Anátomo-radiografia dos ossos longos do membro torácico do Tamandua tetradactyla / Anatomo-radiography of long-bones in thoracic limb ofTamandua tetradactyla

Objetivou-se descrever os acidentes anatômicos dos ossos longos do membro torácico de Tamandua tetradactyla por meio de análises macroscópicas e radiográficas. Foram utilizados 34 espécimes, que foram a óbito por atropelamento. A avaliação do úmero demonstrou as mesmas estruturas presentes nos animais domésticos, além de outras sem prévia descrição. Já no antebraço, rádio e ulna se apresentaram completamente separados, e apesar de, como o úmero, serem identificados alguns dos mesmos acidentes anatômicos descritos em outras espécies, também notamos particularidades. Todas as estruturas descritas na análise macroscópica foram identificadas à radiografia, quando realizada em pelo menos duas projeções ortogonais. As estruturas anátomo-radiográficas dos ossos longos do T. tetradactyla demonstraram grande variação anatômica em comparação a outros mamíferos, o que torna a referida espécie muito singular. Assim o conhecimento de suas particularidades é fundamental para abordagens clínico-cirúrgicas mais seguras.

The objective was to describe the anatomical accidents of the long bones of the thoracic limb of Tamandua tetradactyla by means of macroscopic and radiographic analyzes. We used 34 specimens, which were deaths by running over. Evaluation of the humerus demonstrated the same structures present in domestic animals, besides others without previous description. In the forearm, radius and ulna were completely separated, and although, like the humerus, some of the same anatomical accidents described in other species were identified, we also noticed particularities. All the structures described in the macroscopic analysis were identified on radiography, when performed in at least two orthogonal projections. The anatomic-radiographic structures of the long bones of T. tetradactyla showed great anatomical variation compared to other mammals, which makes the species very unique. Thus knowledge of their particularities is fundamental for safer clinical-surgical approaches.

Radiological investigation and clinical evaluation of the morphometric development of the forearm in human fetuses / Investigación radiológica y evaluación clínica del desarrollo morfométrico del antebrazo en fetos humanos

Fetal period of time during which the fetus grows rapidly and the organs are formed. The prenatal and postnatal analyses of the fetal structure provide information as to fetal growth, growth retardation, gestational age and congenital malformations. The development of the skeletal system during the intrauterine period takes place in an orderly manner as it also does in other systems. It was aimed that the morphometric development of the forearm in human fetuses during the period between 20-40 gestational weeks be radiologically investigated and that its clinical importance be evaluated, as well. A total of 100 fetal forearms (50 fetuses: 23 male, 27 female), the ages of which varied between 20-40 gestational weeks, without having any external pathology or anomaly were incorporated into the study. The fetuses were separated into groups according to weeks, trimesters and months. After the general external measurements of the fetuses had been performed, the mammographies and forearm radiographies of the fetuses were shot in the way that the forearms would remain in a prone position. Morphometric measurements pertaining to forearm structures were taken from the forearm radiographies that were shot with the help of a digital compass. Later on, the morphometric measurements in question were statistically evaluated. The mean values and the standard deviations of the measured parameters were determined according to gestational weeks, trimesters and months. There was a significant correlation between the measured parameters and the gestational age (p<0.001). In the comparison of the measured parameters between trimesters and months, it was observed that there was a statistically significant difference between the groups (p<0.05). Separately, it was also determined that there was no statistically significant difference in the comparison of the parameters, which was made between genders and right-left forearms (p>0.05). As for the results obtained in our study, we are of the opinion that the data obtained during this study period will be beneficial for the involved clinicians, such as those in charge of gynecology, radiology, forensic medicine and perinatology, in terms of evaluating the clinical studies related to the morphometric development of the forearm throughout the fetal period, in determining the fetal age and sex, and also in determining the pathologies and variations regarding the development of fetal skeletal system.

El período fetal es el tiempo en el cual el feto crece rápidamente y se forman los órganos. Los análisis prenatal y postnatal de la estructura fetal proporcionan información sobre el crecimiento fetal, el retraso de crecimiento, la edad gestacional y las malformaciones congénitas. El desarrollo del sistema esquelético, como también el de otros sistemas durante el período intrauterino, avanza de manera ordenada. Se investigó radiológicamente el desarrollo morfométrico del antebrazo en fetos humanos durante el período comprendido entre 20-40 semanas gestacionales y se evaluó su importancia clínica. Un total de 100 antebrazos fetales (50 fetos: 23 de sexo masculino, 27 de sexo femenino), cuya edad varió entre 20-40 semanas de gestación, sin patología externa o anomalía, fueron incluidos en el estudio. Los fetos fueron separados en grupos de semanas, trimestres y meses. Después de realizar las mediciones externas generales de los fetos, las mamografías y las radiografías fueron realizadas de tal manera que los antebrazos permanecieran en pronación. Las radiografías de las medidas morfométricas correspondientes a las estructuras del antebrazo se tomaron con apoyo de una compás digital; posteriormente, las medidas fueron tratadas estadísticamente. Los valores medios y las desviaciones estándar de los parámetros medidos se determinaron de acuerdo con las semanas de gestación, los trimestres y los meses. Hubo una correlación significativa entre los parámetros medidos y la edad gestacional (p <0,001). En la comparación de los parámetros medidos entre los trimestres y los meses, se observó una diferencia estadísticamente significativa entre los grupos (p <0,05). Se determinó también que no hubo diferencias estadísticamente significativas en la comparación de los parámetros, que se realizó entre los sexos y los antebrazos derecho-izquierdo (p> 0,05). En cuanto a los resultados de nuestro estudio, los datos obtenidos durante este período de estudio serán beneficiosos para los clínicos, como también para profesionales de las áreas de ginecología, radiología, medicina forense y perinatología, en la evaluación de estudios clínicos relacionados con el desarrollo morfométrico del antebrazo durante todo el período fetal, determinación de la edad y el sexo fetal, así como en la determinación de variaciones en el desarrollo del sistema esquelético fetal.

