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Marzocchi G, Damiani Ferretti M, Mengoli M, Lovato L. Non-traumatic fat necrosis of the buttock: MRI findings of an unusual entity. BMJ Case Rep 2024; 17:e258530. [PMID: 38508600 PMCID: PMC10952900 DOI: 10.1136/bcr-2023-258530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 03/22/2024] Open
Affiliation(s)
- Guido Marzocchi
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Margherita Damiani Ferretti
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Mengoli
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luigi Lovato
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Suto A, Fujii K, Nakatani T, Ogawa K, Ichihara T, Li S, Sato K, Miura K, Funayama T, Yamazaki M. Correlation between preoperative CT scan of the paraspinal, psoas, and gluteus muscles and postoperative ambulatory status in patients with femoral neck fractures. BMC Musculoskelet Disord 2024; 25:132. [PMID: 38347481 PMCID: PMC10860248 DOI: 10.1186/s12891-024-07251-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/02/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND This study aimed to investigate the relationship between femoral neck fractures and sarcopenia. METHODS This was a retrospective analysis of 92 patients with femoral neck fractures, from September 2017 to March 2020, who were classified into high ambulatory status (HG) and low ambulatory status (LG) groups. Ambulatory status was assessed before surgery, one week after surgery, at discharge, and during the final follow-up. To evaluate sarcopenia, muscle mass and fatty degeneration of the muscles were measured using preoperative CT. An axial slice of the superior end of the L5 vertebra was used to evaluate the paraspinal and psoas muscles, a slice of the superior end of the femoral head for the gluteus maximus muscle, and a slice of the inferior end of the sacroiliac joint for the gluteus medius muscle. The degeneration of the muscles was evaluated according to the Goutallier classification. RESULTS The cross-sectional area of the gluteus medius and paraspinal muscles was significantly correlated with ambulatory status before the injury, at discharge, and during the final follow-up. CONCLUSIONS Measurement of the gluteus medius and paraspinal muscles has the potential to evaluate sarcopenia and predict ambulatory status after femoral neck fractures.
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Affiliation(s)
- Akihito Suto
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Kengo Fujii
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Takushi Nakatani
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Kaishi Ogawa
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Takumi Ichihara
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Sayori Li
- Department of Orthopaedic Surgery, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo, Japan
| | - Kosuke Sato
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan
| | - Kousei Miura
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan
| | - Toru Funayama
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan.
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan
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Kushida-Contreras BH, Gómez-Calva B, Gaxiola-García MA. Cosmetic Injection of Illicit Foreign Materials: Imaging Features and Patterns of Migration in 413 Cases. Aesthet Surg J 2024; 44:183-191. [PMID: 37863473 DOI: 10.1093/asj/sjad336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The injection of illicit, nonregulated foreign materials is increasingly common and has negative consequences relative to the inflammatory process that ensues. OBJECTIVES The aim of this study was to identify anatomical and imaging characteristics after the cosmetic injection of illicit foreign materials. METHODS A retrospective review of clinical and imaging records was performed. The issues analyzed were the anatomical site, type of injected substance, imaging method for diagnosis, and patterns of migration. RESULTS Data on 413 patients were collected. Most patients were female, with a mean age of 44 years. The most commonly infiltrated region was the buttocks (n = 284; 53.58%) followed by the breast (n = 99; 18.67%). Magnetic resonance imaging was the most common method of diagnosis in those patients who had an imaging study (159 out of 168). The most frequent depth of foreign material detected by imaging was the muscular plane (n = 103; 61.30%). Migration was detected in 56.55% of patients who had an imaging study. Most infiltrated substances were unknown; biopolymers were the most commonly identified substances. Depending on the type of substance, migration rates varied from 13% to 29%; rate differences were not statistically significant (P = .712). Migration was more common when the depth of infiltration was in muscle (77.66%) than in subcutaneous tissue (23.4%); this difference was statistically significant (P < .0001). CONCLUSIONS Deep infiltration is related to greater migration rates, apparently regardless of the substance injected. LEVEL OF EVIDENCE: 3
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Tanaka M, Kanayama M, Oha F, Shimamura Y, Tsujimoto T, Hasegawa Y, Hashimoto T, Nojiri H, Ishijima M. Potential of whole-body dual-energy X-ray absorptiometry to predict muscle size of psoas major, gluteus maximus and back muscles. BMC Musculoskelet Disord 2023; 24:917. [PMID: 38012671 PMCID: PMC10680309 DOI: 10.1186/s12891-023-07051-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Measurement of trunk muscle cross-sectional area (CSA) using axial magnetic resonance imaging (MRI) is considered clinically meaningful for understanding several spinal pathologies, such as low back pain and spinal sagittal imbalance. However, it remains unclear whether trunk muscle mass (TMM) measured using dual-energy X-ray absorptiometry (DXA) can predict the trunk muscle CSA. The aim of this study is to determine if DXA-derived TMM is associated and predicts with CSA of paraspinal muscles and gluteus maximus measured using MRI in healthy volunteers. METHODS A total of 48 healthy volunteers underwent whole-body DXA and MRI of the spinopelvic region. The CSA of the psoas major, back muscles, and gluteus maximus were measured on axial MRI. Correlations and linear regressions between the TMM measured using DXA and the CSA of each musculature were investigated. RESULTS There was a weak correlation between TMM and CSA of the psoas major in men (r = 0.39, P = 0.0678), and the linear regression was y = 301.74x - 401.24 (R2 = 0.2976, P = 0.0070). A moderate correlation was found in women (r = 0.58, P = 0.0021), and the linear regression was y = 230.21x - 695.29 (R2 = 0.4445, P = 0.0003). Moderate correlations were observed between TMM and CSA of the back muscles in both men (r = 0.63, P = 0.0012) and women (r = 0.63, P = 0.0007), the linear regression was y = 468.52x + 3688.5 (R2 = 0.5505, P < 0.0001) in men and y = 477.39x + 2364.1 (R2 = 0.564, P < 0.0001) in women. There was a strong correlation between TMM and CSA of the gluteus maximus in men (r = 0.72, P < 0.0001), and the linear regression was y = 252.69x - 880.5 (R2 = 0.6906, P < 0.0001). A moderate correlation was found in women (r = 0.69, P < 0.0001), and the linear regression was y = 230.74x - 231.32 (R2 = 0.6542, P < 0.0001). CONCLUSIONS The DXA-derived TMM was able to predict the CSA of the psoas major, back muscles, and gluteus maximus, and significantly correlated with the CSA of the back muscles and gluteus maximus. It might be a safer and cheaper alternative for evaluating the size of the back muscles and gluteus maximus.
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Affiliation(s)
- Masaru Tanaka
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan.
| | - Masahiro Kanayama
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Fumihiro Oha
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yukitoshi Shimamura
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Takeru Tsujimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Yuichi Hasegawa
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Tomoyuki Hashimoto
- Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan
| | - Hidetoshi Nojiri
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, 1-5-29-4F, Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan
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Danilla S, Troncoso E, Jara R, Dominguez C, Albornoz C, Erazo C, Sepulveda S, Nielsen J, Serra S, Yamada N. What Makes a Beautiful Buttock Beautiful? A Case-Control Study Comparing Buttocks Models versus Normal Women by Magnetic Resonance Imaging, Photography and Anthropometry. Aesthetic Plast Surg 2023; 47:1896-1904. [PMID: 36542093 DOI: 10.1007/s00266-022-03222-w] [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: 10/15/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To describe characteristics of women with aesthetically ideal buttocks and differentiate them from women with normal buttocks. METHODS Case-control study comparing anatomy of women with ideal buttocks (buttocks models) to women with normal buttocks using magnetic resonance images, anthropometric measurements and photography. RESULTS Comparing to normal women, buttocks models have a narrower waist, narrower iliac crest, wider C point, wider hips and bigger and thicker gluteus maximus muscle (GMM). A bigger GMM adds more projection to the C point, point of maximum projection in the lateral view is 2.7 cm higher than the pubic bone. The amount of subcutaneous fat was equal in models and controls. CONCLUSIONS Our study provides new knowledge regarding the tridimensional aspects of the beauty of the buttocks area. A beautiful buttock is a conjunction of adequate bony shape, muscle development, subcutaneous fat layer, and tight skin. Comparing to normal women, buttocks models have a narrower waist, narrower iliac crest, wider C point, wider hips and bigger and thicker Gluteus Maximus Muscle. Accurate understanding of the aesthetic goals in a given patient can guide surgical technique. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Stefan Danilla
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile.
