DOCSLIB.ORG

The Fibular Collateral Ligament-Biceps Femoris Bursa an Anatomic Study* Robert F

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Fibular Collateral Ligament-Biceps Femoris Bursa an Anatomic Study* Robert F The Fibular Collateral Ligament-Biceps Femoris Bursa An Anatomic Study* Robert F. LaPrade,† MD, and Christopher D. Hamilton, MD From the Division of Sports Medicine, Knee & Shoulder Surgery, Department of Orthopaedics and Rehabilitation, The University of Texas Medical Branch, Galveston, Texas ABSTRACT fibular collateral ligament but without defining the anatomy of this bursa. The anatomy of the fibular collateral ligament-biceps In the course of a series of dissections to identify the femoris bursa is described. The bursa is located lateral anatomy and surgical approach of the posterolateral to the distal of the fibular collateral quarter ligament knee, 13 a bursa was consistently identified medial to the and forms an inverted "J" around the anterior shape anterior arm of the long head of the biceps femoris muscle and anteromedial of the Its most portions ligament. as it crossed the fibular collateral ligament. The purpose distal is to the fibular head where margin just proximal of this study was to identify the prevalence and anatomic the fibular collateral ligament inserts, and its more size of the fibular collateral ligament-biceps femoris proximal aspect is at the superior edge of the anterior bursa, and to describe its relationship to the surrounding arm of the long head of the biceps femoris muscle. We structures. found this structure in all 50 knees dissected; there was a constant anatomic location of the fibular collat- eral ligament-biceps femoris bursa in all specimens. Measurement of the anatomic dimensions of the bursa MATERIALS AND METHODS revealed a mean width of 8.4 mm and a mean height of We made thorough dissections of the lateral aspect of the 18 mm. the and Knowing prevalence, shape, size, knee in 50 cadaveric knees. No paired specimens were anatomic location of this bursa aid the clinician in may used. There were 25 right and 25 left knees from 27 male the differential of lateral knee diagnosis pain. and 23 female cadavers. The average age of the donors was 73.7 years. After the skin and subcutaneous tissues of the lateral aspect of the knee were carefully dissected the iliotibial band was incised in line A number of authors have described bursae around the away, longitudinally with its fibers and retracted both anteriorly and posteri- knee that have clinical significance, including bursae on to the more of the fibular the medial side of the knee around the tibial collateral orly expose superior aspect collateral and the lateral aponeurotic attach- ligament 1, 3, 5,14; but descriptions of a bursa around the ligament ments of the long and short heads of the biceps femoris fibular collateral ligament are rare. Although the presence muscle. 8,10 Once the fibular collateral ligament was iden- of a bursa in this region is acknowledged, the location of the iliotibial band was transected and re- this bursa is not agreed on. 8,10 Furthermore, no descrip- tified, axially tracted both and so that the attach- tion of the size, shape, prevalence, or exact location of such proximally distally ment of the fibular collateral on the femur could a bursa has been provided. Others have reported on sev- ligament be identified. Dissection of the lateral of the eral cases of bursitis in the region of the fibular head and aponeurosis long head of the biceps femoris muscle from the lateral and posterior aspect of the fibular collateral ligament was then performed for better identification of the margins of * Presented at the Second World Congress of Sports Trauma, Orlando, the fibular collateral At this the Flonda, June 1996 ligament. point, proximal t Address correspondence and reprint requests to Robert F LaPrade, MD, three-fourths of the fibular collateral ligament was ex- Department of Orthopaedic Surgery, University of Minnesota, 420 Delaware posed. The more distal portion of the fibular collateral Street SE, Box 492 UMHC, Mmneapohs, MN 55455 was covered arm No author or related institution has received financial benefit from research ligament by the anterior of the long head in this study of the biceps femoris muscle. Downloaded from ajs.sagepub.com at NORTHWESTERN439 UNIV LIBRARY on March 4, 2010 440 We identified the fibular collateral ligament-biceps fem- oris bursa by means of a coronal incision between the anterior arm of the long head of the biceps femoris muscle and its lateral aponeurosis. This incision allowed access to the most superior aspect of the bursa. The interval be- tween the anterior arm and the direct arm attachment of the long head of the biceps femoris muscle was then iden- tified and developed further by a splitting incision be- tween these two structures in the sagittal plane proximal to the bursa. Thus, the anterior arm was dissected sharply away from the direct arm, the main tendinous unit of the long head of the biceps femoris muscle that inserts on the posterolateral aspect of the fibular head just lateral to the fibular styloid. 