Internal Derangement of the Hip

Author(s):  
Imran M. Omar

Chapter 107 discusses the hip and its component tissues, including the bones, labrum, synovial tissues, muscles, and tendons, and covers the MRI appearances of many of the most common pathologies that occur in and around the hip joint. The hip is a ball-and-socket joint consisting of the femoral head and the cup-shaped acetabulum. Because of its shape, the hip allows multi-axial movements, including flexion/extension, abduction/adduction, and internal/external rotation. A number of supporting structures, including the acetabular labrum and joint capsule, surrounding muscles and tendons, and bursae, help stabilize the hip and allow for a smooth range of motion. Injuries to any of these structures can result in hip pain and loss of function. MRI has become the test of choice to assess hip internal derangement because of its superior assessment of soft tissues and bone marrow and its contrast resolution, which improves conspicuity of pathologic conditions.

2021 ◽  
Vol 11 (16) ◽  
pp. 7407
Author(s):  
Cosmin Ioan Faur ◽  
Daniel Laurentiu Pop ◽  
Ahmed Abu Awwad ◽  
Carmen Lacramioara Zamfir ◽  
Roxana Folescu ◽  
...  

Synovial sarcoma (SS) is a rare and highly malignant tumor and a type of soft tissue sarcoma (STS), for which survival has not improved significantly in recent years. Synovial sarcomas occur mostly in adolescents and young adults (15–35 years old), usually affecting the deep soft tissues near the large joints of the extremities, with males being at a slightly higher risk. Despite its name, synovial sarcoma is neither related to the synovial tissues that are a part of the joints, i.e., the synovium, nor does it express synovial markers; however, the periarticular synovial sarcomas can spread as a secondary tumor to the joint capsule. SS was initially described as a biphasic neoplasm comprising of both epithelial and uniform spindle cell components. Synovial sarcoma is characterized by the presence of the pathognomonic t (X; 18) (p11.2; q11.2) translocation, involving a fusion of the SS18 (formerly SYT) gene on chromosome 18 to one of the synovial sarcoma X (SSX) genes on chromosome X (usually SSX1 or SSX2), which is seen in more than 90% of SSs and results in the formation of SS18-SSX fusion oncogenes.


2007 ◽  
Vol 20 (01) ◽  
pp. 01-07 ◽  
Author(s):  
D. H. Sha ◽  
J. A. Stick ◽  
P. Robinson ◽  
H. M. Clayton

SummaryThe objective was to measure 3D rotations of the distal (DIP) and proximal (PIP) interphalangeal joints at walk and trot. 3D trajectories of markers fixed to the proximal phalanx, middle phalanx and the hoof wall of the right forelimb of four sound horses were recorded at 120 Hz. Joint kinematics were calculated in terms of anatomically-based joint coordinate systems between the bone segments. Ranges of motion were similar at walk and trot. Values for the DIP joint were: flexion/extension: 46 ± 3° at walk, 47 ± 4° at trot; internal/ external rotation: 5 ± 1° at walk, 6 ± 3° at trot; and adduction/abduction: 5 ± 2° at walk, 5 ± 3° at trot. Within each gait, kinematic profiles at the DIP joint were similar between horses with the exception of adduction/abduction during breakover, which may vary depending on the direction of hoof rotation over the toe. Knowledge of the types and amounts of motion at the DIP joint will be useful in understanding the aetiology and treatment of injuries to the soft tissues, which are being recognized more frequently through the use of sensitive imaging techniques. Ranges of motion for the PIP joint were: flexion/extension: 13 ± 4° at walk, 14 ± 4° at trot; adduction/abduction: 3 ± 1° at walk, 3 ± 1° at trot; and internal/external rotation: 3 ± 1° at walk, 4 ± 1° at trot. The PIP joint made a significant contribution to flexion/extension of the digit. During surgical arthrodesis, the angle of fusion may be important since loss of PIP joint extension in late stance is likely to be accommodated by increased extension of the DIP joint.


2019 ◽  
pp. 121-131

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Jing Zhou ◽  
Yang Lin ◽  
Xiuhua Kang ◽  
Zhicheng Liu ◽  
Wei Zhang ◽  
...  