| | - Ekaterina Troncoso
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
| | - Rocio Jara
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
| | - Carlos Dominguez
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
| | - Claudia Albornoz
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
| | - Cristian Erazo
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
| | - Sergio Sepulveda
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
| | - Johanna Nielsen
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
| | - Sofia Serra
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
| | - Naomi Yamada
- Departamento de Cirugía, Unidad de Cirugía Plástica, Hospital Clínico Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile
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Sukun A, Weber MA. Gluteus Maximus Calcific Tendinitis. ROFO-FORTSCHR RONTG 2023; 195:721-723. [PMID: 37019143 DOI: 10.1055/a-2032-3032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Affiliation(s)
- Abdullah Sukun
- Exchange Programme for Musculoskeletal Radiology Fellowships, European School of Radiology (ESOR), Vienna, Austria
- Baskent University Alanya Application and Research Center, Antalya, Türkiye
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Marc-André Weber
- Institute for Diagnostic and Interventional Radiology, Pediatric and Neuroradiology, University Medical Center Rostock, Rostock, Germany
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Gabryszuk K, Bonczar M, Ostrowski P, Gliwa J, Yika ADC, Iskra T, Kłosiński M, Wojciechowski W, Walocha J, Koziej M. The inferior gluteal artery anatomy: a detailed analysis with implications for plastic and reconstructive surgery. Folia Morphol (Warsz) 2023; 83:53-65. [PMID: 37144850 DOI: 10.5603/fm.a2023.0029] [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: 02/06/2023] [Revised: 03/25/2023] [Accepted: 03/26/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND The inferior gluteal artery (IGA) is a large terminal branch of the anterior division of the internal iliac artery (ADIIA). There is a significant lack of data regarding the variable anatomy of the IGA. MATERIALS AND METHODS A retrospective study was conducted to establish anatomical variations, their prevalence and morphometrical data on IGA and its branches. The results of 75 consecutive patients who underwent pelvic computed tomography angiography were analysed. RESULTS The origin variation of each IGA was deeply analysed. Four origin variations have been observed. The most common type O1 occurred in 86 of the studied cases (62.3%). The median IGA length was set to be 68.50 mm (lower quartile [LQ]: 54.29; higher quartile [HQ]: 86.06). The median distance from the origin of the ADIIA to the origin of the IGA was set to be 38.22 mm (LQ: 20.22; HQ: 55.97). The median origin diameter of the IGA was established at 4.69 mm (LQ: 4.13; HQ: 5.45). CONCLUSIONS The present study thoroughly analysed the complete anatomy of the IGA and the branches of the ADIIA. A novel classification system for the origin of the IGA was created, where the most prevalent origin was from the ADIIA (type 1; 62.3%). Furthermore, the morphometric properties (such as the diameter and length) of the branches of the ADIIA were analysed. This data may be incredibly useful for physicians performing operations in the pelvis, such as interventional intraarterial procedures or various gynaecological surgeries.
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Affiliation(s)
- Kamil Gabryszuk
- Chiroplastica - The Lower Silesian Centre of Hand Surgery and Aesthetic Medicine, Wroclaw, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
- Youthoria, Youth Research Organization, Krakow, Poland
| | - Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
- Youthoria, Youth Research Organization, Krakow, Poland
| | - Jakub Gliwa
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
- Youthoria, Youth Research Organization, Krakow, Poland
| | | | - Tomasz Iskra
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Michał Kłosiński
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Wadim Wojciechowski
- Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
- Youthoria, Youth Research Organization, Krakow, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
- Youthoria, Youth Research Organization, Krakow, Poland.
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Billuart F, Lalevée M, Brunel H, Van Driessche S, Beldame J, Matsoukis J. MRI assessment of minimally invasive anterolateral approaches in total hip arthroplasty. Orthop Traumatol Surg Res 2022; 108:103356. [PMID: 35724839 DOI: 10.1016/j.otsr.2022.103356] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/10/2022] [Accepted: 01/31/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Total hip arthroplasty (THA) on a minimally invasive anterolateral (MIAL) approach frequently leads to gluteus minimus and gluteus medius lesions, and sometimes to tensor fasciae latae (TFL) denervation. We therefore developed compensatory strategies, which we assessed on pre- and post-operative MRI: 1) to assess gluteus minimus and gluteus medius fatty infiltration (FI), 2) to assess TFL FI, and 3) to assess FI in the other periarticular muscles. HYPOTHESIS The modified MIAL approach reduces the rate of gluteus minimus and gluteus medius lesion. MATERIALS AND METHODS A continuous prospective single-surgeon series of THA using a MIAL approach included 25 patients. Femoral implantation was performed with the hip in extension so as to distance the proximal femur from the gluteals, avoiding muscle trauma. The superior gluteal nerve branch in the space between the gluteus medius and TFL, running toward the TFL, was systematically released and protected. MRI was performed preoperatively and at 3 months and 1 year post-surgery. FI was analyzed according to the Goutallier classification in all periarticular muscles. RESULTS One patient lacked preoperative MRI and was excluded, leaving 24 patients, for 72 MRIs. In 10/24 patients (41.7%) the gluteus minimus and in 8/24 patients (33.3%) the anterior third of the gluteus medius showed ≥2 grade increase in FI between preoperative and 1-year MRI, with significant increases in both at 3 months (p<0.001) and 1 year (p<0.001). At least a 2 grade increase in FI at 1 year was seen in 1 patient (4.2%) in the TFL, in 2 (8.3%) in the piriformis, and in 1 (4.2%) in the obturator internus. There were no significant differences in FI between preoperative, 3-month or 1-year MRI in any other periarticular muscles. CONCLUSION Femoral implantation in hip extension did not reduce the rate of gluteal lesions, which remained frequent. In contrast, release of the superior gluteal nerve branch could be effective in conserving TFL innervation. Some rare lesions of the proximal part of the pelvi-trochanteric muscles were also observed. LEVEL OF EVIDENCE IV, Prospective case series.
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Affiliation(s)
- Fabien Billuart
- Laboratoire d'analyse du mouvement, institut de formation en masso-kinésithérapie Saint-Michel, 68, rue du Commerce, 75015 Paris, France; Université Paris-Saclay, UVSQ, Erphan, 78000 Versailles, France
| | - Matthieu Lalevée
- Centre hospitalier universitaire de Rouen, service de chirurgie orthopédique et traumatologique, 37, boulevard Gambetta, 76000 Rouen, France.
| | - Helena Brunel
- Laboratoire d'analyse du mouvement, institut de formation en masso-kinésithérapie Saint-Michel, 68, rue du Commerce, 75015 Paris, France
| | | | - Julien Beldame
- Institut clinique du Pied-Paris, Ramsay santé, clinique blomet, 136, rue Blomet, 75015 Paris, France; Clinique Mégival, 1328, avenue de la Maison-Blanche, 76550 Saint-Aubin-sur-Scie, France
| | - Jean Matsoukis
- Département de Chirurgie Orthopédique, Groupe Hospitalier du Havre, BP 24, 76083 Le Havre cedex, France
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Lalevée M, Curado J, Matsoukis J, Beldame J, Brunel H, Van Driessche S, Billuart F. Comparative MRI assessment of three minimally invasive approaches in total hip arthroplasty. Orthop Traumatol Surg Res 2022; 108:103354. [PMID: 35716987 DOI: 10.1016/j.otsr.2022.103354] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/10/2022] [Accepted: 04/22/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Minimally invasive approaches (direct anterior approach: DAA; minimally invasive anterolateral: MIAL; piriformis-sparing posterior approach: PSPA) are widely used for total hip arthroplasty (THA), with a muscle-sparing objective. There are no published comparative studies of muscle damage secondary to these approaches. The aim of the present study was to compare fatty infiltration (FI) on MRI induced by DAA, MIAL and PSPA in THA 1) in the tensor fasciae latae (TFL) and sartorius muscles, 2) in the gluteal muscles, and 3) in the pelvitrochanteric muscles. HYPOTHESIS Greater FI is induced by DAA in anterior muscles, by MIAL in gluteal muscles and by PSPA in pelvitrochanteric muscles. MATERIALS AND METHODS Three continuous prospective series of THA by DAA, MIAL and PSPA included 25 patients each. MRI was performed preoperatively and at 1 year postoperatively. FI was graded on the Goutallier classification in all periarticular hip muscles. Muscles showing ≥2 grade aggravation at 1 year were considered damaged. RESULTS Nine patients whose preoperative MRI was uninterpretable were excluded. In all, 66 patients (21 DAA, 24 MIAL and 21 PSPA) with 132 MRI scans were analyzed. TFL was damaged in 2/21 DAA patients (9.5%), 1/24 MIAL patients (4.2%) and 0/21 PSPA patients (0%). There were no sartorius lesions. The anterior third of the gluteus medius was damaged in 8/24 MIAL patients (33.3%) and the gluteus minimus in 10/24 (41.7%), compared to 1/21 DAA patients (4.8%) and 0/21 PSPA patients (0%). The mid and posterior thirds of the gluteus medius and the gluteus maximus were never damaged. The piriformis muscle was damaged in 3/21 DAA patients (14.3%), 2/24 MIAL patients (8.3%) and 2/21 PSPA patients (9.5%). The obturator internus was damaged in 4/21 DAA patients (19%), 1/24 MIAL patients (4.2%) and 16/21 PSPA patients (76.2%). The obturator externus and quadratus femoris were mainly damaged in PSPA patients: respectively, 5/21 (23.8%) and 4/21 patients (19%)). CONCLUSION The muscle-sparing properties of minimally invasive hip approaches are only theoretical. In the present series, there were rare TFL lesions with DAA and MIAL. Gluteus medius and minimus lesions were frequent in MIAL. Pelvitrochanteric muscles lesions were more frequent in PSPA, but found in all 3 approaches. These findings should help guide surgeons in their choice of approach and in informing patients about the damage these minimally invasive approaches can cause. LEVEL OF EVIDENCE III, prospective comparative study.
