Limb Problems Research Articles

Running shoe cushioning properties at the rearfoot and forefoot and their relationship to injury: study protocol for a randomised controlled trial on leisure-time runners

Previous work has demonstrated the protective effect of shoe cushioning on injury risk in leisure-time runners, but most models currently available on the market have greater cushioning than those investigated...

Efficacy of soothing cream gel in the range of motion and chronic pain at the shoulder and elbow: protocol of a double-blinded, randomised, placebo-controlled trial

IntroductionUpper limb problems have a significant impact on the global population leading to pain and restricted joint mobility, ultimately impacting their quality of life. Traditional treatments, such as non-steroidal anti-inflammatory...

ROBUSTNESS EVALUATION OF MACHINE LEARNING ALGORITHMS FOR NEUROCOMPUTER INTERFACE SOFTWARE USING DISTRIBUTED AND PARALLEL COMPUTING

This article highlights the field of information technology for brain-computer interaction, and the main goal is to use it to determine patterns of human brain activity using electroencephalography (EEG) data. During the execution of the article, machine learning methods were used, namely such classifiers as Random Forest, Multi-Layer Perceptron (MLP), and Logistic Regression. The investigation begins with real-world experiments recording EEG signals during finger movement tasks, providing valuable insight into the complex dynamics of brain operation and interaction. Utilizing 10-fold cross-validation, the performance of each classifier is rigorously evaluated across various metrics, including accuracy, f1_weighted та roc_auc_ovr_weighted. Through this process, the robustness and consistency of classifier performance are assessed, with dispersion values computed to gauge variability across iterations. The findings reveal nuanced differences among the classifiers, with MLP demonstrating the highest robustness, followed by Logistic Regression and Random Forest. The main goal of the article was to find out the importance of such a classifier performance parameter as robustness. Software robustness is a key characteristic, especially in medical applications, where consistent and reliable performance of information technology is paramount. Neural interfaces offer many avenues for solving various limb problems, spinal cord injuries, and neurological diseases in humans. These devices contribute to improving the quality of life by minimizing these problems in people, which leads to increased mobility and functional capabilities of people. The article also emphasizes the potential associated with the transformation of neurointerface technologies in expanding human capabilities and revolutionizing human-machine interaction. In conclusion, the research contributes to advancing the field of brain-computer interaction by leveraging machine learning algorithms to decode neural signals and uncover hidden patterns within EEG data. By identifying the most stable classifier, the study lays the groundwork for the development of robust neurointerface technologies with practical applications in healthcare, rehabilitation, and beyond. Through interdisciplinary collaboration and innovative methodologies, the journey towards unlocking the full potential of brain-computer interaction continues, promising new horizons in human augmentation and technological innovation.

Level of and factors associated with foot self-care among people with diabetes in Idlib Province of Northwest Syria: A cross-sectional study.

Diabetic foot and lower limb problems are among the most neglected complications during the Syrian armed conflict due to the absence of a functioning health infrastructure, including early detection and timely management of limb-threatening wounds. This study aimed to determine self-reported diabetes-related foot disease (DRFD), adherence to recommended foot self-care (FSC) practices, and associated factors among people with diabetes in war-torn Northwest Syria (NWS). This was a cross-sectional study conducted at six primary care clinics in Idlib, NWS, between March 27 and April 17, 2022, utilizing the validated interviewer-administered Diabetes Foot Disease and Foot Care Questionnaire. Data on demographic characteristics, DRFD, and FSC practices were collected. FSC score was determined by adding the points from all 12 FSC items, with a maximum score of 48, and were categorized into very poor (≤12), poor (13-24), moderate (25-36), and good (37-48). A convenience sample of 331 consecutive Syrians, aged ≥18 years, with diabetes, were invited. Multiple linear regression was used to identify variables associated with FSC practices. A total of 328 patients completed the questionnaire (response rate: 99.1%). The overall FSC score was average (mean total score 27.24, SD 7.03). Over one-third (37.8%) had a very poor/poor score, 50.3% had an average score, and 11.9% had a good score. Household income/month of ≥51 USD (β = 2.6, 95% confidence interval [95% CI]:1.06-4.1, p = 0.001) and diabetes duration of ≥10 years (β = 1.8, 95% Cl: 0.2-3.4, p = 0.027) significantly predicted better FSC practice. A significant proportion of participants had inadequate adoption FSC behaviors. Higher socioeconomic status was associated with better FSC practices. Future research should evaluate diabetic foot education and professional foot care in this population.

