Bony Protuberance Research Articles

On a cranial bony nodular protuberance on Mourasuchus pattersoni Cidade et al. 2017 (Crocodylia, Alligatoroidea) from the late Miocene of Venezuela

Mourasuchus pattersoni, from the late Miocene Urumaco Formation of Venezuela, is the fourth and most recent species described for the genus. The holotype, and only known specimen, is comprised of an almost complete skull with both mandibular rami and several postcranial remains. In ventral view, the right palatine bone has a spherical, nodular bony protuberance located on the anterior portion, near the suture with the maxilla. Unfortunately, we cannot assign a specific diagnosis based only on macroscopic inspection. Its appearance, form and location are compatible with three conditions: torus palatinus, a common benign intraoral bone overgrowth; osteoma, a benign neoplasical overgrowth of the bone; and hamartoma, an overgrowth of normal bone tissue that can only be differed from an osteoma by histological features. While occurrences of torus palatinus or hamartomas are not yet known in the nonhominid vertebrate fossil record, there are previous records of osteomas in fossil vertebrates, including in crocodylians, such as a specimen assigned to ‘Crocodylus sp.’ from the Eocene, aside from several records for living crocodylians. Future studies are needed to uncover an accurate diagnosis of this unusual structure and help increase our knowledge of paleopathology in fossil crocodylomorphs in general, especially in the Caimaninae clade.

Fully Endoscopic Minimally Invasive Transrectus Capitis Posterior Muscle Triangle Approach to the Posterolateral Condyle and Jugular Tubercle.

Background We evaluated a transrectus capitis posterior muscle triangle approach to the posterolateral foramen magnum, occipital condyles, jugular tubercle, and the fourth ventricle. We also assessed factors that affect the amount of bone removal required. Objective To evaluate if the proposed approach is as effective as standard open approaches to expose the lateral portion of the foramen magnum. Methods The proposed minimally invasive fully endoscopic approach was performed in 15 cadaveric specimens using 4-mm (0- and 45-degree) endoscopes. Results Using a 5-cm straight paramedian incision, the rectus capitis posterior minor and major muscles were partially removed unilaterally, providing a corridor through the muscles to reach the foramen magnum region. After meticulous soft tissue dissection, key anatomical landmarks can be identified such as the greater occipital nerve, the vertebral artery that wraps around the atlanto-occipital joint, and the bony protuberance that heralds the occipital condyle. A suboccipital craniotomy associated with the transcondylar, supracondylar or paracondylar approach is performed depending on the amount of bone removal desired to maximize the surgical view. By doing so, the jugular foramen can be exposed laterally as well as the fourth ventricle medially. Conclusion The proposed endoscopic approach can provide access through the transrectus capitis posterior muscle triangle leading directly to the occipital condyle. A stepwise approach is critical to gain a surgical corridor to the inferolateral petroclival region and the fourth ventricle.

The Anterolateral Limit of the Occipital Lobe: An Anatomical and Imaging Study.

Objectives The boundaries of the temporal lobe, the parietal lobe, and the anterior portion of the occipital lobe (OL) are poorly defined. Lesions in these areas can be difficult to localize. Therefore, we studied the anterolateral limit of the OL to identify reliable anatomical landmarks. Design In 10 formalin-fixed cadaveric heads, the boundaries of the OL and relative anatomical landmarks were studied. Main Outcome Measures Distances between the following structures were measured: (1) preoccipital tentorial plica (POTP) to the junction between lambdoid suture and superior border of the transverse sinus (POTP-SL), (2) POTP to the sinodural angle of Citelli (POTP-PP), (3) lambda to parietooccipital sulcus (L-POS), and (4) preoccipital notch to termination of the vein of Labbé (PON-VL). Landmarks in 559 computed tomography and magnetic resonance images were also studied. Results The POTP was found on the tentorium of all anatomical specimens, located at the same coronal level as the PON and its attachment to the bony protuberance (BP) at the lateral cranial wall. The mean distances were POTP-SL, 6.5 ± 6.4 mm; POTP-PP, 18.1 ± 7.8 mm; L-POS, 10.8 ± 5.0 mm; and PON-VL, 8.8 ± 10.1 mm. Conclusion Osseous (asterion, lambda, and BP), dural (POTP), and vascular (VL) landmarks can be used as reference structures to identify the anterolateral limit of the OL.