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Affiliation(s)
- Matthieu Lalevée
- Centre Hospitalier Universitaire de Rouen, Service de Chirurgie Orthopédique et Traumatologique, 37, boulevard Gambetta, 76000 Rouen, France.
| | - Jonathan Curado
- Centre Hospitalier Universitaire de Rouen, Service de Chirurgie Orthopédique et Traumatologique, 37, boulevard Gambetta, 76000 Rouen, France
| | - Jean Matsoukis
- Département de Chirurgie Orthopédique, Groupe Hospitalier du Havre, BP 24, 76083 Le Havre cedex, France
| | - Julien Beldame
- Institut Clinique du Pied-Paris, Ramsay Santé, Clinique Blomet, 136, rue Blomet, 75015 Paris, France; Clinique Mégival, 1328, avenue de la Maison-Blanche, 76550 Saint-Aubin-sur-Scie, France
| | - Helena Brunel
- Laboratoire d'Analyse du Mouvement, Institut de Formation en Masso-kinésithérapie Saint-Michel, 68, rue du Commerce, 75015 Paris, France
| | | | - Fabien Billuart
- Laboratoire d'Analyse du Mouvement, Institut de Formation en Masso-kinésithérapie Saint-Michel, 68, rue du Commerce, 75015 Paris, France; Université Paris-Saclay, UVSQ, Erphan, 78000 Versailles, France
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Ghasemi-Rad M, Vadvala HV, Lincoln CM, Irani Z. Embolization of Large Internal Iliac Artery Pseudoaneurysm through a Retrograde Trans-Superior Gluteal Arterial Access. Tomography 2022; 8:2107-2112. [PMID: 36136873 PMCID: PMC9498860 DOI: 10.3390/tomography8050177] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
The presence of osteal stenosis/occlusion or osteal exclusion by prior interventions poses a challenge to selective catheterization of the internal iliac artery. We describe a case where a retrograde access through the superior gluteal artery (SGA) was used to successfully treat an internal iliac artery pseudoaneurysm (PSA) in a patient when an antegrade catheterization was not feasible due to internal iliac osteal exclusion by an endograft.
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Affiliation(s)
- Mohammad Ghasemi-Rad
- Department of Radiology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Harshna V. Vadvala
- Department of Radiology and Radiological Science, Johns Hopkins Hospital, Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287, USA
| | - Christie M. Lincoln
- Department of Radiology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
| | - Zubin Irani
- Department of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St., Boston, MA 02114, USA
- Correspondence:
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11
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Zandee van Rilland ED, Wu JS, Tompkins CM, Kelly SP, Anderson ME. Distant migration of gluteal augmentation fat presenting as a soft tissue knee mass. Skeletal Radiol 2022; 51:1093-1098. [PMID: 34618183 DOI: 10.1007/s00256-021-03931-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
Gluteal augmentation with autologous fat grafting is an increasingly popular procedure. While complication rates are low, the clinical and imaging evaluation of the various complications can be challenging. We report a case of distal migration of a failed gluteal fat graft in a young female patient presenting as a soft tissue mass in the knee, mimicking a soft tissue sarcoma. Surgical resection of the migrated fat graft confirmed the diagnosis. The diagnosis was challenging as the patient was initially reluctant to disclose her surgical history due to perceived negative social stigmas related to cosmetic contouring procedures. This case highlights the imaging findings of a rare complication following autologous fat grafting for gluteal augmentation and the importance of obtaining a thorough medical history.
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Affiliation(s)
- Eddy D Zandee van Rilland
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
| | - Jim S Wu
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Cana M Tompkins
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sean P Kelly
- Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Megan E Anderson
- Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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12
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Park GJ, Jeng A, Choudhary MR, Roudnitsky V. Gluteal Arteriovenous Fistula from Blunt Trauma. Am Surg 2020; 86:e216-e218. [PMID: 32391785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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13
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You T, Yang B, Zhang XT, Ren SY, Bai L, Jiao FJ, Jiang XC, Guan SY, Zhang WT. A possible prediction of dystocia at the time of cesarean delivery: Gluteal muscle contracture, a single center experience from China. Medicine (Baltimore) 2020; 99:e19138. [PMID: 32049835 PMCID: PMC7035071 DOI: 10.1097/md.0000000000019138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The study assessed the pelvic dimensions by computed tomography (CT) performed for gluteal muscle contracture women, and evaluated the impact of malformations on several essential obstetric parameters.The CT pelvimetry was retrospectively performed in 25 gluteal muscle contracture women selected consecutively whether they had delivery history or not. Among the pelvic inlet plane, the mid plane and the outlet plane, 12 indicators including the transverse diameter of the pelvic inlet, the conjugate vera, the diagonal conjugate, the biischial diameter, the anteroposterior diameter of the middle pelvis, transverse outlet, the posterior sagittal diameter of outlet, the conjugate of the outlet, the anterior sagittal diameter of the outlet, the curvature and length of the sacrum, the angle of pubic arch were collected.Finally, the mean age of these women was 26.6 ± 5.0 years. Most pelvises had anteroposterior elliptical appearance in inlet and size of the female pelvis. The most statistically different and most clinically significant indicator was the biischial diameter, gluteal muscle contracture women were 95.6 ± 9.3 mm and the normal women from other study were 105.0 ± 7.9 mm, the comparison showed a significant difference (P < .001).Generally, most gluteal muscle contracture women had features of anthropoid pelvis which were quite different from normal Chinese female. These results may serve as a basis for future studies to assess its utility and prognostic value for a safe vaginal delivery in gluteal muscle contracture women.
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Affiliation(s)
- Tian You
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Bei Yang
- Gynecology Department, Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Xin-tao Zhang
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Shi-you Ren
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Lu Bai
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Fu-jia Jiao
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Xiao-cheng Jiang
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Si-yao Guan
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
| | - Wen-tao Zhang
- Sports Medicine and Rehabilitation Department, Peking University Shenzhen Hospital
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Al Dandan O, Hassan A, Al Muhaish M, AlMatrouk J, Almuhanna H, Hegazi T. Concomitant bilateral elastofibroma in the infrascapular and gluteal regions: a report of a rare case. BMC Musculoskelet Disord 2020; 21:16. [PMID: 31914985 PMCID: PMC6950919 DOI: 10.1186/s12891-020-3037-7] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Elastofibroma is a benign soft tissue tumor characterized by the presence of elastic fibers in a stroma of collagen and mature adipose tissue. It is reported to have a prevalence of 2.73%, as shown by a study through computed tomography (CT) images. However, multiple elastofibromas are uncommon. CASE PRESENTATION We report a case of concomitant bilateral elastofibroma in the infrascapular and gluteal regions. A 63-year-old male patient presented with a 6-month history of gradually increasing painless swellings in the upper back. On physical examination, firm, painless bilateral infrascapular masses were identified; these masses were more noticeable on forward arm flexion. Contrast-enhanced computed tomography showed well-defined bilateral infrascapular masses deep to the serratus anterior muscles as well as poorly defined bilateral gluteal masses with attenuation similar to that of the adjacent skeletal muscle. Magnetic resonance imaging revealed heterogenous masses with internal fatty streaks, consistent with elastofibroma. The histopathological diagnosis of elastofibroma was established based on the results of image-guided core-needle biopsy. The patient underwent surgical excision of both infrascapular elastofibromas with no post-operative complications. As the gluteal masses were incidental, surgical management was not warranted. CONCLUSION The presence of multiple elastofibromas is unusual. This report describes a rare case of multiple elastofibromas and its typical imaging features, and alerts us that elastofibromas are not exclusive to the periscapular region.