12 We divided the anterior arm of the biceps approximately 5 cm proximal to the fibular head to sepa- rate it from the main tendinous substance of the long head of the biceps femoris muscle, and the anterior arm of the biceps was then retracted distally. This allowed for iden- tification of the dimensions of the fibular collateral liga- ment-biceps femoris bursa as it lay deep to the anterior arm of the long head of the biceps femoris muscle and superficial to the fibular collateral ligament (Figs. 1 and 2). The attachment of the fibular collateral ligament on the lateral aspect of the fibular head could also be identi- fied at this point. We recorded measurements for each specimen. The fol- lowing dimensions were recorded: total length of the fib- ular collateral ligament (in millimeters); the width be- tween the posterior aspect of the bursa to the posterior aspect of the fibular collateral ligament at the top, middle, and inferior aspect of the bursa (in millimeters); the width between the anterior aspect of the bursa to the anterior aspect of the fibular collateral ligament at the top, middle, and inferior aspect of the bursa (in millimeters); the width of the bursa at its midportion (in millimeters); the total 1. The fibular collateral femoris circumferential coverage of the bursa around the fibular Figure ligament-biceps bursa. of the fibular collateral collateral ligament (in degrees); and the width of the fib- A, photograph ligament-biceps femons bursa. The anterior arm of the head of the ular collateral at its aspect, middle, and long ligament superior femoris muscle is and retracted. The at the middle of the bursa (in millimeters). biceps split coronally probe is located (in the bursa) anteromedially to the fibular For the histologic portion of the study, we prepared collateral ligament. B, the fibular collateral ligament (FCL)- blocks of tissue from the lateral aspect of two knees. We biceps femons bursa and its relationship to adjacent ana- examined a tissue block the at- initially involving bony tomic structures of the lateral knee. tachments of the fibular collateral ligament on the femur and on the fibular head, as well as the overlying biceps expansion. Extraneous tissue was then dissected free. An- tal-most portion of the biceps bursa. Supplemental sec- atomic landmarks and measurements paralleling those in tions were obtained in other orientations. the cadaveric portion of the study were present in all sectioned for and specimens processed histologic staining RESULTS were marked for future identification. We placed these specimens into tissue containers. They were subsequently We identified a sizable fibular collateral ligament-biceps dehydrated and embedded in paraffin blocks. We prepared femoris bursa in all 50 specimens. In all specimens, the thin sections using a microtome and evaluated the histo- fibular collateral ligament-biceps femoris bursa was lo- logic details by standard hematoxylin and eosin staining cated laterally and anterior-anteromedially to the distal procedures. Transverse sections were initially performed aspect of the fibular collateral ligament, just proximal to at the superior-most portion of the biceps bursa. Under the insertion of the fibular collateral ligament onto the gross examination, the fibular collateral ligament, ante- lateral aspect of the fibular head. In all cases, the lateral rior arm of the biceps tendon, biceps bursa, and inferior wall of the fibular collateral ligament-biceps femoris bursa lateral geniculate artery could all be identified within abutted the anterior arm of the long head of the biceps each tissue specimen. We also took sections from the dis- femoris muscle where it crossed the fibular collateral lig- Downloaded from ajs.sagepub.com at NORTHWESTERN UNIV LIBRARY on March 4, 2010 441 The average length of the fibular collateral ligament- biceps femoris bursa measured 18 mm (Table 1). The average length of the fibular collateral ligament from its most proximal origin to its most distal insertion was 71 mm. Therefore, the fibular collateral ligament-biceps fem- oris bursa covered the distal quarter of the fibular collat- eral ligament. The average width of the bursa at its mid- portion was 8.4 mm, with an average of 2.0 mm extending anterior to the fibular collateral ligament, and an average of 2.3 mm extending posteriorly. The anterior extension was more consistently present among specimens (range, 1 to 5 mm) and was part of a pocket that formed anterior to the fibular collateral ligament. The posterior width of the bursa was more variable (range, 2 to 15 mm). The poste- rior aspect of the bursa did not appear to form a pocket around the fibular collateral ligament; the medial aspect of the anterior arm of the biceps tendon usually attached directly to the posterior border of the fibular collateral ligament. Histologic Examination Figure 3A is a photomicrograph ( x 60) of a hematoxylin and eosin preparation.
