Acromion Process Of Scapula Research Articles

Superficial anatomic landmarks can be used to triangulate the location of canine peripheral lymphocentrums: superficial cervical, axillary, and superficial inguinal.

To utilize the geometry of superficial anatomic landmarks to guide incisional location and orientation for peripheral lymphadenectomy, document deep anatomic landmarks for lymphocentrum identification, and develop novel surgical approaches to the superficial cervical, axillary, and superficial inguinal lymphocentrums in dogs. 12 canine cadavers. 2 cadavers were used for a pilot investigation to determine optimal body positioning, select superficial anatomic landmarks for lymphocentrum identification, and evaluate novel surgical approaches to the 3 lymphocentrums. These lymphocentrums were then dissected in 10 additional cadavers using these novel surgical approaches. Measurements of the distances from lymphocentrum to landmark and between landmarks were obtained for each lymphocentrum. Deep anatomic landmarks were recorded for each dissection. The mean and SD were calculated for each measurement and used to develop geometric guidelines for estimating the location of each lymphocentrum for these surgical approaches. Each peripheral lymphocentrum was found in the same location relative to the respective, predetermined, superficial, anatomic boundaries in all cadavers. Briefly, the superficial landmarks to each lymphocentrum were as follows: (1) superficial cervical: wing of atlas, acromion process of scapula, greater tubercle of humerus; (2) axillary: caudal border of transverse head of superficial pectoral muscle, caudal triceps muscle, ventral midline; and (3) superficial inguinal: origin of pectineus muscle, ipsilateral inguinal mammary gland, ventral midline. The proposed superficial and deep surgical landmarks were identified within every cadaver. The previously undescribed surgical approaches were effective for lymphocentrum identification. Anatomic landmarks provided in this study may help reduce surgical time and tissue trauma during peripheral lymphadenectomy in dogs. This study was also the first to describe a surgical approach to the superficial inguinal lymphocentrum and ventral approaches to the superficial cervical and axillary lymphocentrums and provided previously unpublished anatomic landmarks for a lateral approach to the superficial cervical lymphocentrum.

Morphometric analysis of acromion process of scapula with special emphasis on its clinical implications

Morphometric analysis of acromion process of scapula with special emphasis on its clinical implications

Morphometry of Acromion Process of Scapula with Respect to Gender

Background: Of the wide spectrum of musculoskeletal disorders affecting the shoulder, subacromial impingement syndrome is considered to be quite common. The main objective of the present study is to evaluate the morphometry of acromion and to measure other parameters like acromiocoracoid distance (ACD) and acromioglenoid distance (AGD). Materials And Method: Study was conducted on 100 male and 100 female adult scapulae. Length and breadth of the acromion, ACD, and AGD were measured using vernier callipers. Measured parameters were tabulated and analysed for statistical significance. Results: Acromial length, acromial breadth, ACD and AGD varied significantly with sex. Positive correlation was observed between above parameters in male scapulae, whereas positive correlation was seen only between ACD & AGD among female scapulae. Conclusion: The studied parameters could be help during diagnoses and treatment of shoulder pathologies. They can also be used for forensic and anthropological purposes for determining gender, ethnicity

Acromion morphology and morphometry in the light of impingement syndrome and rotator cuff pathology

Introduction: Acromion process of the scapula and the subacromial space plays an important role in shoulder impingement syndrome and rotator cuff pathology. The aim is to study the morphological and morphometric parameters of the acromion process of human dry scapula in the South Indian population for its relevance in shoulder impingement syndrome and rotator cuff pathology. Material and Methods: Seventy adult unpaired dry scapulae (35 right and 35 left) of unknown age, gender, and without deformity were studied. The various shapes of acromion process were identified. Parameters such as acromioglenoid (AG) distance, coracoglenoid (CG) distance, coracoacromial (CA) distance, and height of the coracoacromial arch (HtCAA) were measured using a digital vernier caliper. The data were statistically analyzed. Results: The three types of acromion process observed were Type I flat in 57.14%, Type II curved in 40%, and Type III hooked in 2.86%. The mean ± standard deviation of AG distance was 24.9 ± 3.7 mm, CG distance was 22.7 ± 4.2 mm, AC distance was 30.9 ± 5.4 mm, and HtCAA was 19.2 ± 2.7 mm. A significant difference was observed with respect to AG (P = 0.04) and CG (P = 0.0007) between both sides of the scapula. Discussion and Conclusion: Knowledge about the common variant and morphometric dimensions of acromion process can aid to better understanding and planning for the treatment of rotator cuff pathology due to impingement syndrome.