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Affiliation(s)
- Omran Al Dandan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Ali Hassan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Mona Al Muhaish
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Jumanah AlMatrouk
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Haidar Almuhanna
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Tarek Hegazi
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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15
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Shauly O, Gould DJ, Siddiqi I, Patel KM, Carey J. The First Reported Case of Gluteal Implant-Associated Anaplastic Large Cell Lymphoma (ALCL). Aesthet Surg J 2019; 39:NP253-NP258. [PMID: 30768141 DOI: 10.1093/asj/sjz044] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 01/28/2023] Open
Abstract
Anaplastic large-cell lymphoma (ALCL) is a very rare but life-threatening complication that has largely been demonstrated to be associated with breast implants (BIA-ALCL). Patients are at risk of BIA-ALCL with the placement of breast implants for either cosmetic or reconstructive purposes, with the highest risks associated with textured breast implants. In the past decade, an increasing number of publications have focused on BIA-ALCL, but there has yet to be a reported case outside of the breast. Here, we describe a unique instance of gluteal implant-associated ALCL (GIA-ALCL) in a middle-aged woman. The patient received bilateral textured silicone gluteal implants only a year prior to her diagnosis of GIA-ALCL. The patient later presented to the Plastic and Reconstructive Surgery Department at our institution with ulceration at the site of her gluteal implants. Unfortunately, her condition deteriorated before explanation could be performed. Biopsy of a left lung mass demonstrated "hallmark" cells of ALCL ("horseshoe"-shaped nuclei). The diagnosis was verified by immunohistochemical testing that revealed expression of CD30, CD4, CD43, BCL6, Perforin, and Ki67 in a population of abnormal cells. The goals of this case report are thus to demonstrate that all patients undergoing implantation of textured silicone implants are at risk of developing ALCL and to provide evidence for the possible new diagnosis of GIA-ALCL. Level of Evidence: 5.
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MESH Headings
- Biomarkers, Tumor/analysis
- Biopsy
- Body Contouring/adverse effects
- Body Contouring/instrumentation
- Buttocks/diagnostic imaging
- Buttocks/surgery
- Fatal Outcome
- Female
- Humans
- Lung/diagnostic imaging
- Lung/pathology
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/etiology
- Lymphoma, Large-Cell, Anaplastic/pathology
- Lymphoma, Large-Cell, Anaplastic/therapy
- Magnetic Resonance Imaging
- Middle Aged
- Postoperative Complications/diagnosis
- Postoperative Complications/etiology
- Postoperative Complications/pathology
- Prostheses and Implants/adverse effects
- Silicone Gels/adverse effects
- Tomography, X-Ray Computed
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Affiliation(s)
- Orr Shauly
- Keck Hospital of University of Southern California, Los Angeles, CA
| | - Daniel J Gould
- Keck Hospital of University of Southern California, Los Angeles, CA
| | - Imran Siddiqi
- Keck Hospital of University of Southern California, Los Angeles, CA
| | - Ketan M Patel
- Keck Hospital of University of Southern California, Los Angeles, CA
| | - Joseph Carey
- Keck Hospital of University of Southern California, Los Angeles, CA
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16
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Graham DS, Kadera BE, Eilber FC. Irregular Lipomatous Extremity Tumor. JAMA 2019; 321:1718-1719. [PMID: 30951173 DOI: 10.1001/jama.2019.3719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Danielle S Graham
- Division of Surgical Oncology, University of California, Los Angeles Medical Center
- UCLA-Jonsson Comprehensive Cancer Center Sarcoma Program, University of California, Los Angeles Medical Center
| | - Brian E Kadera
- Division of Surgical Oncology, University of California, Los Angeles Medical Center
- UCLA-Jonsson Comprehensive Cancer Center Sarcoma Program, University of California, Los Angeles Medical Center
| | - Fritz C Eilber
- Division of Surgical Oncology, University of California, Los Angeles Medical Center
- UCLA-Jonsson Comprehensive Cancer Center Sarcoma Program, University of California, Los Angeles Medical Center
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17
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Li X, Jiang L, Chen L, Lei Y, Xu B, Liu B, Li S. A study of the MR imaging manifestations with injection of sedative at the buttocks in pediatric patients. J Xray Sci Technol 2019; 27:73-81. [PMID: 30373997 DOI: 10.3233/xst-180422] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND During the MRI examination, pediatric patients sleep under the sedation so that the image artifacts caused by the patient motion could be minimized. However, the sedative injection at the buttocks might cause a difficulty in the diagnosis of the buttock diseases using the MRI manifestations. OBJECTIVE This study aims to explore the imaging characteristics of MR for the pediatric patients with the sedative injected at the buttocks in order to correctly diagnose the diseases. METHODS MR imaging data of 64 pediatric patients injected with the sedative at the buttocks were retrospectively collected, including 8 cases of buttock disease. The imaging manifestations were analyzed and compared. RESULTS Out of 64 patients, 8 were diagnosed as the buttock diseases. MR imaging manifestations of the sedatives injected at the buttocks were the locally patchy and streaky long T1 and long T2 signals and were different from what were shown for the normal tissues and diseases. CONCLUSION The sedative injected at the buttocks has the MRI manifestations different from the normal tissues and diseases. Correctly understanding the MRI manifestations for the pediatric patients with the injection of sedative at the buttocks would reduce the chances of the misdiagnosis on the diseases.
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Affiliation(s)
- Xiaobo Li
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Liuqing Jiang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Lifang Chen
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yu Lei
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Benhua Xu
- Department of Radiation Oncology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Biying Liu
- Department of Radiology, The People's Hospital of Fujian Traditional Chinese Medicine University, Fuzhou, China
| | - Sicong Li
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, USA
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18
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Adabala V, Govil N. Anesthetic challenges in a case of Klippel-Trenaunay Syndrome with severe anaemia. J Clin Anesth 2018; 53:27-28. [PMID: 30290279 DOI: 10.1016/j.jclinane.2018.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/27/2018] [Revised: 08/31/2018] [Accepted: 09/26/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Vijay Adabala
- Department of Anesthesiology, AIIMS, Rishikesh 249203, India
| | - Nishith Govil
- Department of Anesthesiology, AIIMS, Rishikesh 249203, India.
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19
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Seo KH, Lee JY, Yoon K, Do JG, Park HJ, Lee SY, Park YS, Lee YT. Long-term outcome of low-energy extracorporeal shockwave therapy on gluteal tendinopathy documented by magnetic resonance imaging. PLoS One 2018; 13:e0197460. [PMID: 30016333 PMCID: PMC6050036 DOI: 10.1371/journal.pone.0197460] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/02/2018] [Indexed: 12/18/2022] Open
Abstract
Background Previous outcome studies for extracorporeal shock wave therapy (ESWT) have included clinically diagnosed greater trochanteric pain syndrome (GTPS). The purpose of this study is to investigate outcome of ESWT on GTPS with gluteal tendinopathy documented by magnetic resonance imaging (MRI). Methods Medical records of 38 consecutive patients were retrospectively reviewed, who underwent ESWT for GTPS with MRI-documented gluteal tendinopathy (> 6 months). ESWT was conducted (1/week) when the Roles-Maudsley score (RMS) showed “Poor” or “Fair” grade after conservative treatment until RMS had reached “Good” or “Excellent” grade (treatment success) or until 12 treatments had been applied. Numeric rating scale (NRS) and RMS were evaluated before, 1 week after (immediate follow-up) and mean 27 months after ESWT program (long-term follow-up). Success rate was calculated at each follow-up point. Results Initial NRS (5.9 ± 1.6) significantly decreased at immediate (2.5 ± 1.5, p< 0.01) and long-term follow-up (3.3 ± 3.0, p< 0.01), respectively. Success rates were 83.3% (immediate) and 55.6% (long-term), respectively. There was no correlation among age, symptom duration and NRS. Conclusion Low-energy ESWT can be an effective treatment for pain relief in chronic GTPS with MRI-documented gluteal tendinopathy. However, its long-term effect appears to decrease with time.
