Objective
To investigate the etiologic diseases of inflammatory back pain (IBP) and to propose a diagnostic algorithm for approaching the patients with IBP. Method: One-hundred-and-forty patients with IBP visiting the clinic for spinal disorders were involved. Clinical features of spondyloarthropathy (SpA) through medical records, presence of intervertebral disc disease, sacroiliitis and degenerative spondylosis through plain radiography and magnetic resonance image (MRI) of spine and pelvis, HLA B27 positivity, and quantitative laboratory results of acute phase reactant were retrospectively reviewed. Results: Diverse spinal disorders were indentified as etiologic diseases for IBP that were SpA (44 patients), diffuse idiopathic skeletal hyperostosis (DISH) (15 patients), degenerative spondylosis (15 patients), HLA B27 associated IBP (14 patients), lumbosacral radiculopathy (4 patients), and others (48 patients). When onset age was less than 45 years, the most frequent cause was SpA. When onset age was more than 45 years, DISH and degenerative spondylosis were the most frequent causes. Onset age (p=0.002), age at presenting to clinic (p=0.001), number of items satisfying IBP criteria (p=0.001), HLA B27 positivity (p=0.000), and elevated acute phase reactant (p=0.002) were statistically associated with SpA. Conclusion: The relative frequency among various etiologic disease of IPB is different depending on the onset age of IPB. Onset age of IBP, numbers of items satisfying IBP criteria, and laboratory test for HLA B27 and acute phase reactant can be useful factors for determining the causes of IBP, especially for diagnosing SpA. Diagnostic algorithm for approaching the patients with IBP is proposed according to the sensitivity and specificity of the factors which have statistically meaningful relationship with diagnosis of SpA. (J Korean Acad Rehab Med 2009; 33: 377-385)

Objective
To investigate clinical and ultrasonographic findings of Morton's neuroma with or without interdigital bursitis. Method: Eighty patients who were diagnosed as Morton's neuroma were included. The diagnostic criterion of Morton's neuroma at ultrasonography was hypoechoic mass was 5 mm in sagittal view. When the hypoechoic mass was molded by compression of the probe, Morton's neuroma accompanied with interdigital bursitis was diagnosed. The mean difference of symptom duration from onset to the hospital visit and the size of Morton's neuroma was evaluated. Results: In eigthy patients, total 117 feet, 210 Morton's neuromas were detected. Of the 117 feet, 66% revealed more than one Morton's neuroma per one foot. Mostly Morton's neuroma was at the second (46.7%) and the third interdigital space (43.8%). Mean duration was 19.1±16.9 months. Comorbidity of interdigital bursitis was 23.3% of all Morton's neuroma. Mean size of Morton's neuroma with interdigital bursitis was significantly larger (10.3±3.0 mm) than single neuroma (8.5±2.5 mm). The symptom duration from onset to the hospital visit was significantly shorter in neuroma with interdigital bursitis (14.1±16.8 months) than single Morton's neuroma (21.2±16.6 months). Conclusion: Morton's neuroma had multiple propensity, mostly at the second and the third web space with comparable rate. Comorbidity of interdigital bursitis with Morton's neuroma was 23.3%. When interdigital bursitis was accompanied, the size of hypoechoic mass was larger and symptom duration from onset to the hospital visit was shorter than single Morton's neuroma. (J Korean Acad Rehab Med 2009; 33: 386-391)

