PURPOSE OF THE STUDY: Os vesalianum pedis (OVP) is a rare accessory bone of the foot located at the base of the fifth metatarsal bone. It is usually asymptomatic and incidentally seen on radiographs. When symptomatic, it manifests itself with lateral foot pain. OVP, which can become symptomatic as a result of traumatic injuries, can also be confused with fracture. The aim of this study is to determine the prevalence and morphometric characteristics of OVP in the Turkish population. MATERIAL AND METHODS: Radiographic images of 5268 individuals aged 16 years and older (mean 39.65±17.21) who completed ossification of the fifth metatarsal bone were evaluated for OVP. Of the cases included in the study, 44.8% were female and 55.2% were male. The general and sex-based prevalence of OVP was calculated, and morphometric measurements were done. RESULTS: OVP prevalence in the Turkish population was found to be 0.15% regardless of sex. OVP prevalence was calculated to be 0.24% in men and 0.04% in women. CONCLUSIONS: Anatomy, radiology, orthopedics and emergency medicine physicians are frequently encountered with foot disorders in clinical and educational practices. It is important to keep in mind the rare presence of OVP (0.15%), in the preliminary diagnosis. KEY WORDS: os vesalianum pedis, accessory ossicle, foot, radiography.
- MeSH
- Adult MeSH
- Clinical Relevance MeSH
- Middle Aged MeSH
- Humans MeSH
- Metatarsal Bones * diagnostic imaging abnormalities MeSH
- Adolescent MeSH
- Young Adult MeSH
- Prevalence MeSH
- Radiography methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Turkey MeSH
Several accessory bones can be found around the wrist, which may pose a diagnostic challenge. Hereby, we report a unique case of a traumatic fracture of an aberrant os styloideum in a 66-year-old male. The patient presented with a swollen dominant right hand and a hematoma on its anterior and posterior aspects, as a result of a fall on an outstretched hand. The diagnosis was based on a CT scan, which showed a fractured accessory bone between the distal portion of the capitate bone and the base of the third metacarpus. Due to its typical location, the ossicle was identified as os styloideum. The patient was treated conservatively and the symptoms subsided on a short forearm cast after 2 weeks. At a 12-month follow-up, no other episodes were declared. Strong anatomical knowledge and sharing of such cases is essential for proper diagnosis and treatment of this very rare condition.
- MeSH
- Fractures, Bone * MeSH
- Carpal Bones * MeSH
- Humans MeSH
- Tomography, X-Ray Computed MeSH
- Aged MeSH
- Accidental Falls MeSH
- Wrist Joint MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
PURPOSE: The accessory bones around the elbow are very rare variant structures, present in approximately 0.7% of cases. They can cause diagnostic problems and can be mistaken for pathological structures, especially when pain and limitation of elbow movements are present and a trauma can be traced in the patient's history. They are of different nature, either presenting within muscle tendons as sesamoids (brachialis and triceps brachii muscles) or presenting intra-articularly probably as separated or accessory ossification centres. The least common is the os supratrochleare anterius. METHODS: We present a case of a young male, featuring chronic blocking and 20° limited flexion of his right elbow, which bothered him during his occupation as a locksmith. In history, he suffered minor trauma to the elbow 20 years ago. X-ray and CT showed a large ossicle in the coronoid fossa of the humerus. RESULTS: The ossicle was surgically extracted in small pieces. The patient left satisfied with no mention of complaints. CONCLUSION: The os supratrochleare anterius is a very rare accessory bone of the elbow, located in the coronoid fossa of the humerus which can mimic many pathological states, and limit movements and causing pain around the elbow.
- MeSH
- Anatomic Variation MeSH
- Adult MeSH
- Humerus abnormalities diagnostic imaging MeSH
- Humans MeSH
- Elbow Joint * MeSH
- Tomography, X-Ray Computed MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Review MeSH
There are many osseous variants that occur around the elbow joint such as supracondylar process, supratrochlear foramen, accessory ossicles, and others. Scientific databases were searched for variants around the elbow joint. Elbow radiographs from our center demonstrating some of these findings were included in the study. The aim of the present review was to provide comprehensive information on the terminology, prevalence, history, etiology, and clinical importance of these variants. These anatomical variants are important for radiologists while interpreting radiographs, computed tomography, and magnetic resonance imaging for trauma and orthopedic surgeons during osteosynthesis at the distal humerus, proximal ulna, and radius.