MicroRNA profiling of antler stem cells in potentiated and dormant states and their potential roles in antler regeneration.

MicroRNAs (miRNAs) can effectively regulate gene expression at the post-transcriptional level and play a critical role in tissue growth, development and regeneration. Our previous studies showed that antler regeneration is a stem cell-based process and antler stem cells reside in the periosteum of a pedicle, the permanent bony protuberance, from which antler regeneration takes place. Antlers are the only mammalian organ that can fully regenerate and hence provide a unique opportunity to identify miRNAs that are involved in organ regeneration. In the present study, we used next generation sequencing technology sequenced miRNAs of the stem cells derived from either the potentiated or the dormant pedicle periosteum. A population of both conserved and 20 deer-specific miRNAs was identified. These conserved miRNAs were derived from 453 homologous hairpin precursors across 88 animal species, and were further grouped into 167 miRNA families. Among them, the miR-296 is embryonic stem cell-specific. The potentiation process resulted in the significant regulation (>±2 Fold, q value <0.05) of conserved miRNAs; 8 miRNA transcripts were down- and 6 up-regulated. Several GO biology processes and the Wnt, MAPK and TGF-beta signaling pathways were found to be up-regulated as part of antlerogenic stem cell potentiation process. This research has identified miRNAs that are associated either with the dormant or the potentiated antler stem cells and identified some target miRNAs for further research into their role played in mammalian organ regeneration.

Guided cutting of bone for intraoral vertical ramus osteotomy with a freer marking technique

ntraoral vertical ramus osteotomy (IVRO) is useful in the reatment of mandibular prognathism, its advantages being hat it is faster and simpler than sagittal split ramus osteotomy s it requires only a single cutting line.1 Although IVRO is done through a single simple steotomy, arterial and neurological injuries may be caused if his is made in the wrong place. The antilingular eminence is he main reference structure for IVRO, because it is often corelated with the position of the lingula as the point of entrance f the mandibular neurovascular bundle into the mandible.2 he line to cut the bone for an IVRO can be routinely set just ehind the antilingular eminence. However, the antilingular eminence is not prominent in ome cases and it is not always related to the point of entrance f the mandibular nerve. It can be anatomically defined s a bony protuberance that is attached to the masseteric usculature.3 We have therefore developed a technique to

Torus Palatinus as a Criterion for Sex Determination - a Study in 60 Adult Human Skulls

Torus palatinus is a bony protuberance which occurs in the midline of the hard palate. The prevalence of torus palatinus in dental patients and skulls of different races has been studied by many researchers because of its clinical significance. In addition, the correlation of torus palatinus with various factors like age, sex, torus mandibularis has also been studied. Most of the previous researchers have found sex differences in its prevalence. Few studies have been conducted with regard to torus palatinus in Indian population. Thus, in the present study, 60 adult human skulls of North Indian individuals have been studied to assess the reliability of the palatine torus development in sex determination. The palatine torus development has been graded on the basis of visual inspection. The data has been statistically analyzed by Logistic and Probit regression models. Subsequent to analysis, it has been found that the palatine torus development correctly classified 48.3% of the sample. The correlation between the palatine torus development and maxillo-alveolar index has also been studied. The factors which affect the palatine torus development and ultimately the reliability of palatine torus development in sex determination have also been highlighted in the present study.