Mercury exposure in riverine populations of Terra do Meio Extractive Reserves in the Xingu basin, Amazon, Brazil.

Amazon is a hotspot for mercury (Hg) contamination and Terra do Meio region, despite its protected status for sustainable use, has never been monitored for this element. Looking to address this gap, this study aimed to quantify capillary Hg concentration in riverine populations of Terra do Meio (Xingu Basin, Central Amazon, Brazil) and associated factors with high Hg levels (90 percentile). Hair samples from 182 individuals from Iriri, Riozinho do Anfrísio and Xingu Extractive Reserves (RESEX), aged between 18 and 70 years old, were collected to measure total mercury levels (HgT), and socioeconomic, demographic, and clinical-epidemiological data were annotated. Overall, high levels of Hg were observed (mean 4.985 µg/g, median 3.531µg/g) with significant differences between localities. Among the factors related to high capillary Hg levels, male gender, smoking habit, work in agriculture, livestock or extractivism, and residence in Iriri and Riozinho do Anfrísio RESEX were highlighted. A high prevalence of symptoms related to Hg intoxication, including anxiety, memory deficit, and lower limb problems, was observed. Overall, the results reveal that communities in these RESEXs are exposed to Hg and appear to be suffering from chronic health effects. Considering the increased anthropogenic alterations observed recently in the Amazon region and the subsequent amplified environmental bioavailability of Hg, further studies and mitigating actions are critical. This includes better surveillance of illegal anthropic activities and provision of ongoing education on this matter and incentives for dietary adaptations.

Error Enhancement for Upper Limb Rehabilitation in the Chronic Phase after Stroke: A 5-Day Pre-Post Intervention Study.

A large proportion of chronic stroke survivors still struggle with upper limb (UL) problems in daily activities, typically reaching tasks. During three-dimensional reaching movements, the deXtreme robot offers error enhancement forces. Error enhancement aims to improve the quality of movement. We investigated clinical and patient-reported outcomes and assessed the quality of movement before and after a 5 h error enhancement training with the deXtreme robot. This pilot study had a pre-post intervention design, recruiting 22 patients (mean age: 57 years, mean days post-stroke: 1571, male/female: 12/10) in the chronic phase post-stroke with UL motor impairments. Patients received 1 h robot treatment for five days and were assessed at baseline and after training, collecting (1) clinical, (2) patient-reported, and (3) kinematic (KINARM, BKIN Technologies Ltd., Kingston, ON, Canada) outcome measures. Our analysis revealed significant improvements (median improvement (Q1-Q3)) in (1) UL Fugl-Meyer assessment (1.0 (0.8-3.0), p < 0.001) and action research arm test (2.0 (0.8-2.0), p < 0.001); (2) motor activity log, amount of use (0.1 (0.0-0.3), p < 0.001) and quality of use (0.1 (0.1-0.5), p < 0.001) subscale; (3) KINARM-evaluated position sense (-0.45 (-0.81-0.09), p = 0.030) after training. These findings provide insight into clinical self-reported and kinematic improvements in UL functioning after five hours of error enhancement UL training.

Female teleworkers with pain have the highest presenteeism, where its primary contributing variable was not those of musculoskeletal disability.

Presenteeism, among desk workers with pain can be affected by musculoskeletal disabilities (MSDs), working styles, and gender. In this study, teleworkers were defined as those who teleworked >70% of the time at home, while others were defined as non-full teleworkers. This study aimed to (1) compare the magnitude of presenteeism among four groups: male and female teleworkers with pain and male and female non-full teleworkers with pain, and (2) create a regression model of presenteeism with 66 independent biopsychosocial variables for each group. Data were collected through an anonymous online survey. Presenteeism was evaluated using the work functioning impairment scale. The 66 independent biopsychosocial variables included four disability measures, namely, stiff neck/shoulders, low back pain, and upper or lower limb problems, along with other factors relevant to presenteeism in previous studies, such as age, body mass index, comorbidities, work-related variables, pain catastrophizing, and various psychological distress measures. Data from 1068 male non-full teleworkers, 1,043 female non-full teleworkers, 282 male teleworkers, and 307 female teleworkers were analyzed. Presenteeism was the highest among female teleworkers with pain. Furthermore, in all models, overall psychological distress, rather than the four MSD measures, was the primary contributing factor for presenteeism.

