RESUMEN
The proximal musculo-tendinous junction (MTJ) is a common site of hamstring strain injury but the anatomy of this region is not well defined. A morphometric analysis of the proximal MTJs of biceps femoris long head (BFlh), semitendinosus (ST), and semimembranosus (SM) was undertaken from dissection of 10 thighs from five male cadavers and magnetic resonance imaging of 20 thighs of 10 active young men. The length, volume, and cross-sectional area of the proximal tendon, MTJ and muscle belly, and muscle-tendon interface area were calculated. In both groups, MTJs were reconstructed three-dimensionally. The proximal tendons and MTJs were expansive, particularly within SM and BFlh. Morphology varied between muscles although length measurements within individual muscles were similar in cadavers and young men. Semimembranosus had the longest proximal tendon (cadavers: mean 33.6 ± 2.0 cm; young men: mean 31.7 ± 1.6 cm) and MTJ (>20 cm in both groups) and the greatest muscle-tendon interface area, followed by BFlh and ST. Mean muscle belly volumes were more than three times greater in young men than elderly male cadavers (P < 0.001). These unique morphometric data contribute to a better understanding of hamstring anatomy, an important factor in the pathogenesis of hamstring strain injury.
Asunto(s)
Músculos Isquiosurales/diagnóstico por imagen , Tendones Isquiotibiales/diagnóstico por imagen , Adulto , Anciano , Cadáver , Músculos Isquiosurales/anatomía & histología , Tendones Isquiotibiales/anatomía & histología , Humanos , Imagen por Resonancia Magnética , Masculino , Tamaño de los Órganos , Adulto JovenRESUMEN
UNLABELLED: Pathology of the hip abductor muscles and their associated tendons is implicated in the aetiology of lateral hip pain (LHP). Muscle atrophy is an important factor to consider in the diagnosis of this condition as it could result in reduced muscle volume and associated decreases in strength. PURPOSE: (1) To estimate the volumes of the gluteus medius (GMed), gluteus minimus (GMin) and tensor fascia lata (TFL) muscles, and (2) to examine pathological changes of the soft tissues in the vicinity of the hip joint, in women with and without LHP. METHODS: Twenty female participants (10 with LHP and 10 age-matched controls) underwent magnetic resonance imaging. Two radiologists reviewed the images for signs of pathological changes. Hip abductor muscle volumes were estimated using cross-sectional areas and Cavalieri's method. Differences in volume between sides, study groups and the three muscles were assessed. RESULTS: The volume of GMed was the largest (292.5 ± 33.3 cm3), followed by GMin (82.1 ± 12.1 cm3), then TFL (49.7 ± 18.9 cm3). No differences were evident in the volumes of the hip abductor muscles in individuals with LHP when compared to age- and sex-matched controls (GMed, p = 0.30; GMin, p = 0.40; TFL, p = 0.90). Pathology of the soft tissues was not specific to the symptomatic hips. CONCLUSIONS: Novel muscle volume data are presented for GMed, GMin and TFL in the context of LHP. Further research is needed to determine if symptom severity and duration have an impact on the extent of muscle atrophy in this population.
Asunto(s)
Articulación de la Cadera/patología , Imagen por Resonancia Magnética/métodos , Músculo Esquelético/patología , Atrofia Muscular/diagnóstico , Dolor/patología , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Persona de Mediana Edad , Variaciones Dependientes del Observador , Tamaño de los Órganos , Dolor/etiologíaRESUMEN
A 38 year old female with treated carcinoma of the breast presented with a clinical and radiological diagnosis of bronchiolitis obliterans organising pneumonia. Based on these findings a biopsy was not performed and she was treated with steroids. Following lack of response to steroid therapy a lung biopsy was performed showing peribronchiolar, lymphatic, venular and arteriolar metastatic carcinoma. Her symptoms responded to chemotherapy. Interstitial and intracellular spread of carcinoma should be considered in the differential diagnosis of the radiological appearance of BOOP, and therefore a histological diagnosis should be obtained to determine appropriate management.