Clinics in diagnostic imaging (148)

Rotator cuff injury comprises a continual spectrum of lesions ranging from tendinopathy, which may progress to partial- or full-thickness tear. This progression may be influenced by the interplay of extrinsic and intrinsic factors. We describe the case of a 29-year-man who presented with right shoulder pain for one year. His initial magnetic resonance (MR) arthrogram showed supraspinatus tendinopathy. Subsequent MR arthrogram, obtained after a road traffic accident, showed a bursal-sided partial-thickness tear of the supraspinatus tendon. In view of his worsening clinical symptoms, surgery was performed ten months later, revealing a full-thickness rotator cuff tear near the tendon insertion, with a tight subacromial space and bony protuberance of the humeral head. The pathogenesis of rotator cuff injuries, the roles of different imaging modalities in the diagnosis of rotator cuff injuries, as well as the advantages and limitations of various radiological modalities, are discussed.

A bony human tail causing tethered cord syndrome: case report

Dorsal cutaneous appendages, sometimes referred to as "human tails," are considered to be markers of underlying occult spinal dysraphism. Rarely, these tail-like structures can themselves be the cause of tethered cord syndrome. However, to date, a "bony human tail" causing tethered cord has not been reported in the literature. One such rare lesion is being reported. A 2-days-old female child was brought for neurosurgical consultation with a skin-covered bony protuberance in the lower back. Examination of the child did not reveal any neurological deficits. Plain radiographic and CT evaluation showed a dorsal bony protuberance arising from the posterior elements of L1 vertebra. MRI showed the cord to be displaced posteriorly and adherent to the undersurface of the bony tail through a lipoma. During surgery, the bony "tail" was excised, and the cord was untethered with excision of the lipoma, which was tethering the cord to the bony "tail." When examined 1 year later, the child was developing normally without any focal neurological deficits. This case is being reported for its rarity and to highlight the hitherto unreported occurrence of "bony human tail" causing tethered cord syndrome.

An 11th finger in the pelvis

A robust 26-year-old man suffered from blunt trauma of the chest and abdomen after a vehicle accident. On arrival at the emergency department, he presented with diffuse tenderness over the abdomen. Pelvic radiography was performed for an initial trauma survey. Subsequently, a computed tomographic (CT) scan was highly suggestive of internal bleeding. Plain film radiography showed a bony protuberance at …

Inheritance and Developmental Pattern of Cerebral Hernia in the Crested Polish Chicken

A number of crested chicken strains, such as the Polish chicken, exhibit a bony protuberance in the anterodorsal region of their skulls. The shape of their brain shows the anatomical peculiarity that is characterized by the upthrusting of cerebral hemispheres, called "cerebral hernia." Some early works suggested that this phenotype may be caused by a genetic factor and any modifiers influencing the development of brain and/or skull. However, the causative gene and its formation mechanism are still unclear. The present study is aimed to analyze the inheritance and ontogenic process of cerebral hernia in the crested Polish chicken. Firstly, we constructed the resource family with the Polish chicken and PNP inbred strain. Genetic analysis of this family revealed that cerebral hernia is controlled by a single autosomal recessive gene and is closely associated with crest formation. Furthermore, our morphological analysis of brain structures in the progenies suggested that the significant enlargement of brain cavity at later stages of embryos, particularly after 15 days of incubation, may be the main cause of cerebral hernia.

Late-onset social anxiety disorder following traumatic brain injury

Background: Neuropsychiatric sequelae are the predominant long-term disability after traumatic brain injury (TBI). This study reports a case of late-onset social anxiety disorder (SAD) following TBI.Case report: A patient that was spontaneous and extroverted up to 18-years-old started to exhibit significant social anxiety symptoms. These symptoms became progressively worse and he sought treatment at age 21. He had a previous history of traumatic brain injury (TBI) at age 17. Neuroimaging investigations (CT, SPECT and MRI) showed a bony protuberance on the left frontal bone, with mass effect on the left frontal lobe. He had no neurological signs or symptoms. The patient underwent neurosurgery with gross total resection of the lesion and the pathological examination was compatible with intradiploic haematoma.Conclusions: Psychiatric symptoms may be the only findings in the initial manifestation of slowly growing extra-axial space-occupying lesions that compress the frontal lobe from the outside. Focal neurological symptoms may occur only when the lesion becomes large. This case report underscores the need for careful exclusion of general medical conditions and TBI history in cases of late-onset SAD and may also contribute to the elucidation of the neurobiology of this disorder.

