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Naredo E, Murillo-González J, Mérida Velasco JR, Olivas Vergara O, Kalish RA, Gómez-Moreno C, García-Carpintero Blas E, Fuensalida-Novo G, Canoso JJ. Examining the Forearm Intersection through Palpation and Ultrasonography. Diagnostics (Basel) 2024; 14:116. [PMID: 38201426 PMCID: PMC10802148 DOI: 10.3390/diagnostics14010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/10/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Forearm intersection syndrome causes pain, swelling, and a rub at the dorsal distal forearm where the first extensor compartment muscles intersect with the second compartment tendons. Although primary care settings tend to treat mild cases, high-performance athletes may suffer from severe symptoms that require surgery. This proof-of-concept study aims to help detect the anatomical substrate of forearm intersection syndrome using palpation and ultrasonography when available. METHODS Five individuals were studied using independent palpation and ultrasonography to identify the first dorsal compartment muscles and the second dorsal compartment tendons. The distances between the dorsal (Lister's) tubercle of the radius and the ulnar and radial edges of the first dorsal compartment muscles were measured to determine the location and extent of the muscle-tendon intersection. The palpatory and ultrasonographic measurements were compared using descriptive statistics and the paired t-test. RESULTS The mean distances from the dorsal tubercle of the radius to the ulnar and radial borders of the first dorsal compartment muscles were 4.0 cm (SE 0.42) and 7.7 cm (SE 0.56), respectively, based on palpation. By ultrasonography, the corresponding distances were 3.5 cm (SD 1.05, SE 0.47) and 7.0 cm (SD 1.41, SE 0.63). Both methods showed a similar overlap length. However, ultrasonography revealed a shorter distance between the dorsal tubercle of the radius and the ulnar border of the first compartment than palpation (p = 0.0249). CONCLUSIONS Our findings indicate that a basic knowledge of anatomy should help health professionals diagnose forearm intersection syndrome through palpation and, if available, ultrasonography.
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Affiliation(s)
- Esperanza Naredo
- Department of Rheumatology and Bone and Joint Research Unit, Hospital Universitario Fundación Jiménez Diaz, IIS Fundación Jiménez Díaz, Autónoma University, 28049 Madrid, Spain; (E.N.); (O.O.V.)
| | - Jorge Murillo-González
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
| | - José Ramón Mérida Velasco
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Otto Olivas Vergara
- Department of Rheumatology and Bone and Joint Research Unit, Hospital Universitario Fundación Jiménez Diaz, IIS Fundación Jiménez Díaz, Autónoma University, 28049 Madrid, Spain; (E.N.); (O.O.V.)
| | - Robert A. Kalish
- Division of Rheumatology, Tufts University School of Medicine, Boston, MA 02111, USA; (R.A.K.); (J.J.C.)
| | - Cristina Gómez-Moreno
- Department of Nursing, Hospital Universitario Fundación Jiménez Díaz, 28049 Madrid, Spain; (C.G.-M.); (E.G.-C.B.); (G.F.-N.)
| | - Eva García-Carpintero Blas
- Department of Nursing, Hospital Universitario Fundación Jiménez Díaz, 28049 Madrid, Spain; (C.G.-M.); (E.G.-C.B.); (G.F.-N.)
| | - Gema Fuensalida-Novo
- Department of Nursing, Hospital Universitario Fundación Jiménez Díaz, 28049 Madrid, Spain; (C.G.-M.); (E.G.-C.B.); (G.F.-N.)
| | - Juan J. Canoso
- Division of Rheumatology, Tufts University School of Medicine, Boston, MA 02111, USA; (R.A.K.); (J.J.C.)
- Department of Medicine, Emeritus, ABC Medical Center, Mexico City 01120, Mexico
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Naredo E, Largo R, Olivas-Vergara O, Herencia C, Mateos-Fernández M, García-de-Pereda-Notario CM, Mérida-Velasco JR, Herrero-Beaumont G, Murillo-González J. What happens under the flexor tendons of the fingers in dactylitis? Med Ultrason 2023; 25:42-47. [PMID: 36996392 DOI: 10.11152/mu-4026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
AIM Tenosynovitis is one of the most frequently described inflammatory lesions in psoriatic dactylitis. The aim of the study was to assess by ultrasound the distribution of content within the synovial sheath of the finger flexor tendons in a cadaveric experimental model of tenosynovitis and to describe anatomically the elements of the space between the flexor tendons and the palmar aspect of the proximal phalanx of the fingers. MATERIAL AND METHOD Silicone was injected under ultrasound guidance into the digital flexor sheath of the index finger of a hand specimen. Ultrasound images of the distribution of the filling of the flexor synovial space with the injected material were obtained. These images were compared with images from patients with psoriatic dactylitis. The palmar regions of the hand and fingers were dissected to check the distribution of the injected silicone in the synovial cavity. Additionally, we dissected the 2nd to 5th fingers of five cadaveric hands, including the one used for the experiment. RESULTS During the injection of the substance, we observed an increasing homogeneous hypoechoic band around the flexor tendons that differed from the images of patients. Dissection of the specimen showed the injected silicone distributed throughout the digital flexor sheath to the distal interphalangeal joint. In addition, we provided an illustrated anatomical description of the elements located between the flexor tendons and the palmar aspect of the proximal phalanx, the inflammation of which could simulate flexor tenosynovitis. CONCLUSION The observations of this study may contribute to a better understanding of the anatomical structures involved in PsA dactylitis.
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Affiliation(s)
- Esperanza Naredo
- Department of Rheumatology. Hospital Universitario Fundación Jiménez Díaz, Madrid. Spain. Bone and Joint Research Unit. IIS-Fundación Jiménez Díaz- Universidad Autónoma of Madrid. Madrid, Spain..
| | - Raquel Largo
- Bone and Joint Research Unit. IIS-Fundación Jiménez Díaz- Universidad Autónoma of Madrid. Madrid, Spain..
| | - Otto Olivas-Vergara
- Department of Rheumatology. Hospital Universitario Fundación Jiménez Díaz, Madrid. Spain. Bone and Joint Research Unit. IIS-Fundación Jiménez Díaz- Universidad Autónoma of Madrid. Madrid, Spain..
| | - Carmen Herencia
- Bone and Joint Research Unit. IIS-Fundación Jiménez Díaz- Universidad Autónoma of Madrid. Madrid, Spain..
| | - Myriam Mateos-Fernández
- Bone and Joint Research Unit. IIS-Fundación Jiménez Díaz- Universidad Autónoma of Madrid. Madrid, Spain..
| | | | - José Ramón Mérida-Velasco
- Department of Anatomy and Embryology, Faculty of Medicine, Universidad Complutense of Madrid. Madrid, Spain..
| | - Gabriel Herrero-Beaumont
- Department of Rheumatology. Hospital Universitario Fundación Jiménez Díaz, Madrid. Spain. Bone and Joint Research Unit. IIS-Fundación Jiménez Díaz- Universidad Autónoma of Madrid. Madrid, Spain..
| | - Jorge Murillo-González
- Department of Anatomy and Embryology, Faculty of Medicine, Universidad Complutense of Madrid. Madrid, Spain..
