Metacarpal Joint Research Articles

Diagnostic imaging findings in lame Warmblood horses with bone injuries of the medial proximal phalanx glenoid cavity.

This retrospective study aims to describe baseline and follow-up imaging findings in subchondral and trabecular bone damage occurring outside of the sagittal groove in the proximal phalanx (P1) glenoid in a case series of lame Warmblood horses. Thirteen lame horses (16 forelimbs) with standing magnetic resonance imaging (sMRI) evidence of nonsagittal groove glenoid subchondral and trabecular bone injury of P1 as the main lesion were included. All injuries were located at the medial aspect of the P1 glenoid. At sMRI, changes included subchondral bone plate thickening and trabecular sclerosis, bone marrow edema-like signal, subchondral bone resorption (11/16), and new bone production (8/16). Subchondral bone resorption in the transverse plane was linear (8/11), round (2/11), or ill-defined (1/11). Sclerosis, bone resorption, and new bone production were seen radiographically in 10, 4, and 5 limbs, respectively. All limbs had concurrent metacarpal condyle sMRI imaging abnormalities, osteophytosis, and joint effusion. Follow-up sMRIs were obtained in 8 of 16 limbs, five of which showing progression of the resorptive lesion. One horse encountered a comminuted fracture of the affected P1 18 months after the follow-up sMRI examination. The imaging appearance of the medial glenoid bone injuries of P1 in this case series is consistent with chronic bone overload. The linear configuration of bone resorption seen in eight lesions suggests short, incomplete stress fractures, which is supported by the ultimate catastrophic fracture occurring in one case.

Validity and reliability of a finger training tool for assessing metacarpal phalangeal joint ranges of motion in asymptomatic participants

This pilot study aims to evaluate concurrent validity using the goniometer as a reference tool and test–retest reliability of flexion of metacarpal phalangeal joint (MCP) measurements taken from a finger training device (air-guitar system) in healthy participants. There were ten self -reported asymptomatic participants recruited to test the devices. The measurements of all metacarpophangeal joints of the dominant hands were conducted using a finger goniometer and the air-guitar system. Two measuring sessions were conducted on the same day. The concurrent validity of the air-guitar indicated by strong concordance correlation coefficient (0.62–0.90) with the goniometer and mean difference (approximately 1°) between the two instruments are well below the limit of 5°. The test–retest reliability of MCP measurements from the air-guitar glove (0.82–0.99) was acceptable as a clinically meaningful measurement tool as the intraclass correlation coefficients were higher than 0.7. The standard error of measurement and minimal detectable change of the air-guitar are similar to those of the goniometer. The air-guitar tracking features, when used as a home-based therapy tool, may assist in monitoring change of MCP flexion over a time course with good reliability and strongly associated with the measurements from the goniometer.

Clinical Features of ACPA-Negative and ACPA-Positive Variants of Rheumatoid Arthritis.

: The study included patients with a reliable diagnosis of rheumatoid arthritis (RA) according to the criteria of ACR/EULAR 2010. Depending on the ACPA values, two groups of patients were recruited: ACPA-positive and ACPA-negative, comparable in gender, age, duration of the disease, and therapy. The nature of the onset and course of the disease and the activity of RA were evaluated (according to the DAS28, SDAI, CDAI indices). : The study involved 79 patients with ACPA-negative variant of RA and 79 ACPA-positive patients. The age of patients (Me [IR] (in years)) with the ACPA(-) variant was 52 [39; 62]; with the ACPA(+) variant, 54 [42; 62]; the duration of the disease (in months) was 59 [23; 122] and 48 [17; 84], respectively. In ACPA(+) patients, a higher disease activity was determined (by the indices DAS 28crp, DAS28esr, SDAI, CDAI), higher values of C-reactive protein and erythrocyte sedimentation rate, and a greater number of painful and swollen joints (p < 0.05). According to the localization of the involved joints, arthritis of the proximal interphalangeal, metacarpal, wrist and shoulder joints was more often determined in ACPA(+) patients. Systemic manifestations of RA at the time of examination and in the anamnesis were statistically significantly more common in ACPA(+) (32.9%) than in ACPA(-) (17.7%) patients. Of the systemic manifestations, rheumatoid nodules were more common in ACPA(+) patients, whereas a tendency to a higher frequency of neuropathy, sclerites, and episcleritis was revealed in ACPA(-) patients. . In patients with ACPA(-) subtype, clinical signs of joint damage and the inflammatory component are less pronounced compared to ACPA(+). However, the mixed picture of manifestation, the less "bright" course of the disease, the absence of characteristic immunological biomarkers necessitate long-term and careful monitoring of this group of patients. At the same time, the subjective severity of the disease and dysfunction due to ankylosing joints do not differ from the ACPA(+) variant of RA.