Load more

Recommended publications
  • Anatomy of the Dog the Present Volume of Anatomy of the Dog Is Based on the 8Th Edition of the Highly Successful German Text-Atlas of Canine Anatomy
    Klaus-Dieter Budras · Patrick H. McCarthy · Wolfgang Fricke · Renate Richter Anatomy of the Dog The present volume of Anatomy of the Dog is based on the 8th edition of the highly successful German text-atlas of canine anatomy. Anatomy of the Dog – Fully illustrated with color line diagrams, including unique three-dimensional cross-sectional anatomy, together with radiographs and ultrasound scans – Includes topographic and surface anatomy – Tabular appendices of relational and functional anatomy “A region with which I was very familiar from a surgical standpoint thus became more comprehensible. […] Showing the clinical rele- vance of anatomy in such a way is a powerful tool for stimulating students’ interest. […] In addition to putting anatomical structures into clinical perspective, the text provides a brief but effective guide to dissection.” vet vet The Veterinary Record “The present book-atlas offers the students clear illustrative mate- rial and at the same time an abbreviated textbook for anatomical study and for clinical coordinated study of applied anatomy. Therefore, it provides students with an excellent working know- ledge and understanding of the anatomy of the dog. Beyond this the illustrated text will help in reviewing and in the preparation for examinations. For the practising veterinarians, the book-atlas remains a current quick source of reference for anatomical infor- mation on the dog at the preclinical, diagnostic, clinical and surgical levels.” Acta Veterinaria Hungarica with Aaron Horowitz and Rolf Berg Budras (ed.) Budras ISBN 978-3-89993-018-4 9 783899 9301 84 Fifth, revised edition Klaus-Dieter Budras · Patrick H. McCarthy · Wolfgang Fricke · Renate Richter Anatomy of the Dog The present volume of Anatomy of the Dog is based on the 8th edition of the highly successful German text-atlas of canine anatomy.
    [Show full text]
  • A Case of Septic Arthritis of the Shoulder Joint That Developed After Suprascapular Nerve Block
    Open Journal of Orthopedics, 2020, 10, 25-32 https://www.scirp.org/journal/ojo ISSN Online: 2164-3016 ISSN Print: 2164-3008 A Case of Septic Arthritis of the Shoulder Joint That Developed after Suprascapular Nerve Block Taihei Go1, Toshiyuki Tsutsui2*, Yasuaki Iida3, Katsunori Fukutake1, Ryoichi Fukano3, Kosei Ishigaki4, Masayuki Sekiguchi1, Hiroshi Takahashi1 1Department of Orthopedics, Toho University, Tokyo, Japan 2Department of Orthopedics, Sagamihara Chuo Hospital, Kanagawa, Japan 3Department of Orthopedics, Omori Red Cross Hospital, Tokyo, Japan 4Department of Orthopedics, Japan Community Health Care Organization Tokyo Kamata Medical Center, Tokyo, Japan How to cite this paper: Go, T., Tsutsui, T., Abstract Iida, Y., Fukutake, K., Fukano, R., Ishigaki, K., Sekiguchi, M. and Takahashi, H. (2020) Septic arthritis of the shoulder is uncommon in the immunocompetent pa- A Case of Septic Arthritis of the Shoulder tient with no previous risk factors for joint infection. We treated an immu- Joint That Developed after Suprascapular nocompetent patient who developed septic arthritis of the shoulder after su- Nerve Block. Open Journal of Orthopedics, 10, 25-32. prascapular nerve block for pain due to rotator cuff tear. An 80-year-old man https://doi.org/10.4236/ojo.2020.102005 with no underlying disease visited a nearby orthopedics clinic with complaint of left shoulder joint pain. Left suprascapular nerve block was performed, but Received: November 30, 2019 Accepted: January 19, 2020 the pain gradually aggravated. On the day after the block, he had a fever of Published: January 22, 2020 39˚C and came to our department. On examination, enlargement and ten- derness were present at the injection site.