Abstract Background Previous reports have identified that human bone marrow mesenchymal stem cell-derived extracellular vesicles (BMSC-EVs) with their cargo microRNAs (miRNAs) are a promising therapeutic approach for the treatment of idiopathic pulmonary fibrosis (IPF). Therefore, we explored whether delivery of microRNA-186 (miR-186), a downregulated miRNA in IPF, by BMSC EVs could interfere with the progression of IPF in a murine model. Methods In a co-culture system, we assessed whether BMSC-EVs modulated the activation of fibroblasts. We established a mouse model of PF to evaluate the in vivo therapeutic effects of BMSC-EVs and determined miR-186 expression in BMSC-EVs by polymerase chain reaction. Using a loss-of-function approach, we examined how miR-186 delivered by BMSC-EVs affected fibroblasts. The putative relationship between miR-186 and SRY-related HMG box transcription factor 4 (SOX4) was tested using luciferase assay. Next, we investigated whether EV-miR-186 affected fibroblast activation and PF by targeting SOX4 and its downstream gene, Dickkopf-1 (DKK1). Results BMSC-EVs suppressed lung fibroblast activation and delayed IPF progression in mice. miR-186 was downregulated in IPF but enriched in the BMSC-EVs. miR-186 delivered by BMSC-EVs could suppress fibroblast activation. Furthermore, miR-186 reduced the expression of SOX4, a target gene of miR-186, and hence suppressed the expression of DKK1. Finally, EV-delivered miR-186 impaired fibroblast activation and alleviated PF via downregulation of SOX4 and DKK1. Conclusion In conclusion, miR-186 delivered by BMSC-EVs suppressed SOX4 and DKK1 expression, thereby blocking fibroblast activation and ameliorating IPF, thus presenting a novel therapeutic target for IPF.


2021 ◽  
Vol 11 (8) ◽  
pp. 3391
Author(s):  
Jan Marušič ◽  
Goran Marković ◽  
Nejc Šarabon

The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.


2021 ◽  
pp. 1-6
Author(s):  
Young Jin Jo ◽  
Young Kyun Kim

BACKGROUND: Dynamic knee valgus (DKV) is a known risk factor for acute and chronic knee injuries and is more frequently diagnosed in females. A real-time single-leg squat test (SLST) could screen for DKV to prevent injuries. OBJECTIVE: To compare the differences in lower extremity strength and range of motion (ROM) in female soccer athletes with and without DKV during an SLST. METHODS: Eighteen subjects with DKV (DKV group) and 18 subjects without DKV (control group) during a single-leg squat were included. Hip strength (flexion, extension, abduction, adduction, internal rotation, and external rotation) was measured with a hand-held dynamometer. Hip ROM (internal and external rotation), and ankle ROM (dorsiflexion with the knee flexed and extended) were measured. Independent t-test was used to compare the averages of the groups. RESULTS: There were significant differences in hip abduction to adduction strength ratio (DKV: 1.48 ± 0.3, control: 1.22 ± 0.26, p< 0.01) and ankle dorsiflexion with knee flexed (DKV: 17.22 ± 6.82, control: 21.22 ± 4.55, p< 0.05) and extended (DKV: 10.14 ± 4.23, control: 14.75 ± 3.40, p< 0.001) between the groups. CONCLUSION: The hip abduction to adduction strength ratio and gastrocnemius and soleus flexibility may be associated factors in dynamic knee valgus and therefore should be assessed and treated, if indicated, as a possible preventive measure in female athletes with this variation.


2012 ◽  
Vol 38 (3) ◽  
pp. 237-241 ◽  
Author(s):  
J. A. Bertelli ◽  
M. F. Ghizoni

Stretch injuries of the C5-C7 roots of the brachial plexus traditionally have been associated with palsies of shoulder abduction/external rotation, elbow flexion/extension, and wrist, thumb, and finger extension. Based on current myotome maps we hypothesized that, as far as motion is concerned, palsies involving C5-C6 and C5-C7 root injuries should be similar. In 38 patients with upper-type palsies of the brachial plexus, we examined for correlations between clinical findings and root injury level, as documented by CT tomomyeloscan. Contrary to commonly held beliefs, C5-C7 root injuries were not associated with loss of extension of the elbow, wrist, thumb, or fingers, but residual hand strength was much lower with C5-C7 vs C5-C6 lesions.


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