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Martínez-Sanz E, Catón J, Maldonado E, Murillo-González J, Barrio MC, Paradas-Lara I, García-Serradilla M, Arráez-Aybar L, Mérida-Velasco JR. Study of the functional relationships between the buccinator muscle and the connective tissue of the cheek in humans. Ann Anat 2023; 246:152025. [PMID: 36375681 DOI: 10.1016/j.aanat.2022.152025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/17/2022] [Accepted: 11/02/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The buccinator muscle derives from the mesenchyme of the second pharyngeal arch. In adults, it has a quadrilateral shape, occupying the deepest part of the cheek region. Its function is complex, being active during swallowing, chewing, and sucking. To our knowledge, there are no studies that have specifically analyzed the relationship of the buccinator muscle fibers and neighboring connective tissue of the cheek in humans, neither during development nor in adults. Such relationships are fundamental to understand its function. Thus, in this study the relations of the buccinator muscle with associated connective tissue were investigated. METHODS The buccinator muscle region was investigated bilaterally in 41 human specimens of 8-17 weeks of development. Moreover, four complete adult tissue blocks from human cadavers (including mucosa and skin) were obtained from the cheek region (between the anterior border of the masseter muscle and the nasolabial fold). All samples were processed with standard histological techniques. In addition, subsets of sections were stained with picrosirius red (PSR). Furthermore, immunoreactivity against type I and III collagen was also studied in adult tissues. RESULTS The buccinator muscle showed direct relationships with its connective tissue from 8 to 17 weeks of development. Collagen fibers were arranged in septa from the submucosa to the skin through the muscle. These septa were positive for type I collagen and presented elastic fibers. Fibrous septa that were positive for type III collagen were arranged from the lateral side of the muscle to the skin. CONCLUSIONS The intimate relationship between buccinator muscle fibers and cheek connective tissue may explain the complex functions of this muscle.
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Affiliation(s)
- Elena Martínez-Sanz
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, Ciudad Universitaria, 28040 Madrid, Spain
| | - Javier Catón
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, Ciudad Universitaria, 28040 Madrid, Spain.
| | - Estela Maldonado
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, Ciudad Universitaria, 28040 Madrid, Spain
| | - Jorge Murillo-González
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, Ciudad Universitaria, 28040 Madrid, Spain
| | - María Carmen Barrio
- Department of Anatomy and Embryology, Faculty of Optics and Optometry, Complutense University of Madrid, Calle de Arcos de Jalón, 118, 28037 Madrid, Spain
| | - Irene Paradas-Lara
- Department of Anatomy and Embryology, Faculty of Optics and Optometry, Complutense University of Madrid, Calle de Arcos de Jalón, 118, 28037 Madrid, Spain
| | - Moisés García-Serradilla
- Department of Anatomy and Embryology, Faculty of Optics and Optometry, Complutense University of Madrid, Calle de Arcos de Jalón, 118, 28037 Madrid, Spain
| | - Luis Arráez-Aybar
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, Ciudad Universitaria, 28040 Madrid, Spain
| | - José Ramón Mérida-Velasco
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Plaza de Ramón y Cajal, s/n, Ciudad Universitaria, 28040 Madrid, Spain
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Mérida-García AJ, Murillo-González J, Martínez-Sanz E, Catón J, Arráez-Aybar LA, Martín-Cruces J, Cobo T, Vega JA, Mérida-Velasco JR. Functional hypothesis of the juxtaoral organ: Role of collagen types I and III. Oral Dis 2023; 29:322-326. [PMID: 34252255 DOI: 10.1111/odi.13959] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/18/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jorge Murillo-González
- Facultad de Medicina, Departamento de Anatomía y Embriología, Universidad Complutense de Madrid, Madrid, Spain
- Laboratorio de Desarrollo y Crecimiento Craneofacial, Facultad de Odontología, Grupo UCM de Investigación, Investigación en Desarrollo del Paladar y Fisura Palatina. Desarrollo Craneofacial', Universidad Complutense de Madrid, Madrid, Spain
| | - Elena Martínez-Sanz
- Facultad de Medicina, Departamento de Anatomía y Embriología, Universidad Complutense de Madrid, Madrid, Spain
- Laboratorio de Desarrollo y Crecimiento Craneofacial, Facultad de Odontología, Grupo UCM de Investigación, Investigación en Desarrollo del Paladar y Fisura Palatina. Desarrollo Craneofacial', Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Catón
- Facultad de Medicina, Departamento de Anatomía y Embriología, Universidad Complutense de Madrid, Madrid, Spain
- Laboratorio de Desarrollo y Crecimiento Craneofacial, Facultad de Odontología, Grupo UCM de Investigación, Investigación en Desarrollo del Paladar y Fisura Palatina. Desarrollo Craneofacial', Universidad Complutense de Madrid, Madrid, Spain
| | - Luis A Arráez-Aybar
- Facultad de Medicina, Departamento de Anatomía y Embriología, Universidad Complutense de Madrid, Madrid, Spain
- Laboratorio de Desarrollo y Crecimiento Craneofacial, Facultad de Odontología, Grupo UCM de Investigación, Investigación en Desarrollo del Paladar y Fisura Palatina. Desarrollo Craneofacial', Universidad Complutense de Madrid, Madrid, Spain
| | - José Martín-Cruces
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
| | - Teresa Cobo
- Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Oviedo, Oviedo, Spain
- Instituto Asturiano de Odontología, Oviedo, Oviedo, Spain
| | - José Antonio Vega
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Oviedo, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile
| | - José Ramón Mérida-Velasco
- Facultad de Medicina, Departamento de Anatomía y Embriología, Universidad Complutense de Madrid, Madrid, Spain
- Laboratorio de Desarrollo y Crecimiento Craneofacial, Facultad de Odontología, Grupo UCM de Investigación, Investigación en Desarrollo del Paladar y Fisura Palatina. Desarrollo Craneofacial', Universidad Complutense de Madrid, Madrid, Spain
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Carneiro MC, Rubira CMF, Martínez-Sanz E, Arráez-Aybar LA, Murillo-González J. Prevalence of retromolar foramen in nineteenth century Spanish population. Odontology 2022:10.1007/s10266-022-00779-5. [DOI: 10.1007/s10266-022-00779-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