Stroke severity to determine musculoskeletal symptoms in family caregivers.

the objective of this study is to examine the relationship between the musculoskeletal problems experienced by the family members who care for stroke patients, physical health and disability levels. the subjects included in the study were patients and family caregivers admitted to the Kanuni Sultan Suleyman Training and Research Hospital Physical Medicine and Rehabilitation outpatient clinic with a stroke diagnosis between May 30 th, 2019, and May 30 th, 2021. The caregivers were assessed using the Extended Nordic Musculoskeletal Questionnaire. Validated scales were employed to evaluate stroke patients' physical health and disability level. a total of 104 stroke patients and 104 caregivers who met our inclusion criteria took part in this study. Low back complaints in the last month were associated with the patients' Functional Ambulation Score(FAS), Functional Independence Measure (FIM), Stroke Impact Scale (SIS) and Brunnstrom scores. Neck pain was the second musculoskeletal complaint, but was not statistically associated with patient-related factors. Upper limb problems were associated with FAS, FIM, SIS, Brunnstrom and the Modified Ashworth Scale scores. according to our findings, the low back is the body area most affected by musculoskeletal complaints in family caregivers of stroke patients, closely related to the patients' functional capacity and disability levels. NCT04901637 (1) Stroke survivors highly depend on informal caregivers for daily living. (2) Family caregivers are at an increased risk of experiencing musculoskeletal problems. (3) The caregivers' musculoskeletal symptoms are related to the level of the patient disability. (4) Preventive medicine should become a part of nursing education for family caregivers.

Gravidade do AVC e determinação dos sintomas musculoesqueléticos dos cuidadores familiares

Objective: the objective of this study is to examine the relationship between the musculoskeletal problems experienced by the family members who care for stroke patients, physical health and disability levels. Method: the subjects included in the study were patients and family caregivers admitted to the Kanuni Sultan Suleyman Training and Research Hospital Physical Medicine and Rehabilitation outpatient clinic with a stroke diagnosis between May 30 th, 2019, and May 30 th, 2021. The caregivers were assessed using the Extended Nordic Musculoskeletal Questionnaire. Validated scales were employed to evaluate stroke patients’ physical health and disability level. Results: a total of 104 stroke patients and 104 caregivers who met our inclusion criteria took part in this study. Low back complaints in the last month were associated with the patients’ Functional Ambulation Score (FAS), Functional Independence Measure (FIM), Stroke Impact Scale (SIS) and Brunnstrom scores. Neck pain was the second musculoskeletal complaint, but was not statistically associated with patient-related factors. Upper limb problems were associated with FAS, FIM, SIS, Brunnstrom and the Modified Ashworth Scale scores. Conclusion: according to our findings, the low back is the body area most affected by musculoskeletal complaints in family caregivers of stroke patients, closely related to the patients’ functional capacity and disability levels. Clinical trials number: NCT04901637

Study of genes polymorphisms in RANK/RANKL/OPG and WNT signaling pathways and their associations with bone parameters in broiler chicken

Limb problems are one of the most common problems with fast-growing meat-type chickens. Various bone abnormalities, which can lead to limping, bone weakness, or even fractures, bring overall discomfort to birds and a loss of production. Genetic aspects are often associated with these side effects on bone stability and are also cited as the dominant cause. These points to a close negative relationship of genetic selection for rapid growth with traits involved in bone integrity. Due to the assumption of an additive genetic background, improvements through genetic tools can be used. Our study is focused on selected genes of important signaling pathways for bone metabolism. We tried to detect polymorphisms that would show associations with selected bone parameters in a total of 48 broilers. Those were fast-growing Ross 308 hybrids and slow-growing Hubbard M22BxJA87A hybrids. The TNFRSF11A and WISP1 genes were tested. A total of fourteen polymorphisms were found, three of them were synonymous and five in the intron. In the case of four polymorphisms found in exons of the TNFRSF11A gene (c.11G > T, c.31G > A, c.37C > G, c.514G > A), associations with the observed bone parameters (bone strength, bone dimensions and bone mass) were demonstrated. The genetic architecture of bone traits is not fully understood, therefore the present study and the knowledge gained can help to increase the potential in poultry breeding processes and thus reduce the death of individuals.