Objective
To evaluate the difference of coracohumeral ligament (CHL) thickness between asymptomatic shoulders and adhesive capsulitis. Method: Ultrasound examination was performed in 44 consecutive shoulders of 24 individuals (12 males and 12 females). Nine were diagnosed as adhesive capsulitis by clinical examination. We measured the maximum thickness of CHL. For CHL assessment, participants were scanned in sitting position with shoulder in maximal external rotation, elbow in 90° flexion, forearm in neutral position, and hand in fist. The transducer was positioned between coracoid process and greater tuberosity of humerus. We used t test to compare the CHL thickness between asymptomatic and adhesive capsulitis and bivariate correlation analysis to assess a correlation between age and CHL thickness. Results: There was a significant positive linear relationship between age and CHL thickness (p＜0.01, Ճ=0.424). In female, there was a positive linear relationship between age and CHL thickness (p＜0.01, Ճ=0.610). However, in male, there was no significant correlation (Ճ=0.224). The mean value of CHL thickness was 1.53 mm in 9 adhesive capsulitis and 0.92 mm in 35 asymptomatic ones. CHL thickness was significantly greater in adhesive capsulitis than in asymptomatic ones (p＜0.01). Conclusion: The thickened CHL is a good suggestive diagnostic value of adhesive capsulitis. (J Korean Acad Rehab Med 2009; 33: 392-395)

Objective
To evaluate the effect of comprehensive rehabilitation treatment in patients with moderate lateral ankle ligament sprain. Method: We reviewed the medical records of 22 patients who had been in rehabilitation program after moderate lateral ankle ligament sprain. We measured the range of motion of ankle joint, pain intensity by visual analogue scale (VAS) score, the difference of ankle circumference between normal and affected side, and strength of dorsiflexor, plantarflexor, invertor and evertor of ankle before and after rehabilitation. Results: The range of motion, VAS score, ankle circumference, strength of dorsiflexor, invertor and evertor of the affected ankle significantly improved after rehabilitation exercise (p＜0.05). Eighteen out of 22 patients returned to the sports activities successfully after systemic rehabilitation. Conclusion: Systemic and appropriate rehabilitation is inevitably necessary after acute ankle sprain for the successful return to the sports activities. (J Korean Acad Rehab Med 2009; 33: 396-401)

Objective
To investigate the treatment efficacy between low and high dose of triamcinolone acetonide in the treatment of ultrasonographic-guided subacromial bursa injection. Method: Forty two patients with periarticular shoulder disorders were randomly assigned to receive injection with 10 mg (group 1, 20 patients) or 40 mg (group 2, 22 patients) triamcinolone acetonide. After a single injection, participants were followed up for 6 weeks. Treatment efficacy was measured upon pre-treatment and post-treatment on week 1, 3, 6, using visual analog scale for average pain intensity during 24 hours (24 h VAS), Shoulder Function Assessment scale (SFA), Shoulder Disability Questionnaire (SDQ), and active range of motion (AROM). Participants and the assessor were blinded for group assignment. Results: Six weeks after injection, the 24 h VAS, the SFA, the SDQ, and the AROM (internal rotation, external rotation, and abduction) showed a significantly greater improvement in group 2 than group 1 (p＜0.05). Conclusion: This study showed that in the treatment of periarticular shoulder disorders greater pain relief and functional improvement were obtained with a dose of 40 mg triamcinolone acetonide than with a dose of 10 mg. (J Korean Acad Rehab Med 2009; 33: 402-407)

Objective
To investigate the effects of modified constraint- induced movement therapy (CIMT) on motor function and cortical activation in children with hemiplegic cerebral palsy (CP). Method: Five children with hemiplegic cerebral palsy were studied with Jebsen hand function test and quality of upper extremity skills test (QUEST), dynamic electromyography (EMG), and single photon emission computed tomography (SPECT) at rest before and after the CIMT period. Children were treated with a 4-week protocol of modified CIMT, consisting of twice-weekly 2-hour sessions of structured activities and a home program for non-treatment days. Children wore orthoses on their less affected upper extremities for 6 hours per day, during which time they were engaged in play, functional activities and 2-hour protocol of motor tasks. Results: Improvements in upper-extremity function were found in Jebsen hand function test and QUEST. Increased muscle activities in elbow extensors were observed in dynamic EMG during affected hand grip. In right hemiplegic patients, regional cerebral perfusion increased in right Brodmann area (BA) 3 and lentiform nucleus. In left hemiplegic patients, regional cerebral perfusion increased in right BA 6, 9, 21, left BA 19 and left cerebellum, but decreased in left BA 11. Conclusion: Modified CIMT appears to change local cerebral perfusion in areas known to participate in movement planning and execution. These changes might be a sign of cortical activation after CIMT in the children with hemiplegic cerebral palsy. Results of this study suggest that modified CIMT may be an effective way of treating children with hemiplegic CP. (J Korean Acad Rehab Med 2009; 33: 408-414)