PURPOSE: Cubital tunnel syndrome is a well-described entity with many reported etiologies and anatomical compression sites. Accessory ossicles of either traumatic or congenital origin might occur around the elbow joint. Only one case reporting such ossicles compressing the ulnar nerve exists in previous literature. We aim to present this entity with a detailed description of the patient history and treatment. CASE REPORT: We report a case of 30-year-old female presenting with classical signs of cubital tunnel syndrome-positive Wartenberg's and Froment's signs, hypoesthesia in the fourth and fifth finger with decreased finger duction strength but without gross hypotrophy of interosseous and hypothenar muscles. Tinel's sign was positive over the ulnar sulcus and an accessory ossicle was found on the elbow radiograph within the ulnar sulcus. The first signs of calcification in this patient were reported 6 years prior in a follow-up after the dislocation of her elbow joint following a bike accident. The EMG confirmed ulnar nerve neuropathy in the elbow area. The ossicle was extirpated, the ulnar nerve was decompressed in the ulnar sulcus in a standard manner and the symptoms quickly resolved. The patient has been regularly visiting our outpatient clinic for the next 12 years without any complaints considering her elbow and the ulnar nerve. CONCLUSION: This is a rare case of cubital tunnel syndrome caused by an accessory ossicle of traumatic origin. Simple bone extirpation with ulnar nerve release followed by anterior subcutaneous transposition is the recommended method of treatment. No report of congenital accessory bones causing ulnar nerve compression in the elbow exists in the literature.
- MeSH
- Adult MeSH
- Ossification, Heterotopic * diagnosis diagnostic imaging MeSH
- Humans MeSH
- Elbow MeSH
- Elbow Joint * physiology MeSH
- Ulnar Nerve MeSH
- Cubital Tunnel Syndrome * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
BACKGROUND: Mild to moderate hearing loss is common in patients with mucopolysaccharidosis (MPS) IVA. The hearing loss can be conductive, sensorineural, or mixed. However, in these patients, the mixed form is frequent, attributed to the combination of conductive and neurosensory elements, with slowly progressive evolution. Conductive hearing loss may be secondary to recurrent upper respiratory tract infections, serous otitis media, and deformities of the ear ossicles due to the accumulation of glycosaminoglycans (GAGs). Meanwhile, the sensorineural form is mainly attributed to the accumulation of GAGs in the auditory system. OBJECTIVE: The aim of this scoping review is to understand the extent and type of evidence in relation to the physiopathology, classification, epidemiology, and clinical management of hearing loss and the effect of therapy for hearing loss in patients with MPS IVA. METHODS: This scoping review includes participants across all genders and of no particular age group who are diagnosed with MPS IVA and develop hearing loss as a comorbidity. No exclusion criteria (country, language, or document type) will be applicable. The information sources will include experimental and quasi-experimental, analytical observational, observational, and qualitative studies. Unpublished literature will not be covered. Grey literature will be covered. A total of 2 independent reviewers will participate in the process of screening the literature, paper selection, and data extraction, and this process will be performed blindly. When all manuscripts have been selected, disagreements that arise between the 2 reviewers at each stage of the selection process will be resolved through discussion or with an additional reviewer. Results will be reported with descriptive statistics and information will be displayed in a diagrammatic or tabular manner, as explained in the JBI guidelines. RESULTS: The literature search was performed in November 2021 in MEDLINE, LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde), the Cochrane Library, ScienceDirect, Google Scholar, and OpenGrey; a total of 780 results were retrieved. Completion of the review is expected in mid-2022. CONCLUSIONS: This scoping review will be the first to describe the extent of the information regarding the development of hearing loss in the MPS IVA population. The data gathered by this review may lead to an understanding of the grade of hearing loss in this population and allow for the assessment of possible interventions according to the disease pattern. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/32986.
