scholarly journals Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study

2021 ◽  
Author(s):  
Paweł Szaro ◽  
Khaldun Ghali Gataa ◽  
Bogdan Ciszek
Keyword(s):  
Surgical Treatment ◽  
Significant Relationship ◽  
Final Decision ◽  
Anatomical Variants ◽  
Spring Ligament ◽  
Chi Squared ◽  
Foot Arch ◽  
3.0 T ◽  
Mri Study ◽  
Static Stabilizer

Abstract Purpose The spring ligament complex (SL) is the chief static stabilizer of the medial longitudinal foot arch. The occurrence of normal anatomical variants may influence radiological diagnostics and surgical treatment. The aim of this study was to evaluate anatomical variants of the part of SL located inferior to the talar head (i-SL), medioplantar oblique ligament (MPO) and inferoplantar longitudinal ligament (IPL). Methods We included 220 MRI examinations of the ankle performed on a 3.0 T engine. Only patients with a normal SL were included. Two musculoskeletal radiologists assessed the examinations and Cohen’s kappa was used to assess agreement. Differences between groups were assessed using the chi-squared test; p < 0.05 was considered as significant. The final decision was made by consensus. Results Most commonly, i-SL was composed of the two ligaments IPL and MPO n = 167 (75.9%); in this group, bifid ligaments occurred in 19.2%, most commonly in the MPO. A branch to the os cuboideum was seen in n = 17 (10.2%). Three ligaments were seen in n = 52 (23.6%). In this group, bifid ligaments occurred in 13.5%; most commonly, the IPL was bifid and a branch to the os cuboideum was noted in n = 6 (11.5%). In one case, n = 1 (0.04%), we identified MPO, IPL and two accessory ligaments. No significant relationship was noted between the number of ligaments, the presence of bifid ligaments and side or gender (p > 0.05). Conclusion. More than two aligaments were seen in 24.1% of examined cases, the most common variant was the presence of MPO, IPL and one accessory ligament.

An MRI study of typical anatomical variants of the anterior communicating artery complex

2021 ◽  
Author(s):  
Fabien Fredon ◽  
Maxime Baudouin ◽  
Jeremy Hardy ◽  
Assia Kouirira ◽  
Léa Jamilloux ◽  
...  
Keyword(s):  
Anterior Communicating Artery ◽  
Anatomical Variants ◽  
Mri Study

Prevelance of Fabella: An MRI Study in The Eastern Anatolia Region Of Turkey

2021 ◽  
Vol 17 ◽  
Author(s):  
Huseyin Akdeniz ◽  
Sezai Ozkan ◽  
Cihan Adanas
Keyword(s):  
Femoral Condyle ◽  
Left Knee ◽  
Final Decision ◽  
Eastern Anatolia ◽  
Orthopedic Surgeons ◽  
Expert Radiologist ◽  
Number Of Patients ◽  
And Gender ◽  
The Right ◽  
Mri Study

Background: The fabella, which is generally located in the lateral head of the gastrocnemius muscle, is a sesamoid bone that articulates with the posterior face of the lateral femoral condyle. As traditional information, the prevalence of fabella is between 10–30% in the population and is usually present in both knees. Introduction: The objective of this study was to investigate the knee MRIs in the Eastern Anatolia Region of Turkey subjects in order to assess the prevalence of the fabella and analyse the differences between gender, age and laterality and its symmetry pattern. Methods: This study was a retrospective study in patients older than 18 years whose knee MRIs were taken between February 2014 and February 2016. In this study, a total of 531 patients [290 females and 241 males] were included. The radiographs were examined by two orthopedic surgeons and the fabella was located. Later, an expert radiologist made the final decision and confirmed the results. Results: The number of patients included in the study was 531. We detected os fabella in 59 (11.1%) patients. Of the 59 os fabella, 33 were in the right knee and 26 were in the left knee, 38 were female and 21were male. Conclusion: In this study, we investigated the age and gender differences besides the prevalence and the symmetry pattern of the fabella in the Eastern Anatolia Region of Turkey’s population. Prevalence of the fabella was found to be 11.1% which is different than previously published studies.

