The sacroiliac joint: anatomical study in the coronal plane and MR correlation.

The current clinical imaging technique applied to the sacroiliac joint (SIJ) is coronal Computed Tomography (CT). The aims of this study were: 1) to section the cartilage, the ligaments of the SIJ, and their relations to adjacent organs, in a coronal plane; 2) to correlate anatomical and magnetic resonance (MR) sections; 3) to extend these data in vivo. A topographic dissection of a 52 year-old female specimen was performed to identify the various components, and spatial relationships of the SIJ. Another fresh frozen 50 year-old female cadaver was chosen on CT criteria of normality, and examined with a high resolution (HR) T1-weighted spin echo sequence, in a plane parallel to the ventral limit of the first two sacral vertebrae. This cadaver was then sliced with a sliding gauge device (slice thickness: 5 mm, and device thickness: 1 mm). The SIJ of a 28 year-old nulliparous volunteer, were examined in HR MR imaging, and with a faster sequence, for comparison with the post mortem data. The slice study was correlated with conventional dissection. The continuity and thickness of the auricular cartilage, the complex fascicles of proximal ventral and dorsal sacroiliac ligaments, and distant sacrotuberous and sacrospinous ligaments, were studied. In each plane, coronal HR MR imaging studies were correlated with anatomical sections. The clinical relevance of this comparison was to extend these data in vivo. The auricular cartilage and the ligaments of the SIJ are clearly analyzed by MR imaging, which could contribute to the study of sacroiliitis.

Ultrasonographic anatomy of the liver.

Two characteristics of the ultrasonic image, that it is rebuilt and non figurative in its details, led us to establish specific relationships between anatomic structures and their ultrasonic images. The anatomic study was made on fresh, injected, frozen, livers, sectioned along the classical echographic planes. The echographic study was conducted in healthy patients, without any hepatic lesions. The results fall under three heads: analysis of the basic structures (portal vein, hepatic vein, and bile ducts) enables to establish perfect relationship between the anatomic and echographic features; the echo-anatomic study of the echographic planes pertaining to percutaneous examination of the liver provides a satisfactory correlation between the anatomy and the ultrasonogram; analysis of the hepatic vascular arrangement enables to define a sectorial systematization of liver structure. Segmental systematization of the right side of the liver is more difficult to define because of the virtual limits of the upper and lower segments of the right paramedian and lateral sectors. This study leads to better echographic understanding of the liver and to a tentative systematization essential to the localization of focal hepatic lesions.

Morphology and functional anatomy of the first dorsal interosseous muscle of the hand.

The aim of this study, based upon anatomical and electrophysiological evaluation, was to identify the relationship between the morphology and physiology of the first dorsal interosseous muscle of the hand, which should be distinguished from the other dorsal interosseous muscles of the hand. Its morphology, distal attachments and physiology have been subject of numerous studies yielding conflicting results. The study reported herein was made on the basis of anatomical and electrophysiological investigation. Most of the dissections (20/34) were made on fresh specimens. Results of this study confirm the existence of the deep and superficial heads of the 1st dorsal interosseous muscle. The muscle is attached distally to the palmar plate of the metacarpophalangeal joint, the lateral tubercle of the base of the proximal phalanx of the index and the interosseous hood. Conversely, the muscle did not show any attachment to the oblique radial wing of the extensor apparatus in our dissections. The deep head of the muscle causes mainly flexion pinch between thumb and index superficial head abduction. Within the complex physiology of the various types of apposition of thumb and index, the dorsal interosseous muscle acts as a stabilizer. The results of electrophysiological study confirmed most of the interpretations deduced from morphological investigation.

[Diagnostic and prognostic contribution of electromyography in postoperative incontinence in men]. / Apport diagnostique et pronostique de l'électromyogramme dans les incontinences post-opératoires de l'homme.

The authors have drawn up a classification of sphincteral lesions, using electromyographic criteria, with the aid of electromyograms of the striated sphincter of the urethra in forty eight patients treated surgically for prostatic adenoma, and presenting with postoperative incontinence persisting for more than eight days after removal of the catheter. This classification in turn serves as a basis for the drawing up of prognostic criteria for these incontinences, treated by electrotherapy.

The muscles of the abdominal wall: a new functional approach with anatomoclinical deductions.

The basic functional anatomy of muscle can be investigated by histochemical analysis of the muscle fibers and kinesiologic electromyography. The results of these techniques lead to anatomoclinical deductions based on the structure of muscle. Histochemical analysis of the striated fibers of a given muscle shows the existence of three functionally different populations of fibers. The relative abundance of each category of muscle fibers (expressed as a percentage) demonstrates the basic function of the muscle. The investigation of muscle function by kinesiologic electromyography shows that there are three categories of motor activity in the course of movement. These different types of motor activity are dependent upon the muscle fibers which display different physiological features, especially with respect to their contraction time. These two investigative techniques, the overall results of which are concordant, were applied to the study of the function of the muscles of the abdominal wall and led to the following anatomo-clinical deduction: tonico-postural motor activity is predominant in the rectus abdominis and flat abdominal muscles. Kinesiologic electromyography also allowed to demonstrate the functional development of these muscles according to the age, sex, corpulence and physical activity of the subjects studied.

[Enzymatic study of muscle fibers of the antero-lateral wall of the abdomen in man: functional interpretation]. / Etude enzymatique des fibres des muscles de la paroi antéro-latérale de l'abdomen chez l'homme: interprétation fonctionnelle.

After a recall of muscular histo-enzymology, the authors expose the results of an analysis of the antero-lateral muscles of the abdomen. They establish a predominance of the muscular fibers, type I, that are tonic as compared with the muscular fibers, type II, that are phasic. Thus the role of support and of maintenance of the intra-peritoneal pressure by these muscles is confirmed. The tonic characteristic is also important for the functional reeducation and the electrotherapy of the abdominal wall.