Clinical Anatomy最新文献

The infrapatellar fat pad (IFP), also known as the Hoffa fat pad, is an essential structure in the knee joint with diverse functions and characteristics. Pathological changes in it can lead to anterior knee pain and impingement. The aim of this study was to investigate the relationship between age and Hoffa fat pad volume. A retrospective analysis was conducted on MRI scans of 100 individuals aged 10-80 years with no Hoffa fat pad pathology. The IFP was meticulously segmented on each sagittal and coronal MRI plane and its volume was calculated on the basis of the segmented boundaries. Correlation analysis was used to explore the relationships among age, sex, height, weight, and patella-related variables. Contrary to the hypothesis, there was no significant correlation between age and Hoffa fat pad volume. However, there were strong positive correlations between Hoffa fat pad volume and individuals' height, patellar height, and patellar ligament length. Multivariable linear regression analysis revealed that height, weight, patellar height, and patellar ligament length collectively explained 67% of Hoffa fat pad volume variability. These findings suggest that the Hoffa fat pad adapts to accommodate morphological changes in the knee joint as individuals grow taller. In conclusion, our study examined Hoffa fat pad volume in individuals across the age spectrum, using advanced imaging techniques to reveal the importance of considering height and knee-related variables for assessing Hoffa fat pad volume. This elucidates age-related volume changes and highlights the need for further research to understand its functional implications and interactions within the knee joint, with the aim of improving orthopedic interventions.

In medical education, traditional anatomy labs have relied heavily on the hands-on dissection of cadavers to teach the complex spatial relationships within the human body. However, the advent of virtual reality (VR) technology offers the potential for significantly enhancing this traditional approach by providing immersive, interactive 3D visualizations that can overcome some of the limitations of physical specimens. This study explores the integration of VR into a traditional gross anatomy lab to enrich the learning experience for medical students. Methods included the deployment of a VR application developed to complement the dissection process, featuring detailed 3D models of human anatomy that students could manipulate and explore digitally. Approximately 60 s-year medical students participated in the lab, where they engaged with both traditional dissection and the VR application. Results indicated that the VR integration not only increased engagement and satisfaction but also improved the students' ability to understand anatomical structures and their spatial relationships. Moreover, feedback from students suggested more efficient learning and retention than with traditional methods alone. We conclude that VR technology can significantly enhance medical anatomy education by providing an adjunct to traditional dissection, potentially replacing certain aspects of physical specimens with digital simulations that offer repeatable, detailed exploration without the associated logistical and ethical constraints.

The primary objective of this study was to develop a custom algorithm to assess three-dimensional (3D) acetabular coverage of the femoral head based on surface models generated from computed tomography (CT) imaging. The secondary objective was to apply this algorithm to asymptomatic young adult hip joints to assess the regional 3D acetabular coverage variability and understand how these novel 3D metrics relate to traditional two-dimensional (2D) radiographic measurements of coverage. The algorithm developed automatically identifies the lateral- and medial-most edges of the acetabular lunate at one-degree intervals around the acetabular rim based on local radius of curvature. The acetabular edges and the center of a best-fit sphere to the femoral head are then used to compute the mean 3D subchondral arc angles and hip joint coverage angles in five acetabular octants. This algorithm was applied to hip models generated from pelvis/hip CT imaging or abdomen/pelvis CT angiograms of 50 patients between 17 and 25 years of age who had no history of congenital or developmental hip pathology, neuromuscular conditions, or bilateral pelvic and/or femoral fractures. Corresponding 2D acetabular coverage measures of lateral center edge angle (LCEA) and acetabular arc angle (AAA) were assessed on the patients' clinical or digitally reconstructed radiographs. The 3D subchondral arc angle in the superior region (58.0 [54.6-64.8] degrees) was significantly higher (p < 0.001) than all other acetabular subregions. The 3D hip joint coverage angle in the superior region (26.2 [20.7-28.5] degrees) was also significantly higher (p < 0.001) than all other acetabular subregions. 3D superior hip joint coverage angle demonstrated the strongest correlation with 2D LCEA (r = 0.649, p < 0.001), while 3D superior-anterior subchondral arc angle demonstrated the strongest correlation with 2D AAA (r = 0.718, p < 0.001). The 3D coverage metrics in the remaining acetabular regions did not strongly correlate with typical 2D radiographic measures. The discrepancy between standard 2D measures of radiographic acetabular coverage and actual 3D coverage identified on advanced imaging indicates potential discord between anatomic coverage and the standard clinical measures of coverage on 2D imaging. As 2D measurement of acetabular coverage is increasingly used to guide surgical decision-making to address acetabular deformities, this work would suggest that 3D measures of acetabular coverage may be important to help discriminate local coverage deficiencies, avoid inconsistencies resulting from differences in radiographic measurement techniques, and provide a better understanding of acetabular coverage in the hip joint, potentially altering surgical planning and guiding surgical technique.

