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Quantitative Imaging in Medicine and... Mar 2023
PubMed: 36915338
DOI: 10.21037/qims-22-1276 -
Folia Morphologica 2022The triticeal cartilage can be found in the lateral thyrohyoid ligament. The triticeal cartilage may exist in different shapes and locations, may be present unilaterally...
BACKGROUND
The triticeal cartilage can be found in the lateral thyrohyoid ligament. The triticeal cartilage may exist in different shapes and locations, may be present unilaterally or bilaterally, or absent. The study aims to determine the prevalence, distribution, level, shape, and the degree of ossification of the triticeal cartilage by using three-dimensional computed tomography angiography (CTA).
MATERIALS AND METHODS
Computed tomography angiography images of 1450 patients (785 women and 665 men), obtained in the period from 1 January 2017 to 30 September 2019, were evaluated retrospectively. Any unilateral or bilateral presence or the absence of triticeal cartilage was recorded with its anatomical level, shape, and degree of ossification.
RESULTS
At least one triticeal cartilage was found in the CTA images of 57.4% (833 out of 1450) patients. The prevalence was 51.3% in women (403 out of 785) and 64.7% in men (430 out of 665). Bilateral triticeal cartilages were more common compared to unilateral ones. Ossification was most commonly mild at a rate of 39.1%. A round-shaped triticeal cartilage was the most common form at a rate of 46.6%. Triticeal cartilage was detected at various intervertebral disc levels from the second and third cervical vertebrae to the level of the sixth cervical vertebra.
CONCLUSIONS
Triticeal cartilage is common in the Turkish population and it should receive substantial attention from clinicians because it can be confused with calcified plaques and fractures of the superior horn of the thyroid cartilage. Therefore, for appropriate diagnoses and treatment, it is important to know the prevalence of triticeal cartilage with its distribution, intervertebral disc levels of location, shapes, and ossification degrees.
Topics: Cervical Vertebrae; Female; Humans; Male; Prevalence; Retrospective Studies; Thyroid Cartilage; Tomography, X-Ray Computed
PubMed: 33438185
DOI: 10.5603/FM.a2020.0153 -
Orthopaedic Journal of Sports Medicine Dec 2020Physeal injuries of the coracoid process are rare but may be increasing because of increased participation of youth in year-round sports. (Review)
Review
BACKGROUND
Physeal injuries of the coracoid process are rare but may be increasing because of increased participation of youth in year-round sports.
PURPOSE
To analyze reported physeal and apophyseal injuries of the coracoid process.
STUDY DESIGN
Systematic review; Level of evidence, 4.
METHODS
PubMed and Scopus were searched using the terms and . The inclusion criteria were English full-text articles describing coracoid fracture as well as articles that described patient characteristics and presented appropriate images. The exclusion criteria were descriptive cases without images as well as those lacking appropriate images. Citation tracking was conducted to find additional articles and full-text articles written in other languages. Articles were included if they reported physeal injury or judged to involve physeal injury based on the provided images.
RESULTS
Overall, 22 studies including 32 patients (29 males, 3 females) were identified. All but 2 patients were younger than 18 years of age, and 66% (21/32) had sustained injuries during or as a result of participation in sporting activities. The affected site was the physis at the base in 18 patients, an intra-articular fracture in the primary coracoid ossification center combined with the subcoracoid ossification center to form an intra-articular fracture in 5, the apophysis of the tip in 3, the apophysis of the angle in 5, and uncertain in 1. Eleven patients had concurrent acromioclavicular injuries. The injury was acute in 23 patients, chronic in 6, and traumatic nonunion in 3. Among 21 cases in which treatment methods and outcomes were described, 21% of the acute cases (4/19), and 2 of the 3 nonunions were surgically treated. Only 1 study used a widely accepted evaluation method. Follow-up periods ranged from 6 weeks to 2 years. Outcomes were generally excellent for nonoperative and operative treatment and without any serious complications.
CONCLUSION
Coracoid physeal injuries occurred most commonly in patients aged 13 to 15 years of age (71%) and were usually sustained during or as a result of sports activities (66%). The most common injury site was the physis at its base. The cause of these injuries is probably severe or repeated traction of the attached muscles and ligaments. The majority of these injuries can be successfully treated nonoperatively.
PubMed: 33403213
DOI: 10.1177/2325967120967914 -
International Journal of Surgery Case... 2017Cysts of the liver round ligament are rare and they are benign in the majority of cases. Current literature has been reviewed on this subject.
INTRODUCTION
Cysts of the liver round ligament are rare and they are benign in the majority of cases. Current literature has been reviewed on this subject.