Mechanical Interaction Between the Tendons of the Extrinsic Finger Flexors

ABSTRACTHumans possess an incredible capacity for dexterity, but independent finger control is limited. One factor constraining finger independence is the connections between the tendons of the extrinsic finger muscles. The aim of this study was to assess to what extent the linkages between the distal tendons of flexor digitorum profundus (FDP) and those of the flexor digitorum superficialis (FDS) constrain finger independence. Experiments on human fresh frozen cadaveric upper extremities (n = 6) were performed. First, one finger (target) was flexed whereas the other (nontarget) fingers were held in a nearly extended position. The change (Δ) in total flexion angle (∑Θ; i.e., the sum of angles of the different finger joints) of the target finger from the ∑Θ corresponding to the extended position at the start of the movement until the ∑Θ corresponding to the onset of force exertion at the nontarget fingers was assessed. Second, the distribution of force across the four fingers upon loading the tendon of the target finger was assessed for two finger positions (extended, 90° flexion of metacarpal phalangeal joint). For both muscles and for all fingers, the range of independent movement was small (&lt;7°). Δ∑Θ at force onset was lowest for fingers immediately adjacent to the target finger and highest for more distant fingers. For both muscles and for all fingers, some of the target finger force (&lt;14% for FDP, &lt;2% for FDS) was distributed to the nontarget fingers, which increased (up to 58%) only for FDP in response to target finger flexion. We conclude that mechanical connections between the FDP and FDS tendons constrain finger independence. Such constraints become apparent when moving one finger relative to the other fingers.

Prevalence of Psoriatic Arthritis among Patients with Arthritis: Insights from a Tertiary Rheumatology Clinic in Bangladesh

Background: Psoriatic Arthritis (PsA) is a complex seronegative inflammatory arthritis associated with psoriasis, characterized by a wide range of clinical manifestations. This study aimed to explore the prevalence of PsA in arthritic patients along with associated demographic and clinical characteristics in a tertiary care setting in Bangladesh. Methods: This cross-sectional study was conducted at the Rheumatology Clinic of Dhaka Medical College Hospital over a period of 6 months from March 2018 to August 2018. A total of 600 arthritis patients underwent screening for PsA, with subsequent evaluations of confirmed cases based on the CASPAR criteria. Demographic and clinical characteristics were documented through face-to-face interviews and physical examination. For data collection, a pre-structured questionnaire was used. Disease activity was assessed using the DAPSA score. The study was conducted according to the ‘Declaration of Helsinki’. The statistical analysis was done with SPSS v-21. Results: The prevalence of PsA in arthritis patients was 5%. Age distribution of PsA showed a majority in between 30-39 years age group with a mean of 36.33±11.86 (SD). Slight female predominance was reported with a percentage of 53.3%. Almost three-fourths of study patients presented with a current diagnosis of psoriasis while the rest had a personal history or family history. A higher incidence (67.7%) of plaque psoriasis was observed followed by sebopsoriasis (20%) and for the rest of the patients, the type of psoriasis was unknown. The disease mostly involved multiple joints (90%), with ankle and metacarpal joints being the most commonly affected at 43.3% and 33.3%, respectively. Disease activity was high in the majority of the patients according to the DAPSA score, representing 53.34% of the patients, with the remainder exhibiting moderate to low disease activity. Conclusion: The study revealed a significant incidence of PsA among the arthritic population which indicates a pressing need for further extensive research on PsA across diverse populations. J MEDICINE 2024; 25: 35-40