A Morphometric Study of Acromion Process of Scapula in Telangana Region

A Morphometric Study of Acromion Process of Scapula in Telangana Region

A morphometric study of acromion process of scapula in Telangana

A morphometric study of acromion process of scapula in Telangana

A morphometric study of acromion process of scapula and its clinical significance

A morphometric study of acromion process of scapula and its clinical significance

A morphometric study of acromion process of scapula and its clinical significance

Objective: The acromion process is associated with a variety of ailments in the shoulder. Therefore, the aim of this study was to record and study all the morphometric values of the acromion process and its morphological features. Materials and Methods: The study was carried out on 50 unpaired dried scapulae. The length, width, and thickness of the acromion process were measured, and the length and width of scapula was also measured using vernier calipers. The acromiocoracoid and acromioglenoid distances were also measured. The shape, type of acromion process, and the presence of enthesophytes were noted and whether the anterior 2/3 rd of inferior surface of acromion process is rough or smooth was also noted. Results: The mean length, width, and thickness of acromion process were 4.21, 2.42, and 0.73 cm, respectively. The mean length and width of scapula were 13.93 and 10.14 cm, respectively. The mean acromiocoracoid distance and acromioglenoid distance were 3.09 and 2.47 cm, respectively. The most common shape of the acromion process noted was quadrangular in 40% of scapulae. In 90% of scapulae, the anterior 2/3 rd of inferior surface was rough and in 80% scapulae, enthesophytes were present. Conclusions: This study will help the clinicians in understanding and curing various shoulder joint disorders.