A rare patella anatomical abnormality causing locking in an adolescent girl

Locking is an inability to fully extend the knee and is most commonly associated with meniscal pathology and loose bodies. The locked knee is an infrequent presentation in paediatric orthopaedics, and the presence of a patella protuberance as a cause has never been reported in children or adults. An adolescent female presented with a 4-year history of intermittent locking of the right knee associated with a painful audible 'clunk' on full extension. Plain film radiographs and computed tomography showed a posteriorly projecting bony protuberance over the inferior aspect of the patella. The protuberance was removed via an arthrotomy, and the patient made significant improvement in pain and function with no further locking episodes experienced. IV.

Carpal tunnel syndrome secondary to an osteophyte of the trapezium

We report a 42-year-old man with a rare carpal tunnel syndrome (CTS) secondary to an osteophyte of the trapezium. The patient presented with a 3-year history of CTS, consisting of progressive pain and paresthesias in his right hand, positive Tinel and Phalen signs, and an electrodiagnostic study demonstrating median nerve compression at the wrist. The procedure was an open carpal tunnel release. Intraoperatively, a bony protuberance was found beneath the transverse carpal ligament (TCL), resulting in compression of the median nerve. The median nerve was decompressed and the patient’s symptoms resolved postoperatively. Surgical pathology revealed bony fragments, and a postoperative CT scan was supportive of an osteophytic remnant protruding from the trapezium. Carpal bone osteophytes are rarely reported causes of CTS.

Rigid videolaryngoscope for difficult intubation caused by mandibular tori

A mandibular torus, an exophytic bony protuberance located along the lingual aspect of the mandible, often increases in size with aging and occupies the floor of the mouth. The torus is one of the most common oral exostoses, with its occurrence reported in up to 63.4% of the population. However, it requires no treatment unless it interferes with denture fabrication or leads to recurrent

Occipital Bone Abnormality Causing Recurrent Posterior Circulation Strokes

We report the case of a young man with recurrent posterior circulation strokes over the course of 6 years. Standard stroke evaluation was unremarkable until careful review of catheter angiogram and CT angiogram images revealed a bony protuberance from the occiput impinging on the left vertebral artery. Local vessel injury with thrombosis and distal embolization is the presumed etiology of the recurrent infarcts. Surgical removal of this developmental anomaly was accomplished, with no subsequent neurological events.

Ultrasound for the evaluation of femoroacetabular impingement of the cam type. Diagnostic performance of qualitative criteria and alpha angle measurements

To develop and assess a technique to evaluate cam type femoroacetabular impingement (FAI) using ultrasound (US). Fifty patients (24 women, 26 men) were included (mean age: 39.1years; age range: 16-59). US images of the anterior and anterosuperior contour of the femoral neck were obtained and analysed in 50 patients. Non-spherical shape of the head-neck junction (cam deformity), bony protuberances at the femoral neck, shape of the femoral neck (waist deficiency) and alpha angle were assessed. Magnetic resonance (MR) arthrography served as the standard of reference. Diagnostic performance and receiver operating characteristics (ROC) curves were calculated. Based on MR arthrography 28 patients had cam-type FAI. On US, an anterosuperior cam deformity was seen in 40/44 patients (Reader 1/Reader 2; sensitivity 93%/89%, specificity 36%/14%). A bony protuberance anterosuperiorly in 23/13 patients (sensitivity 71%/32%, specificity 86%/82%) and an anterosuperior waist deficiency in 19/35 patients (sensitivity 25%/54%, specificity 100%/54%). Sensitivity and specificity of the other criteria were lower than 70% (average of Reader 1 & 2). A technique to evaluate cam type FAI using US is presented. The detection of an anterosuperior cam deformity is sensitive, and presence of an anterosuperior bony protuberance is specific for cam FAI. Alpha angle measurements are not helpful in establishing the diagnosis.