scholarly journals Bilateral Neck Exploration May Not Reduce the Risk of Persistence but Shows a Perspective Advantage

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A256-A256
Author(s):  
Dmitrii Buzanakov ◽  
Ilya Sleptsov ◽  
Arseny Semenov ◽  
Roman Chernikov ◽  
Konstantin Novokshonov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Statistical Significance ◽  
Bilateral Neck Exploration ◽  
Neck Exploration ◽  
True Rate ◽  
Bilateral Exploration ◽  
Blind Area ◽  
Significant Difference ◽  
Chi Squared ◽  
History Of

Abstract There is still no consensus for an optimal surgical treatment of primary hyperpararthyroidism (PHPT). Virtually, most of the patients could be successfully treated with the selective parathyroidectomy (SPTE) based on preoperative visualization. However, this approach still has a “blind area” of undetected multiglandular disease (MGD). Bilateral neck exploration (BNE) may serve as a reasonable alternative but it meets the higher requirements for the surgical technique. A retrospective cohort study was conducted in order to reveal factors associated with the persistence of PHPT. 587 cases of PHPT patients who had received surgical treatment at SPSU Hospital in 2017–2018 were included. All the patients have at least one preoperative visualization study (neck ultrasound performed by a surgeon) before the operation. In 356 cases two studies were performed (additional 4D CT or MIBI scan) and 116 cases had all three. A surgeon was free to choose a type of the operation (selective or explorative) according to their strategic preferences. Bilateral neck exploration was performed in 160 cases. There was no difference in bilateral exploration rate (p = 0.3896) between the groups (with 1, 2 or 3 studies performed) indicating that the additional visualization does not allow to avoid bilateral exploration. MGD rate accounted for 7.4% (40 cases). It is important that any set of preoperative visualization modalities prove the absence of MGD reliably and select patients for SPTE precisely. Negative predictive value for different combinations of concordant studies (US+MIBI, US+CT and US+CT+MIBI) did not differ significantly and was 96.95%, 97.4% and 97.7% respectively. 26 cases of persistent disease were reported with no significant difference between BNE and SPTE groups. (6 vs 20 respectively, p = 0.792). A history of the thyroid or parathyroid operations was found to be the only factor predicting the higher risk of persistence (OR = 7.98; 95% CI [2.62 - 24.27]), while neither the number of parathyroid glands found during the surgery nor the number of preoperative visualization studies showed statistical significance. Only 47,5% cases of BNE was reported to have all four glands visualized. There rate of failure to found each gland was similar. Surprisingly, the superior parathyroid adenomas (P4) were more likely to be removed (chi-squared 10.378, p = 0.0006) but not in the cases with all four glands visualized intraoperatively (chi-squared 1.822, p = 0.0884). The true rate difference due to a hypothetical feature of parathyroid physiology seems to be not very likely. One may rather suggest than it is not an uncommon for a surgeon to identify a P3 gland as a P4 unless all for glands are visualized. This fact shows a perspective advanantage which may prevent some cases of persistence.

Morphology of Spring Ligament Fibrocartilage Complex Lesions

2019 ◽  
Vol 109 (5) ◽  
pp. 407-411 ◽  
Author(s):  
Marcin Domzalski ◽  
Adam Kwapisz ◽  
Sebastian Zabierek
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Anatomical Variations ◽  
Patient Age ◽  
Spring Ligament ◽  
The Mean ◽  
Mean Time ◽  
Time From Injury ◽  
Complex Lesions

Background: The spring ligament fibrocartilage complex (SLFC) is an important static foot stabilizer comprising the superomedial ligament (SML) and the inferior ligament, with anatomical variations (third ligament). The aim of this study was to describe the patterns of the lesions found during SLFC surgery, to allow direct comparison between the results with various surgical techniques. Methods: Fourteen consecutive patients with SLFC lesions were analyzed during surgical treatment. The mean patient age was 37.3 years, and the mean time from injury was 6.9 months. Intraoperative assessments and anatomical descriptions of the lesions were collected. Results: Three types of lesion were found. In 13 of 14 cases, only the superomedial ligament was involved: five superomedial ligament distentions and eight superomedial ligament ruptures. In one case, total SLFC (superomedial and inferior ligaments) rupture was observed. Conclusions: The first classification of SLFC lesions is presented, which is simple, consistent, and based on anatomical description.