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6
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Viñas MJ, Galiotto-Barba F, Cortez-Lede MG, Rodríguez-González MÁ, Moral I, Delso E, González-Meli B, Lobo F, López-Cedrún JL, Neagu D, Garatea J, Garatea A, Berenguer B, Lorca-García C, Delgado MD, Martí E, Gutiérrez JM, Hernández C, Murillo-González J, Martínez-Álvarez C, Martínez-Sanz E. Craniofacial and three-dimensional palatal analysis in cleft lip and palate patients treated in Spain. Sci Rep 2022; 12:18837. [PMID: 36336749 PMCID: PMC9637697 DOI: 10.1038/s41598-022-23584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022] Open
Abstract
Growth alterations have been described in patients operated on for oral clefts. The purpose of this work was to analyze the craniofacial and palate morphology and dimensions of young adults operated on for oral clefts in early childhood in Spain. Eighty-three patients from eight different hospitals were divided into four groups based on their type of cleft: cleft lip (CL, n = 6), unilateral cleft lip and palate (UCLP, n = 37), bilateral cleft lip and palate (BCLP, n = 16), and cleft palate only (CPO, n = 24). A control group was formed of 71 individuals. Three-dimensional (3D) digital models were obtained from all groups with an intraoral scanner, together with cephalometries and frontal, lateral, and submental facial photographs. Measurements were obtained and analyzed statistically. Our results showed craniofacial alterations in the BCLP, UCLP, and CPO groups with an influence on the palate, maxilla, and mandible and a direct impact on facial appearance. This effect was more severe in the BCLP group. Measurements in the CL group were similar to those in the control group. Cleft characteristics and cleft type seem to be the main determining factors of long-term craniofacial growth alterations in these patients. Prospective research is needed to clearly delineate the effects of different treatments on the craniofacial appearance of adult cleft patients.
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Affiliation(s)
- María José Viñas
- grid.4795.f0000 0001 2157 7667Facultad de Odontología, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Francesca Galiotto-Barba
- grid.4795.f0000 0001 2157 7667Facultad de Odontología, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - María Gabriela Cortez-Lede
- grid.419058.10000 0000 8745 438XHospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, 30120 Murcia, Spain
| | - María Ángeles Rodríguez-González
- grid.419058.10000 0000 8745 438XHospital Clínico Universitario Virgen de la Arrixaca, Servicio Murciano de Salud, 30120 Murcia, Spain
| | - Ignacio Moral
- grid.438293.70000 0001 1503 7816Hospital Universitario Miguel Servet, Servicio Aragonés de Salud, 50009 Zaragoza, Spain
| | - Elena Delso
- grid.438293.70000 0001 1503 7816Hospital Universitario Miguel Servet, Servicio Aragonés de Salud, 50009 Zaragoza, Spain
| | - Beatriz González-Meli
- grid.410361.10000 0004 0407 4306Hospital Universitario Infantil Niño Jesús, Servicio Madrileño de Salud, 28009 Madrid, Spain
| | - Fernando Lobo
- grid.410361.10000 0004 0407 4306Hospital Universitario Infantil Niño Jesús, Servicio Madrileño de Salud, 28009 Madrid, Spain
| | - José Luis López-Cedrún
- grid.420359.90000 0000 9403 4738Complejo Hospitalario Universitario A Coruña, Servizo Galego de Saúde, 15006 A Coruña, Spain
| | - David Neagu
- grid.420359.90000 0000 9403 4738Complejo Hospitalario Universitario A Coruña, Servizo Galego de Saúde, 15006 A Coruña, Spain
| | - Joaquín Garatea
- grid.419060.a0000 0004 0501 3644Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Amaia Garatea
- grid.419060.a0000 0004 0501 3644Complejo Hospitalario de Navarra, Servicio Navarro de Salud, 31008 Pamplona, Spain
| | - Beatriz Berenguer
- grid.410361.10000 0004 0407 4306Hospital General Universitario Gregorio Marañón, Servicio Madrileño de Salud, 28009 Madrid, Spain
| | - Concepción Lorca-García
- grid.410361.10000 0004 0407 4306Hospital General Universitario Gregorio Marañón, Servicio Madrileño de Salud, 28009 Madrid, Spain
| | - María Dolores Delgado
- grid.410361.10000 0004 0407 4306Hospital Universitario 12 de Octubre, Servicio Madrileño de Salud, 28041 Madrid, Spain
| | - Eunate Martí
- grid.410361.10000 0004 0407 4306Hospital Universitario 12 de Octubre, Servicio Madrileño de Salud, 28041 Madrid, Spain
| | - José Manuel Gutiérrez
- grid.459669.10000 0004 1771 1036Hospital Universitario de Burgos, Sanidad de Castilla y León, 09006 Burgos, Spain
| | - Carlos Hernández
- grid.459669.10000 0004 1771 1036Hospital Universitario de Burgos, Sanidad de Castilla y León, 09006 Burgos, Spain
| | - Jorge Murillo-González
- grid.4795.f0000 0001 2157 7667Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Concepción Martínez-Álvarez
- grid.4795.f0000 0001 2157 7667Facultad de Odontología, Universidad Complutense de Madrid, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Elena Martínez-Sanz
- grid.4795.f0000 0001 2157 7667Facultad de Odontología, Universidad Complutense de Madrid, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Dorado-Fernández E, Ramírez-González I, Parro-González L, Ruiz-Tagle E, Paulos-Bravo R, Barrio-Asensio C, Murillo-González J. The supracondylar process in the skeletal remains of a full-term fetus from Central Spain (V-VII century BC). Anthropol Anz 2022; 79:433-437. [PMID: 35403662 DOI: 10.1127/anthranz/2022/1584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
A rare case in the remains of a full-term fetus was recovered from the archaeological site 'Arriaca-Zaide' (Guadalajara, Spain) that dates to the century V-VII BC. The right humerus presents an osseous tubercle, fractured at its end that extends obliquely forward and medially, from the anteromedial aspect of the lower third of the humerus. It is a supracondylar process, a rare osseous anatomic variation. The presence of the supracondylar process in the fetal period allowed us to propose its congenital nature. Furthermore, its disposition and state of ossification allowed us to suggest that it was formed from the ossification center of the humeral diaphysis and not from a secondary ossification center. This case represents the first time that the supracondylar process during the fetal period has been described in the anthropological physical literature.
