Humans ; Infant, Newborn ; Lower Extremity ; pathology ; Lymphedema ; congenital ; Male

Athletic injuries of the lower extremities are commonly encountered in clinical practice. While some pathology can be diagnosed on physical exam, others are a clinical dilemma with nonspecific symptomatology. In these situations, ultrasound imaging can be utilized as an exceptional diagnostic tool, offering unique advantages over other imaging modalities. This article will review the imaging characteristics of commonly encountered athletic injuries of the lower extremity.
Athletic Injuries* ; Lower Extremity* ; Musculoskeletal Diseases ; Pathology ; Sports* ; Ultrasonography*

Although numerous reports have found accessory or supernumerary muscles throughout the human body, multiple appearances of these variations biased toward one side of body are rare. We report a 76-yr-old male cadaver with an accessory head of the biceps brachii and palmaris profundus, and a muscular slip between the biceps femoris and semitendinosus on the left side in addition to a bilateral accessory belly of the digastric muscle. No remarkable nervous, vascular, or visceral variation accompanied these variations. An interruption of normal somitogenesis or myogenesis may be a cause of these variations.
Aged ; Cadaver ; Humans ; Lower Extremity ; Male ; Muscle, Skeletal/*pathology ; Neck ; Upper Extremity

OBJECTIVETo explore the acting mechanism of electrical field in electrical injury.

METHODSThirty-six New Zealand white rabbits were employed in the study and were randomly divided into 7 groups. There were 12 rabbits in group 1 and 4 in each group of other 6 groups. The animal model of nonthermal electrical injury previously replicated was employed in the study. Experiment with paralleled muscular fibers in electrical field was carried out in groups 2 approximately 4, while that of vertical muscular fibers in electrical field in groups 5-7. Anatomical examination was done to determine the index of deep burn injury (IDBI) in all groups of rabbits at 0, 2 and 24 postburn hour (PBH). Histological and ultrastructural examination, gamma picturing and isotope scanning with 99mTc were done in group 1 at 2 PBH.

RESULTSThere was no obvious skin injury in the white rabbits in group 1. Deep tissue necrosis was identified under the small electrode. Constant muscular spasm was observed in the inner side of the thigh. The muscles in paralleled electrical field suffered more severe injury than those in vertical one. Tissue injury was more severe in those areas with higher current density, less soft tissue, and also in the central area of the axis of the electric field. There were obvious changes in the perfusion and blood pool phases in these areas as observed with the aid of 99mTc. Light microscopic examination revealed swelling and necrosis of muscular fibers. Under electron microscopy, it was found that there were edema and dissolution with separation of lipid molecular layers of cell membrane, Shortened nucleus with partial dissolution of nuclear membrane, increased heparin granules within nucleus, swelling of mitochondria and endoplasmic reticulum, myofilament dissolution, expanded gap between myofilament and decreased number of heparin granules.

CONCLUSIONNon-thermal tissue injury in the electrical field, in terms of cell, ultrastructural and molecular levels, was induced and aggravated by all the factors constituting high voltage electrical field.

Animals ; Electric Injuries ; pathology ; Lower Extremity ; injuries ; Necrosis ; Rabbits ; Soft Tissue Injuries ; pathology

Acupuncture Points ; Acupuncture Therapy ; Edema ; pathology ; therapy ; Humans ; Lower Extremity ; pathology ; Male ; Middle Aged

BACKGROUNDLower extremity bursae are very vulnerable to injury during strenuous physical exercises. Understanding the imaging characteristics of normal bursae is essential for early diagnosis of morphological abnormalities. Therefore, we evaluated the normal range of lower extremity bursae in healthy young men using high-resolution ultrasound (HR-US) imaging.

METHODSBursae in the lower extremities were examined by HR-US in 290 Chinese healthy young men with a median age of 18 years (range, 18-23 years). The bilateral suprapatellar bursa (SPB), deep infrapatellar bursa (DIPB), popliteal bursa (PB), and retrocalcaneal bursa (RCB) were imaged and measured for analysis.

RESULTSThe HR-US identification rates of the SPB, DIPB, PB, and RCB were 89.0% (517/580), 55.0% (319/580), 29.4% (171/580), and 49.5% (287/580), respectively. With the assumption that the bursae were normal in 95% of the study participants, the length and width values at the maximal cross-section of the SPB, DIPB, PB, and RCB were ≤18.00 and 6.09 mm, 8.10 and 2.11 mm, 7.67 and 3.93 mm, and 7.82 and 2.04 mm, respectively.

CONCLUSIONSUsing HR-US imaging, we were able to analyze lower extremity bursae with high detection rates in healthy young men. The normal ranges of lower extremity bursa dimensions in healthy young men measured by HR-US in this study could be used as reference values for evaluation of bursa abnormalities in the lower extremity.