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Affiliation(s)
- Kyoung-Ho Seo
- Department of Physical Medicine & Rehabilitation, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-si, Gyeonggi-do, Republic of Korea
| | - Joon-Youn Lee
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungjae Yoon
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong Geol Do
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee-Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - So-Yeon Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Sook Park
- Department of Physical & Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon-si, Gyeongsangnam-do, Republic of Korea
| | - Yong-Taek Lee
- Department of Physical & Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- * E-mail: ,
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20
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Johnson CS, Johnson RL, Niesen AD, Stoike DE, Pawlina W. Ultrasound-Guided Posterior Femoral Cutaneous Nerve Block: A Cadaveric Study. J Ultrasound Med 2018; 37:897-903. [PMID: 29027690 DOI: 10.1002/jum.14429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/05/2017] [Accepted: 07/08/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To identify any anatomic barriers to local anesthetic spread between the sciatic nerve (SN) and the posterior femoral cutaneous nerve (PFCN) at the level of the infragluteal crease and to describe a potential technique for an ultrasound (US)-guided subgluteal PFCN block in a cadaveric model. METHODS Bilateral US-guided subgluteal injections of a colored latex solution were performed around the SN (15 mL) and PFCN (10 mL) in 4 unembalmed cadavers, for a total of 8 cadaver thighs. The specimens were dissected after latex polymerization to observe the spread of the latex solutions. RESULTS With US guidance, the PFCN was visualized deep to the gluteus maximus and slightly superficial or lateral to the SN at the level of the infragluteal crease. The SN and PFCN were found on dissection to be coated with their respective colored latex in all 8 thighs. The SN and PFCN were consistently separated by the deep investing muscular fascia of the thigh, with only 2 thighs showing substantial mixing of latex injectates. CONCLUSIONS The deep investing muscular fascia of the thigh appears to impede the spread of injectate between the SN and PFCN in a most unembalmed cadaver specimens. A US-guided subgluteal PFCN blockade may be a feasible technique to complement an SN block when complete anesthesia of the posterior thigh is required.
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Affiliation(s)
- Christopher S Johnson
- Departments of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Rebecca L Johnson
- Departments of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Adam D Niesen
- Departments of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - David E Stoike
- Departments of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
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21
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Spinelli M, Gillibrand R. Metastasis to gluteal muscle from high grade transitional cell carcinoma of bladder. Report of a case and review of literature. Pathologica 2018; 110:78-81. [PMID: 30259916] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
High grade bladder malignancies have tendency to local and distant invasion. The most commonly involved sites are lymph nodes, lungs, bone and liver. Muscle metastases are generally rare and have been described in few cases of Genito-Urinary cancer. In this work we describe a rare case of high grade transitional cell carcinoma from bladder metastatising to the left gluteal muscle together with the review of the pertinent literature.
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Affiliation(s)
- M Spinelli
- Department of Cellular Pathology, north Middlesex University Hospital, Sterling Way London (UK), N18 1XQ
| | - R Gillibrand
- Department of Cellular Pathology, north Middlesex University Hospital, Sterling Way London (UK), N18 1XQ
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22
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Swaine JM, Breidahl W, Bader D, Oomens C, O'Loughlin E, Santamaria N, Stacey MC. Ultrasonography Detects Deep Tissue Injuries in the Subcutaneous Layers of the Buttocks Following Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2018; 24:371-378. [PMID: 30459500 PMCID: PMC6241223 DOI: 10.1310/sci17-00031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Indexed: 11/11/2022]
Abstract
Background: Ultrasonography may have potential as an effective diagnostic tool for deep tissue injury (DTI) in tissues overlying bony prominences that are vulnerable when under sustained loading in sitting. Methods: Three cases of DTI in the fat and muscle layers overlying the ischial tuberosity of the pelvis in 3 persons with spinal cord injury (SCI) with different medical histories and abnormal tissue signs are described. Conclusion: There is a need for prospective studies using a reliable standardized ultrasonography protocol to diagnose DTI and to follow its natural history to determine its association with the development of pressure injuries.
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Affiliation(s)
- Jillian M. Swaine
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Perth, Western Australia, Australia
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - William Breidahl
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Perth, Western Australia, Australia
- Perth Radiological Clinic, Mirrabooka, Western Australia, Australia
| | - D.L. Bader
- Faculty of Health Sciences, University of Southampton, Southampton General Hospital, Southampton, UK
| | - C.W.J. Oomens
- Biomedical Engineering Department, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Edmond O'Loughlin
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Perth, Western Australia, Australia
- Fiona Stanley Hospital, Department of Health, Government of Western Australia, Perth Business Centre, Perth, Western Australia, Australia
| | - Nick Santamaria
- Melbourne School of Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Michael C. Stacey
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Perth, Western Australia, Australia
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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23
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Ando W, Yamamoto K, Koyama T, Hashimoto Y, Yasui H, Tsujimoto T, Aihara M, Ohzono K. Chronic Expanding Hematoma After Metal-on-Metal Total Hip Arthroplasty. Orthopedics 2017; 40:e1103-e1106. [PMID: 28662252 DOI: 10.3928/01477447-20170619-04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 05/10/2017] [Indexed: 02/03/2023]
Abstract
A 76-year-old woman who underwent bilateral metal-on-metal total hip arthroplasty fell 3 years after this procedure and subsequently incurred continuous pain in her buttock. Plain radiographs showed no fracture and no loosening of the hip prosthesis. Magnetic resonance imaging revealed an abnormal, large, thick-walled mass with heterogeneous signal intensity at the right buttock. The prerevision diagnosis was adverse reaction to metal debris. The mass was surgically resected, and the metal femoral head was replaced by a dual-mobility prosthesis. The intraoperative and histological analyses indicated an expanding hematoma. Cobalt ion concentrations of whole blood and effusion around the hematoma-1.9 µg/L and 1.3 µg/L, respectively-were not indicative of adverse reaction to metal debris. Transcatheter arterial embolization was performed 2 days postoperatively. The hematoma was reduced and was not present after 9 months. The diagnosis of a periprosthetic soft tissue mass after metal-on-metal total hip arthroplasty should be carefully reached with magnetic resonance imaging and assessment of blood metal ion concentrations. Expanding hematoma should be considered a potential diagnosis if metal ion concentrations are not increasing and magnetic resonance imaging shows a periprosthetic mass with a heterogeneous lesion. Embolization is useful for the management of an expanding hematoma. [Orthopedics. 2017; 40(6):e1103-e1106.].
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Nwawka OK, Meyer R, Miller TT. Ultrasound-Guided Subgluteal Sciatic Nerve Perineural Injection: Report on Safety and Efficacy at a Single Institution. J Ultrasound Med 2017; 36:2319-2324. [PMID: 28593710 DOI: 10.1002/jum.14271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To determine the safety and efficacy of ultrasound (US)-guided subgluteal sciatic nerve injections. METHODS A retrospective chart review of US-guided subgluteal sciatic nerve injections at our institution was performed. RESULTS Of 221 US-guided subgluteal sciatic nerve injections, 100% achieved technical success, with no postprocedure complications. Sixty-eight percent of patients with follow-up reported symptom relief. Most patients with no relief had suboptimal preprocedure screening. CONCLUSIONS With appropriate screening, our technique of US-guided subgluteal sciatic nerve injection is safe and effective.
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Affiliation(s)
- O Kenechi Nwawka
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
- Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Russell Meyer
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
- Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Theodore T Miller
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA
- Weill Cornell Medical College of Cornell University, New York, New York, USA
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Abstract
RATIONALE Although trigger point injection is known as an easy and low-risk procedure, it is contraindicated to patients with hemorrhagic disorders or who regularly take anticoagulants/antiplatelets. However, taking clopidogrel is not a defined contraindication to this low-risk procedure. PATIENT CONCERNS The chief complaint of a 76-year old woman regularly taking clopidogrel was low back and left buttock pain which prolonged for several years. DIAGNOSES The patient was diagnosed with L4-5 and L5-S1 spinal stenosis at the orthopedics department and was referred for lumbar spinal epidural steroid injection. INTERVENTION She was treated with trigger point injection. OUTCOMES Three hours after the injection, she complained motor weakness and pain in the injection area. A hematoma on left gluteus medium muscle was detected with ultrasonography and ultrasound-guided needle aspiration was accomplished to relieve the symptom. LESSONS Trigger point injection for patients taking clopidogrel should be done with a caution to prevent such complication.