PRESENTATION OF CASE
A 22-year-old woman with a history of epigastric pain was admitted at our institution. Computed tomography (CT) of the abdomen showed a 14-mm cystic lesion in the epigastrium. A large cyst of the liver round ligament was successfully removed during exploratory laparoscopy and histopathology revealed a benign mesothelial cyst.
DISCUSSION
Mesothelial cysts of the liver round ligament are rare entities and we found a total of 5 cases from the literature. Diameter varies from 5 to 14cm. Most patients were asymptomatic or may complain abdominal pain in the upper quadrants. Ultrasonography and CT scan are the most useful diagnostic tools, however differential diagnosis between various abdominal cystic lesions can be difficult. Treatment is usually surgical excision.
CONCLUSION
Mesothelial cysts of the liver round ligament are extremely rare but should be taken in consideration in the differential diagnosis of intra-abdominal cystic lesions. We stress the importance of exploratory laparoscopy that can allow both diagnosis and radical surgical excision.
PubMed: 28633124
DOI: 10.1016/j.ijscr.2017.06.017 -
Journal of Anatomy Jun 2019The ligament of the head of femur (LHF), or ligamentum teres, is believed to provide blood supply to the head of femur and mechanical stability to the hip joint. But...
The ligament of the head of femur (LHF), or ligamentum teres, is believed to provide blood supply to the head of femur and mechanical stability to the hip joint. But these functions in the adult are often debated. The existence and distribution of neurovascular structures within the ligament are not widely documented. This study examined the blood vessels and nervous tissue within the LHF to determine whether the ligament may have a vascular and proprioceptive function at the hip joint. Histological sections from the LHF from 10 embalmed hips (six female, four male; mean age 80.4 ± 8.7 years) were cut at three levels: the foveal attachment, mid-length and its base where it attaches to the transverse acetabular ligament. Sections were stained with haematoxylin and eosin to study general tissue architecture or with von Willebrand factor and neurofilament to identify blood vessels and nervous tissue, respectively. The proportion of the ligament's cross-sectional area occupied by blood vessels was expressed as a vascularity index (VI). Nerve endings within the ligament were identified and morphologically classified. Comparisons between the VI at the three levels, or between the tissue layers of the ligament, were made using 95% confidence intervals; statistical significance was set P < 0.05. The ligament tissue comprised three distinct layers: a synovial lining with cuboidal cells, a sub-synovial zone formed of loose connective tissue and the ligament proper composed of dense collagen bundles. Patent blood vessels and nerve fibres were present both in the sub-synovial zone and the ligament proper; Pacinian corpuscles and free nerve endings were found scattered only in the sub-synovial zone. The VI of the ligament proper at the fovea was significantly higher than its middle (P = 0.01) and basal levels (P = 0.04); it was also higher than that of the sub-synovial layer (P = 0.04). The LHF has three histologically distinct zones, and blood vessels and nerves are distributed both in the sub-synovial layer and ligament proper. Higher vascularity within the ligament proper at its foveal insertion suggests a possible nutritive role of the LHF to the adult head of femur. The presence of nerves and nerve receptors indicates the ligament is involved in the perception of pain and proprioception, thereby contributing to mechanical stability of the joint.
Topics: Aged; Aged, 80 and over; Cadaver; Female; Femur; Hip Joint; Humans; Male; Round Ligament of Femur
PubMed: 30882902
DOI: 10.1111/joa.12979 -
BMC Women's Health Aug 2023Laparoscopic transabdominal preperitoneal repair (TAPP) was recommended for female patients with groin hernias. Whereas, only a few studies focused on whether and how to...
BACKGROUND
Laparoscopic transabdominal preperitoneal repair (TAPP) was recommended for female patients with groin hernias. Whereas, only a few studies focused on whether and how to preserve the round ligament of the uterus in TAPP.
METHODS
Clinical data of 159 female patients with 181 groin hernias who underwent TAPP at a single institution in China from January 2016 to June 2022 were retrospectively reviewed and collected.
RESULTS
All the patients underwent the operation smoothly without conversion. Division of the round ligament was performed for 33 hernias. Preservation of the round ligament was adopted for 148 hernias, 51 with the "keyhole" technique, 86 with the "longitudinal incision of peritoneum" method, and 11 with total dissection of the round ligament. The mean operative time was 55.6 ± 8.7 min for unilateral TAPP and 99.1 ± 15.8 min for bilateral TAPP. The mean estimated blood loss was 7.1 ± 4.5 mL. The postoperative complications included 6 (3.3%) cases of seroma, 1 (0.5%) case of hematoma, and 3 (1.6%) cases of mild chronic pain. The incidences of chronic pelvic pain and genital prolapse seemed to be higher in the division group than in the preservation groups (6.1% vs. 0.6% and 3.0% vs. 0%, separately). However, no statistical difference was observed (p > 0.05).