Adolescent ; Adult ; Bursa, Synovial ; pathology ; Cross-Sectional Studies ; Humans ; Lower Extremity ; pathology ; Male ; Young Adult

Objective To summarize the characteristics of cases of electrocution due to direct current （DC） electronic hunter, and to provide references for forensic identification. Methods Four cases of electrocution due to DC electronic hunter were collected. Statistical analysis was carried out from the perspective of the scene and electric marks distribution, damage characteristics and histopathological changes. Results All the 4 cases of electrocution were accidental events. There were multiple electric marks, most of which were located in the lower limbs with serious damage. Some strip type electric marks were visible. Conclusion The distribution, morphological characteristics and severity of the electric marks caused by DC electronic hunter are different from those of the ordinary low-voltage alternating current damage. It is alerting that there would be actions of destroying the scene and abandoning the corpse in such cases.
Cadaver ; Electric Injuries/pathology* ; Electricity/adverse effects* ; Fatal Outcome ; Forensic Pathology/methods* ; Humans ; Lower Extremity

BACKGROUND: Epidural adhesion can cause pain from compression and irritation of nerves. But a simple injection into the lumbar epidural space usually goes into the area of least resistance and cannot deliver the medication to the target area. Thus, the adhesiolysis of the affected area is sometimes mandatory. We performed an adhesiolysis, irrigating with normal saline, and targeted an injection of a local anesthetic and steroid mixture to the epidural space, using a flexible catheter-secured epiduroscopic unit in 15 patients with low back pain, and assessed the pain score changes. METHODS: With the patient in the prone position, the epidural space was entered with a 17-gauge Tuohy needle. A guide-wire was inserted through the needle and advanced under fluoroscopic guidance to the level of the suspected pathology. A catheter was then advanced over the guide-wire. After the removal of the guide-wire, an adapter was then attached to the proximal end of the catheter, and its side arm was connected to a syringe containing normal saline flush. The 0.9 mm diameter fiberoptic scope was introduced into the catheter via the adaptor, and a video camera was then attached. Gentle irrigation of normal saline less than 50 ml distended the epidural space. The catheter and fiberoptic scope were advanced to the adhesion area and adhesiolysis was done by moving the tip of the steering catheter. Assuming that original NRS (Numeric Rating Scale) before the procedure was 10, we asked the NRS at 1, 4, 8, 12, 16 weeks after the epiduroscope. RESULTS: NRS at 1, 4, 8, 12, 16 weeks after the epiduroscope showed significant decrease of both low back pain and radiating pain, compared with the original pain (P<0.05). CONCLUSIONS: The flexible catheter-secured epiduroscopic unit proved to be painless, safe, and more simple, than an operation, it is, thus, a practical method for pain relief using adhesiolysis and irrigation of epidural space under the direct visualization of the epidural space in patients with low back and lower extremity pain.
Arm ; Catheters ; Epidural Space ; Humans ; Low Back Pain ; Lower Extremity* ; Needles ; Pathology ; Prone Position ; Syringes

OBJECTIVE: Sensory symptoms are common in patients with Parkinson disease (PD), although its exact prevalence and causes are not well known. We aimed to investigate whether peripheral pathology contribute to chronic sensory symptoms in patients with PD by nerve conduction test. METHODS: We recruited consecutively 34 patients with clinically probable PD (Hoehn-Yahr stage, 1–3) who developed persistent sensory symptoms in their lower extremities during optimal dopamine replacement therapy. Twenty-five patients who are above age of 70 or have other possible causes of neuropathy as determined by laboratory testing or medical record were excluded. Age- and gender-matched PD patients with same disease severity who have never developed sensory symptom during the same period were allocated to paired controls. Total 18 subjects participated in this study. Nerve conduction tests on peroneal motor nerve and sural sensory nerve were performed in all subjects. Amplitude and conduction velocity were compared between the paired subjects using Wilcoxon signed rank test. RESULTS: Subjective sensory symptoms of the 9 patients were variable: pain (4/9), chilling (3/9), burning (1/9), and tingling sense (1/9). There were no significant difference of mean values of compound muscle action potential/sensory nerve action potential amplitude and conduction velocity between patients and their paired controls. CONCLUSION: This study supports the hypothesis that the origin of chronic sensory symptoms in PD patients is more central than peripheral.
Action Potentials ; Burns ; Dopamine ; Humans ; Levodopa* ; Lower Extremity ; Medical Records ; Neural Conduction* ; Parkinson Disease* ; Pathology ; Prevalence

BACKGROUND AND PURPOSE: Centronuclear myopathy (CNM) is characterized by the presence of central nuclei within a large number of muscle fibers. Mutations of the dynamin 2 gene (DNM2) are common causes of autosomal dominant or sporadic CNM. The aim of this study was to characterize the clinical and pathological features of CNM relative to the presence of DNM2 mutations. METHODS: Six patients with clinical and pathological features of CNM were recruited. Detailed clinical and pathological findings were analyzed according to the presence of DNM2 mutations. RESULTS: We detected DNM2 mutations in four of the six sporadic CNM patients, and identified the following distinct clinical and pathological features in those patients with DNM2 mutations: preferential involvement of the distal lower limbs, typical nuclear centralization, and radially distributed sarcoplasmic strands in muscle pathology. In contrast, those without DNM2 mutations exhibited rather diffuse muscular involvement, and nuclear internalization and myofibrillar disorganization were more pronounced features of their muscle pathology. CONCLUSIONS: These findings suggest the presence of specific features in Korean CNM patients. A detailed clinical and pathological examination of CNM patients would be helpful for molecular genetic analyses of this condition.
Dynamin II ; Humans ; Lower Extremity ; Molecular Biology ; Muscles ; Myopathies, Structural, Congenital* ; Pathology