Objective
To describe the motor development and quality of life in children with severe cerebral palsy (CP) stratified by gross motor function classification system (GMFCS), and to investigate various factors that affect quality of life in these subjects. Method: Ninety eight children with severe cerebral palsy, mean age 5.8y, were included. The assessment consisted of a clinical evaluation of gross motor function measure (GMFM), a semi-structured interview for child health questionnaire (CHQ), and a review of medical records. Results: CP in GMFCS level V showed lower mean score of GMFM and CHQ than level IV (p＜0.05). Scores that present physical quality of life were lower than scores of psychosocial quality of life (p＜0.05). Motor distribution and sex were found to be significant factors that affect quality of life in children with severe CP (p＜0.05). In particular, as the father's education level is higher, the physical quality of life in CP is better (p＜0.05). Conclusion: In this study, we report general life quality status of children with severe CP in Korea. Some factors such as severity and distribution of paralysis of the CP, sex, parental factor were found to affect their quality of life. We suggest that it is necessary to consider not only motor function, but also quality of life for children with severe CP. (J Korean Acad Rehab Med 2009; 33: 415-422)

Objective
To find out the most useful method among three electrodiagnostic tests for carpal tunnel syndrome (CTS) in patients with diabetic peripheral polyneuropathy (PPN). Method: Eighty-three hands out of seventy-four patients who had diabetic PPN and tingling sensation in their hands were included in this study. They were divided into two groups: Group A, PPN with CTS; Group B, PPN only. Fifty-four hands with CTS in patients without diabetes were included as a control group (Group C). Another forty normal hands were also included as a healthy control group (Group D). Clinical and electrophysiologic information was gathered from those subjects. Sensitivity, specificity and receiver operating characteristic (ROC) curves of the three electrodiagnostic tests, namely, the difference between the median nerve latency to the second lumbrical muscle and the ulnar nerve latency to the second interosseous muscle (L-I difference), ratio of distoproximal latency in median sensory nerve (MW ratio), and difference of distoproximal latency in median sensory nerve (MW difference) to diagnose clinical CTS were obtained. Results: The specificity of L-I difference as a diagnostic test for CTS was highest (87.0%). The area of ROC curve of L-I difference was also highest (0.949) among three different electrodiagnostic tests of CTS with diabetic PPN. Conclusion: We suggest that L-I difference as the most useful test with highest specificity for the diagnosis of CTS in the patients with diabetic PPN. (J Korean Acad Rehab Med 2009; 33: 423-428) Key Words:

Objective
To assess and to compare the balance control between healthy old and young adults using clinical tests and tetra-ataxiametric posturography. Method: Eighteen healthy elderly adults over 60 years old and twenty one young individuals under 60 years old were recruited. All subjects had no neurological, cognitive and musculoskeletal problems, and were capable of standing and walking independently. The postural control capabilities of the subjects were assessed using the timed up and go test, Berg balance scale and a Tetrax^Ⱂ tetra-ataxiametric posturography (Tetrax, Ramat Gan, and Sunlight Medical, Tel-Aviv, Israel), which utilized two paired force plates measuring vertical pressure fluctuations over both heels and forefeet. Stability index, weight distribution index, synchronization index, and Fourier index were measured at six different head positions and at two positions with standing on pillows, and analyzed by independent t-test. Results: The stability index was higher in the elderly subjects (p＜0.05) than in young subjects, which indicated that the ability of balance control in the elderly subjects was poor. The abnormality of peripheral vestibular system, central nervous system and musculoskeletal system all affected the balance control in the elderly subjects, when standing on pillows or turning head to the up, down, right and left sides. However, the weight distribution index and synchronization of both heels and forefeet were not significantly different between the elderly and young subjects. Conclusion: These findings suggest that elderly adults have more deficits in postural control than young subjects. Therefore changing environment around elderly adults and educating for prevention of falls were needed. (J Korean Acad Rehab Med 2009; 33: 429-435)