    [Show full text]
  • Anatomy and Physiology of the Human Knee Joint
    Curriculum Units by Fellows of the Yale-New Haven Teachers Institute 1985 Volume VII: Skeletal Materials- Biomineralization Anatomy and Physiology of the Human Knee Joint Curriculum Unit 85.07.06 by Mara A. Dunleavy Introduction This unit takes an indepth look at a very complex part of the human anatomy, the knee joint. There are numerous structures that are found in this joint, classified as a diarthrodial or synovial joint. Study of this area must include a review of the skeletal and muscular systems in order to see how they interact under normal use. Some knee injuries and the pathologies will be considered. The objectives of this unit are: 1. to introduce the student to the skeletal system with emphasis on the lower extremity; 2. to explain the chemical make-up of bone and the process of ossification; 3. to differentiate between the types of joints in the human body; 4. to introduce the student to the muscular system, with emphasis on those muscle groups of the leg; 5. to describe other structures that are essential for normal movement of this diarthrodial joint, including ligaments, tendons, cartilage and bursa; 6. to explain, demonstrate, and illustrate the coordination of the different systems and each of their specializations; 7. to describe some knee injuries and the pathologies. The outline of the unit is divided into the following five parts: I. Bone, as a tissue Curriculum Unit 85.07.06 1 of 15 a. Histology of bone b. Other tissues related to bones as organs II. Skeleton, bones as organs or structures a.
    [Show full text]
  • Anatomy First Stage
    ANATOMY FIRST STAGE Myology Myology: Is the science deal with study of the description of muscles in the body including tendon, apenurosis, and accessory structures like fascia, synovial bursa, and synovial sheath of the tendon. Note 1-The muscle tissue consist of elongated cells called fibers 2-The sytoplasm of muscle cells called sarcoplasm 3-The cell membrane of muscle cells called sarcolemma 4-The sarcoplasm contains numerous myofibrils which contain two types of contractil protein filaments termed actin and myosin Function of the muscles 1-Assist the movement of articulated bones 2-Ability of excitation (contraction and relaxation)of viscera ,blood vessels and iris of eye. 3-Accept the body its architecture and shape . 4-Act as energy stories (glycogen within muscles). 5-Act as protection and fixation of viscera. 6-Responsible of heart movement . Types of muscle: There are 3 types of muscle in the body 1-Skeletal muscle:the skeletal muscle characterized by 1- Striated muscle fiber 2-Generally attached to bone 3-Usually under voluntary control 4-Consist of numbers of muscular bundles which surrounded by fibrous sheath 5- The muscle fiber have multinuclei located peripherally 6- The skeletal muscle fiber cylindrical in shape and extend along entire length of muscle. Note :- Skeletal muscles are usually arranged in pairs so that they oppose each other (they are "antagonists"), one flexing the joint (a flexor muscle) and the other extending it (extensor muscle). ANATOMY FIRST STAGE 2-Cardiac muscle The cardiac muscle like skeletal muscle but differ from it as follow 1- The cardiac muscle fiber is shorter than skeletal muscle fiber 2- They are branched muscle 3- The have certain structures termed intercalated discs ,(the cardiac muscle fiber is restricted between each two intercalated discs.