Association of upper extremity anthropometry and subcutaneus adipose tissue with carpal tunnel syndrome

<p>Body mass index (BMI) is positively correlated with the frequency of carpal tunnel syndrome (CTS). However, there are different types of obesity, and the localization of adipose tissue differs between the genders. In this study, we purposed to investigate whether there was an association between the amount of local adipose tissue thickness and anthropometry in upper extremity with the presence and/or electrophysiological severity of CTS on both genders.</p>. <p>Our study included 150 patients who were diagnosed with CTS clinically and electrophysiologically and 165 healthy controls. The biceps and triceps skinfold thickness, the diameters of the wrist and metacarpal joints, and the upper arm circumferences over the belly of the biceps muscle were measured by using skinfold caliper and measuring cylinder. All data were analyzed by using the Statistics Open For All package (SofaStats) programme. To detect the role of anthropometric indexes, we used multivariable multinomial logistic regression models.&nbsp;</p>. <p>We revealed that BMI, biceps and triceps adipose tissue thicknesses were higher in females and also in patients with CTS. There was a positive correlation between electrophysiological grades of CTS and BMI with logistic regression analyzes. The mean Wrist circumference/Metacarpo&shy;ph&shy;arengeal Circumference ratio and biceps circumference were higher in moderate CTS groups. Metacarpofarengeal circumference was smaller in mild and moderate CTS cases compared to healthy ones.</p>. <p>We suggest that the differen&shy;ces between the anatomical bone structure and local adiposity between the genders may play an important role in the occurrence of CTS. Moreover, the structures of proximal muscle groups and distal metacarpal joints may contribute both to the development and severity of CTS.</p>.

Correction of Congenital Ring-Little Finger Metacarpal Synostosis Through Simultaneous Interpositional Allograft Bone After Split Osteotomy of the Synostosis Site and Distraction Lengthening of the Fifth Metacarpal

We attempted a technique for patients with congenital ring-little finger metacarpal synostosis involving simultaneous interpositional allograft bone after split osteotomy of the synostosis site and distraction lengthening of the fifth metacarpal along with correction of the metacarpal joint abduction contracture. The purpose of this study was to describe the surgical technique and its outcomes. We reviewed the medical records of children with congenital ring-little finger metacarpal synostosis treated surgically at our institute. Eight hands of six children with an average age of 5.0 (range, 1.7-9.3) years were treated by simultaneous interpositional allograft bone after split osteotomy, distraction lengthening, and tenotomy of abductor digiti minimi. We measured the metacarpal head-to-capitate area ratios from serial radiographs and analyzed them according to age. We also measured the change in the intermetacarpal angle (IMA) and metacarpal length ratio during an average of 8.1 (range, 1.4-16.8) years of follow-up. These changes were compared with changes in seven hands of five children with an average age of 8.1 (range, 1.5-15.6) years treated by the same method, but without a distraction lengthening of the fifth metacarpal and followed up for an of average 12.1 (range, 4.1-19.8) years, as a control group. Abnormal metacarpal head-to-capitate area ratio before surgery was normalized in all patients within the first 2 years after surgery. The IMA change averaged 39.8°, and the metacarpal length ratio changed by 17%. The control group showed an average IMA change of 36.6° and metacarpal length ratio change of 6%. Simultaneous interpositional allograft bone after split osteotomy of the synostosis site and distraction lengthening of the fifth metacarpal with correction of metacarpal joint abduction contracture can restore the radiographic parameters in congenital ring-little finger metacarpal synostosis. The normalized ossification of the fifth metacarpal head indicates that the surgical procedure is probably safe. Therapeutic V.

Comparison of mini-plate versus Kirschner wire internal fixation for fifth metacarpal basal fractures with carpometacarpal joint dislocation.