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Affiliation(s)
- Enrique Dorado-Fernández
- Forensic Anthropology Department. Institute of Legal Medicine. 28042 Madrid, Spain
- Department of Legal Medicine, Psychiatry and Pathology. Faculty of Medicine, Complutense University of Madrid. 28040 Madrid, Spain
| | | | | | - Elisa Ruiz-Tagle
- Forensic Anthropology Department. Institute of Legal Medicine. 28042 Madrid, Spain
- Department of Legal Medicine, Psychiatry and Pathology. Faculty of Medicine, Complutense University of Madrid. 28040 Madrid, Spain
| | - Rodrigo Paulos-Bravo
- Department of Prehistory, Ancient History and Archeology. Faculty of Geography and History. Complutense University of Madrid. 28040 Madrid, Spain
| | - Carmen Barrio-Asensio
- Department of Anatomy and Embryology. Faculty of Medicine. Complutense University of Madrid. 28040 Madrid, Spain
| | - Jorge Murillo-González
- Department of Anatomy and Embryology. Faculty of Medicine. Complutense University of Madrid. 28040 Madrid, Spain
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8
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Dorado-Fernández E, Aso-Escario J, Aso-Vizán A, Ramírez-González I, Carrillo-Rodríguez MF, Cáceres-Monllor D, Murillo-González J. A Case of Acute Plastic Deformation of the Forearm in a Medieval Hispano-Mudejar Skeleton (13-14th Centuries AD). Pathobiology 2022; 90:56-62. [PMID: 35504265 DOI: 10.1159/000524452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/01/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Acute plastic deformation refers to a traumatic bending or bowing without a detectable cortical defect. CASE PRESENTATION AND DISCUSSION We describe a rare case from an individual that was exhumed from the Hispano-Mudejar necropolis in Uceda (Guadalajara, Spain) dated between the 13th and 14th centuries AD. The case corresponds to an adult woman, with a bowing involvement of the left ulna and radius. After making the differential diagnosis with various pathologies likely to present with this alteration, we reached the diagnosis of acute plastic deformation of the forearm through external and radiological examination and comparison with the healthy contralateral forearm. CONCLUSIONS Acute plastic deformation is a rare traumatic injury, not described until the last century and only rarely described in palaeopathological contexts. We contribute a new case, the first being sufficiently documented, contributing to the knowledge and diagnosis of this type of trauma in the ancient bone, while deepening the knowledge of the living conditions of the medieval Mudejar population of Uceda.
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Affiliation(s)
- Enrique Dorado-Fernández
- Forensic Anthropology Department, Institute of Legal Medicine, Madrid, Spain
- Faculty of Medicine, Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, Madrid, Spain
| | | | - Alberto Aso-Vizán
- Orthopedic Surgery and Traumatology Service, Hospital General de la Defensa, Zaragoza, Spain
| | - Ildefonso Ramírez-González
- Grupo 365 Arqueología, Guadalajara, Spain
- Escuela Politécnica, Universidad Europea de Madrid, Madrid, Spain
| | - Manuel F Carrillo-Rodríguez
- Faculty of Medicine, Department of Surgery, Medical and Social Sciences, University of Alcalá, Madrid, Spain
| | | | - Jorge Murillo-González
- Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
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9
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Morán-Morán J, Mérida-Velasco JR, Del Valle EB, Murillo-González J. A mini-incision carpal tunnel release technique to prevent pillar pain: A technical note. Acta Orthop Traumatol Turc 2021; 55:73-75. [PMID: 33650516 DOI: 10.5152/j.aott.2021.20086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pillar pain represents one of the most common complications of classic open carpal tunnel release (CTR). This complication causes a sense of discomfort worse than the compression syndrome itself. We, herein, introduce a new treatment method for CTR through a mini-incision, which allows subcutaneously cutting the transverse carpal ligament (TCL) and releasing the median nerve without neurovascular complications. This mini-incision approach can allow the direct visualization and preservation of the thenar motor branch in those rare cases where it has an aberrant origin. For the past 10 years, we have consecutively performed this technique in the surgical treatment of 318 patients with the diagnosis of primary CTS, without developing any neurovascular and tendon injuries as well as pillar pain.