Objective
To develop Korean version of Frenchay Aphasia Screening Test (K-FAST) and to standardize K-FAST in normal adult population in Korea. Method: The 'river scene' of stimulus set in original version of FAST was adapted for K-FAST. English version of the test instructions and scoring methods were translated into Korean and reverse-translation was performed by English- Korean bilinguals. The test structures and language domains (comprehension, expression, reading, and writing) were unchanged and possible maximum score was 30 points. We standardized K-FAST in 240 normal adult populations (male 102, female 138) whose ages were above 44. Basic personal information was collected through an interview and we performed Edinburgh handedness inventory (EHI), K- MMSE and K-FAST. Subjects who had history of brain disease, cognitive communicative disorders, or K-MMSE scores less than 2 percentile of same age group were excluded. K-FAST scores were analyzed according to the age and education groups. Results: Mean EHI, K-MMSE, and K-FAST scores in total subjects were 9.4±1.2, 25.9±2.8, 25.4±3.3 points, respectively. Post-hoc analysis of K-FAST scores according to age groups classified into 3 age groups, 45∼64, 65∼74, and ≥74 years and education groups into 0, 1∼9, ≥10 years of total education. K-FAST scores decreased significantly as increase of age (r=−0.441, p=0.000) and decrease of total years of education (r=0.580, p=0.000). Conclusion: Newly adapted K-FAST can be used for screening of aphasia in Korea and the standardized data according to age and education levels may provide useful reference values for interpretation of the results of K-FAST. (J Korean Acad Rehab Med 2009; 33: 436-440)

Objective
To investigate the change of neurogenic bowel dysfunction (NBD) in spinal cord injury (SCI) patients during admission. Method: Thirty eight SCI patients were enrolled. The NBD score by Krogh was converted to the Korean-version of NBD score. The questionnaires of NBD score included questions about neurogenic bowel symptoms, signs, gender, age, duration, injury level, American spinal cord injury association impairment scale (AIS) and Spinal cord independence measure (SCIM) were used for evaluation of the functional impairment of the SCI. The Korean version of NBD score was applied to the SCI patients at the time of admission and discharge. Neurogenic bowel was treated according to scheduled bowel care. The subcomponents of bowel care protocol were education of bowel habit, abdominal massage, triggered defecation, oral medication and rectal stimulants insertion. Results: The NBD score at the time of discharge decreased significantly in all patients within three months after SCI (p＜0.001). Particularly, AIS A, C, D patients (except for cauda equina syndrome patients) (p＜0.005) showed significant decrease of NBD score. There were no significant difference of NBD score according to age, sex, injured cord level and SCIM (p＞0.05). Conclusion: We could reveal the significant improvement of NBD in patients within three months after SCI during admission. The change was more evident in AIS A, C, D patients. (J Korean Acad Rehab Med 2009; 33: 441-447)

Objective
To evaluate the usefulness of infrared thermography in the diagnosis of unilateral carpal tunnel syndrome (CTS). Method: Thirty six patients confirmed electrodiagnostically as CTS and fifteen adults with normal electrodiagnostic study were included in this study. For the thermographic diagnosis, we measured the skin temperature of the palmar area of all 5 fingers, thenar area, hypothenar area and volar area of forearm bilaterally. We compared the interside peak temperature difference between median nerve innervated area and noninnervated area in three different groups (normal control, mild CTS and moderate to severe CTS groups). Results: Thermography of the CTS patients showed significant temperature differences in more than one area of the median vasomotor nerve territory, and no significant temperature difference in all the areas that were not innervated by the median vasomotor nerve. When we considered interside temperature differences of more than 0.3°C as abnormal findings, the sensitivity of thermography was 2.7% and the specificity was 86.6%. With more than 0.6°C as abnormal, the sensitivity was 25% and the specificity was 66.6%. With more than 1.0°C, the sensitivity was 8.3% and the specificity was 73.3%. There was no significant interside peak temperature difference in all groups. Conclusion: This study suggests that infrared thermography has low sensitivity and specificity, which implies that it is not useful for the diagnosis of CTS. (J Korean Acad Rehab Med 2009; 33: 448-452)