CONCLUSIONS
TAPP is feasible and effective for female patients with groin hernias, especially in preserving the round ligament of the uterus.
Topics: Humans; Female; Groin; Retrospective Studies; Herniorrhaphy; Laparoscopy; Hernia, Inguinal; Chronic Pain; Treatment Outcome; Recurrence
PubMed: 37559009
DOI: 10.1186/s12905-023-02527-5 -
Journal of Medical Case Reports Jan 2020Necrosis of the falciform and round ligaments is extremely rare, thus making the diagnosis challenging. It is often misdiagnosed as gallbladder pathology due to the... (Review)
Review
BACKGROUND
Necrosis of the falciform and round ligaments is extremely rare, thus making the diagnosis challenging. It is often misdiagnosed as gallbladder pathology due to the presenting symptoms. Due to the rarity of this pathology, there is limited literature available.
CASE PRESENTATION
A 53-year-old white man presented to our hospital with signs and symptoms of gallbladder pain but turned out to have the rare entity of necrosis of the falciform and round ligaments. An extensive review of the world literature was performed using PubMed. Manual cross-referencing of reference lists was performed to obtain all available articles. The personal operative log of the senior author was also searched to reveal one additional case. Statistical analysis was descriptive only, given the small number of reported cases. Thirty-nine articles were found, among which forty-three case were identified, and one additional case was extracted from the operative log of the senior author. Unlike previous reports, we found that isolated inflammation and necrosis of the ligaments occurs at nearly the same frequency in both men and women, not predominantly in women as previously reported in smaller series. The mean age at presentation was 59.5 years old, and cases were typically initially diagnosed as gallbladder pathology, most commonly acute cholecystitis. Computed tomography more frequently than ultrasound revealed the falciform and round-ligament pathology.
CONCLUSIONS
Isolated falciform and round-ligament inflammation and necrosis is a rare condition that is difficult to diagnose because it can present mimicking a wide variety of intra-abdominal pathologies, particularly gallbladder pathologies. It is often best treated by laparoscopic resection. Unlike prior reports, our review of the literature, which is the largest that we know of to date, shows that males and females are equally affected. Greater awareness of this entity will aid in future diagnosis.
Topics: Abdominal Wall; Diagnosis, Differential; Female; Gallbladder; Humans; Inflammation; Laparoscopy; Ligaments; Male; Middle Aged; Necrosis; Round Ligaments; Tomography, X-Ray Computed; Ultrasonography
PubMed: 31969190
DOI: 10.1186/s13256-019-2335-x -
Hernia : the Journal of Hernias and... Oct 2023The processing of the round ligament of uterus in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia in women has contended. This study aimed to...
Retrospective study of preservation and transection of the round ligament of uterus during laparoscopic transabdominal preperitoneal inguinal hernia repair in adult women.
PURPOSE
The processing of the round ligament of uterus in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia in women has contended. This study aimed to explore whether there is any difference in the surgical outcome and postoperative complications between the two processing modalities, preservation, and transection of the round ligament of uterus, in adult female inguinal hernia patients undergoing TAPP.
METHODS
Retrospective analysis of 84 female patients (117 sides) who underwent TAPP in XXX Hospital from July 2013 to August 2022. Patient characteristics and technical details of the surgical procedure were collected and divided into two groups according to whether the round ligament of uterus was severed intraoperatively or not. There were 52 cases (77 sides) in the group with preservation of the round ligament of uterus and 32 cases (40 sides) in the group with transection of the round ligament of uterus, comparing the general condition, surgical condition, and the occurrence of postoperative related complications between the 2 groups.
RESULTS
The operative time for unilateral primary inguinal hernia was (129.2 ± 35.1) and (89.5 ± 42.6) minutes in the preservation and transection groups, respectively. There were no statistical differences between the two groups in terms of age, length of hospital stay, ASA, BMI, history of lower abdominal surgery, type and side of hernia, intraoperative bleeding, and time to surgery for primary bilateral hernia (P > 0.05). In addition, there was likewise no statistical difference in the occurrence of postoperative Clavien-Dindo classification, VAS, seroma, mesh infection, labia majora edema, chronic pain or abnormal sensation in the inguinal region, and hernia recurrence in the two groups as well (P > 0.05).
CONCLUSION
There is no evidence that the transection of the round ligament of the uterus during TAPP has an impact on postoperative complications in patients. However, given the important role of the uterine round ligament in the surgical management of patients with uterine prolapse and the high incidence of uterine prolapse in older women, hernia surgeons should also be aware of the need to protect the round ligament of uterus in older women.