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Sun Y, Xiong X, Pandya D, Jung Y, Mintz A, Hayasaka S, Wadas TJ, Li KCP. Enhancing tissue permeability with MRI guided preclinical focused ultrasound system in rabbit muscle: From normal tissue to VX2 tumor. J Control Release 2017; 256:1-8. [PMID: 28412225 PMCID: PMC6047512 DOI: 10.1016/j.jconrel.2017.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 04/08/2017] [Accepted: 04/11/2017] [Indexed: 10/19/2022]
Abstract
High Intensity Focused Ultrasound (HIFU) is an emerging noninvasive, nonionizing physical energy based modality to ablate solid tumors with high power, or increase local permeability in tissues/tumors in pulsed mode with relatively low power. Compared with traditional ablative HIFU, nondestructive pulsed HIFU (pHIFU) is present in the majority of novel applications recently developed for enhancing the delivery of drugs and genes. Previous studies have demonstrated the capability of pHIFU to change tissue local permeability for enhanced drug delivery in both mouse tumors and mouse muscle. Further study based on bulk tissues in large animals and clinical HIFU system revealed correlation between therapeutic effect and thermal parameters, which was absent in the previous mouse studies. In this study, we further investigated the relation between the therapeutic effect of pHIFU and thermal parameters in bulky normal muscle tissues based on a rabbit model and a preclinical HIFU system. Correlation between therapeutic effect and thermal parameters was confirmed in our study on the same bulk tissues although different HIFU systems were used. Following the study in bulky normal muscle tissues, we further created bulky tumor model with VX2 tumors implanted on both hind limbs of rabbits and investigated the feasibility to enhance tumor permeability in bulky VX2 tumors in a rabbit model using pHIFU technique. A radiolabeled peptidomimetic integrin antagonist, 111In-DOTA-IA, was used following pHIFU treatment in our study to target VX2 tumor and serve as the radiotracer for follow-up single-photon emission computed tomography (SPECT) scanning. The results have shown significantly elevated uptake of 111In-DOTA-IA in the area of VX2 tumors pretreated by pHIFU compared with the control VX2 tumors not being pretreated by pHIFU, and statistical analysis revealed averaged 34.5% enhancement 24h after systematic delivery of 111In-DOTA-IA in VX2 tumors pretreated by pHIFU compared with the control VX2 tumors.
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Affiliation(s)
- Yao Sun
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Xiaobing Xiong
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Darpan Pandya
- Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Youngkyoo Jung
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Akiva Mintz
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Satoru Hayasaka
- Department of Psychology, The University of Texas at Austin, SEA 2.214, 108 E. Dean Keeton Stop A8000, Austin, TX 78712, USA
| | - Thaddeus J Wadas
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - King C P Li
- Carle Illinois College of Medicine, University of Illinois at Urbana- Champaign, Urbana, IL 61801, USA.
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Furet E, Bendifallah S, Ballester M, Darai E. Spontaneous intergluteal cleft endometriosis. J Gynecol Obstet Hum Reprod 2017; 46:665-666. [PMID: 28603088 DOI: 10.1016/j.jogoh.2017.06.001] [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: 12/21/2016] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 11/20/2022]
Abstract
Endometriosis is a condition where hormonal-responsive endometrial tissue grows outside the uterus usually within the pelvic cavity. Extra-abdominal endometriosis is less common and may involves the skin. Subcutaneous endometriosis is rare. We report the first case of spontaneous intergluteal cleft endometriosis revealed by pain and bleeding during menstruation.
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Affiliation(s)
- E Furet
- Clinical Research Group: GRC-6 UPMC, Centre Expert En Endométriose (C3E), UMRS-938, service de gynécologie obstétrique, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris 6, Paris, France.
| | - S Bendifallah
- Clinical Research Group: GRC-6 UPMC, Centre Expert En Endométriose (C3E), UMRS-938, service de gynécologie obstétrique, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris 6, Paris, France
| | - M Ballester
- Clinical Research Group: GRC-6 UPMC, Centre Expert En Endométriose (C3E), UMRS-938, service de gynécologie obstétrique, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris 6, Paris, France
| | - E Darai
- Clinical Research Group: GRC-6 UPMC, Centre Expert En Endométriose (C3E), UMRS-938, service de gynécologie obstétrique, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris 6, Paris, France
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28
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Ramos Pascua L, Santos Sanchez JA, Samper Wamba JD, Alvarez Castro A, Rodriguez Altonaga J. Atypical image findings in a primary subcutaneous hydatid cyst in the gluteal area. Radiography (Lond) 2017; 23:e65-e67. [PMID: 28687303 DOI: 10.1016/j.radi.2017.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 01/04/2017] [Revised: 03/25/2017] [Accepted: 03/27/2017] [Indexed: 12/31/2022]
Affiliation(s)
- L Ramos Pascua
- Department of Orthopaedics and Traumatology, University Hospital of León, C/Altos de Nava s/n, León, 24071, Spain.
| | - J A Santos Sanchez
- Department of Radiology, University Hospital of Salamanca, Paseo de San Vicente 88-182, Salamanca, 37007, Spain.
| | - J D Samper Wamba
- Department of Radiology, University Hospital of Elda-Virgen de la Salud, Ctra Sax-La Torreta s/n, Elda, 03600, Spain.
| | - A Alvarez Castro
- Department of Orthopaedics and Traumatology, University Hospital of León, C/Altos de Nava s/n, León, 24071, Spain.
| | - J Rodriguez Altonaga
- Veterinary Department, University of León, Avenida Facultad de Veterinaria 25, León, 24004, Spain.
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Chang L, Lv D, Jin Y, Yu W, Yang X, Ma G, Chen H, Lin X. High-frequency color Doppler ultrasound as the first diagnostic and monitoring choice for early superficial high-flow vascular malformations. J Med Ultrason (2001) 2017; 44:275-278. [PMID: 28224305 DOI: 10.1007/s10396-017-0771-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 06/11/2016] [Accepted: 12/19/2016] [Indexed: 11/25/2022]
Abstract
Diagnosis and monitoring of early high-flow vascular malformations could be a meaningful pursuit. However, there has been no ideal method for their long-term monitoring and prognosis. We examined 21 early high-flow vascular malformations in this study and deemed that high-frequency color Doppler ultrasound could be regarded as the first diagnostic and monitoring choice for early high-flow vascular malformations at present.
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Affiliation(s)
- Lei Chang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China
| | - Dongze Lv
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China
| | - Yunbo Jin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China
| | - Wenxin Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China
| | - Xi Yang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China
| | - Gang Ma
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China
| | - Hui Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China
| | - Xiaoxi Lin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Zhizaoju Road, Shanghai, 200011, China.
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30
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Hoffman DF, Smith J. Sonoanatomy and Pathology of the Posterior Band of the Gluteus Medius Tendon. J Ultrasound Med 2017; 36:389-399. [PMID: 28039889 DOI: 10.7863/ultra.16.03073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/27/2016] [Indexed: 06/06/2023]
Abstract
Greater trochanteric pain syndrome is a common clinical entity that most often results from disorders of the gluteus medius tendon. There are two distinct bands of the gluteus medius tendon, and abnormalities may affect the anterior or posterior band in isolation or simultaneously. Although abnormalities of the anterior band are more common, awareness and sonographic detection of posterior band abnormalities is essential to guide treatment in the setting of greater trochanteric pain syndrome.
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Affiliation(s)
- Douglas F Hoffman
- Departments of Orthopedics and Radiology, Essentia Health, Duluth, Minnesota, USA
| | - Jay Smith
- Departments of Physical Medicine and Rehabilitation and Radiology, Mayo Clinic College of Medicine and Mayo Clinic Sports Medicine Center, Rochester, Minnesota, USA
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Affiliation(s)
- A G Kriger
- A.V. Vishnevsky Institute of Surgery, Ministry of Health, Russia, Moscow, Russia
| | - A O Gushcha
- Neurological research center, Moscow, Russia
| | - D S Gorin
- A.V. Vishnevsky Institute of Surgery, Ministry of Health, Russia, Moscow, Russia
| | - A R Kaldarov
- A.V. Vishnevsky Institute of Surgery, Ministry of Health, Russia, Moscow, Russia
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32
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Prakash M, Gupta P, Gulati A, Khandelwal N. It's Even Here! Two Rare Cases of Pyriformis Myocysticercus. JNMA J Nepal Med Assoc 2016; 55:29-32. [PMID: 27935920] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Cysticercus, the larval form of Taenia Solium, a tapeworm, can infest various tissues in the human body. Though central nervous system involvement is the most dramatic form of infestation, several other uncommon sites of has been reported in the literature. One such involvement is that of the musculature. The most easily recalled manifestation of myocysticercus is that in the orbit where the patients present with painful proptosis. However, other less common muscular sites of involvement are documented in case reports. To the best of our knowledge, there are no documented cases of pyriformis muscle infestation with cysticercus. We came across two interesting cases, where imaging established the diagnosis of isolated pyriformis cysticercosis. Follow up after one month of antihelminthic treatment imaging revealed disappearance of the lesions.
