ABSTRACT
Urinary stone disease still persists as a major health care problem due to its high prevalence. The management of patients with ureteral stones still remains under debate in several areas. There are different therapeutic approaches for ureteral stones depending on stone size, location, anatomical variations of the urogenital tract and patient performance. Extracorporeal shockwave lithotripsy [ESWL] being the main stay of treatment of choice for the stones, the management of large stone remains a point of discussion. With the latest advance in technology coupled with knowledge, there have been recent changes in therapeutic options for ureteric stones. Therefore, the treatment approaches may be individualized in order to achieve optimum outcomes. This article reports on a case of a large proximal ureteric stone with acute flank pain and hematuria managed by ESWL
ABSTRACT
Abductor pollicis longus [APL] muscle is known to exhibit different variations with respect to its attachments. During a routine dissection performed on cadaver forearms in the anatomy department, we encountered an unusual attachment of the APL muscle in the forearm of a male cadaver. APL had a normal proximal fleshy belly arising from middle third of the dorsal surface of the body of the radius; it was then separated into two bellies [lateral and medial] just proximal to the wrist. The lateral belly had a normal attachment to the radial side of the base of the first metacarpal bone whereas the medial belly at its distal part was fusiform, fleshy and was inserted into the lateral side of the base of the proximal phalanx of the thumb overlapping the insertion of the abductor pollicis brevis. Such an unusual variation of APL with its attachment into proximal phalanx is a rare finding and may be of importance in altering the mechanics of the thumb during abduction. The clinical significance of such an anatomical variation of APL may be important during reconstructive surgeries involving thumb and also of academic interest