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Affiliation(s)
- Julio Morán-Morán
- Clinic of Orthopedic Surgery and Traumatology, University General Hospital "Gregorio Marañón", Madrid, Spain
| | - José Ramón Mérida-Velasco
- Departmen of Anatomy and Embryology, Complutense University of Madrid, School of Medicine, Madrid, Spain
| | | | - Jorge Murillo-González
- Departmen of Anatomy and Embryology, Complutense University of Madrid, School of Medicine, Madrid, Spain
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Catón J, Martínez-Sanz E, Morán-Morán J, López-Fernández P, Murillo-González J. An Accessory Abductor Digiti Minimi as Possible Risk Factor of the Median and Ulnar Nerves Compression. INT J MORPHOL 2020. [DOI: 10.4067/s0717-95022020000601555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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González-Pinilla J, Ruiz-Gallego-Largo T, Barrio-Asensio C, Catón J, Martínez-Sanz E, Murillo-González J. Does Education About Death and Dying Decrease Stress Generated in the Dissection Room? INT J MORPHOL 2020. [DOI: 10.4067/s0717-95022020000501184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Minuesa-Asensio A, García-Esteo F, Mérida-Velasco JR, Barrio-Asensio C, de la Cuadra-Blanco C, Murillo-González J. Basic morphological characteristics of coracoid grafts obtained by open and arthroscopic Latarjet techniques: A comparative study. Orthop Traumatol Surg Res 2020; 106:1083-1087. [PMID: 32763008 DOI: 10.1016/j.otsr.2020.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 04/12/2020] [Accepted: 04/23/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND A knowledge of the anthropometric characteristics of the coracoid graft (CG) that can be obtained by the open and arthroscopic Latarjet techniques may be beneficial in the preoperative planning and intraoperative decision making for coracoid osteotomy and transfer. We have not found any study that compared the morphology of the CG that can be obtained from open and arthroscopic Latarjet techniques. The purpose of this study was to verify if the basic anthropometric characteristics of CGs are equivalent. HYPOTHESIS We hypothesize that the basic anthropometric characteristics of the CGs are similar. METHODS Twenty fresh-frozen human paired cadaveric shoulder specimens that had been randomly distributed in two groups of 10 specimens each were used. Two surgeons, each with experience in performing the open and arthroscopic Latarjet technique, performed these procedures in each of the respective groups (OG, open group; AG, arthroscopic group). A CT scan was performed. Using the volume rendering technique, a metric analysis of the volume, area and length of the CG were performed, evaluated and statistically analysed. RESULTS There were no significant differences in length (p=0.162) (mean length, 22.6mm for OG and 23.6mm for AG). There were significant differences in the volume (p=0.031) and area (p=0.007) of the CG, being lower in the OG (mean volume, 2.8 cm3 for OG and 3.6 cm3 for AG; mean area, 9.9 cm2 for OG and 12.8 cm2 for AG). No significant differences were observed by sex or laterality. CONCLUSION The mean lengths of the CGs that were obtained by each technique are equivalent. However, the areas and volumes of the grafts are different, being lower in the open surgery. These differences have not been an impediment to perform the technique. Our results corroborates that consolidation is more related to the preparation and placement than to the anthropometric characteristics of the CG. No significant differences were observed by sex or laterality. LEVEL OF EVIDENCE Basic Science.
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Affiliation(s)
| | | | - José Ramón Mérida-Velasco
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Carmen Barrio-Asensio
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Crótida de la Cuadra-Blanco
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Jorge Murillo-González
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain.
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de-la-Cuadra-Blanco C, Murillo-González J, Martínez-Sanz E, Mérida-Velasco JR. An Unusual Case of Primate Arterial Pattern in a Human Upper Limb. INT J MORPHOL 2020. [DOI: 10.4067/s0717-95022020000400963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Minuesa-Asensio A, García-Esteo F, Mérida-Velasco JR, Barrio-Asensio C, López-Fernández P, Aramberri-Gutiérrez M, Murillo-González J. Comparison of Coracoid Graft Position and Fixation in the Open Versus Arthroscopic Latarjet Techniques: A Cadaveric Study. Am J Sports Med 2020; 48:2105-2114. [PMID: 32667269 DOI: 10.1177/0363546520930419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Since the description of the arthroscopic Latarjet technique, discussion about the superiority of the open or arthroscopic procedure has arisen. The appropriate placement of the coracoid graft (CG) on the anterior glenoid neck is reported to be the most important step of the Latarjet procedure. PURPOSE To verify if there are differences in the parameters that may affect the final position and fixation of CG obtained from the open and arthroscopic Latarjet techniques. STUDY DESIGN Controlled laboratory study. METHODS Twenty fresh-frozen human paired cadaveric shoulder specimens were randomly distributed in 2 surgery groups (open group [OG] and arthroscopic group [AG]) with 10 specimens in each. Two surgeons, each with experience performing open and arthroscopic Latarjet techniques, executed these procedures: one surgeon performed all open techniques, and the other performed all arthroscopic techniques, respectively. After surgery, a computerized tomography scan was performed. The surgical time, the position of each CG, a series of variables that might affect the CG fixation, and the level of the subscapularis muscle split were evaluated. RESULTS The mean surgical time was significantly longer in the AG (mean, 26 minutes for OG and 57 minutes for AG). Three intraoperative complications (30%) were identified in the AG, consisting of graft fractures. The CG was determined to be in an optimal cranial-caudal position in 90% of specimens of the OG and 44% of the AG (Fisher, P = .057). In both groups, the CG was placed in an optimal medial-lateral position in all specimens. In the OG, the degree of parallelism between the major axes of the glenoid surface and CG was significantly greater than in the AG (mean, 3.8º for OG and 15.1º for AG). No significant differences were observed in superior and inferior screw orientation between the groups. In the longitudinal and transverse directions, significant differences were found in the centering of the superior screw, being closer to the ideal point in the OG than in the AG. The location where the longitudinal subscapularis muscle split was performed was significantly higher in the AG. CONCLUSION The open Latarjet technique required less surgical time; presented a lower number of intraoperative complications; and allowed more adequate placement of the CG, better centering of the screws, and a subscapularis muscle split closer to the ideal position. CLINICAL RELEVANCE The reported benefits of the arthroscopic Latarjet technique seem less clear if we take into account the added surgery time and complications.
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Affiliation(s)
| | - Francisco García-Esteo
- Service of Traumatology, Jiménez Díaz Foundation, Madrid, Spain.,Department of Basic Medical Sciences, Faculty of Medicine, Francisco de Vitoria University, Madrid, Spain
| | - José Ramón Mérida-Velasco
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Carmen Barrio-Asensio
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Pedro López-Fernández
- Division of Human Anatomy and Embryology, Department of Basic Health Sciences, Rey Juan Carlos University, Madrid, Spain.,Department of Surgery, University Hospital Rey Juan Carlos, Madrid, Spain
| | - Mikel Aramberri-Gutiérrez
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.,Alai Sports Medicine Clinic, Madrid, Spain
| | - Jorge Murillo-González
- Department of Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
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López-Fernández P, Murillo-González J, Arráez-Aybar LA, de la Cuadra-Blanco C, Moreno-Borreguero A, Mérida-Velasco JR. Early stages of development of the alar fascia (human specimens at 6-12 weeks of development). J Anat 2019; 235:1098-1104. [PMID: 31418466 DOI: 10.1111/joa.13074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2019] [Indexed: 12/22/2022] Open
Abstract
In recent years, there has been much discussion concerning the cervical fasciae. The aim of this study is to confirm and to describe the development of the alar fascia as well as its relationship with nearby structures. Histological preparations of 25 human embryos (6-8 weeks of development) and 25 human fetuses (9-12 weeks of development) were studied bilaterally using a conventional optical microscope. Our study confirms the existence of the alar fascia and permits three stages to be established during its development. The initial stage (1st), corresponding to the 6th week of development (Carnegie stages 18-19), is characterized by the beginning of the alar fascia primordium in the retroesophageal space at the level of C7-T1. In the formation stage (2nd), corresponding to the 7th and 8th weeks of development (Carnegie stages 20-23), the alar fascia primordium grows upwards and reaches the level of C2-C3. In the maturation stage (3rd), beginning in the 9th week of development, the visceral, alar and prevertebral fasciae can be identified. The alar fascia divides the retrovisceral space (retropharyngeal and retroesophageal) into two spaces: one anterior (between the alar fascia and the visceral fascia and extending from C1 to T1, named retropharyngeal or retroesophageal space according to the level) and the other posterior (between the alar fascia and the prevertebral fascia, named danger space). We suggest that this latter space be named the retroalar space. This study suggests that alar fascia development is related to mechanical factors and that the alar fascia permits the sliding of the pharynx and the oesophagus during swallowing.