Workshop (Clinical/Best Practice Implementation) ID 1983439

Objective Participants of this workshop will be able to identify and recommend multimodal treatment options in managing challenging cases in spasticity management of lower limbs in spinal cord injury (SCI). Methods The complexities of spasticity management will be identified through case-based presentations, including assessment and treatment directed by patient-oriented goals. Facilitated interactive discussion on these cases will engage participants for input, debate and critique. Procedural techniques for neurolysis will be discussed. Results Goals of spasticity management in SCI often include both proximal and distal lower limb problems. Therapies include oral medications, chemodenervation with neuromuscular junction blockade with botulinum toxin or neurolysis with phenol, intrathecal baclofen, bracing, and surgery. Many patients require multiple of these therapeutic options during their course of spasticity management. Discussion Multimodal therapy as part of the clinician toolbox is essential in tone management. Patient-oriented goals are important guideposts in spasticity management. SCI is a lifespan condition, and often patient goals and health conditions change over the years, requiring different tools to address such longitudinal needs.

A Review of the Analysis of Ground Reaction Force among Adults with Lower Limb Problems

The ground reaction force (GRF) is the equal opposing load transfer from the body to the ground, also called vertical load transfer. The GRF would produce stress waves transmitted toward the lower extremities during the heel strike of a gait cycle. Too much force imposed on the lower extremities for an extended period will cause harmful effects such as injuries or alterations in gait. This article presents a review of the literature on GRF analysis among adults with lower limb problems where comparisons between healthy and unhealthy subjects were analyzed, focusing on the compensation in each lower limb. A literature search of published articles in Science Direct and PubMed databases from August 2015 to March 2021 was analyzed. The keywords used for the search were (plantar force OR vertical load transfer OR ground reaction force) AND (lower limb OR lower extremities OR leg OR foot) AND (impairment OR problem OR injury). The literature search identified 22 relevant studies which were screened independently by two reviewers. Lower limb problems such as unilateral transfemoral amputation, unilateral transtibial amputation, patellofemoral pain, anterior cruciate ligament injury, knee arthroplasty, knee osteoarthritis, diabetic foot, total hip replacement, pronated foot proved to alter the GRF significantly. Patients used to shift their weight on the opposite leg as compensation, which acts as a pain-free mechanism. This paper has provided sufficient understanding regarding GRF among adults with lower limb problems. The knowledge concerning compensation may help physical therapists implement the appropriate intervention for patients with lower limb problems.

Correlation of mobile phone usage on grip strength, disabilities and posture in young adults

Background: The musculoskeletal issues are now common in excessive use of mobile phone for communication, gamming and socialization on internet. The excessive use of mobile phone may decrease the muscle strength and lead to poor posture ultimately functional impairment related to upper extremity. Objective: to determine correlation among duration of mobile phone usage, neck posture, disabilities and hand grip strength. Methods: A correlational cross sectional study was done at Riphah International University Lahore from March 2020 to February 2021. The target population was male and female young students of 18 to 24 years, used mobile phone more than 6 hours in a day. A total of n=400 subjectsarticipated in the study in which n=235 were females and n=165 were males. The information was gathered using the DASH Questionnaire to identify upper limb problems, the photogrammetry method to determine the cervical angle, and a dynamometer to determine the strength of each hand's grasp. The pearson product-moment correlation coefficient was done by using SPSS version 21. Result: The mean age of the study participant was 20.99±2.34 years. A total of n=165(41.25%) were male and remaining n=235 were female participated in the study. Increase use of mobile had negative significant small correlation with degree of cervical angle (p=0.04), right hand grip strength (p=0.01) and positive significant small correlation with DASH score (0.01). While no significant correlation between daily use of mobile phone and left hand grip strength Conclusion: The study concluded that as the duration of mobile phone usage increased, the forward head posture and disabilities of the upper limb also increased. But the grip strength of right hand decreased as the mobile phone duration is increased. Key words: Correlation, disabilities, female, grip strength, mobile phone, male, posture.