- Publication type
- Journal Article MeSH
Meckel's cartilage was first described by the German anatomist Johann Friedrich Meckel the Younger in 1820 from his analysis of human embryos. Two hundred years after its discovery this paper follows the development and largely transient nature of the mammalian Meckel's cartilage, and its role in jaw development. Meckel's cartilage acts as a jaw support during early development, and a template for the later forming jaw bones. In mammals, its anterior domain links the two arms of the dentary together at the symphysis while the posterior domain ossifies to form two of the three ear ossicles of the middle ear. In between, Meckel's cartilage transforms to a ligament or disappears, subsumed by the growing dentary bone. Several human syndromes have been linked, directly or indirectly, to abnormal Meckel's cartilage formation. Herein, the evolution, development and fate of the cartilage and its impact on jaw development is mapped. The review focuses on developmental and cellular processes that shed light on the mechanisms behind the different fates of this cartilage, examining the control of Meckel's cartilage patterning, initiation and maturation. Importantly, human disorders and mouse models with disrupted Meckel's cartilage development are highlighted, in order to understand how changes in this cartilage impact on later development of the dentary and the craniofacial complex as a whole. Finally, the relative roles of tissue interactions, apoptosis, autophagy, macrophages and clast cells in the removal process are discussed. Meckel's cartilage is a unique and enigmatic structure, the development and function of which is starting to be understood but many interesting questions still remain.
- Publication type
- Journal Article MeSH
- Review MeSH
Cíl: Cílem práce je shrnutí prvních zkušeností s vyšetřováním klinicky indikovaných vyšetření výpočetní tomografií pomocí jedno-zdrojového prototypu photon-counting detektor CT. Metodika: Vyšetření byla prováděna na jednozdrojovém přístroji s detektorovou soustavou na bázi photon-counting detektoru. Hodnocena byla vyšetření u 50 vyšetřených pacientů, 20 vyšetření plic, 15 vyšetření dvoufázového vyšetření břicha, deset vyšetření tepen hlavy a krku a pět vyšetření hlavy včetně kosti spánkové, vyšetření byla prováděna pomocí akvizice datových stop s šíří elementu 0,4 nebo 0,2 mm. Byla hodnocena spolehlivost akvizice a kvalita zobrazení anatomických struktur Výsledky: U neselektovaných nemocných indikovaných pro vyšetření výpočetní tomografií byla získána zobrazení, která jsou klinicky minimálně rovnocenným zobrazením ke konvenčnímu CT. Vzhledem k vynikajícímu rozlišení je možné získat zobrazení jemných struktur těla, jakými jsou distální větvení bronchů, kvalitní separace cév a skeletu v oblasti báze lební, zobrazení skloubení sluchových kůstek. U všech vyšetření plic s referenční hodnotou 10 mAs byla dosažena hodnota pod 1 mSv, podobně i u vyšetření CTA hlavy, CT mozku i kosti spánkové, u vyšetření břicha bylo dosaženo srovnatelných hodnot jako u obvyklých při vyšetření konvenčním detektorem. Závěr: Zobrazení photon-counting detektor CT jsou klinicky plně využitelná, radiační zátěž je u většiny vyšetření snížená ve srovnání s použitím konvenčního přístroje CT. Je možné spolehlivě zobrazit submilimetrové detaily anatomických struktur.