Objective
To evaluate the actual condition of management of stump and prosthesis, difficulties with or without prosthesis in the activities of daily living and the present status of cognizance of rehabilitation services in amputees. Method: This study was designed as a questionnaire survey. The questionnaire included the general demographic characteristics, causes of amputation, amputation level and time, practical status of fitting and management of prosthesis, satisfaction of prosthesis, difficulties in activities of daily living under prosthesis. The change of recognition of rehabilitation medicine and the degree of acceptance of rehabilitation services followed by duration-after amputation was also investigated. Results: The most common cause of amputation was vehicular accidents and the mean age was 35.6 years old. The results showed that the amputees had low satisfaction in the prosthesis itself and the management. The role of rehabilitation medicine in fitting and management of prosthesis was insignificant. The 69% of amputees answered that the rehabilitation services were provided after the amputation, but only 40% of amputees reported they had known the services were provided by rehabilitation medicine. This discrepancy probably implied the poor recognition of the role of rehabilitation medicine, even though the rehabilitation services provided to the amputees has been significantly increased in recent 5 years. Conclusion: There is a little progress of recognition and role of rehabilitation medicine although the acceptants of rehabilitation services were increased. Physiatrists should take an active participation to the amputee community for extension of recognition and role of rehabilitation medicine. (J Korean Acad Rehab Med 2009; 33: 453-457)

Objective
To assess the validity of Gugging Swallowing Screen (GUSS) that allows separate evaluations for non-fluid and fluid textures for aspiration risk of acute stroke patients. Method: Fifty-five acute stroke patients were assessed prospectively. For interrater reliability, 2 independent physicians evaluated 40 patients in two hours. For external validity, another group of 15 patients were tested by dysphagia therapist. The validity of the GUSS was established by videofluoroscopic swallowing study (VFSS). After GUSS, all patients were investigated by VFSS within 1 hour. To compare the results of VFSS, they were graded according to the Penetration Aspiration Scale (PAS). Results: The cut-off value of GUSS was 14 points and 5 stage of PAS. GUSS reached 100% sensitivity, 61.1% specificity, and 100% negative predictive value when compared with VFSS by physician A (p＜0.001). By physician B, GUSS (p＜0.001) reached 100% sensitivity and 60.0% specificity, and 100% negative predictive value and 100%, 85.7%, 88.9%, 100%, in the 15 patient group (p＜0.05). The Պ-value was 0.916 between physician A and B (p＜0.05). Conclusion: This study proposes that GUSS is a reliable method in identifying stroke patients with aspiration risk. Such a graded assessment can provide less discomfort for those patients who can continue with their oral feeding for semisolid food while refraining from drinking fluids. (J Korean Acad Rehab Med 2009; 33: 458-462)

Objective
To evaluate the influence of hemispatial neglect on trunk balance control and functional ability in stroke patients. Method: Fourty eight inpatients exhibiting (n=25) or not exhibiting (n=23) hemispatial neglect following strokes within 6 months were matched for age and sex. Hemispatial neglect was assessed with a line bisection test (LBT) and a baking tray task test (BTT). Static and dynamic trunk balance control was assessed using a Balance Master System. Static balance control was measured with a weight bearing test and a Modified Clinical Sensory Interaction Balance Test (mCSIBT). Dynamic balance control was measured using a Limit of Stability (LOS) test and a rhythmic weight shift (RWS) test. A Functional Independence Measure (FIM) for functional ability and the Brunnstrom stage assessment for motor recovery were also recorded. Results: There was no statistical difference in the achievement of static trunk balance control between neglect and non-neglect patients. Where dynamic balance control was concerned, both LOS and RWS tests showed a deterioration in neglect patients compared to non-neglect patients (p＜0.05). The Brunnstrom stage correlated significantly with dynamic balance control only in non-neglect patients (p＜0.05) and the FIM score of neglect patients was significantly lower than that of non-neglect patients (p＜0.05). Conclusion: Stroke patients with hemispatial neglect displayed pronounced dynamic trunk instability and functional dependency compared to patients without it. However, the recovery of dynamic balance control may not relate to the degree of motor recovery in stroke patients with hemispatial neglect. (J Korean Acad Rehab Med 2009; 33: 463-469)