Topics: Adult; Humans; Female; Aged; Retrospective Studies; Hernia, Inguinal; Round Ligament of Uterus; Uterine Prolapse; Herniorrhaphy; Laparoscopy; Postoperative Complications; Round Ligaments; Surgical Mesh; Uterus; Treatment Outcome; Recurrence
PubMed: 36949269
DOI: 10.1007/s10029-023-02765-4 -
Arthroscopy : the Journal of... Feb 2021To observe the morphology of the transverse geniculate ligament of the knee (TGL) by magnetic resonance imaging (MRI) and to analyze the cause of the pseudotear sign of...
PURPOSE
To observe the morphology of the transverse geniculate ligament of the knee (TGL) by magnetic resonance imaging (MRI) and to analyze the cause of the pseudotear sign of the anterior horn of the meniscus caused by the TGL.
METHODS
Patients who underwent MRI examination of the knee joint in the orthopaedics department of our hospital from July 2016 to August 2019 were identified. The occurrence rate, length, width, thickness, cross-sectional shape, pattern, appearance, and position relative to the anterior horn of the lateral and medial meniscus and anatomical variations were observed by multiplane and multisequence MRI. The frequency and cause of the pseudotear sign also were observed.
RESULTS
The data of 101 patients were analyzed. Among them, 60 were male, and 41 were female. The average age was 42.01 (18-75) years. The occurrence rate of the TGL was 67.3% (68/101), the average length was 38.75 ± 3.56 mm, the median coronal diameter was 1.79 ± 0.60 mm, the median sagittal diameter was 1.88 ± 0.35 mm, and the cross-sectional morphology was mostly oval and round. There were 5 types of TGL connection to the anterior horn of the medial meniscus: type 1, located at the front edge; type 2, located at the upper front edge; type 3, located at the upper edge; type 4, located at the back upper edge; and type 5, was located at the back edge of the anterior horn of the medial meniscus. There was only one type of TGL insertion into the anterior horn of the lateral meniscus, located at the anterior superior edge of the anterior horn of the lateral meniscus. There were 4 cases of the pseudotear sign in the anterior horn of the meniscus, 3 in the lateral meniscus and 1 in the medial meniscus. The pseudotear sign of the anterior horn of the meniscus caused by the TGL was observed at a rate of 5.88% (4/68).
CONCLUSIONS
In MRI examination of the knee, the anterior horn of the meniscus sometimes shows a pseudotear sign. According to the shape and route of the TGL on MRI and the direction and position of the pseudotear sign of the anterior horn of the meniscus, true and false tears of the anterior horn of the meniscus can be identified.
LEVEL OF EVIDENCE
Level III, diagnostic study (retrospective, noncomparative, observational case series without a consistently applied reference "gold" standard).
Topics: Adolescent; Adult; Aged; Computer Simulation; Cross-Sectional Studies; Female; Humans; Knee Joint; Ligaments; Magnetic Resonance Imaging; Male; Menisci, Tibial; Middle Aged; Retrospective Studies; Tibial Meniscus Injuries; Young Adult
PubMed: 32890637
DOI: 10.1016/j.arthro.2020.08.024 -
Polski Przeglad Chirurgiczny Jan 2023A left-sided gallbladder (LSG) represents a rare anatomical variation defined by the location of the gallbladder to the left side of the liver falciform and round... (Review)
Review
A left-sided gallbladder (LSG) represents a rare anatomical variation defined by the location of the gallbladder to the left side of the liver falciform and round ligaments, which is often not discovered until surgery. The reported prevalence of this ectopia ranges from 0.2% to 1.1%, however, those values may be underestimated. It is mostly an asymptomatic condition, thus not causing the patient any harm, and being few reported cases in the current literature. Based on clinical presentation and standard diagnostic procedures, LSG can remain undetected and represent accidental intraoperative finding. The attempts to explain the cause of this anomaly have been different, but the numerous variations described do not allow a clear definition of its origin. Although this debate is still open, it is of considerable importance to know that LSG is frequently associated with alterations of both the portal branches and the intrahepatic biliary tree. The association of these anomalies, therefore, represents an important risk of complications in cases when surgical treatment is necessary. In this context, our literature review aimed to summarize possible anatomical anomalies coexisting with LSG and discuss the clinical significance of the LSG, when the patient requires cholecystectomy or hepatectomy.
Topics: Female; Humans; Gallbladder; Cholecystectomy, Laparoscopic; Hepatectomy; Clinical Relevance
PubMed: 36808060
DOI: 10.5604/01.3001.0016.2124