To compare the outcome of mini-plate versus Kirschner wire (K-wire) internal fixation for treating fifth metacarpal basal fractures with carpometacarpal joint dislocation. A total of 46 patients with fifth metacarpal basal fractures combined with carpometacarpal joint dislocation were divided into two groups. The control group received K-wire fixation, while the observation group underwent mini-plate fixation. We assessed treatment effectiveness, surgical parameters, range of motion, serum stress markers, quality of life scores, and postoperative complication rates. A multivariable logistic regression analysis was performed to identify factors influencing postoperative joint function. The observation group demonstrated a significantly higher excellent and good rate compared to the control group (P<0.05). Additionally, the observation group had a lower intraoperative bleeding volume, shorter incision lengths, and faster fracture healing times, all significant differences (all P<0.05). Postoperative assessments indicated that range of motion, quality of life scores, and superoxide dismutase levels were significantly improved in the observation group (P<0.05). Conversely, cortisol, angiotensin II, and norepinephrine levels, along with the incidence of postoperative complications, were lower in the observation group compared to the control group (all P<0.05). Logistic regression analysis identified the surgical method as an independent factor affecting postoperative metacarpal joint function (OR = 0.16, P = 0.003). Mini-plate internal fixation is superior to K-wire fixation for the treatment of fifth metacarpal basal fractures with carpometacarpal joint dislocation. It promotes faster fracture healing, reduces serum stress markers, enhances joint mobility and quality of life, and decreases postoperative complications.

Dynamics of movement amplitude indicators in joints of patients with rheumatoid arthritis

The purpose of the paper is to evaluate the effectiveness of the technology of rehabilitation measures in patients with rheumatoid arthritis according to the dynamics of the amplitude of movements indicators. Theoretical (analysis and generalization of literary and Internet data), survey, collection of anamnesis, objective examination, anthropometric (goniometry) methods of mathematical statistics. 188 patients with rheumatoid arthritis were examined, of which 156 (83%) were women, 32 (17%) were men, and their average age was 44.9±7.6 years old. The analysis of the goniometric indicators of the joints of hands affected by rheumatoid arthritis after six months of conducted rehabilitation measures showed a significant improvement in the mobility of the radiocarpal joint and hand fingers in the examined patients. In particular, active flexion in the radiocarpal joint significantly increased in patients of the experimental group and was 72.5±6.0º, while in the patients of the control group this indicator was 5.3º less (67.2±5.0º) (р&lt;0.05). A significant result was achieved in restoring flexion of the hand fingers in patients of the experi­mental group: mobility of the fingers in the metacarpal phalangeal joints was 83.2±3.6º, and in the control group it was 73.4±5.0º, in the proximal interphalangeal joints in patients of the experimental group it was 84.1±3.3º, and in the control group – 67.8±4.8º (р&lt;0.05). Positive dynamics of active movements in the foot and finger joints was also observed in pa­tients of both groups at the end of the study. In the patients of the experimental group, the active dorsiflexion in the ankle joint was 27.7±1.4º, the plantar flexion was 41.3±1.8º, which was significantly better than in patients of the control group in which the observed dorsiflexion was 23.4±1.7º, and plantar flexion – 41.3±1.8º (р&lt;0.05). Accordingly, there was a significant increase in the motor function indicators in the metatarsal phalangeal joints of patients in the expe­rimental group: flexion was up to 37.1±1.4º, extension – up to 39.2±1.0º, compared with the indicators in the control group: flexion – up to 33.5±1.2º, extension – up to 36.2±1.1º (р&lt;0.05). The effectiveness of the developed technology is con­firmed by improvement of the results of goniometric indicators in patients of the experimental group compared with the control group.