Objective
To evaluate the therapeutic effect of the tibia counter rotator orthosis for tibial internal torsion children. Method: The 16 limbs included in this study were both lower extremities of 6 subjects and unilateral ones of 4 subjects (7 female and 3 male), ranging in age from less than 3 year to 11 years. These subjects were diagnosed as in-toeing gait with tibial internal torsion and had no history of forefoot adductus or other musculoskeletal abnormality. Tibial torsion was evaluated by thigh-foot angle and computed tomography before and after applying the Tibia Internal Brace^Ⱂ (TIB^Ⱂ). Results: Thigh-foot angle and computed tomography showed significant improvement of tibial internal torsion before and after applying the TIB^Ⱂ (p＜0.05). There was no significant correlation between duration of the TIB^Ⱂ application and improvement of tibial internal torsion (p＞0.05). And there was no significant correlation between age and improvement of tibial internal torsion (p＞0.05). Conclusion: TIB^Ⱂ was effective for in-toeing gait children with tibial internal torsion. (J Korean Acad Rehab Med 2009; 33: 470-476)

Objective
To observe the long-lasting changes of pain progression with time course in an autologous nucleus pulposus model of rat. Method: The subjects were 25 Sprague-Dawley (Sprague- Dawley, 250 gm) male rats. They were randomly assigned into either the sham or experimental group. In the experimental group (n=15), autologous nucleus pulposus was harvested from the coccygeal intervertebral disc of the rat and this was grafted on the left L5 dorsal root ganglion. In the sham group (n=10), the left L4 and L5 nerve roots were exposed by laminectomy, but the nucleus pulposus was not grafted. All the rats were evaluated for mechanical allodynia and thermal hyperalgesia at 2 days before surgery, and on days 1, 5, 10, 20, 30, 40 and 50 after surgery. The morphological changes of the spinal nerves were assessed by toluidine blue staining on days 5 after surgery. Results: In the ipsilateral hindpaw of the experimental group, there was a dramatic drop of the mechanical withdrawal threshold and the thermal withdrawal latency on day 1 after surgery, which was maintained at day 50 after surgery. In morphological study, pathological findings such as swelling of the myelin sheath, demyelination, swelling and degeneration of the axoplasm were observed in the spinal nerve at day 5 after surgery. Conclusion: The long-lasting pattern of neuropathic radicular pain shown in a rat model of lumbar disc herniations is helpful to understand the natural history of neuropathic radicular pain due to ruptured nucleus pulposus. (J Korean Acad Rehab Med 2009; 33: 477-482)

Duchenne muscular dystrophy (DMD) is a severe X-linked recessive disorder characterized by rapid progression of muscle wasting and weakness. The disorder is caused by a mutation in the dystrophin gene on chromosome Xp21.1. DMD may be accompanied by heart failure, but conduction abnormalities are uncommon. We report a case of a 28-year- old male patient with DMD who presented with symptoms of bradycardia, chest discomfort and dyspnea. He was diagnosed as having complete atrioventricular block by electrocardiogram. Pacemaker was inserted, and subsequently symptoms and electrocardiogram findings showed improvement. (J Korean Acad Rehab Med 2009; 33: 483-485)

