ABSTRACT
AIM: The human coccyx varies considerably in shape and size. The objective of this study was to investigate the morphology and morphometry of the coccyx on pelvic magnetic resonance imaging in asymptomatic individuals among Turkish adults. MATERIALS AND METHODS: This study was conducted retrospectively on the pelvic magnetic resonance images of 456 adult patients without a history of trauma in the coccyx region. The coccygeal vertebrae count, number of bone segments, and intercoccygeal and sacrococcygeal joint fusions were determined from the sagittal plane images. In addition, the length and angles (the sacrococcygeal angle, intercoccygeal joint angle, and sacrococcygeal joint angle) were measured. STATISTICAL ANALYSIS USED: Data were analyzed using the T-test or Mann-Whitney U-test, the ANOVA, or Kruskal-Wallis tests, and the chi-square test was used for the categorical variables. RESULTS: The coccyx is formed by four, five, or three vertebrae in a decreasing ratio. The coccyx is composed of one to five bone segments; one bone segment was found in 2.8% of the cases. Intercoccygeal joint fusions been observed predominantly in the last intercoccygeal joint, with or without sacrococcygeal joint fusion. The coccyx was found to be longer in adult males than in adult females. The sacrococcygeal angle might be anteverted or retroverted. CONCLUSION: The findings are contrary to the conventional knowledge in that the vertebrae shaping the coccyx were completely fused and consisting of a single bone in very few cases. Better understanding of the anatomical variation of the coccyx may be useful for clinicians evaluating patients presenting with conditions in the coccygeal region.
Subject(s)
Coccyx/anatomy & histology , Coccyx/diagnostic imaging , Magnetic Resonance Imaging , Adult , Aged , Chi-Square Distribution , Female , Humans , Joints/diagnostic imaging , Male , Middle Aged , Pelvic Bones/anatomy & histology , Pelvic Bones/diagnostic imaging , Retrospective StudiesABSTRACT
Considering the functions of aggrecanase-1 (ADAMTS4) and -2 (ADAMTS5), which are thought to be the two major enzymes responsible for the destruction of aggrecans in arthritic diseases, we investigated whether important polymorphisms in the ADAMTS4 and ADAMTS5 genes affect osteoarthritis (OA) susceptibility. Our study took place in Mugla, Turkey. Ninety-five cases were recruited following OA diagnosis (72 women and 23 men), and 80 individuals without any symptoms or radiographic signs of OA (56 women and 24 men) were chosen as healthy controls. After obtaining DNA from patients and control subjects, ADAMTS4 and ADAMTS5 genotypes were determined using the ABI Prism StepOnePlus Real-Time system. In addition, we categorized patients based on OA grade. There were no significant differences in the genotype distributions of the four polymorphisms between the groups (P > 0.05). Moreover, ADAMTS4 and ADAMTS5 allele frequencies did not differ between OA and control participants (P > 0.05). These findings suggest that the ADAMTS4 (rs4233367 and rs11807350) and ADAMTS5 (rs226794 and rs2830585) variants examined may not contribute to susceptibility to knee OA in the Turkish population. Other gene polymorphisms should be assessed in order to explain variations in OA susceptibility.
Subject(s)
ADAMTS4 Protein/genetics , ADAMTS5 Protein/genetics , Osteoarthritis, Knee/genetics , ADAMTS4 Protein/metabolism , ADAMTS5 Protein/metabolism , Aged , Aggrecans/genetics , Alleles , Case-Control Studies , Female , Gene Frequency , Genetic Predisposition to Disease , Humans , Male , Middle Aged , Osteoarthritis, Knee/epidemiology , Polymorphism, Genetic , Turkey/epidemiologyABSTRACT
Piriformis syndrome, a relatively rare condition, is described as entrapment of a sciatic nerve at the level of the piriformis muscle. There have been a few reports of bilateral piriformis syndrome in literature. In this study, we present bilateral piriformis syndrome in two professional soccer players from different teams who are symptom free at last follow-up after surgery. In both patients, resting EMG records were read normal, however EMG recording during the activity revealed prolonged H-reflexes. Both patients had no relief from conservative treatment and rehabilitation, therefore surgical treatment was performed. Preoperative mean visual analogue scale (VAS) value was 7, and decreased to 3 at the sixth month follow-up visit and at the longer term follow-up, mean 85months (74-96) it was valued at 1. Both soccer players returned to their active sports lives in the sixth postoperative month. According to Benson's functional evaluation scale, in long-term follow-up, there have been excellent results and both patients resumed their professional carrier for many years (mean 7 years).