Fungsi Sekuens Dixon Pada Pemeriksaan Mri Wrist Joint Dengan Kasus Dequervein Tenosinovitis Syndrome

Function Of Dixon Sequences In Wrist Joint Mri Examination In Dequervein Tenosynovitis Syndrome Cases. Magnetic Resonance Imaging (MRI) is the primary modality in patients with symptoms associated with De Quervain's Tenosynovitis Syndrome which is a stenosing tenosynovitis condition that affects the extensor tendons of the carpometacarpal and metacarpal joints of the thumb. The Dixon technique has the advantage of being able to produce fat images and water images. The basic principle of the Dixon technique is that each voxel has its signal coded periodically at a fixed offset. The purpose of using the Dixon sequence is to: analyze fluid and tissue which can differentiate between the firmness of fluid and tissue including nerves and blood vessels. The Dixon can press fat so that the boundaries are firm, the presence of muscle and fat infiltration can be seen. This research is a qualitative study using a case study method using 3 patients who underwent MRI Wrist Joint examinations in cases of Dequervein Tenosynovitis Syndrome. Data was collected using observation, documentation and interviews with radiographers and radiologists. The results of the data that have been collected can be concluded from the MRI Wrist Joint examination in cases of Dequervein Tenosynovitis Syndrome which was carried out at one of the hospitals in Jakarta, using the Sequence T1_tse_tra, T2_tse dixon_fs_cor, T2_tse_dixon_fs_sag, T1_vibe_we_cor, Pd_tse_fs_tra_2.5mm. Because by using the Dixon sequence the results obtained are more detailed in evaluating pathological abnormalities.

Fibular Allograft Osteoplasty and Silicone Arthroplasty following Gunshot Injury of the Metacarpal

Summary: The complexity of a gunshot wound to the hand with segmental bone loss and adjacent joint disruption presents a unique challenge for the reconstructive surgeon. There are several options for posttraumatic reconstruction of hand joint defects, ranging from arthrodesis, implants, and autologous arthroplasty. Despite the abundance of literature regarding guidelines for isolated osteoplasty and arthroplasty, there are only case reports describing management of bone and joint defects, all within the setting of cancer resection. This case report presents a 24-year-old, right-hand dominant man with a gunshot wound to his left hand involving the fifth metacarpal and metacarpal phalangeal joint. The metacarpal was reconstructed with a fibular bone allograft with simultaneous placement of a silicone arthroplasty implant, allowing preservation of motion at the metacarpal phalangeal joint with satisfactory functional outcomes. This illustrates the feasibility of successfully reconstructing segmental bone loss and adjacent joint defects simultaneously in the traumatic setting of firearm injuries.

Baricitinib improves bone properties and biomechanics in patients with rheumatoid arthritis - results of the prospective interventional BARE BONE trial.

Rheumatoid arthritis (RA) is characterized by erosive joint damage, deterioration of bone mass and biomechanics. Preclinical evidence suggests a beneficial effect of Janus Kinase inhibition (JAKi) on bone properties, but clinical data are scarce to date. In this study we evaluated the effect of JAKi through baricitinib (BARI) on (i) volumetric bone mineral density (vBMD), bone microstructure, biomechanics, erosion repair and (ii) synovial inflammation in RA patients. Prospective, single-arm, interventional, open-label, single-center phase 4 study in RA patients with pathological bone status and clinical indication of JAKi (BARE BONE trial). Participants received BARI (4mg/day) over 52 weeks. To assess bone properties and synovial inflammation, high-resolution CT scans and Magnetic resonance imaging (MRI) were performed at baseline (BL), at week 24 and 52. Clinical response and safety was monitored. Thirty RA patients were included. BARI significantly improved disease activity (DAS28-ESR: 4.82±0.90 to 2.71±0.83) and synovial inflammation (RAMRIS synovitis score: 5.3 (4.2) to 2.7 (3.5)). We observed a significant improvement in trabecular vBMD with a mean change of 6.11 mgHA/mm3 (95%CI 0.01 to 12.26). Biomechanical properties also improved with mean change from baseline in estimated stiffness of 2.28 kN/mm (95% CI 0.30 to 4.25) and estimated failure load of 98.8 Newtons (95%CI 15.9 to 181.7). The number and size of erosions in the metacarpal joints remained stable. No new safety signals with baricitinib treatment were observed. Bone of RA patients improves with BARI therapy as shown by an increase in trabecular bone mass and an improvement of biomechanical properties.