One of common injury sites in golfers is the wrist, but ulnar neuropathies at wrist in golfers have been rarely reported. We report a case of ulnar neuropathy within the Guyon's tunnel occurred in a single golfer diagnosed with electrodiagnosis and ultrasound. A 59-year old man suffered from difficulty with extension of left 4th and 5th finger joints and weakness of hand grasping, which had occurred 2 weeks ago and aggravated slowly. He had no sensory disturbance. During recent two months, he had practiced golf for three to four hours daily. Electrodiagnostic study showed that the deep branch of left ulnar nerve was compromised at the wrist (type II_A). Ultrasound study revealed a ganglion cyst within the Guyon's tunnel. Therefore we diagnosed the patient as having ulnar neuropathy (only deep branch involvement) associated with a ganglion cyst within the Guyon's tunnel. (J Korean Acad Rehab Med 2009; 33: 486-488)

We report a patient with ankylosing spondylitis presenting dysphagia as a chief complaint. A 43-year-old man complained of swallowing difficulty persisted for a year. Laryngoscopy revealed bilateral arytenoid swelling. Videofluoroscopic swallowing study (VFSS) revealed penetration and aspiration of liquid, food residue in pyriform sinuses, multiple swallowing and passage disturbance of food. C-reactive protein and erythrocyte sedimentation rate were elevated. On physical examination, neck stiffness and limitation of motion of whole spine were shown. Simple radiography of spine and sacroiliac joints displayed cervical osteophyte, bamboo spine and bilateral sacroilitis. Bath ankylosing spondylitis disease activity index was 6.3 points. He was diagnosed as severe active ankylosing spondylitis. After the conservative treatment, range of motion of whole spine increased and dysphagia improved on follow-up VFSS. Dysphagia in ankylosing spondylitis may be attributed to postural changes due to limitation of cervical motion and inflammation of soft tissue. (J Korean Acad Rehab Med 2009; 33: 489-492)

Eosinophilic fasciitis (EF) in childhood is a very rare, and it is characterized by diffuse fasciitis and peripheral eosinophilia. It has been reported that EF shows good recovery after systemic steroids. We report a case of 18 months old boy with eosinophilic fasciitis which affected the right lower extremity and flank. The case we present here differs from other published reports, in that the patient with eosinophilic fasciitis presented serious musculoskeletal complications such as muscle atrophy, osteoporosis, fracture, and inequality of limb length that were associated with chronic course of steroids therapy. Interdisciplinary approach is critical in preventing complications in children with eosinophilic fasciitis. (J Korean Acad Rehab Med 2009; 33: 493-497)

We report a case of hemipelvectomy, which was successfully treated with custom-molded supportive seating and a cosmetic prosthesis. A 32-year-old woman with a history of right traumatic hemipelvectomy, 24 years ago, visited our outpatient clinic for proper prosthetic rehabilitation. After injury, she was not able to use functional prostheses because of persistent skin problems of the hemipelvectomy site. She was able to perform all activities of daily living independently, but had to rely on crutch walking and was not able to sit on an even surface for longer periods of time. With the molded supportive seating the patient was able to perform outdoor activities for up to 10 hours. This case shows an approach in amputee rehabilitation, in which the ultimate goal of prosthetic fitting is not independent walking, but the improvement of independence and hence the improvement of quality of life. (J Korean Acad Rehab Med 2009; 33: 498-501)

Mirror movements can be defined as involuntary movements on one side of the body that occur as mirror reversals of intended movement on the other side of the body. These are common as normal phenomenon in young children. When mirror movements persist after first decade of life, they are abnormal. We studied a patient with congenital mirror movement by neurophysiological methods. Neurological examination revealed mirror movements in both upper extremities, but not in legs or face. Transcranial magnetic stimulation elicited bilateral motor evoked potentials of the first dorsal interossei muscle and ipsilateral responses showed shorter onset latencies and larger peak to peak amplitude than contralateral response, implying greater ipsilateral projection than contralateral projection. This observation indicates direct ipsilateral corticospinal projections. Our findings are consistent with aberrant organization of motor representation areas and corticospinal pathways with ipsilateral as well as contralateral control of voluntary movement. (J Korean Acad Rehab Med 2009; 33: 502-505)