Diagnostic accuracy of DW MR imaging in the differentiation of chordomas and chondrosarcomas of the skull base: A 3.0-T MRI study of 105 cases

2018 ◽  
Vol 105 ◽  
pp. 119-124 ◽  
Author(s):  
Thomas Welzel ◽  
Eva Meyerhof ◽  
Matthias Uhl ◽  
Kristin Huang ◽  
Andreas von Deimling ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Diagnostic Accuracy ◽  
Skull Base ◽  
3.0 T ◽  
Mri Study ◽  
3.0 T Mri

scholarly journals Klippel–Feil Syndrome (KFS) with Multiple Cervical Anomalies Discovered Following Trauma

2020 ◽  
Author(s):  
Fernando Celi ◽  
Giancarlo Saal-Zapata
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Vascular Malformations ◽  
Upper Cervical Spine ◽  
Congenital Disease ◽  
Cervical Injury ◽  
Anatomical Variants ◽  
Complex Anatomy ◽  
Upper Cervical ◽  
Type Of Surgery

AbstractThe approach to the upper cervical spine is a challenge for surgeons, not only for its complex anatomy but also for the great variety of pathologies. Klippel–Feil syndrome (KFS) is a congenital disease characterized by the fusion of two or more cervical segments and is associated with various musculoskeletal and vascular malformations. However, there is no consensus on the type of surgery, approach, level of fixation or fusion. We report the case of a KFS, associated with multiple anatomical variants, who suffered a traumatic cervical injury and underwent surgical treatment.

scholarly journals Ankle and syndesmosis instability: consensus and controversies

2021 ◽  
Vol 6 (6) ◽  
pp. 420-431
Author(s):  
Nuno Corte-Real ◽  
João Caetano
Keyword(s):  
Surgical Treatment ◽  
Ankle Instability ◽  
Valgus Deformity ◽  
Diagnosis And Treatment ◽  
Deltoid Ligament ◽  
Ankle Sprains ◽  
Ankle Osteoarthritis ◽  
Permanent Disability ◽  
Spring Ligament ◽  
Repair Techniques

Ankle sprains are mainly benign lesions, but if not well addressed can evolve into permanent disability. A non-treated lateral, syndesmotic or medial ankle instability can evolve into ankle osteoarthritis. For this reason, diagnosis and treatment of these entities is of extreme importance. In general, acute instabilities undergo conservative treatment, while chronic instabilities are better addressed with surgical treatment. It is important to identify which acute instabilities are better treated with early surgical treatment. Syndesmosis injuries are frequently overlooked and represent a cause for persistent pain in ankle sprains. Unstable syndesmotic lesions are always managed by surgery. Non-treated deltoid ligament ruptures can evolve into a progressive valgus deformity of the hindfoot, due to its links with the spring ligament complex. This concept would give new importance to the diagnosis and treatment of acute medial ligament lesions. Multi-ligament lesions are usually unstable and are better treated with early surgery. A high suspicion rate is required, especially for combined syndesmotic and medial lesions or lateral and medial lesions. Ankle arthroscopy is a powerful tool for both diagnostic and treatment purposes. It is becoming mandatory in the management of ankle instabilities and multiple arthroscopic lateral/syndesmotic/medial repair techniques are emerging. Cite this article: EFORT Open Rev 2021;6:420-431. DOI: 10.1302/2058-5241.6.210017

scholarly journals Seroprevalence and characterisation of herpes simplex virus from human immunodeficiency virus in samples collected from the North-West and KwaZulu-Natal Provinces: a retrospective study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 105
Author(s):  
Oluwafemi Samuel Obisesan ◽  
Nomathamsanqa Patricia Sithebe ◽  
Hazel Tumelo Mufhandu
Keyword(s):  
Human Immunodeficiency Virus ◽  
Herpes Simplex ◽  
Significant Relationship ◽  
Enzyme Linked Immunosorbent Assay ◽  
Herpes Simplex Viruses ◽  
Immunodeficiency Virus ◽  
High Prevalence ◽  
Chi Squared ◽  
Hiv 1 ◽  
Hsv 1