Aim: The aim of the study is to summarize the first experience with the imaging using prototype of single-source photon-counting-detector CT in clinically indicated examinations. Method: All examinations were performed using single-source CT equipped with photon-counting detector. The sample of examinations in 50 patients were evaluated. There were 20 lung parenchyma examinations in diffuse lung diseases (including 10 with ultrahigh resolution mode with slice resolution 0.2 mm), 15 examinations of the abdomen in arterial and portal venous phase (incl. 5 ultrahigh resolution mode with slice resolution of 0.2 mm), 10 examinations of cervical and intracranial arteries, five brain examinations including ultrahigh resolution of the temporal bone. The data acquisition was made using resolution of 0.4 mm for a standard mode and 0.2 mm for ultrahigh resolution. Results: In non-selected patients with the indication for a clinical imaging, there were obtained images fully useful for a clinical assessment. Those images were minimally at the same level as made with conventional CT, or better. Thanks to the excellent resolution, it could be possible to visualize the tiny anatomical structures like bronchi on sub-segmental level of higher generation, the high quality display of vascular structures and articulations of middle ear ossicles. The effective dose equivalent reaches value less than one mSv in all lung, cervical and intracranial arteries, brain and temporal bone, those examinations of the abdomen did not exceed the for conventional CT typical levels of mSv. Conclusion: The imaging using photon-counting-detector CT were acquired with full clinical usefulness, radiation doses burden to the scanned individual are lower than those in conventional CT in most of indication. The subtle, submillimeter details of the anatomical structures could be visualized with the high certainty.
Anatomical middle and inner ear parameters are often used to predict hearing sensitivities of mammalian species. Given that ear morphology is substantially affected both by phylogeny and body size, it is interesting to consider whether the relatively small anatomical differences expected in related species of similar size have a noticeable impact on hearing. We present a detailed anatomical description of the middle and inner ears of the red fox Vulpes vulpes, a widespread, wild carnivore for which a behavioural audiogram is available. We compare fox ears to those of the well-studied and similarly sized domestic dog and cat, taking data for dogs and cats from the literature as well as providing new measurements of basilar membrane (BM) length and hair cell numbers and densities in these animals. Our results show that the middle ear of the red fox is very similar to that of dogs. The most obvious difference from that of the cat is the lack of a fully formed bony septum in the bulla tympanica of the fox. The cochlear structures of the fox, however, are very like those of the cat, whereas dogs have a broader BM in the basal cochlea. We further report that the mass of the middle ear ossicles and the bulla volume increase with age in foxes. Overall, the ear structures of foxes, dogs and cats are anatomically very similar, and their behavioural audiograms overlap. However, the results of several published models and correlations that use middle and inner ear measurements to predict aspects of hearing were not always found to match well with audiogram data, especially when it came to the sharper tuning in the fox audiogram. This highlights that, although there is evidently a broad correspondence between structure and function, it is not always possible to draw direct links when considering more subtle differences between related species.
- MeSH
- Phylogeny * MeSH
- Cats MeSH
- Foxes anatomy & histology physiology MeSH
- Dogs MeSH
- Ear, Middle anatomy & histology physiology MeSH
- Organ Size physiology MeSH
- Body Size physiology MeSH
- Hair Cells, Auditory physiology MeSH
- Ear, Inner anatomy & histology physiology MeSH
- Animals MeSH
- Check Tag
- Cats MeSH
- Dogs MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
Implantáty pro kostní vedení a aktivní středoušní implantáty vedou do vnitřního ucha informaci o zvuku a řeči v podobě vibrací. Vibrace rozkmitávají nitroušní tekutiny, stimulují vláskové buňky a vyvolávají zvukové vjemy. Tím se liší od implantátů kochleárních, které dráždí nervové struktury elektrickými impulzy. Implantát pro kostní vedení přenáší vibrace do kostí lebky, aktivní středoušní implantát přenáší vibrace cíleně na středoušní struktury (středoušní kůstky, membránu okrouhlého okénka). Klíčová slova: ucho, střední, sluch, kostní vedení
Implants for bone-conducted hearing and active middle ear implants transfer information about sound and speech to middle ear in the form of vibrations. Vibrations quiver inner ear fluids, stimulate the hair cells and evoke the sound percepts. That is how they differ from cochlear implants, which stimulate nervous structures by electric impulses. The implant for bone-conducted hearing transfers vibrations into the skull bones, whereas the active middle ear implant transfers the vibrations aiming at midle ear structure (middle ear ossicles, oval window membrane).
- MeSH
- Bone Conduction MeSH
- Humans MeSH
- Hearing Loss therapy MeSH
- Hearing Disorders therapy MeSH
- Ossicular Prosthesis * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