In this issue of Clinical Anatomy, the clinical anatomist can answer these questions based on a wide array of topics in our field, from education to research.

Cooke T. 1893. A Plea For Practical Work in Anatomy. London, Longmans & Co.

Despite being a prevalent clinical condition, cauda equina concussion has not been thoroughly elucidated in the literature. The aim of this study is to delineate the etiology and pathogenesis of cauda equina concussion and its associated clinical manifestations. Patients exhibiting clinical manifestations indicative of spinal cord injury and transient neurological deficits after spinal trauma were evaluated retrospectively. The pathogenesis was elucidated through correlating clinical presentations with radiological findings. Neurological deficits were categorized into two principal groups, symmetrical and asymmetrical. Non-penetrating fractures were classified to ascertain the relationship between the type of trauma and the ensuing neurological deficits. A cohort of 82 patients was diagnosed with cauda equina concussion. Among these, 58 had experienced vertical trauma resulting from falls, while 24 had encountered axial trauma in vehicular accidents. Stable spinal fractures were identified in 52 patients across multiple levels, whereas single-level fractures were observed in 30. Asymmetrical neurological deficits were detected in 51 (62.19%) patients, with a notably higher incidence among those subjected to vertical trauma (p < 0.014). The mean recovery time was 14.25 ± 15.16 h for sensory deficits and 11.25 ± 13.36 h for motor deficits in those patients. Notably, motor deficits resolved more expeditiously than sensory deficits in all cases presenting with both. Cauda equina concussion emerges as a frequently encountered clinical phenomenon attributable to the impact of high-energy vertical forces. Neurological deficits commonly manifest asymmetrically. The rapid resolution of neurological deficits presents challenges for the diagnostic process.

This study critically reassesses the etymology of the tendo Achillis, examining its connection to Achilles as depicted in classic epics. It challenges the interpretation by Joseph Hyrtl, first presented in the 19th century and still widely accepted, which credits Philippus Verheyen with the introduction of Achilles-related terminology in the late 17th century. Through an extensive review of anatomical publications from the 16th to the early 18th century across Western Europe, categorized into four distinct periods, this study investigates the origins of the nomenclature for the distal tendon of the triceps surae (DTTS = tendo calcaneus), including both the terminology and the narrative contexts beyond its anatomical functions. The findings reveal that names associated with Achilles predate Verheyen, contradicting Hyrtl's timeline, and suggesting a more intricate association with the figure of Achilles. This not only illuminates the development of one of the most recognized anatomical eponyms but also enhances our understanding of the interplay between medical terminology and cultural narratives.

Rheumatoid arthritis (RA) is a chronic autoimmune disease with a complex etiology. It has been suggested that the pathogenesis of RA begins in the mucosa and then transitions to the joints when many factors interact, including microbial dysbiosis, inflammatory responses, and immune abnormalities at the mucosal site. Data from RA animals and patients suggest there are changes in the mucosal microflora before the onset of RA, and that dysbiosis of the mucosal ecology continues to play a role in the development of arthritis. Microbial dysbiosis of the mucosa reduces the normal barrier function of the intestinal tract, promotes inflammatory reactions in the mucosal areas of the intestines, and then activates the intestinal immune cells abnormally to produce a large number of auto-reactive antibodies that exacerbate arthritis. Current findings do not clarify whether dysbiosis is only a potential trigger for the development of RA. If it is possible to intervene in such microbial changes before the onset of RA, could the clinical symptoms of arthritis be prevented or reduced? Finding new ways to regulate gut flora composition to maintain gut barrier function is an ongoing challenge for the prevention and treatment of RA.

Benign prostatic hyperplasia (BPH) is a prevalent medical disorder that primarily affects elderly males. It is distinguished by enhanced angiogenesis of the prostate, aggravating lower urinary tract symptoms (LUTS) and diminishing overall quality of life. Dutasteride, a 5α-reductase inhibitor, has emerged as a significant therapeutic choice for BPH owing to its efficacy in reducing prostate volume. The objective of this study is to analyze alterations in the shapes of prostate zones resulting from dutasteride treatment of BPH, using MRI. We examined 19 drug-administered patients and 33 non-drug-administered patients. MRI sections of all participants before and after drug treatment were collected retrospectively. The transition zone and peripheral zone of the prostate were marked with selected landmarks using TPSDIG v2.04. Generalized Procrustes Analysis was used to analyze shapes statistically. Our results showed that the 5α-reductase inhibitor significantly altered the shape of the transition zone by narrowing its posterior part. There were significant statistical differences between the drug-administered and non-drug-administered groups in the initial and final shapes of the transition zone. These findings indicate that the use of 5α-reductase inhibitors yielded favorable outcomes in terms of prostate size reduction and amelioration of symptoms associated with BPH.