Evaluation of 6 DOF Robotic Arm Using Leap Motion Sensor

Due to their increased functionality, robotic arms provide a well-organized method for developing assistive devices. By 2035, statistics indicate that half of Germany’s population will be over the age of fifty, and every third person will be over the age of sixty. These aging societies face numerous obstacles when it comes to performing basic activities of daily living, or ""ADLs."" A growing body of research is focusing on Ambient Assisted Living, or ""AAL,"" as a novel approach to addressing the needs of elderly people. A critical objective of AAL is to improve the quality of life for the elderly and disabled and to assist them in maintaining an independent lifestyle. Robotics and technology-enabled environments will be critical in enabling elderly and physically disabled people to maintain a self-determined, independent lifestyle in their familiar surroundings. The purpose of this article is to propose the implementation of a novel intuitive and adaptive manipulation scheme by creating a human-machine communication interface between the Leap Motion controller and the 6-DOF Jaco robotic arm. An algorithm is developed to optimize the mapping between the user’s hand movement and the Jaco arm, as tracked by the Leap Motion controller. By constantly adapting to the user’s hand tremor or shake, the system should enable a more natural human-computer interaction and smooth manipulation of the robotic arm. The implementation would significantly improve people’s quality of life, particularly those with upper limb problems, by assisting them in performing several essential Activities of Daily Living ""ADLs."" The applications of this human-robot interaction will be discussed in relation to Ambient Assisted Living, with the introduction of several use case scenarios.

Control of robot-assisted gait trainer using hybrid proportional integral derivative and iterative learning control

&lt;p&gt;&lt;span lang="EN-US"&gt;An inexpensive exoskeleton of the lower limb was designed and developed in this study. It can be used as a gait trainer for persons with lower limb problems. It plays an essential role in lower limb rehabilitation and aid for patients, and it can help them improve their physical condition. This paper proposes a hybrid controller for regulating the lower limb exoskeleton of a robot-assisted gait trainer that uses a proportional integral and derivative (PID) controller combined with an iterative learning controller (ILC). The direct current motors at the hip and knee joints are controlled by a microcontroller that uses a preset pattern for the trajectories. It can learn how to monitor a trajectory. If the trajectory or load is changed, it will be able to follow the change. The experiment showed that the PID controller had the smallest overshoot, and settling time, and was responsible for system stability. Even if there are occasional interruptions, the tracking performance improves with the ILC.&lt;/span&gt;&lt;/p&gt;

Welfare assessment of horses and mules used in recreational and muleteer work in the Colombian coffee region.

The welfare of working equids in developing countries is sometimes threatened due to the limited resources and/or knowledge of their owners. The objective of this study is to evaluate the welfare of creole horses and mules using a validated protocol that assesses animal-based indicators. A total of 160 horses and 40 mules from three municipalities in the Colombian coffee-growing region were evaluated by means of direct observation of health and behavioral parameters. A descriptive analysis of the variables expressed in proportions was performed. Interactions between the different measurements were examined using the Chi-squared test. Spearman correlations were used to relate the measurements. Horses and mules demonstrated friendly behavior in front of the evaluators (78.13 and 61.54%, respectively); apathetic or severely depressed behavior was low (10.7 and 17.5%, P > 0.05). Significant differences in body condition score (BCS) were observed between mules and horses (P < 0.05); eighty percent of the mules and 54.4% of the horses exhibited a healthy body condition score (3 or more on a scale of 1 to 5). Less than 15% of the animals had eye problems, limb deformities, and gait abnormalities. Injuries to the head, withers, spine, ribs/flank, hindquarters, and hind legs were observed in a frequency between 12.5 and 30.43% of the animals, with a higher frequency in horses (P < 0.05). Weak correlations (R2 coefficient < 0.5), although statistically significant, were observed between low body conditions and the presence of skin and deeper tissue lesions, systemic health abnormalities, and limb problems (P < 0.05). The results indicate that owners care for their animals. However, the presence of skin and deep tissue lesions, especially in horses, suggests that they are subjected to high workloads. Therefore, it is essential to train owners in aspects related to the importance of providing their equids with adequate rest periods to recover from work and develop actions to strengthen human-equine interaction.

The effectiveness of compression garment in relieving muscular pain: a review

PurposeThe purpose of this paper is to understand compression garment in the area of medical industry, compression garments were used initially for patients with circulatory problems. External pressure was created by compression garments on the body surface which prevents blood clots, leg swelling and improves venous hemodynamics.Design/methodology/approachCompression rehabilitation is a significant element in the effective management of lower limb problems of people associated with venous, lymphatic, fat disorders like lipoedema.FindingsCompression garments have been attributed primarily for the increase in blood flow, improvement in recovery, reduction in muscle vibration that increase stability, improvement in thermoregulation, decrease in muscle pain, elimination of blood lactate and creatine kinase after exercise.Originality/valueCompression garments are extraordinary clothes that contain elastomeric yarns or fibers that are responsible for applying significant mechanical pressure on the required body surface for compressing, stabilizing and supporting underlying tissues.