    [Show full text]
  • Chapter 14: the Musculoskeletal System
    The musculoskeletal system 14 Introduction – Challenges of lameness and gait abnormalities 14.1 Lameness examination and diagnostic techniques 14.2 Hoof anatomy and conformation 14.3 Trimming and shoeing 14.4 Conditions affecting the hoof 14.5 Conditions affecting the bones 14.6 Conditions affecting the joints 14.7 Conditions affecting the tendons and ligaments 14.8 Conditions affecting the muscles 14.9 Conditions affecting the synovial bursae 14.10 Case study – Malignant oedema 14.11 References 14.12 351 Introduction – Challenges of lameness and gait 14.1 abnormalities The musculoskeletal system consists of structures which move the body or maintain its form: muscles, tendons, ligaments, bones and joints. Lameness/gait abnormalities are perhaps the most common presenting sign to working equine veterinarians. Data from the welfare assessment of 4,903 working equids (Pritchard et al. 2005) suggest that over 99% of animals surveyed show gait abnormalities. Lameness can be very frustrating to treat, especially as many cases are chronic and may have many contributing factors (Broster et al. 2009). Long-term rest is often the most effective treatment but this is usually impractical for the owners of working equids. Golden Rule 1 Basic knowledge of anatomy is essential for a confident diagnosis. Golden Rule 2 Think holistically: ‘management’ rather than ‘treatment’. Golden Rule 3 The direct cause may be difficult to identify. 1. Think about which structures are under the skin in the affected area. 2. Think about what could be happening to those structures and why: Acute or chronic? Bone, joint, tendon, ligament or muscle? Infected or sterile? Single or multiple limbs? 3.
    [Show full text]
  • Clinical Manifestations of Synovial Cysts
    THE VESTERN Jourx.4 of Medicine Refer to: Burt TB, MacCarter DK, Gelman MI, et al: Clinical manifestations of synovial cysts. West J Med 133:99-104, Aug 1980 Clinical Manifestations of Synovial Cysts TODD B. BURT, MD; DARYL K. MacCARTER, MD; MARTIN 1. GELMAN, MD, and CECIL 0. SAMUELSON, MD, Salt Lake City Although synovial cysts are most commonly associated with rhaumatoid arthritis and osteoarthritis, they may occur in many other conditions. The clinical manifestations of these cysts are numerous and may result from pressure, dissection or acute rupture. Vascular phenomena occur when pop- liteal cysts compress vessels, and result in venous stasis with subsequent lower extremity edema or thrombophlebitis. Rarely, popliteal cysts may cause arterial compromise with intermittent claudication. Neurological sequelae in- clude pain, paresthesia, sensory loss, and muscle weakness or atrophy. When synovial cysts occur as mass lesions they may mimic popliteal aneurysms or hematomas, adenopathy, tumors or even inguinal hernias. Cutaneous joint fistulas, septic arthritis or osteomyelitis, and spinal cord and bladder compres- sion are examples of other infrequent complications. Awareness of the heter- ogeneous manifestations of synovial cysts may enable clinicians to avoid unnecessary diagnostic studies and delay in appropriate management. Ar- thrography remains the definitive diagnostic procedure of choice, although ultrasound testing may be useful. SYNOVIAL CYSTS are fluid-filled spaces lined by in 1877, resulting in the common eponym Baker synovial membrane and arise from diarthrodial cysts, for popliteal cysts.2 Subsequently, synovial joints, bursae and tendon sheaths. The first pub- cysts have been described in numerous locations lished report of a synovial cyst was made by although the knees, shoulders and wrists remain Adams, an Irish surgeon, in 1840.1 He described the most frequently involved areas.