Imaging in the Diagnosis of Symptomatic Forearm Muscle Herniation.

Symptomatic muscle herniations are an unusual cause of upper extremity pain that is rarely reported in the literature. Out of 18 reported cases of upper extremity herniations, only 3 were caused by strenuous exertion6. Dynamic ultrasound and Dynamic MRI test are the very good tool for diagnosis of muscle herniation, FNAC and biopsy are rarely needed. This article describes a successful repair of a 22yr old manual worker’s ventral forearm herniation with polypropylene mesh. Prevalence Muscle herniation in an extremity is a well-known cause of pain, even though there have been extremely few documented cases. In a 2009 report published by the “Journal of Hand and Microsurgery,” only 200 cases of herniated muscles of the extremities had been reported since the mid-1800s, and only 17 cases of muscle herniation in the upper limb have been described10. Characteristics A herniated muscle in the forearm can cause mild to severe localized pain, affect grip, cause nerve pain or have no physical symptoms at all. Causes of documented cases include sporting or occupational activities, or an unrelated primary medical condition. Patients usually have a swollen mass that increases in size when the affected muscle is engaged and decreases when the muscles are relaxed. One differential diagnosis for a herniated forearm muscle is a tumor. Muscle herniation in the forearm typically affects males in their adolescent or young-adult years1. We report a case of a disappearing forearm nodule that appeared with muscle contraction. This is characteristic of a transfascial muscle hernia. Ultrasound and MRI are the key to identifying an area of fascial alteration. Treatment alternatives of this unusual condition are discussed.

Arm span, height and forearm bone mineral density in normal young and postmenopausal women.

The value of arm span and height measurements in the erect position were evaluated by (1) comparing them in individual young adults and postmenopausal women and (2) comparing them with forearm bone mineral density (BMD) using a Panasonic dual energy X-ray absorptiometry (DXA). The study group consisted of 301 healthy women composed of 165 young adults (20-40 years), 62 postmenopausal women and 74 women whose age was more than 40 and had regularity of menstruation. Arm span and height of the individual young adults and postmenopausal women were not significantly different (p>0.05). It indicated that arm span and height measurements were independent of normal aging. Height loss occurred in some elderly women who had some diseases or conditions which induced short stature. We suggested that arm span can be used to predict height during the younger adult life of elderly women and to predict the current height in patients who had a height loss problem. A simple linear regression equation of height and arm span has already been constructed. During the increase of years since menopause in postmenopausal women, height and arm span measurements were relatively constant, while BMD gradually declined. We also found that the greater the number of years since menopause, the higher the rate of BMD loss (%). Height and arm span had low correlation with BMD. Height or arm span alone can not be used to predict BMD, but may be combined with other risk factors of osteoporosis.

Diagnostic agreement of combined radiogrammetric analysis with texture analysis in the evaluation of bone density: a comparison with dual energy X-ray absorptiometry.

To assess the reliability and validity of combined radiogrammetric analysis with texture analysis (digital X-ray radiogrammetry: DXR) of metacarpals and distal forearm when compared to dual energy X-ray absorptiometry (DXA) of the distal radius. DXA readings from the supradistal and distal 1/10 of radius were compared with DXR obtained on the same day with a sample of 274 women and 87 men (average age 31.33 years, range 20-65 years). The results showed that both sites of forearm DXA scores were significantly correlated with DXR scores (r = 0.5211 and 0.6090, respectively). DXA scores were used as the standard, defining moderate fracture risk by a standardized t score <-2 and marked risk by t <-3. Following the current WHO definition of osteoporosis, t <-2.5 was also applied. Using cutting points of t <-2, <-2.5 and <-3 for DXA and t <-2 for DXR values, the sensitivity to osteopenia was 38.98 per cent, 40.63 per cent and 55.56 per cent respectively, with specificity of 94.36 per cent for all cutting points of DXA. At these cutting points, the corresponding false positive was 5.64 per cent and false negatives were 61.02 per cent, 59.37 per cent and 44.44 per cent, respectivety. It indicated that DXR measurement had low sensitivity but was appropriate with high specificity for discrimination of forearm osteoporosis.