Using active or functional range of motion as a further indicator to detect hand osteoarthritis. A preliminary study

Purpose Propose further indicators for helping to detect hand osteoarthritis (HOA) using either active or functional ranges of motion (AROM or FROM). Method Hand kinematics data of 16 hand joint angles from previous studies were used, taken from healthy participants and HOA patients with differently affected joints and distinct levels of compromise. Data consisted of: (i) AROM (extreme values and ranges); (ii) FROM while performing the Sollerman Hand Function Test (mean, extreme percentiles and ranges). Two linear discriminant analyses (stepwise method) were conducted, one per dataset (AROM and FROM), with condition (healthy/patient) as the grouping variable. The potential predictors were the data from the joints with significant differences between samples for each analysis (A-predictors and F-predictors). Results Good sensitivity-specificity values of 85.2–90.9% and 93.8–93.9% for F-predictors and A-predictors, respectively. Sets of predictors corresponded to the joints more commonly affected by HOA. F-predictors: lower maximal flexion of carpometacarpal and interphalangeal thumb joints, higher maximal flexion of thumb metacarpal joint, lower flexion/extension range of ring proximal interphalangeal joint and higher maximal little finger adduction. A-predictors: narrower flexion/extension range of the thumb carpometacarpal joint, lesser extension of the ring metacarpophalangeal joint; lower flexion of the middle finger proximal interphalangeal joint along with a narrower palmar arch range. Conclusion Both sets of predictors provide discrimination capacity of HOA with good sensitivity-specificity, slightly better for A-predictors. The AROM measurement is technically less demanding and can be clinically applied even with manual goniometry.

Clinical features of ACPA-negative and ACPA-positive variants of rheumatoid arthritis

The aim of the study was to study the features of the clinical picture of the disease in patients with ACPA-negative and ACPA-positive variants of rheumatoid arthritis.Materials and methods. The study included patients with a reliable diagnosis of rheumatoid arthritis (RA) according to the criteria of ACR/EULAR 2010. Depending on the values of the ACPA, two groups of patients were recruited: ACPA-positive and ACPA-negative, comparable in gender, age, duration of the disease and therapy. The nature of the onset and course of the disease, the activity of RA were evaluated (according to the DAS28, SDAI, CDAI indices).Results and discussion. The study included 79 patients with ACPA-negative variant of RA and 79 with ACPA-positive. Age of patients (Me [IR], in years) with the ACPA(–) variant was 52 [39; 62], with the ACPA(+) – 54 [42; 62], the duration of the disease (in months) is 59 [23; 122] and 48 [17; 84] respectively. In ACPA(+) patients, higher disease activity was determined by the indices DAS28-CRP, DAS28-ESR, SDAI, CDAI, values of C-reactive protein and erythrocyte sedimentation rate, a greater number of painful and swollen joints (p&lt;0.05). According to the localization of the involved joints, arthritis of the proximal interphalangeal, metacarpal, wrist and shoulder joints was more often determined in ACPA(+) patients. Systemic manifestations of RA at the time of examination and in the anamnesis were statistically significantly more common in ACPA(+) (32.9%) than in ACPA(–) (17.7%). Of the systemic manifestations, rheumatoid nodules were more common in ACPA(+) patients, a tendency to a higher frequency of neuropathy, scleritis and episcleritis was revealed in ACPA(–) patients.Conclusion. In patients with ACPA(–) subtype, clinical signs of joint damage and the inflammatory component are less pronounced compared to ACPA(+). However, the mixed picture of manifestation, the less “bright” course of the disease, the absence of characteristic immunological biomarkers necessitate long-term and careful monitoring of this group of patients. At the same time, the subjective severity of the disease and dysfunction due to ankylosing joints do not differ from the ACPA(+) variant of RA.