    [Show full text]
  • Localized Pigmented Villonodular Synovitis of the Shoulder, Acta Med Port 2013 Jul-Aug;26(4):459-462
    Madruga Dias J, et al. Localized pigmented villonodular synovitis of the shoulder, Acta Med Port 2013 Jul-Aug;26(4):459-462 Joint Bone Spine. 2013;80:146–54. Emerg Med. 2012 (in press). 12. Citak M, Backhaus M, Tilkorn DJ, Meindl R, Muhr G, Fehmer T. Necrotiz- 14. Young MH, Aronoff DM, Engleberg NC. Necrotizing fasciitis: pathogen- ing fasciitis in patients with spinal cord injury: An analysis of 25 patients. esis and treatment. Expert Rev Anti Infect Ther. 2005;3:279–94. Spine. 2011;36:E1225-9. 15. Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F. Necrotizing 13. Wilson MP, Schneir AB. A Case of Necrotizing Fasciitis with a LRINEC fasciitis: classification, diagnosis, and management. J Trauma Acute Score of Zero: Clinical Suspicion Should Trump Scoring Systems. J Care Surg. 2012;72:560–6. CASO CLÍNICO Localized Pigmented Villonodular Synovitis of the Shoulder: a Rare Presentation of an Uncommon Pathology Sinovite Vilonodular Pigmentada Circunscrita do Ombro: uma Apresentação Rara de uma Patologia Incomum João MADRUGA DIAS1, Maria Manuela COSTA1, Artur DUARTE2, José A. PEREIRA da SILVA1 Acta Med Port 2013 Jul-Aug;26(4):459-462 ABSTRACT Pigmented Vilonodular Synovitis is a rare clinical entity characterized as a synovial membrane benign tumour, despite possible aggres- sive presentation with articular destruction. The localized variant is four times less frequent and the shoulder involvement is uncommon. We present the case of a Caucasian 59 year-old patient, who presented with left shoulder pain, of uncharacteristic quality, with local swelling and marked functional limitation of 1 month duration. Shoulder ultrasonography showed subacromial bursitis.
    [Show full text]
  • Flexor Digitorum Superficialis and Flexor Digitorum Profundus with Separated Sheaths, a New Normal Variation in Human
    Esmaeilnejad-Ganji SM/et al/Colombia Médica - Vol. 46 Nº4 2015 (Oct-Dec) Colombia Médica colombiamedica.univalle.edu.co Case Report Flexor Digitorum Superficialis and Flexor Digitorum Profundus with separated sheaths, a new normal variation in human Flexor superficial de la y Flexor profundo de los con vainas separadas, una nueva variación normal en humanos Seyed Mokhtar Esmaeilnejad-Ganji, Behnam Baghianimoghadam Department of Orthopedic Surgery, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran Esmaeilnejad-Ganji SM, Baghianimoghadam B. Flexor Digitorum Superficialis and Flexor Digitorum Profundus with separated sheaths, a new normal variation in human. Colomb Med (Cali). 2015; 46(4): 199-201 © 2015. Universidad del Valle. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Article history: Abstract Resumen Received: 31 October 2014 Case description: A 25 years old man presented with a laceration on Descripción del caso: Se presentó un hombre de 25 años con una Revised: 23 September 2015 radial side of proximal phalanx of 4th finger (zone II flexor) which was laceración en la parte radial de la falange proximal del cuarto dedo de la Accepted: 01 December 2015 due to cut with glass. mano (zona flexor II) causada por el corte con un vidrio. Clinical findings: The sheaths of Tendons of flexor digitorum Hallazgos clínicos: Las cubiertas de los tendones del flexor digitorum Keywords: sperficialis and profundus were not the same and each tendon had a sperficialis y profundus estaban separadas en diferentes cubiertas.