Background: Herpes simplex viruses (HSVs) are highly pervasive and show a strong synergistic interaction with human immunodeficiency virus (HIV). High prevalence of HSV type 1 (HSV-1) has been reported in Africa with a prevalence rate of 20-80% in women and 10-50% in men. Studies on the prevalence of HSV in South Africa are few considering the rate of HIV infection in the country. Our focus was to determine the molecular prevalence of HSV-DNA in HIV-1 sera. Methods: In total, 44 convenience samples were screened for HSV and HIV-1 using the highly sensitive enzyme-linked immunosorbent assay (ELISA). The ELISA positive samples were characterized using polymerase chain reaction (PCR) to confirm the positivity of both viruses and to further differentiate HSV into HSV-1 and -2. Thereafter, the samples were analysed for relatedness using phylogenetic analysis. Results: Of 44 samples, 36 (81.8%) were positive for HIV-1, while 35 (79.5%) were positive for HSV when screened with ELISA kits. The results of PCR with type specific primers showed that 4/35 (11.4%) samples were specific for HSV-1 while 30/35 (85.7%) were specific for HSV-2. Statistical analysis performed using chi-squared goodness-of-fit test showed that there is a significant relationship between HSV-2 and HIV-1 transmission. Conclusions: High prevalence of HSV-2 recorded in HIV-1 sera corroborate with similar studies conducted within different cohorts in the continent. SPSS Pearson’s chi-squared test established that there is a significant relationship between HSV-2 and HIV-1 transmission.

scholarly journals EMPATHY AND BURNOUT AMONG PHYSICIANS PROVIDING REANIMATOLOGICAL AND SURGICAL TREATMENT

2018 ◽  
Vol 3 (110) ◽  
pp. 2-9
Author(s):  
Dalia Antinienė ◽  
Žydrūnė Kaklauskaitė
Keyword(s):  
Surgical Treatment ◽  
Significant Relationship ◽  
Work Experience ◽  
Treatment Process ◽  
Demographic Factors ◽  
Scientific Publications ◽  
Work Related ◽  
Physician Empathy ◽  
Practicing Physicians

Background. Among scientific publications it is observed that in medicine the aspect of interpersonal connection is underestimated while providing medical help (Steinhausen et al., 2014), and not enough attention is being allocated to the effect of a physician’s empathy in the treatment process (Hojat et al., 2002a). The lack of scientific publications shows that this topic is under-researched and relevant. Thus, the purpose of the study was to determine relationships between empathy and burnout among practicing physicians. Methods. A total of 185 practicing physicians who provide reanimatological and surgical treatment participated in the research. A questionnaire was designed for the study, consisting of the Jefferson Scale of Physician Empathy (Hojat, 2016), Copenhagen Burnout Inventory (Kristensen Borritz, Villadsen, & Christensen, 2005). Results. Research revealed that the expressiveness of empathy between doctors is not related to sex, age, work experience and speciality (p > .05). Also, it was found that younger physicians experienced more work-related burnout (p = .04). the study showed that there was no statistically significant relationship between empathy and burnout among physicians (p > .05). Conclusions. Research showed that physician’s empathy was not related to demographic factors. Findings revealed that younger doctors experienced more work-related burnout than the older ones. Finally, connection between empathy and burnout was not found.

Endoscopic release of plantar fasciitis - a benign procedure?

2000 ◽  
Vol 21 (6) ◽  
pp. 511-513 ◽  
Author(s):  
Joerg Jerosch
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Plantar Fasciitis ◽  
Pain Syndrome ◽  
Plantar Fascia ◽  
Stress Reaction ◽  
Endoscopic Release ◽  
Mri Study ◽  
Partial Release ◽  
Non Surgical Treatment

This is a case report of a patient suffering from subcalcaneal pain syndrome due to plantar fasciitis that was resistant to non surgical treatment. After endoscopic partial release of the plantar fascia the patient was pain free for several weeks, before he became symptomatic again. This new pain was located more proximally. An MRI study showed a stress reaction of the calcaneus.

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