Detecting hand joint ankylosis and subluxation in radiographic images using deep learning: A step in the development of an automatic radiographic scoring system for joint destruction.

We propose a wrist joint subluxation/ankylosis classification model for an automatic radiographic scoring system for X-ray images. In managing rheumatoid arthritis, the evaluation of joint destruction is important. The modified total Sharp score (mTSS), which is conventionally used to evaluate joint destruction of the hands and feet, should ideally be automated because the required time depends on the skill of the evaluator, and there is variability between evaluators. Since joint subluxation and ankylosis are given a large score in mTSS, we aimed to estimate subluxation and ankylosis using a deep neural network as a first step in developing an automatic radiographic scoring system for joint destruction. We randomly extracted 216 hand X-ray images from an electronic medical record system for the learning experiments. These images were acquired from patients who visited the rheumatology department of Keio University Hospital in 2015. Using our newly developed annotation tool, well-trained rheumatologists and radiologists labeled the mTSS to the wrist, metacarpal phalangeal joints, and proximal interphalangeal joints included in the images. We identified 21 X-ray images containing one or more subluxation joints and 42 X-ray images with ankylosis. To predict subluxation/ankylosis, we conducted five-fold cross-validation with deep neural network models: AlexNet, ResNet, DenseNet, and Vision Transformer. The best performance on wrist subluxation/ankylosis classification was as follows: accuracy, precision, recall, F1 value, and AUC were 0.97±0.01/0.89±0.04, 0.92±0.12/0.77±0.15, 0.77±0.16/0.71±0.13, 0.82±0.11/0.72±0.09, and 0.92±0.08/0.85±0.07, respectively. The classification model based on a deep neural network was trained with a relatively small dataset; however, it showed good accuracy. In conclusion, we provided data collection and model training schemes for mTSS prediction and showed an important contribution to building an automated scoring system.

Osteology and radiology of the thoracic limb of nine-banded armadillo, dasypus novemcinctus linnaeus, 1758

In Brazil, injured nine-banded armadillos are frequently taken to wildlife rehabilitation centers due to direct or indirect anthropic interactions, however, database about osseous structures useful to radiographic interpretation are limited. This work provides bones description from thoracic limb of Dasypus novemcinctus as well as references to radiographic interpretation and the best positioning to perform the radiographies. Twelve deceased specimens seized by IBAMA (Brazilian Institute of the Environment and Renewable Natural Resources) were used to check osteology and radiographic anatomy. Radiographic images were taken in practical routine plans of small animals and were followed by limbs dissection and bones preparations. The bone structure of the thoracic limb was similar to those of other species of armadillos. The scapula presented a prominent caudal angle, as well as a thick acromion with a wide hamate process; the humerus is short, spiraled with a prominent deltoid tuberosity and a wide lateral epicondylar crest; the radius and ulna did not present any fusion between then, allowing a wide rotation movement of the forearm. In general, the bone components of the hand maintained a short and robust shape, digits with developed distal phalange followed by long claws. Several sesamoid bones were found in the metacarpal and interphalangical joints. Clear visualization of bone characteristics was possible using proposed positioning to take the radiographies.

Relationship between carpal bone morphology and scaphoid fracture location

Aim: Morphological variations in carpal bone may have an effect on wrist pathologies. In this study, we examined the relationship between carpal bone morphologies and scaphoid fractures. Materials and Methods: Patients with a prominent scaphoid fracture on posteroanterior and ulnar deviation X-ray were included in the study. Morphological types of lunate, hamate, capitate, presence of capitate-fourth metacarpal joint and scaphoid fracture location were documented retrospectively. A total of 68 patients, 65 (95.6%) male and 3 (4.4%) female, were included in the study. Results: Considering the scaphoid fracture types, 40 (58.8%) patients had waist fractures and 28 (41.2%) patients had proximal pole fractures. The association of fracture type and morphology of carpal bones was examined. Conclusion: In our study, we found that lunate, capitate, hamatum morphology and ulnar variance, fourth metacarpal articulation had no effect on the scaphoid fracture pattern.