MR Imaging Findings of Parosteal Lipoma: Case Report

Parosteal lipoma is a rare benign tumor containing mature adipose tissue having an intimate relationship to the periosteum. Characteristically, this tumor presents as a lipomatous mass adjacent to bone, eliciting variable reactive changes in the underlying cortex. We report a case of parosteal lipoma of the foot. The MR findings consisted of juxtacortical lipomatous mass abutting to bony protuberance, with internal fibrous striations, and osseous reaction in the adjacent bone. By the aid of multiplanar imaging capability, high spatial and contrast resolution of MRI, characteristic features of parosteal lipoma can lead to diagnosis on imaging.

Pelvic digit as a rare cause of chronic hip pain and functional impairment: a case report and review of the literature

IntroductionPelvic digit is a rare congenital anomaly where bone develops in the soft tissue adjacent to normal skeletal bone. The condition is benign and is usually discovered accidentally. On a plain radiography, pelvic digit typically appears as a rib- or phalanx-like bone structure with a clear cortex and medulla related to the pelvis, often with a pseudoarticulation at its base.Case presentationWe present the case of a 40-year-old Caucasian man who presented with chronic pain and tenderness over his right hip together with functional impairment in abduction and external rotation. Radiology identified a bony protuberance at the right anterior inferior iliac spine with fusion of the proximal bony nucleus to the adjacent bone. The pelvic digit was surgically removed and the patient was discharged free of symptoms and with complete range of motion in his right hip joint.ConclusionIt is important to recognize and distinguish a pelvic digit from post-traumatic ossification and avulsion to avoid unnecessary additional investigations.

Multiple saccular aneurysms of the extracranial and intracranial internal carotid artery associated with convexobasia and arachnoid cyst in a 6-year-old boy: a case report

We report an extremely rare case of multiple saccular aneurysms of the extracranial and intracranial internal carotid artery associated with convexobasia of the left temporal region and arachnoid cyst in a 6-year-old boy. A 6-year-old male patient was admitted to the hospital with chief complaint of ptosis and engorgement of the left eyelid for 50 days. A 4 x 10-cm bony protuberance of the left temporal region with hemangiectasia was observed to beat with pulse without vascular murmur. computed tomographic angiography (CTA) showed two saccular aneurysms of the left internal carotid artery. The first one which was about 3 cm in length and 2 cm in maximum diameter was located in the middle of the petrous portion (including parts of C2 and C3). The second one which was about the same size was located from the middle of the cavernous portion to the upper end of the left internal carotid artery. Computed tomography showed an arachnoid cyst in the left temporal region and abnormality of the left temporal bone. According to the specific circumstances of this patient, we believe that surgical treatment is rather risky and the loss might outweigh the gain. Therefore, we suggested to the parents that the child should be followed up for the coming years for monitoring and possible treatment. Multiple saccular aneurysms of extracranial and intracranial internal carotid artery in children are extremely rare. According to this case, the child had congenital bony protuberance of the left temporal region with hemangiectasia, which made this case particularly specific. Besides all those discovered abnormalities, this child was a healthy boy. Due to the difficulty and high risk of possible surgical treatment, we suggested that no further treatment be performed at the moment and the child should be followed up for a long period of time. Worthy examinations such as CT, CTA, and MRI are recommended for reviewing the development of aneurysms and CNS of this boy. Further treatment might be performed in the future. We welcome all forms of discussion about this case and similar cases around the globe.

A palaeopathological investigation of the third intercondylar tubercle of Parsons

AbstractThe third intercondylar tubercle of Parsons (TITP) is a bony protuberance which is sometimes present on the tibial plateau. It corresponds to the insertion of the anterior fibres of the anterior cruciate ligament (ACL). Reasons why TITP is present in some knees and not others are at present unclear. TITP is studied in knee joints from 68 adult individuals from a medieval cemetery. Associations are investigated with age, sex, knee osteoarthritis, clinical and subclinical DISH, and skeletal signs of trauma, with the aim of evaluating existing ideas on the causation of TITP. Only trauma showed an association with the presence of TITP. The results offer support for the aetiology of trauma to the ACL in the formation of TITP. Copyright © 2008 John Wiley &amp; Sons, Ltd.