Multifocal Skeletal Tuberculosis = سل متعدد البؤر

A 6-year-old Indian boy presented with a month-long insidious onset of pain in his back and left shoulder. He had had a low-grade fever, decreased appetite and weight loss for 2 months. There was no history of trauma, chronic cough, or bowel or bladder complaints. His father was on anti-tuberculous therapy for pulmonary tuberculosis (TB) (sputum positive). On examination, the boy had a gibbus deformity of the thoracic spine [Figure 1]. Tenderness was present over the upper thoracic spine and the left shoulder joint. Paraspinal spasm and swelling was present. A systemic examination was normal. Investigations revealed haemoglobin of 9.4 gm%; a total leucocyte count of 12,400/cumm (neutrophils 55%, lymphocyte 45%); a platelet count of 2.1 lac/cumm, and an erythrocyte sedimentation rate of 88 mm at 1 hour. A human immunodeficiency virus (HIV) enzyme linked immunosorbent assay (ELISA) test was negative. A Mantoux test was positive (28 mm). A chest X-ray and an ultrasound of the abdomen were normal. Magnetic resonance imaging (MRI) of the spine revealed multifocal skeletal TB involving the thoracic spine, the lateral end of the left clavicle, and the left acromion process. There was also evidence of prevertebral, paravertebral, and anterior epidural abscesses [Figures 2–4]. Surgical debridement was done and 150 ml of pus was drained. Acid-fast bacilli were demonstrated in the pus by a Ziehl-Neelsen stain. Our patient was diagnosed with multifocal TB and was started on an antituberculous therapy of isoniazid, rifampicin, pyrazinamide, and ethambutol for two months, followed by isoniazid and rifampicin for four months. He was followed up monthly after discharge and at the end of six months showed marked improvement in symptomatology. His appetite and weight had increased, the fever had subsided, and his paraspinal abscess had decreased. Figure 1: Clinical photograph of the patient showing gibbus deformity in the upper thoracic spine and paraspinal abscess. Figure 2: Coronal T2 weighted image shows complete destruction, with a collapse of the T3 and T4 vertebrae. Marrow oedema is noted from T1 to T5 vertebral levels and also in the left lateral end of clavicle and acromion process. Figure 4: Sagittal T2 weighted image showing complete destruction with collapse of T3 and T4 vertebrae with decreased T3 and T4 disc height and the resultant severe gibbus deformity. There is an associated prevertebral and anterior epidural abscess, causing complete ... In recent years, widespread immigration, HIV infection, illicit drug use, and the emergence of multi-drug resistant mycobacteria have resulted in a worldwide resurgence of TB.1 Skeletal TB accounts for less than 10% of all cases of TB. Multifocal TB is rare, occurring in less than 5% of cases even in endemic countries.2 Multifocal skeletal TB is defined as osteoarticular lesions that occur simultaneously in two or more locations, with or without pulmonary involvement. It may affect a single bone with multifocal lytic cortical lesions or multiple sites at different bones.3 Multifocal skeletal TB most often involves the axial skeleton (spine) followed by the major weight bearing joints. It is commonly seen in immunosuppressed patients, and usually associated with pulmonary TB.2,4 Our patient was immunocompetent and had normal pulmonary findings. Other atypical features were the involvement of the lateral end of the clavicle and the acromion process of scapula. TB of the lateral end of the clavicle and shoulder is extremely rare, occurring in less than 1% of cases.5,6 To the best of our knowledge, only two cases of TB of the acromion process and less than ten cases of TB of the lateral end of the clavicle have been reported to date.5,6 Multifocal skeletal TB must be considered in the differential diagnosis of multiple destructive skeletal lesions. Conventional X-rays often fail to detect early skeletal disease, resulting in a delayed diagnosis. In addition, the radiological picture is variable and the lytic bony lesions may easily be confused with osseous, or inflammatory or neoplastic diseases, either primary or metastatic.2,4 Computed tomography (CT) and MRI scans can usefully determine the extent of bone lesion and soft tissue involvement and differentiate between abscess and the granulation of tissue. A radionuclide bone scan is non-specific, may be negative in the early stages of the disease, and does not differentiate between lytic tuberculous lesions or malignancy. The diagnosis is confirmed by biopsy. Uncomplicated tuberculous lesions of the clavicle and scapula usually resolve with anti-tubercular therapy. Similarly, spinal TB is managed with bracing and anti-TB drugs. Surgery is needed only if there is a neurologic deficit or spinal instability.2,4

Dietary Counseling Versus Dietary Supplements for Malnutrition in Chronic Pancreatitis: A Randomized Controlled Trial

Up to 50% of patients with chronic pancreatitis (CP) are malnourished. There are limited data on the role of dietary intervention in improving the nutritional status of such patients. The aim was to compare the efficacy of medium chain triglyceride (MCT)-enriched commercial dietary supplements with dietary counseling for homemade food in the management of malnutrition in patients with CP. In a randomized controlled trial, consecutive undernourished patients with CP (body mass index [BMI] <18.5 kg/m(2)) at a tertiary care hospital were randomized to receive either dietary counseling for regular homemade food or commercial MCT-enriched dietary supplements for a period of 3 months to compensate for the dietary calorie deficit. All patients received standard management for CP including pancreatic enzyme supplements. Primary outcome measure was improvement in BMI. Sixty malnourished patients with CP were randomized to counseling group (n = 29; mean age, 32 +/- 10 years; male, 83%) and supplementation group (n = 31; mean age, 28 +/- 10 years; male, 84%). BMI increased in both the counseling group and supplementation group (17.2 +/- 1.7 vs 18.1 +/- 1.8 kg/m(2), P = .001; 16.7 +/- 1.6 vs 18.2 +/- 1.6 kg/m(2), P = .001). There were similar improvements in triceps skinfold thickness, dietary intake, fecal fat, and pain score during a period of 3 months in both groups. There was, however, no significant difference between the counseling and supplementation groups with regard to any of the outcome measures. Dietary counseling for a balanced homemade diet is as good as commercial food supplements in improving malnutrition in patients with CP.