Is inpatient rehabilitation a predictor of a lower incidence of persistent knee pain 3-months following total knee replacement? A retrospective, observational study

BackgroundModerate to severe levels of persistent knee pain have been estimated to affect up to 25% of people 3-months or more after a total knee replacement. It is unknown whether the type of rehabilitation pathway is associated with persistent high pain after surgery. Using a prospectively followed Australian cohort who underwent total knee replacement for knee osteoarthritis, this study aimed to i) report the incidence of high-intensity knee pain (defined as a score ≤ 15 on the Oxford Knee Score pain subscale) across time and ii) identify whether referral to inpatient rehabilitation was one of the predictors of persistent pain at 3-months post-surgery.MethodsA retrospective analysis of a large prospective study was conducted using the Oxford Knee Score pain subscale to determine if participants had high pain at 3-months, 12-months and 36-months post-surgery. Relative risks for high pain at 3-, 12- and 36-months between the type of rehabilitation pathway were determined using Poisson multivariable regression with robust standard errors. The same technique was also employed to determine potential predictors, including rehabilitation pathway, of high pain at 3 months.ResultsThe incidence of high pain in all participants was 73% pre-surgery and 10, 5 and 6% at 3-, 12- and 36-months respectively following knee replacement. There was a significant interaction between time and rehabilitation pathway, suggesting that the effect of the rehabilitation pathway varied across time. The incidence of high pain at 3-months did not significantly differ between those who attended inpatient rehabilitation (11.6%) and those discharged directly home (9.5%). Multivariable Poisson regression analysis identified the pre-surgical presence of high pain, co-morbid low back pain or other lower limb problem, younger age and having a major complication within 3-months following surgery as significant predictors of persistent pain whilst discharge to inpatient rehabilitation was not.ConclusionA small but clinically significant minority of people continued to have high pain levels at 3-, 12- and 36-months following a primary total knee replacement for osteoarthritis. Participation in an inpatient rehabilitation program does not appear to be an important predictor of ongoing knee pain.Trial registrationThe data were collected in the Evidence-based Processes and Outcomes of Care (EPOC) study, ClinicalTrials.gov Identifier: NCT01899443

862 Process Mapping of 3D Printing for Complex Limb Problems

Abstract Introduction Difficult limb problems such as complex trauma or re-presentation following orthopaedic revision surgeries can present substantial planning and technical challenges. 3D-printed models built from patient-specific CT scans facilitate creative thinking, problem solving and decision making to find better operative solutions. This quality improvement project aims to map the process of using 3D printers to solve orthopaedic problems. Method Stakeholders, including a Consultant Trauma &amp; Orthopaedic surgeon and the Medical Physics team were interviewed to formalise the full structure of their role from start to end, with the support of the Trust's Improvement Team and Innovation Team. A visual representation of the process map was produced using SmartDraw software. Feedback was received from stakeholders and a second cycle of process mapping was completed. Results The process map included the chronological steps of the project, the interaction between different roles and the stages of 3D printing. A database template was produced as a shared OneNote, allowing the tracking of each model production. Stakeholders found the map useful for anticipating problems and considering the future process and providing a framework of implementing innovation within the NHS. Discussion Unique implants cost the NHS significantly more money than batch-made products. Introduction of 3D models into pre-operative planning allow surgeons to utilise readily available solutions instead of custom, single-use implants, which can be cost saving and prevents unnecessary wastage. The project trialled operations on models, facilitated patient explanations and provided an educational tool. Future aims include roll-out to other specialties and Trusts, encouraging collaboration towards a sustainable internal economy.

No Symptoms for Over 70 Years! Incidentally Discovered Congenital Dysplasia of Infrarenal Aorta

A 75 year old female with a past history of pulmonary embolism was admitted with dyspnoea. Computed tomography angiography unexpectedly revealed a significantly narrowed and completely occluded abdominal aorta at the infrarenal level. She did not have any intestinal or lower limb problems, but she had had resistant hypertension for 40 years. Bilateral femoral, popliteal, and pedal pulses were palpable. The superior mesenteric artery (violet arrow), the arc of Riolan (white arrows), and the inferior mesenteric artery (red arrow) were dilated, providing adequate blood flow to the abdomen, pelvis, and lower limbs.