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Affiliation(s)
- Pedro López-Fernández
- Division of Human Anatomy and Embryology, Department of Basic Health Sciences, Rey Juan Carlos University, Madrid, Spain.,Department of Surgery, University Hospital Rey Juan Carlos, Madrid, Spain
| | - Jorge Murillo-González
- Faculty of Medicine, Department of Human Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
| | - Luis Alfonso Arráez-Aybar
- Faculty of Medicine, Department of Human Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
| | - Crótida de la Cuadra-Blanco
- Faculty of Medicine, Department of Human Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
| | - Alicia Moreno-Borreguero
- Department of Nutrition and Endocrinology, University Hospital of Fuenlabrada, Rey Juan Carlos University, Madrid, Spain
| | - José Ramón Mérida-Velasco
- Faculty of Medicine, Department of Human Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
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Mankia K, D'Agostino MA, Murillo-González J, Grainger A, Emery P. Response to: 'Interosseous tendon inflammation of rheumatoid arthritis: what's the real meaning?' by Deng et al. Ann Rheum Dis 2019; 79:e84. [PMID: 31101604 DOI: 10.1136/annrheumdis-2019-215611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Kulveer Mankia
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Maria-Antonietta D'Agostino
- Rheumatology, Ambroise Paré Hospital, APHP, Université Versailles-Saint-Quentin en Yvelines, Boulogne-Billancourt, France
| | | | - Andrew Grainger
- Department of Radiology, Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leedss, UK
| | - Paul Emery
- 1 Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, 2 NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
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Mankia K, D'Agostino MA, Rowbotham E, Hensor EMA, Hunt L, Möller I, Miguel M, Mérida-Velasco JR, Murillo-González J, Naredo E, Nam JL, Tan AL, Freeston JE, Grainger A, Emery P. MRI inflammation of the hand interosseous tendons occurs in anti-CCP-positive at-risk individuals and may precede the development of clinical synovitis. Ann Rheum Dis 2019; 78:781-786. [DOI: 10.1136/annrheumdis-2018-214331] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/01/2019] [Accepted: 03/04/2019] [Indexed: 11/04/2022]
Abstract
Interosseous tendon inflammation (ITI) has been described in rheumatoid arthritis (RA). Whether ITI occurs in at-risk individuals before the onset of clinical synovitis is unknown.ObjectivesTo investigate, by MRI, ITI in anti-cyclic citrullinated peptide (CCP)-positive at-risk individuals (CCP +at risk) and to describe the anatomy, prevalence and clinical associations across the RA continuum.MethodsHand MRI was performed in 93 CCP + at risk, 47 early RA (ERA), 28 established ‘late’ RA (LRA) and 20 healthy controls (HC) and scored for ITI, flexor tenosynovitis (TSV) and RA MRI scoring at the metacarpophalangeal joints (MCPJs). Cadaveric and histological studies were performed to explore the anatomical basis for MRI ITI.ResultsThe proportion of subjects with ITI and the number of inflamed interosseous tendons (ITs) increased along the disease continuum (p<0.001): 19% of CCP +at risk, 49% of ERA and 57% of LRA had ≥1 IT inflamed . ITI was not found in any HC. ITI was more frequently identified in tender MCPJs compared with nontender MCPJs (28% vs 12%, respectively). No IT tenosynovial sheath was identified in cadavers on dissection or histological studies suggesting MRI findings represent peritendonitis. Dye studies indicated no communication between the IT and the joint.ConclusionsITI occurs in CCP + at-risk individuals and can precede the onset of clinical synovitis. The ITs may be important nonsynovial extracapsular targets in the development and progression of RA.
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Quirós-Terrón L, Arráez-Aybar LA, Murillo-González J, De-la-Cuadra-Blanco C, Martínez-Álvarez MC, Sanz-Casado JV, Mérida-Velasco JR. Initial stages of development of the submandibular gland (human embryos at 5.5-8 weeks of development). J Anat 2019; 234:700-708. [PMID: 30740679 DOI: 10.1111/joa.12955] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2019] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to determine the main stages of submandibular salivary gland development during the embryonic period in humans. In addition, we studied submandibular salivary gland development in rats on embryonic days 14-16 and expression in the submandibular salivary gland region with the monoclonal antibody HNK-1. Serial sections from 25 human embryos with a greatest length ranging from 10 to 31 mm (Carnegie stages 16-23; weeks 5.5-8 of development) and Wistar rats of embryonic days (E) 14-16 were analysed with light microscopy. Five stages of submandibular salivary gland development were identified. The prospective stage (1), between weeks 5.5 and early week 6, is characterized by a thickening of the epithelium of the medial paralingual groove in the floor of the mouth corresponding to the primordium of the submandibular salivary gland parenchyma. At this stage, the primordium of the parasympathetic ganglion lies below the lingual nerve. The primordium of the submandibular salivary gland parenchyma is observed in rats on E14 in the medial paralingual groove with mesenchymal cells, underlying the lingual nerve. These cells are HNK-1-positive, corresponding to the primordium of the parasympathetic ganglion. The bud stage (2), at the end of week 6 in humans and on E15 in rats, is characterized by the proliferation and invagination of the epithelial condensation, surrounded by an important condensation of the mesenchyme. The pseudoglandular stage (3) at week 6.5 is characterized by the beginning of the formation of lobes in the condensed mesenchyme. The canalicular stage (4), between week 7 and 7.5, is characterized by the appearance of a lumen in the proximal part of the submandibular duct. The innervation stage (5) occurs during week 8, with the innervation of the submandibular and interlobular ducts. Nervous branches arriving from the parasympathetic ganglion innervate the glandular parenchyma. Numerous blood vessels are observed nearby. Our results suggest that submandibular salivary gland development requires interactions among epithelium, mesenchyme, parasympathetic ganglion and blood vessels.