    [Show full text]
  • Alekzs02.Pdf
    cingulum Upper limb • S Stylopodium - 1 bone Zeugopodium - 2 bones Autopodium - distal part Shoulder (pectoral) girdle 2 • Klíček 4 1 • Lopatka 3 • PH 5 1 StC 2 1 2 AC 3 GH 4 3 4 SuA 5 TSc junction 5 1 Articulatio sternoclavicularis 2 Articulatio acromioclavicularis 9 2 discus 1 4 6a 6b 3 5 10 7 8 3- lig. interclaviculare 4-lig. sternoclaviculare 5-lig costoclaviculare 6-lig. coracoclaviculare a) lig. trapezoideum b) lig. conoideum 7-lig. coracoacromiale (fornix humeri) 8-lig. coracohumerale 9- lig. acromioclaviculare 10 – lig. transversum scapulae Articulatio acromioclavicularis C-C C-A C-H Scapula movements (Movements in thoracoscapular junction) with movements in StC Th3 and AC joint retraction protraction Th7 elevation depression rotation midposition – palm on the neck Ligamentum coracoclaviculare the strongest stabilizer of the AC joint. conoid trapezoid Long head BiBr Labrum glenoidale Glenoid lip Long headTriBr Superior aspect of the acromioclavicular joint 1 P L 1 M Lig. transversum Fornix humeri scapulae superius A X-ray https://www.auntminnie.com/index.aspx?sec=olce&sub=cotx&pag=cpages&ce_id=11221&pno=1 X-ray 1 2 3 7 5 6 4 1- extremitas acromialis 2-acromion 3-greater turebcle 4-lesser tubercle 5-caput humeri 6-cavitas glenoidalis 7-coracoid process Synovial joint description • 1) type and shape of joint General schema of synovial joint • 2) articular surfaces • 3) joint capsule attachment • 4) joint capsule reinforcement – ligaments, muscles • 5) range of movements • 6) midposition • 7) scheme 1-ball (head) 2- collateral ligament 3-fibrous capsule 4-synovial capsule 5- articular cartilage (hyaline) 6-articular lip (labrum 7-socket (fossa) 8- muscle with tendon 9-ligament 10-synovial bursa communicating with the joint cavity 11-menisc 12-synovial bursa (subtendinea) Art.
    [Show full text]
  • Supplementary Appendix D: Literature Search Strategy Details
    Supplementary Appendix D: Literature Search Strategy Details Database: Ovid MEDLINE(R) In‐Process & Other Non‐Indexed Citations and Ovid MEDLINE(R) <1948 to Present> Search Strategy: ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ 1 exp Arthritis, Infectious/us [Ultrasonography] 2 arthritis, psoriatic/us [Ultrasonography] 3 exp arthritis, rheumatoid/us [Ultrasonography] 4 exp osteoarthritis/us [Ultrasonography] 5 Chondrocalcinosis/us [Ultrasonography] 6 exp gout/us [Ultrasonography] 7 periarthritis/us [Ultrasonography] 8 sacroiliitis/us [Ultrasonography] 9 exp spondylarthritis/us [Ultrasonography] 10 exp Lupus Erythematosus, Systemic/us [Ultrasonography] 11 exp arthritis/ and exp inflammatory bowel diseases/us [Ultrasonography] 12 exp arthritis/us and exp inflammatory bowel diseases/ 13 exp Ankylosis/us [Ultrasonography] 14 exp Arthralgia/us [Ultrasonography] 15 Arthropathy, Neurogenic/us [Ultrasonography] 16 exp Bursitis/us [Ultrasonography] 17 Chondromatosis, Synovial/us [Ultrasonography] 18 Hydrarthrosis/us [Ultrasonography] 19 Joint Loose Bodies/us [Ultrasonography] 20 Metatarsalgia/us [Ultrasonography] 21 Shoulder Impingement Syndrome/us [Ultrasonography] 22 exp Synovitis/us [Ultrasonography] 23 exp Temporomandibular Joint Disorders/us [Ultrasonography] 24 Fibromyalgia/us [Ultrasonography] 25 Arthropathy, Neurogenic/us [Ultrasonography] 26 exp Compartment Syndromes/us [Ultrasonography] 27 Polymyalgia Rheumatica/us [Ultrasonography] 28 exp tendinopathy/us 29 Tennis Elbow/us [Ultrasonography] 30 Carpal
    [Show full text]