Karpal kemik morfolojisi ile distal radius kırık paterni arasındaki ilişki

Abstract&#x0D; Background: In this study, we examined whether carpal bones (lunate, hamate, capitate) morphologies and fourth metecarp-capitate articulation have an effect on the distal radius fracture pattern.&#x0D; &#x0D; Methods: 206 patients who applied to the emergency department with distal radius fracture between 2016-2020 were included in the study. Preoperative and pre-reduction x-ray films of the patients were examined. Lunate, hamate, capitate morphologies and 4.metacarp articulation analyzed and classified. Distal radius fracture types were classified according to AO and Fernandez. The relationship between carpal bone morphology and distal radius fracture type was analyzed.&#x0D; &#x0D; Results: This study consisted of 101 men and 103 women. AO fracture types and carpal bone morphologies (lunate joint type according to Viegas, lunate type according to Zapico, capitate morphology, hamate morphology and capitate-4 metacarpal joint morphology) did not differ significantly (p &gt; 0.05). Fernandez fracture types and carpal bone morphologies (lunate joint type according to Viegas, lunate type according to Zapico, capitate morphology, hamatum morphology and capitate-4.metacarp joint morphology) were compared, there was no significant difference (p &gt; 0.05).&#x0D; Conclusion: As a result, no clear relationship could be demonstrated between carpal bone morphology and distal radius fracture pattern.

Case report: Tuberculosis as a cause unilateral of sacroiliitis in lupus patients

Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease, with variable manifestations, which is frequently exacerbated, requiring differential diagnosis with infectious conditions. In the case report, the patient satisfied the following criteria as per ACR/EULAR (2019): FAN 1:640 homogeneous nuclear, fever, alopecia, hypocomplementemia, antidsDNA 1:80 and lymphopenia. She was on: prednisone 20mg/day, hydroxychloroquine 400mg/day and calcium+vitamin D3. She was pale (3/4+), dehydrated and tachycardic. Osteoarticular examination: Patrick-Fabere positive for left sacroiliac; pain in external and internal rotation in left hip and painful palpation in the metacarpal, proximal interphalangeal, wrists, knees, ankles, hip and thigh joints, especially in the left and right. Radiography showed extensive sclerosis (grades 3 and 4) in left sacroiliac and rectified lumbar lordosis. Later, magnetic resonance imaging revealed extensive subcortical bone marrow edema at the left sacroiliac associated with capsulitis. In addition to positive BAAR TRM-TB, Lupus patients present a high incidence of TB, which is an important hypothesis in febrile cases with inflammatory lombalgy, since its osteoarticular form mainly affects the spine. Therefore, the importance of differential diagnosis for effective management is evident.

A flexible wearable e-skin sensing system for robotic teleoperation

AbstractElectronic skin (e-skin) is playing an increasingly important role in health detection, robotic teleoperation, and human-machine interaction, but most e-skins currently lack the integration of on-site signal acquisition and transmission modules. In this paper, we develop a novel flexible wearable e-skin sensing system with 11 sensing channels for robotic teleoperation. The designed sensing system is mainly composed of three components: e-skin sensor, customized flexible printed circuit (FPC), and human-machine interface. The e-skin sensor has 10 stretchable resistors distributed at the proximal and metacarpal joints of each finger respectively and 1 stretchable resistor distributed at the purlicue. The e-skin sensor can be attached to the opisthenar, and thanks to its stretchability, the sensor can detect the bent angle of the finger. The customized FPC, with WiFi module, wirelessly transmits the signal to the terminal device with human-machine interface, and we design a graphical user interface based on the Qt framework for real-time signal acquisition, storage, and display. Based on this developed e-skin system and self-developed robotic multi-fingered hand, we conduct gesture recognition and robotic multi-fingered teleoperation experiments using deep learning techniques and obtain a recognition accuracy of 91.22%. The results demonstrate that the developed e-skin sensing system has great potential in human-machine interaction.