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Affiliation(s)
- Luis Quirós-Terrón
- Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
| | - Luis-Alfonso Arráez-Aybar
- Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
| | - Jorge Murillo-González
- Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
| | | | | | - José-Vicente Sanz-Casado
- Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
| | - José-Ramón Mérida-Velasco
- Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain
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Murillo-González J, De La Cuadra-Blanco C, Arráez-Aybar LA, Herrera-Lara ME, Minuesa-Asensio A, Mérida-Velasco JR. Development of the long head of the biceps brachial tendon: A possible explanation of the anatomical variations. Ann Anat 2018; 218:243-249. [PMID: 29730466 DOI: 10.1016/j.aanat.2018.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/12/2018] [Accepted: 04/19/2018] [Indexed: 01/03/2023]
Abstract
The anatomical variations of the proximal portion of the long head of the biceps brachii tendon (LHBT) are rarely observed in clinical practice. However, an increase in the rate of shoulder arthroscopic surgery has led to an increase in the observation of anatomical variations of this region. The aim of this work was to analyze the development of the LHBT in 23 human embryos ranging from the 6th to 8th weeks of development. The LHBT develops from the glenohumeral interzonal mesenchyme in the 6th week. By week 7, the myotendinous junction of the LHBT develops. The anlage of the LHBT is separated from that of the glenohumeral capsule during week 8. Our results suggest that the most important period for the LHBT development occurs between the 6th and 8th weeks of embryonic development. Alterations during this critical period may cause anatomical variations of the LHBT. An additional case report from our own experience is provided as Supplementary material.
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Affiliation(s)
- Jorge Murillo-González
- Department of Human Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain
| | - Crótida De La Cuadra-Blanco
- Department of Human Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain
| | - Luis-A Arráez-Aybar
- Department of Human Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain.
| | - Manuel-E Herrera-Lara
- Department of Human Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain
| | - Alvaro Minuesa-Asensio
- Hospital Universitario de Guadalajara, Department of Orthopaedics and Traumatology, Guadalajara, Spain
| | - José Ramón Mérida-Velasco
- Department of Human Anatomy and Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain
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Abstract
PURPOSE The purpose of this study was to macroscopically examine the fetal shoulder joint using arthroscopy. We attempted to identify and describe the specific characteristics of the fetal shoulder joint, how it evolves during the last few weeks of intrauterine development, and any possible variations with regard to the adult shoulder. TYPE OF STUDY Observational anatomic case series. METHODS We used 20 frozen fetuses with a gestational age of 24 to 40 +/- 2 weeks, obtained from spontaneous abortions. Examination was performed with standard arthroscopic surgical equipment, using a 2.7-mm optical lens. Whenever possible, we tried to use the standard arthroscopic portals. Images were obtained for comparison with the adult shoulder. RESULTS The arthroscopic images of the fetal glenohumeral joint are similar to those of an adult shoulder, with the only differences being those related to the stage of development. In this study we observed no so-called bare spot in the glenoid cavity such as has been described in treatises on the adult shoulder joint. The arthroscopic images of the anterosuperior region of the fetal joint show more highly defined structures than in the adult shoulder, especially the coracohumeral and glenohumeral ligaments. CONCLUSIONS To our knowledge, this is the first arthroscopic study to target the fetal shoulder joint. The results indicate minimal differences when compared with the adult shoulder joint; for some structures, particularly in the anterosuperior region, the anatomy observed was easier to discern than what is observed in adult shoulder arthroscopy. CLINICAL RELEVANCE Our study obtained clear images of virgin shoulder joints that had never been subjected to deterioration from wear or other distorting forces. The clarity of these images is useful for locating and identifying structures in the adult shoulder.
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Affiliation(s)
- José Tena-Arregui
- C.O.A. Servicio de Traumatología y Cirugía Ortopédica, Clínica Santa Elena, Madrid, Spain
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Puerta-Fonollá J, Vázquez-Osorio T, Ruiz-Cabello J, Murillo-González J, Peña-Melián A. Magnetic resonance microscopy versus light microscopy in human embryology teaching. Clin Anat 2004; 17:429-35. [PMID: 15176043 DOI: 10.1002/ca.20012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A study was carried out on the application of magnetic resonance microscopy (MRM) in teaching prenatal human development. Human embryos measuring 8 mm, 15 mm, 18.5 mm, and 22 mm were fixed in a 4% paraformaldehyde solution and sections obtained with magnetic resonance imaging (MRI) were compared to those prepared for light microscopy (LM), using the same embryos. The MRM and LM slices were of a similar quality. In the MRM sections, embryonic organs and systems were clearly visible, particularly the peripheral and central nervous systems, and the cardiovascular and digestive systems. The digitalization and clarity of the MRM images make them an ideal teaching aid that is suitable for students during the first years of a health-science degree, particularly medicine. As well as providing students with their first experience of MRM, these images allow students to access, at any time, all embryos used, to assess changes in the positions of different organs throughout their stages of development, and to acquire spatial vision, an absolute requirement in the study of human anatomy. We recommend that this technique be incorporated into the wealth of standard embryonic teaching methods already in use.
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Affiliation(s)
- J Puerta-Fonollá
- Departamento de Anatomía y Embriología Humana I, Universidad Complutense, Madrid, Spain
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Abstract
PURPOSE The purpose of this study was to macroscopically examine the fetal knee joint via arthroscopy. We have attempted to identify and describe the specific characteristics of the fetal knee joint, how it evolves during the last few weeks of intrauterine development, and any possible variations with regard to the adult knee. TYPE OF STUDY Observational anatomic case series. METHODS We used 20 frozen fetuses with a gestational age of 24 to 40 +/- 2 weeks, obtained from spontaneous abortions. Examination was performed with standard arthroscopic surgical equipment, using a 2.7-mm optical lens. Whenever possible, we tried to use standard arthroscopic portals. Images were obtained for comparison with the adult knee. RESULTS Suprapatellar and infrapatellar septa were an almost consistent finding. The suprapatellar septum always opened laterally and was intact in the developmentally younger specimens. We found 2 mediopatellar septa. The femoral attachment of the anterior cruciate ligament (ACL) differed in appearance from that of the adult in that it was more ribbon-like. The lateral meniscus had a more spread-out appearance than its adult counterpart, especially in the specimens of a younger gestational age. We were surprised at the easy accessibility of the popliteal hiatus and the clear arthroscopic vision we were able to obtain of the involved structures. CONCLUSIONS To our knowledge, this is the first arthroscopic study to target the fetal knee. The results indicate minimal differences when compared with the adult knee, and for some structures, such as the popliteal hiatus, the anatomy seen was easier to discern than in adult knee arthroscopy.