  • Differential Diagnosis for the Lower Extremity
    Differential diagnosis for the Lower extremity Greg Bellisari MD Introduction • Hip • Knee • Leg • Ankle • Foot • Hope you had tons of coffee, only 128 more slides to go!! Sports and hip injuries • Hip and pelvis subjected to substantial forces. – Up to 8 x body weight • Adult: 5 - 6% of athletic injuries. • Pediatric: 10 - 24% of athletic injuries. • High risk sports: Ballet, Running, Soccer, Contact sports. Introduction Hip & Groin Pain • One of the most difficult problems to diagnose and treat in sports. • Symptoms are often indistinct, poorly localized. • Early and accurate diagnosis is essential: – Rehab times prolonged – May result in chronic, disabling pain “Hip” Pain • Patients may present with chief complaint of “hip” pain, but it may not actually be coming from their hip – Intrarticular hip – Extrarticular hip – Lumbar spin – Sacroiliac joint – Other - Intra-abdominal, hernia, GI, GU History • Knee pain – Can be the initial complaint of hip pathology – Not uncommon for a patient with hip arthritis to present with knee pain – Differentiate with exam, X-rays, injections Initial evaluation • Hip pain – History • Where, how long, trauma, always aware, mechanical, radicular, what aggravates – Joint vs not joint • Joint: FAI, dysplasia, OA, AVN • Not Joint: Gluteal, back, hernia, hamstring, butt History • Absence of groin pain does not preclude an intraarticular hip injury • Testicular pain does not come from the hip Differential Diagnosis Hip & Groin Pain ADULT PEDIATRIC • Stress fractures • Avulsion fracture • Osteitis pubis • ASIS
    [Show full text]
  • Iliopsoas Bursitis—An Unusual Presentation of Metastatic Bone Disease P
    British Journal of Rheumatology 1996;35:285-288 CASE REPORT ILIOPSOAS BURSITIS—AN UNUSUAL PRESENTATION OF METASTATIC BONE DISEASE P. A. C. BYRNE, J. I. S. REES* and B. D. WILLIAMS Department of Rheumatology & * Radiology, University Hospital of Wales, Heath Park, Cardiff SUMMARY Diagnostic uncertainty concerning the nature of an enlarging inguinal mass in an elderly male with a short history of hip pain Downloaded from https://academic.oup.com/rheumatology/article/35/3/285/1782511 by guest on 29 September 2021 was resolved by a combination of ultrasound and magnetic resonance imaging (MRI). Subsequent investigations showed that the enlarged iliopsoas bursa, which contained a number of atypical cells, was an unusual presenting feature of a destructive metastatic lesion in the right hip. KEY WORDS: Iliopsoas bursitis, Neoplasm, Metastatic carcinomatous arthritis. POINTS of potential friction between ligaments and the arthritis. Clubbing, lymphadenopathy, and signs of anaemia skin overlying bony prominences are often protected and liver disease were all absent. A firm clinical diagnosis was by lubricating bursae. The iliopsoas bursa lies lateral to not made at this time. the femoral vessels in a position between the capsule of An ultrasound scan of the mass revealed a complex elongated structure closely related to the right hip joint. It the hip joint and the iliopsoas muscles. A variety of was mostly cystic in nature, but contained some echogenic inflammatory and degenerative diseases of the hip joint elements with no flow on Doppler to suggest an aneurysm can produce weakening of the capsule anteriorly, (Fig. 1). An effusion within the hip joint could not be thereby allowing communication between the joint space and the adjacent iliopsoas bursa.
    [Show full text]