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Affiliation(s)
- M Prakash
- Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education and Research (PGIMER),Chandigarh, 160012, India
| | - P Gupta
- Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education and Research (PGIMER),Chandigarh, 160012, India
| | - A Gulati
- Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education and Research (PGIMER),Chandigarh, 160012, India
| | - N Khandelwal
- Department of Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education and Research (PGIMER),Chandigarh, 160012, India
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Abstract
Pyomyositis is a pyogenic infection of the skeletal muscles causing myalgia and fever in patients. Hematogenous seeding engendered by persistent bacteremia and septic embolism is usually the underlying cause of the disease. Trauma, intravenous drug use, and immunodeficiency are the main predisposing factors.Obturator internus pyomyositis with sciatica has not previously been reported. We report a rare case of a patient with subacute bacterial endocarditis presenting with left buttock pain and sciatica.Computed tomography confirmed the diagnosis of obturator internus pyomyositis. The patient was discharged uneventfully after successful antibiotic treatment.The mortality rate of patients who have pyomyositis comorbid with another condition or disease is extremely high. Early diagnosis and aggressive management are imperative.
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Affiliation(s)
- Wei-Ching Hsu
- Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital
| | | | - Michael Yu-Chih Chen
- Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital
- Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Correspondence: Michael Yu-Chih Chen, Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, 707 Chung Yang Rd., Sec. 3, Hualien 970, Taiwan (e-mail: )
| | - Chung-Chao Liang
- Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital
- School of Medicine, Tzu Chi University
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34
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Yap WT, Jeffrey RB. Sonographic Diagnosis of a Superior Gluteal Artery Arteriovenous Fistula and Pseudoaneurysm After Bone Marrow Biopsy. J Ultrasound Med 2016; 35:1104-1106. [PMID: 27106791 DOI: 10.7863/ultra.15.08048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Woon Teck Yap
- Department of Radiology, Stanford University Medical Center, Stanford University, Stanford, California USA
| | - R Brooke Jeffrey
- Department of Radiology, Stanford University Medical Center, Stanford University, Stanford, California USA
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35
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Arunachalam K. Refractory sciatica could be a sign of malignancy: A unique case presentation. R I Med J (2013) 2016; 99:25-27. [PMID: 26726859] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
t Renal cell carcinoma is one of the highly aggressive tumors and notorious for late presentations. It is associated with high morbidity and mortality. Renal cell carcinoma is known for rare metastatic sites. In clinical practice, it is often important not to anchor to a particular diagnosis but rather revisit and revaluate entire history and clinical examination. We describe a case of metastatic renal cell carcinoma that was initially treated as sciatica and later found to have advanced debilitating malignancy. Internal medicine physicians should be able to recognize one of the rare metastatic sites of renal cell carcinoma and understand the importance of imaging studies if patient has persisting sciatica symptoms without improvement.
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Affiliation(s)
- Karuppiah Arunachalam
- Department of Hospital Medicine, Alpert Medical School of Brown University, Providence, Rhode Island
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36
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Köksal D, Köksal AŞ, Özkara Ş. Isolated tuberculous gluteal abscess in an immunocompetent patient. Acta Clin Belg 2015; 70:155-6. [PMID: 25328062 DOI: 10.1179/2295333714y.0000000091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kumar A, Ramchand T, Contractor S. Percutaneous thrombin injection treatment of a gluteal pseudoaneurysm following radiofrequency ablation of a hip osteoid osteoma in a 6-year-old boy. Skeletal Radiol 2014; 43:1749-53. [PMID: 25015326 DOI: 10.1007/s00256-014-1952-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 06/03/2014] [Accepted: 06/20/2014] [Indexed: 02/02/2023]
Abstract
Osteoid osteomas are benign bone lesions that present with bone pain in children and young adults. Over the last 2 decades, radiofrequency ablation has become the mainstay of treatment and is now preferred over surgical resection. Major complications of the procedure are very rare, consisting mostly of local skin burns. We present a case of a child presenting with a gluteal pseudoaneursym following CT-guided radiofrequency ablation of an acetabular osteoid osteoma, which was then treated successfully with percutaneous thrombin injection.
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Kiyoshige Y, Watanabe E. Fatty degeneration of gluteus minimus muscle as a predictor of falls. Arch Gerontol Geriatr 2014; 60:59-61. [PMID: 25440137 DOI: 10.1016/j.archger.2014.07.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 03/24/2014] [Revised: 07/17/2014] [Accepted: 07/23/2014] [Indexed: 11/19/2022]
Abstract
The cause of falls is multifactorial, however, hip fractures in elderly would be prevented if accidental falls are predictable. We assessed magnetic resonance images of 38 patients with groin pain after taking a fall whose fracture could not be detected by plain X-rays, and 45 patients with no episode of falls. Their ages were over 65 years. Fatty degeneration of muscles, gluteus maximus, gluteus medius, gluteus minimus, obturator externus, adductor longus, rectus femoris and iliopsoas muscles, were evaluated by Goutallier's staging. Odds ratio was calculated by a logistic regression analysis allocating dependent variable for falls and independent variables for Goutallier's stage, age and gender. The fatty degeneration of gluteus maximus muscle was generalized, while that of gluteus minimus muscle was unevenly distributed, especially in anterior area. Gluteus minimus muscle initiated its fatty degeneration earlier than gluteus medius muscle. Odds ratio of falling was 3.2 (95% confidence intervals: 1, 14, 8.94) for Goutallier' stage of the gluteus medius muscle. Fatty degeneration of gluteus medius muscle has a crucial role in providing stability of the pelvis including hip joint. Evaluating fatty streaks in the gluteus minimus muscle could help give early indication to those who have a higher risk of falling.
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Affiliation(s)
- Yoshiro Kiyoshige
- Department of Physical Therapy, Yamagata Prefectural University of Health Science, 260 Kamiyanagi, Yamagata 990-2212, Japan; Department of Orthopaedic Surgery, Saiseikai Yamagata Hospital, 79-1 Oki-machi, Yamagata 990-8545, Japan.
| | - Emi Watanabe
- Department of Radiology, Saiseikai Yamagata Hospital, 79-1 Oki-machi, Yamagata 990-8545, Japan
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39
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Ricci P, Wash A. Pudendal nerve block by transgluteal way guided by computed tomography in a woman with refractory pudendal neuralgia expressed like chronic perineal and pelvic pain. ARCH ESP UROL 2014; 67:565-571. [PMID: 25048589] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To demonstrate that the deep infiltration of the pudendal nerve guided by tomography is a good treatment option for patients with refractory neuralgia. METHOD Two cases of pudendal neuralgia are presented, both expressed mainly with pain in the perineal and gluteal areas. Both cases had changes in the skin and one with urinary symptoms. A deep trans-gluteal infiltration guided by CT scan was performed, administering bupivacaine 0.25% with 80 mg methylprednisolone. RESULTS In women, after infiltration, there was a decrease in pain from 6 to 3. In man infiltrations were performed monthly, completing 4. He reported pain reduction from 8 to 2. CONCLUSIONS Pudendal Neuralgia diagnosis is unknown. The most common cause is inflammation of adjacent structures to the nerve frequently caused by falling. Diagnosis is mainly clinical. Trans-gluteal infiltration guided by CT scan is an effective option in treatment.
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Affiliation(s)
- Paolo Ricci
- Unidad de Uroginecología. Clínica Las Condes. Santiago. Chile
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40
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Kotha VK, Reddy R, Reddy MV, Moorthy RS, Kishan TV. Congenital gluteus maximus contracture syndrome--a case report with review of imaging findings. J Radiol Case Rep 2014; 8:32-7. [PMID: 24967033 DOI: 10.3941/jrcr.v8i4.1646] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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] [Indexed: 11/15/2022] Open
Abstract
Although the clinical features of gluteus maximus contracture syndrome have been frequently described, imaging features have been seldom described. Most commonly reported cases are those following intramuscular injection in the gluteal region although congenital contracture is an uncommon but important occurrence. This condition has most often been reported in children of school going age. These patients often present with difficulty in squatting, limitation of hip motion or specific deformities and often require surgical correction. We describe the plain radiography, ultrasonography (USG) and magnetic resonance imaging (MRI) features of this condition in a patient with no previous known history of intramuscular injections.
