mandible from the articular groove of the temporal bone.^[7] The mandible can dislocate in the anterior, posterior, lateral, or superior position. Description of the dislocation is based on the location of the condyle in comparison to the temporal articular groove.^[8]

Notes

^ Definition: subluxation n : partial displacement of a joint or organ^[1]

References

^ "Webster's Revised Unabridged Dictionary (1913)". Retrieved 12 March 2013.
^ Calleja, Michele (25 May 2011). Chew, Felix S, ed. "Rheumatoid Arthritis Spine Imaging". Medscape reference. WebMD LLC. Retrieved 12 March 2013.
^ Eifrig, Charles W (22 July 2011). Roy Sr, Hampton, ed. "Ectopia Lentis". Medscape reference. WebMD LLC. Retrieved 12 March 2013.
^ Zadik Y, Levin L (February 2009). "Oral and facial trauma among paratroopers in the Israel Defense Forces". Dent Traumatol. 25 (1): 100–102. doi:10.1111/j.1600-9657.2008.00719.x. PMID 19208020.
^ ^a ^b Zadik Y (December 2008). "Algorithm of first-aid management of dental trauma for medics and corpsmen". Dent Traumatol. 24 (6): 698–701. doi:10.1111/j.1600-9657.2008.00649.x. PMID 19021668.
^ Flores MT, Andersson L, Andreasen JO, et al. The International Association of Dental Traumatology (April 2007). "Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth". Dent Traumatol. 23 (2): 66–71. doi:10.1111/j.1600-9657.2007.00592.x. PMID 17367451.
^ Chaudhry, Meher (19 April 2012). Kulkarni, Rick, ed. "Mandible dislocation". Medscape Reference. WebMD LLC. Retrieved 12 March 2013.
^ Haddon, Robert & Peacock IV, W Franklin (2003). "240". In Tintinalli, Judith E; Kelen, Gabor D & Stapczynski, J Stephan. Face and Jaw Emergencies. Emergency Medicine: A Comprehensive Study Guide (6th ed.). McGraw-Hill. pp. 1471–1476. ISBN 978-0071388757. |access-date= requires |url= (help)

UpToDate Contents

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1. 小児または思春期のアスリートにおける頸部の筋骨格損傷の概要 overview of musculoskeletal neck injuries in the child or adolescent athlete
2. 関節リウマチの頚椎亜脱臼 cervical subluxation in rheumatoid arthritis
3. 橈骨頭亜脱臼（肘内障） radial head subluxation nursemaids elbow
4. 膝蓋骨外側脱臼の認識および初期マネージメント recognition and initial management of lateral patellar dislocations
5. 小児における後天性斜頚 acquired torticollis in children

English Journal

Effects of the standing program with hip abduction on hip acetabular development in children with spastic diplegia cerebral palsy.

Macias-Merlo L1, Bagur-Calafat C2, Girabent-Farrés M3, A Stuberg W4.
Disability and rehabilitation.Disabil Rehabil.2016 Jun;38(11):1075-81. doi: 10.3109/09638288.2015.1100221. Epub 2015 Oct 30.
PURPOSE: Early identification and intervention with conservative measures is important to help manage hip dysplasia in children with a high adductor and iliopsoas tone and delay in weight bearing. The effect of a daily standing program with hip abduction on hip acetabular development in ambulatory c
PMID 26517269

Total elbow arthroplasty: a radiographic outcome study.

Bai XS1, Petscavage-Thomas JM2, Ha AS3.
Skeletal radiology.Skeletal Radiol.2016 Jun;45(6):789-94. doi: 10.1007/s00256-016-2351-5. Epub 2016 Mar 4.
OBJECTIVES: Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of
PMID 26940210

Intra-rater and inter-rater reliability of ultrasonographic measurements of acromion-greater tuberosity distance in patients with post-stroke hemiplegia.