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Affiliation(s)
- José Tena-Arregui
- C.O.A. Servicio de Traumatología y Cirugía Ortopédica, Clínica Santa Elena, Madrid, Spain
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Barrio-Asensio C, Peña-Melián A, Puerta-Fonollá J, Vázquez-Osorio T, Murillo-González J. Ciliary muscle in avian is derived from mesenchymal and epithelial cells. Vision Res 2002; 42:1695-9. [PMID: 12127103 DOI: 10.1016/s0042-6989(02)00097-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
It has long been maintained that the ciliary muscle derives from mesenchymal cells. The embryonic development of the avian ciliary muscle was studied in chick embryos from stage 25 HH to the time of hatching. Serial sections of the eye were stained routinely or immunocytochemically using the monoclonal antibody 13F4, which recognizes a cytoplasmic antigen specific for all types of muscle cells. We found that the mesenchymal immunoreactive cells, at stage 37 HH, are arranged in two distinct orientations forming the anterior and posterior portions of the ciliary muscle. At stages 38 and 39 HH the pigmented epithelium contained 13F4 positive cells, which detach from the epithelium and apparently migrate into stroma. These epithelial cells may differentiate into muscle cells. Within this same time period a progressive accumulation of myoblasts was detected between the pigmented epithelium and the ciliary muscle. Some myoblasts containing melanin were also observed. At stage 40 HH the internal portion of the ciliary muscle was visible. These findings indicate that the immunopositive epithelial cells participate in the formation of the internal portion of the muscle. We conclude that the ciliary muscle derives not only from the mesenchymal cells but also from the pigmented epithelium.
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Affiliation(s)
- Carmen Barrio-Asensio
- Departamento de Ciencias Morfológicas I, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Puerta-Fonollá J, Ruiz-Cabello J, Vázquez-Osorio T, Murillo-González J, Peña-Melián A. The human embryo development through MMR. Ital J Anat Embryol 2002; 106:155-60. [PMID: 11732572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
This study evaluates the use of the Microscopic Magnetic Resonance (MMR) in the human prenatal development. Human embryos (8mm, 15mm, 18mm and 22mm in length) fixed in 4% paraformaldehyde were used. Results were compared with light microscopy (LM) images. The internal configuration of the embryos can be clearly observed as well as many organs such as liver, lungs, heart, including their spatial relationships. In general MMR sections are less clear and show minor details than those by LM. Neverthless, many advantages are provided by using this technique. For example it is possible: a) to make three-dimensional (3-D) surface and internal full or partial reconstructions; b) to evaluate the presence of developmental anomalies; c) to evaluate the tissular preservation degree of the specimens; and d) to apply morphometric techniques to unfixed specimens. In our opinion the advantages derived by using MMR are many and overcome the disadvantages. This study demonstrates that MMR can be incorporated into ordinary laboratory techniques in human development studies, being also an initial election technique opposite to others more aggressive.
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Affiliation(s)
- J Puerta-Fonollá
- Departamento de Ciencias Morfológicas I. Fac. Med. UCM, Madrid, Spain.
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Abstract
Embryology as a modern science began at the beginning of the 19th century and continued as the classic period until the 1940s. During this period, a body of basic knowledge was established which, generally, described the events of development. From 1940 to 1970 experimental or causal embryology predominated; explanations of secondary causes were demonstrated for development. The decade of the 1970s was a decade of transition that led to the current revolution in molecular biology that began in the 1980s. Molecular biology and its new branch, molecular genetics, shook up the heretofore serene, but already limited, field of embryology. Today the discipline of embryology is being built on the analysis of the results of genetic expression. Embryology is now concerned with understanding development from the viewpoint of the activation and transcription of DNA sequences, which will allow us to approach the first causes or underlying genetic and epigenetic mechanisms of development. As a result, embryology and genetics have fused into a wider biological subdiscipline, developmental biology. Will this be enough to define the full scope of our knowledge of embryonic development? What is certainly evident is that the molecular period of embryology will help achieve a better understanding of the schemata constructed by classic and experimental embryologists. Furthermore, to the degree that the molecular analysis of whatever phenomenon of development requires additional foundational knowledge, classic and experimental embryology will not have exhausted all their possibilities.
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Affiliation(s)
- J Murillo-González
- Departamento de Ciencias Morfológicas I, Facultad de Medicina, Universidad Complutense de Madrid, Spain.
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Barrio-Asensio C, Murillo-González J, Peña-Meliánn A, Puerta-Fonollá J. Immunocytochemical study on the triple origin of the sphincter iris in the chick embryo. Dev Genes Evol 1999; 209:620-4. [PMID: 10552303 DOI: 10.1007/s004270050296] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The ontogenic development of the sphincter iris has been studied by immunocytochemistry and standard staining on chick embryos from stage 25 HH to the time of hatching. We have used the monoclonal antibody 13F4, a highly specific marker of muscular cells. We have observed three different regions in the iris. In the pupillary region, immunoreactive cells are in continuous contact with the inner epithelium of the pupillary margin. In the intermediate region, the outer epithelium forms buds of pigmented cells that emigrate toward the stroma. In this epithelium cells that are totally or partially unpigmented exist, and they are 13F4 positive. In the sphincter we have observed 13F4 positive cells with melanin granules. In the ciliary region, the immunoreactivity appears in dispersed mesenchymal cells. The present findings are consistent with a triple origin of the sphincter iris in the chick embryo. This muscle is derived from the inner epithelium of the pupillary margin, the intermediate region of the outer epithelium, and from the mesenchymal cells. The cells of the inner epithelium of the pupillary margin are differentiated into smooth muscle cells, and the remaining cells form striated muscle cells.
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Affiliation(s)
- C Barrio-Asensio
- Departamento de Ciencias Morfológicas I, Facultad de Medicina, Universidad Complutense de Madrid, E-28040 Madrid, Spain.
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