Interclavicularis anticus digastricus muscle in a female body donor: a case report

Background and objectives Muscular variations of the ventral thoracic wall are generally common and of great clinical interest. Materials and methods An unusual muscular variation of the ventral thoracic wall was observed and dissected in a West-European female body donor. Results An interclavicularis anticus digastricus muscle was observed and studied. It originated from the manubrium sterni and inserted bilaterally to the clavicles. Both muscle bellies were interconnected by a tendon on the ventral surface of the manubrium sterni. The muscle was innervated by branches of the lateral pectoral nerve. Conclusions The interclavicularis anticus digastricus muscle is a muscular variation of the ventral thoracic wall of unknown prevalence. This variation might be of clinical interest in orthopaedics and thoracic surgery. It is also a vulnerable structure during infraclavicular insertion of a subclavian vein catheter or fractures of the clavicle.

XANTHO-GRANULOMATOUS OSTEOMYELITIS OF STERNUM, RESEMBLING A TUMOR: FIRST REPORTED CASE

Xantho-granulomatous inflammation is a rare type of chronic inflammation, when seen in the bones it is known as xanthogranulomatous osteomyelitis (XO). Here we present a rare case XO of the manubrium sterni, to best of our knowledge this is the first diagnosed. XO of the manubrium sterni mimics radiologically as tuberculosis and as eosinophillic granuloma. We have a 23 year old lady who presented with pain and swelling in the anterior chest, radiology was done and finally the lesion was biopsied. We accepted the patient as Xanthomatous Osteomyelitis and planned for into excision of manubrium sterni, with a flap comprising of ribs and muscle advancements to cover the midline gap in the chest wall, that would have been created. Meanwhile she was put on a short course of antibiotics. It had been observed that the first open biopsy scar had exhibited a tendency for keloid formation. Hence, the risk of final surgery incision producing a disfiguring keloid was informed to the patient, which unfortunately led the patient deter surgery indefinitely, since she was to be married soon. We proposed a local injection of steroid into the lesion to minimize the inflammation. Under image intensifier we injected 40 mg of methyl prednisolone into the tumor. There was some tolerable discomfort the next day of injection that eventually subsided in 3 days. However, the biopsy came inconclusive second core needle biopsy came as XO. Since 1984 with the first case by Cozzutto et al, only 17 cases have been reported in the worldwide literature including us.

Sternocleidohyoid muscle: an unreported variant of cleidohyoid muscle

Sternohyoid, sternothyroid, omohyoid, and thyrohyoid muscles are collectively known as infrahyoid muscles. These muscles frequently show variations in their attachments. Here, an extremely rare variant muscle belonging to this group has been presented. During cadaveric dissection for undergraduate medical students, an additional muscle was found between sternohyoid and superior belly of omohyoid muscles bilaterally in a male cadaver aged approximately 70 years. This muscle took its origin from posterior surface of the manubrium sterni, capsule of the sternoclavicular joint and the posterior surface of the medial part of the clavicle. It was inserted to the hyoid bone between the attachments of sternohyoid and superior belly of omohyoid muscles and was supplied by a branch of ansa cervicalis profunda. There is no report on such a muscle in the literature and it could be named as “sternocleidohyoid muscle”. Knowledge of this muscle could be useful in neck surgeries.

INFECTIOS ARTHRITIS OF STERNOCLAVICULAR JOINT: DIAGNOSTIC AND PERSONALIZED TREATMENT

We analyzed short-term results of personalized treatment of 31 patients with sternoclavicular septic arthritis. Sternoclavicular joint infection was spread hematogenously in 74,2 % of patients and staphylococcus was the most causative pathogen (87,1 %). Diagnostic work-up included computer tomography, ultrasound-guided aspiration and microbiological analyses of aspirate and blood culture. 16 patients with sternoclavicular joint infection underwent incision, debridement and drainage at the first stage of treatment. Three of them died. Negative pressure wound therapy was used in 11 patients. Antibiotic therapy was effective in 50 % of patients with serous arthritis of sternoclavicular joint. Antibiotic with drainage and/or negative pressure wound therapy was efficient in 33,3 % of cases. The final respective-reconstructive stage of treatment was performed in 48,1 % of patients with good results. Wide resection was performed including medial end of clavicular, part of manubrium sterni and medial end of first and second ribs followed by pectoralis muscle flap.

Boncolás nyomai egy XVIII. századi gyermek mumifikálódott testén

In 1994–1995, in the Church of the Whites, the corpses of 265 individuals dressed in funeral clothes, mummified to varying degrees, were unearthed from coffins excavated by the ethnographic museologists of the Ignác Tragor Museum, Vác (Hungary). The individuals were preserved by spontaneous mummification due to the crypt’s unique microclimate and burial pattern. Signs of an autopsy were found on the body of a 10-year old girl, Maria Theresa of Swartz, who died on the 26th January 1784. Two incisions were seen on her body: the longitudinal incision extends from the manubrium sterni to the symphysis, the second one is perpendicular to it, and connects the two hip paddles. The wound edges were later sutured, and the suture was partially retained. Since there was no sign of any other opening in the body, the autopsy was apparently aimed at finding out the cause of death and was limited to the area of the suspected disease. Rapid miliary tuberculosis and extrapulmonary bone tuberculosis must have contributed to the child's death; this was demonstrated by radiological examinations and confirmed by paleomicrobiological examination (residues of Mycobacterium tuberculosis detected in pulmonary and extrapulmonary samples as well). Another hypothesis is that appendicitis might have caused the death of a child with advanced tuberculosis. In the case of appendicitis, the intestinal function may stop. Suspected abdominal complaints may also have been caused by extrapulmonary gastrointestinal tuberculosis.