Kumar P1, Cruziah R1, Bradley M2, Gray S3, Swinkels A1.
Topics in stroke rehabilitation.Top Stroke Rehabil.2016 Jun;23(3):147-53. doi: 10.1080/10749357.2015.1120455. Epub 2015 Dec 10.
BACKGROUND: Glenohumeral subluxation (GHS) is reported in up to 81% of patients with stroke. Ultrasonographic measurements of GHS by measuring the acromion-greater tuberosity (AGT) have been found to be reliable for experienced raters.OBJECTIVES: The primary aim was to assess the intra-rater reliabi
PMID 26653884

Japanese Journal

症例報告乾癬性関節炎の母指MP関節亜脱臼に対する治療経験

臨床整形外科 50(10), 1025-1028, 2015-10
NAID 40020601679

専門医試験をめざす症例問題トレーニング脊椎・脊髄疾患

整形外科 = Orthopedic surgery 66(11), 1204-1213, 2015-10
NAID 40020598510

RA頚椎におけるC2椎弓根形態と動脈走行の評価 : 垂直亜脱臼例と非垂直亜脱臼例の比較 (日本脊椎脊髄病学会特集号)

Journal of spine research : official journal of the Japanese Society for Spine Surgery and Related Research 6(9), 1438-1441, 2015-09
NAID 40020601050

Related Pictures

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★リンクテーブル★

リンク元	「100Cases 16」「亜脱臼」「不全脱臼」
拡張検索	「atlantoaxial subluxation」「atlanto-axial subluxation」

「100Cases 16」

　　[★]

☆case16　膝の痛み

■glossary

indigestion 消化障害、消化不良

■症例

80歳　男性

主訴：左膝の痛みと腫脹

現病歴：左膝の痛みを2日前から認めた。膝は発熱・腫脹しており、動かすと疼痛を生じる。時々胸焼けと消化不良が見られる。6ヶ月前のhealth checkで、高血圧(172/102mmHg)と血中クレアチニンが高い(正常高値)こと以外は正常といわれた。その4週間数回血圧を測定したが、高値が継続したため、2.5mg bendrofluamethizide(UK)/ベンドロフルメチアジド bendroflumethiazide(US)で治療を開始した。最近の血圧は138/84 mmHgであった。

喫煙歴：なし。

飲酒歴：一週間に平均4unit。

既往歴：股関節に中程度(mild)の変形性関節症

家族歴：特記なし

服薬歴：アセトアミノフェン(股関節の疼痛に対して)

身体所見 examination

　血圧 142/86mmHg。体温37.5℃。脈拍88/分。grade 2 hypertensive retinopathy(高血圧症性網膜症)。心血管系、呼吸器系に検査場異常なし。手にDIPにヘバーデン結節なし。

　左膝が発熱し腫脹している。関節内に液、patellar tap陽性。90℃以上膝関節を屈曲させると痛みを生じる。右の膝関節は正常に見える。

検査　 investigation

　生化学：白血球増多、ESR 上昇、尿素高値、グルコース高値

　単純X線：関節間隙やや狭小。それ以外に異常は認めない。

■problem list

　#1 左膝の痛み

　#2 胸焼け

　#3 消化不良

　#4 高血圧

　#5 クレアチニン正常高値

　#6 股関節の変形性リウマチ

　#7 高血圧性網膜症

■考え方

　・関節痛の鑑別診断を考える。

　・VINDICATEで考えてみてもよいでしょう。

　・関節痛の頻度としては　外傷＞慢性疾患(OAなど)＞膠原病＞脊椎疾患＞悪性腫瘍

■関節痛の鑑別疾患

DIF 282

V Vascular 血友病 hemophilia, 壊血病 scurvy, 無菌性骨壊死 aseptic bone necrosis (Osgood-Schlatter diseaseとか)

I Inflammatory 淋疾 gonorrhea, ライム病 lyme disease, 黄色ブドウ球菌 Staphylococcus, 連鎖球菌 Streptococcus, 結核 tuberculosis, 梅毒 syphilis, 風疹 rubella, 単純ヘルペス herpes simplex, HIV human immunodeficiency virus, サイトメガロウイルス cytomegalovirus

N Neoplastic disorders 骨原性肉腫 osteogenic sarcoma, 巨細胞腫 giant cell tumors

D Degenerative disorders degenerative joint disease or 変形性関節症 osteoarthritis

I Intoxication 痛風 gout (uric acid), 偽痛風 pseudogout (calcium pyrophosphate), ループス症候群 lupus syndrome of hydralazine (Apresoline) and procainamide, gout syndrome of diuretics

C Congenital and acquired malformations bring to mind the joint deformities of tabes dorsalis and syringomyelia and congenital dislocation of the hip. Alkaptonuria is also considered here.