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Affiliation(s)
- Vamshi Krishna Kotha
- Department of Radiology, Kamineni Institue of Medical Sciences, Andhra Pradesh, India
| | - Rajasekhar Reddy
- Department of Radiology, Kamineni Institue of Medical Sciences, Andhra Pradesh, India
| | - M Venkateshwar Reddy
- Department of Orthopaedics, Kamineni Institue of Medical Sciences, Andhra Pradesh, India
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41
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Abstract
Dipygus or pygomelia is an incomplete form of twinning due to the incomplete division of the embryonic disc. This extremely rare condition consists in the presence of an accessory limb that generally inserts into the buttock or perineum. Associated anomalies such as duplication of the genitourinary or the intestinal tract are frequent, and recurrently appear associated with spinal anomalies such as congenital scoliosis due to hemivertebra. We present our experience with a 20-year-old girl, the first and only case of dipygus recorded and treated in Switzerland, who came to us complaining of increasing low back pain along with a progressive congenital scoliosis due to the presence of a hemivertebra between L5 and S1, which was removed in a single stage exclusively through a posterior approach.
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Affiliation(s)
- Jose M Cavanilles-Walker
- Spine Unit, Department of Orthopaedic Surgery, Hospital Universitari Germans Trias i Pujol, Crta Canyet s/n, Badalona, 08916, Spain,
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Eikermann M, Velmahos G, Abbara S, Huang PL, Fagan SP, Hirschberg RE, Kwon JY, Nosé V. Case records of the Massachusetts General Hospital. Case 11-2014. A man with traumatic injuries after a bomb explosion at the Boston Marathon. N Engl J Med 2014; 370:1441-51. [PMID: 24716684 DOI: 10.1056/nejmcpc1314240] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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43
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Frank SJ, Flusberg M, Friedman S, Sternschein M, Wolf EL, Stein MW. Aesthetic surgery of the buttocks: imaging appearance. Skeletal Radiol 2014; 43:133-9. [PMID: 24240204 DOI: 10.1007/s00256-013-1753-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 09/25/2013] [Accepted: 10/07/2013] [Indexed: 02/02/2023]
Abstract
Familiarity with the imaging appearance and potential complications of buttocks aesthetic surgery is important for radiologists. In this review, we illustrate the spectrum of imaging features after buttocks implants, liposuction, fat injections and silicone injections. Complications such as fat necrosis, abscess, and silicone migration are also presented.
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Affiliation(s)
- Susan J Frank
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA
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Tarik S, El Bachir B. L’abcès fessier: une complication inhabituelle du cancer du rectum. Pan Afr Med J 2014; 17:312. [PMID: 25328608 PMCID: PMC4198318 DOI: 10.11604/pamj.2014.17.312.4399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 04/17/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
- Souiki Tarik
- Service de Chirurgie Viscérale, Département de Chirurgie, Faculté de Médecine et de Pharmacie de Fès, Université Sidi Mohammed Ben Abdellah, CHU Hassan II, Fès, Maroc
| | - Benjelloun El Bachir
- Service de Chirurgie Viscérale, Département de Chirurgie, Faculté de Médecine et de Pharmacie de Fès, Université Sidi Mohammed Ben Abdellah, CHU Hassan II, Fès, Maroc
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Sönmez Ergün S, Gayretli Ö, Kiliçarslan R, Bilgiç B. The infragluteal sulcus: a histologic and ultrasonographic study. Aesthetic Plast Surg 2013; 37:1209-13. [PMID: 24142117 DOI: 10.1007/s00266-013-0228-8] [Citation(s) in RCA: 1] [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] [Received: 04/19/2013] [Accepted: 09/06/2013] [Indexed: 11/25/2022]
Abstract
UNLABELLED The buttocks are a major component of sexual attraction, and they have their place in the concept of beauty in most cultures and ethnic groups. The infragluteal sulcus, an important part of the gluteal region, determines the attractiveness of the buttocks. For that reason, any small change in the infragluteal sulcus makes a major cosmetic difference in the morphology of the buttock. In recent years, some flaps such as the infragluteal flap, the transverse upper gracilis flap, and the transverse musculocutaneous gracilis flap have become popular because of reduced donor area morbidity and their availability for hiding incision scars. In these cases, there may be distortion of the gluteal morphology and infragluteal sulcus. In this study, the anatomic and histologic features of the tissues that form the infragluteal sulcus were analyzed for their contribution to successful reconstruction of the infragluteal sulcus. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Selma Sönmez Ergün
- Department of Plastic and Reconstructive Surgery, Bezmialem Medical School, Bezmialem Vakif University, Istanbul, Turkey,
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Lee RKL, Griffith JF, Ng AWH, Hung ELK. Sonographic examination of the buttock. J Clin Ultrasound 2013; 41:546-555. [PMID: 23949925 DOI: 10.1002/jcu.22088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 04/20/2013] [Accepted: 07/03/2013] [Indexed: 06/02/2023]
Abstract
The buttock is a common site of pathology and ultrasound and is often the first-line imaging modality to examine soft tissue lesions of the buttock region. This review describes the ultrasound technique used, the relevant ultrasound anatomy, and the sonographic appearances of common and uncommon pathological conditions found in the buttock region.
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Affiliation(s)
- Ryan Ka Lok Lee
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong
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Chao CT. Radiologic intra-abdominal opacity indicating an injection granuloma. Intern Med 2013; 52:2015. [PMID: 23995010 DOI: 10.2169/internalmedicine.52.0816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Chia-Ter Chao
- Department of Traumatology, National Taiwan University Hospital, Taiwan
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Zhang ZW, Deng N, Zhou XB, Wang Z, Shen YH, Shang GD, Wang XY, He L, Fang Y, Yu TY. [Treatment of lumbar disc herniation combine with buttock tender node with Pizhen]. Zhongguo Gu Shang 2011; 24:816-820. [PMID: 22097126] [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: 05/31/2023]
Abstract
OBJECTIVE To observe the therapeutic effects of Pizhen in treating lumbar disc herniation combined with buttock tender node. METHODS From August 2009 to February 2010,83 patients (29 males and 54 females) with lumbar disc herniation combined with buttock tender node were randomly divided into the Pizhen group and acupuncture group. Pizhen group were treated with Pizhen manipulation, inserting needle by vertical prick with quacking inserting and quick withdrawing the needle, no rotating and the depth was through the surface of fascia, two times as a course of treatment; acupuncture group were treated with acupuncture, inserting Ashi-point, retaining the needle 20 min, ten times as a course of treatment. VAS scoring at the end of treatment and B ultrasonic image at 3d after treatment was carried out to observe the therapeutic effects. RESULTS B ultrasonic image of buttock tender node showed inflammation reaction or ellipse. The width of the inflammation reaction decreased after treatment, but there has no statistical significance (P=0.635). There was no significant difference between two groups (P=0.813). CONCLUSION Pizhen manipulation is better than acupuncture. B ultrasonic image gives morphological performance of buttock tender node, the content is inflammatory infiltrates. B ultrasound has certainly significance in diagnosing, treating and evaluating the clinical effect of Pizhen manipulation on treating buttock tender node.
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Affiliation(s)
- Zhi-wei Zhang
- Acupuncture and Massage College of Traditional Chinese Medicine University of Beijing, Beijing 100029, China
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Iizuka S, Miura N, Fukushima T, Seki T, Sugimoto K, Inokuchi S. Gluteal compartment syndrome due to prolonged immobilization after alcohol intoxication: a case report. Tokai J Exp Clin Med 2011; 36:25-28. [PMID: 21769768] [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] [Received: 03/01/2011] [Accepted: 04/12/2011] [Indexed: 05/31/2023]
Abstract
Gluteal compartment syndrome is a relatively rare condition that mostly result from atraumatic causes such as prolonged immobilization due to drug abuse or alcoholic intoxication and incorrect positioning during surgical procedures rather than traumatic causes. Early diagnosis is difficult and sometimes delayed or overlooked because of poor physical signs resulting from altered mental status and inappropriate diagnosis by clinicians. It has been reported that more than half of the cases of gluteal compartment syndrome are associated with crush syndrome and sciatic nerve palsy. Early diagnosis and immediate fasciotomy are necessary to improve the functional prognosis. Here, we report the case of a patient with gluteal compartment syndrome caused by prolonged immobilization after acute alcoholic intoxication. After disease onset, the patient developed complications of crush syndrome and sciatic nerve palsy, but immediate fasciotomy improved his condition.
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Affiliation(s)
- Shinichi Iizuka
- Department of Emergency and Critical Care of Medicine, Odawara Municipal Hospital, 49 Kuno, Odawara-City, Kanagawa 250-8558, Japan.
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