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Metatarsophalangeal Joint (metatarsophalangeal + joint)
Selected AbstractsAtypical molecular profile for joint development in the avian costal jointDEVELOPMENTAL DYNAMICS, Issue 10 2010B.B. Winslow Abstract Development of synovial joints involves generation of cartilaginous anlagen, formation of interzones between cartilage anlagen, and cavitation of interzones to produce fluid filled cavities. Interzone development is not fully understood, but interzones are thought to develop from skeletogenic cells that are inhibited from further chondrogenic development by a cascade of gene expression including Wnt and Bmp family members. We examined the development of the rarely studied avian costal joint to better understand mechanisms of joint development. The costal joint is found within ribs, is morphologically similar to the metatarsophalangeal joint, and undergoes cavitation in a similar manner. In contrast to other interzones, Wnt14/9a, Gdf5, Chordin, Barx1, and Bapx1 are absent from the costal joint interzone, consistent with the absence of active ,-catenin and phosphorylated Smad 1/5/8. However Autotaxin and Noggin are expressed. The molecular profile of the costal joint suggests there are alternative mechanisms of interzone development. Developmental Dynamics 239:2547,2557, 2010. © 2010 Wiley-Liss, Inc. [source] Two clinical manifestations of desmopathy of the accessory ligament of the deep digital flexor tendon in the hindlimb of 23 horsesEQUINE VETERINARY JOURNAL, Issue 6 2005E. ELIASHAR Summary Reasons for performing study: Desmopathy of the accessory ligament of the deep digital flexor tendon (ALDDFT) in the hindlimb is an unusual cause of lameness in horses, and reports of the condition are sparse. Objectives: To describe the clinical and ultrasonographic findings, therapy and outcome of 23 horses treated for desmopathy of the ALDDFT in the hindlimb. Methods: Records of 23 horses with ultrasonographic evidence of desmopathy of the ALDDFT in one or both hindlimbs from 3 referral centres were reviewed retrospectively. Age, breed, sex, duration and nature of clinical signs, results of clinical and lameness examinations, treatment and outcome were recorded. Results: In 13 horses (Group A), there was an acute onset of unilateral lameness. Ten horses (Group B) had an insidious or sudden onset of postural abnormality. There were 10 cobs, 5 British native-breed ponies and 8 horses of various larger breeds. Twenty horses were used for general purposes, and mean age was 12 years. Enlargement of the ALDDFT in the affected hindlimb(s) was identified in all horses. In 44% of horses, ultrasonographic abnormalities were localised to part of the ALDDFT. Treatment included box-rest and controlled exercise, and 10 horses were subjected to desmotomy or desmectomy of the ALDDFT. Seventy-three percent of horses in Group A returned to full function, while 90% of those in Group B remained lame. Conclusions: Two distinct clinical conditions are associated with the ALDDFT of the hindlimb. Traumatically induced injury resulting in acute onset lameness appears to have a favourable prognosis, with most horses returning to previous work. However, postural changes, once present, are irreversible and indicate a poor prognosis. Potential relevance: Desmopathy of the ALDDFT should be recognised as a potential cause of hindlimb lameness and this study provides clinical and prognostic information. Knuckling and/or semiflexion of the metatarsophalangeal joint may accompany the condition; therefore, if a horse is presented with a flexural deformity of this joint, desmopathy of the ALDDFT should be considered as a primary differential diagnosis. [source] Eikinella corrodens wound infection in a diabetic foot: a brief reportINTERNATIONAL WOUND JOURNAL, Issue 4 2005Shmouel Ovadia Abstract Eikinella corrodens normally forms part of the flora of the oral cavity and mucous membranes of the respiratory tract. It is usually associated with dental, head and neck infections (Cohen, Powderly, 2004, Infectious Diseases) and is considered to be an unusual cause of orthopaedic infections. We recently treated a diabetic patient with E. corrodens osteomyelitis of the fifth metatarsophalangeal joint, a phenomenon which has been reported in only three cases previously (Konugres et al., 1987, E. corrodens as a cause of osteomyelitis in the feet of the diabetic patients. Report of three cases). We recommend including E. corrodens in the spectrum of causative pathogens in diabetic foot infections. [source] The phylogeny of the red panda (Ailurus fulgens): evidence from the hindlimbJOURNAL OF ANATOMY, Issue 5 2008Rebecca E. Fisher Abstract The red panda (Ailurus fulgens) is an endangered carnivore living in the temperate forests of the Himalayas and southern China. The phylogeny of the red panda has been the subject of much debate. Morphological and molecular studies have supported a wide range of possible relationships, including close ties to procyonids, ursids, mustelids, and mephitids. This study provides additional morphological data, including muscle maps, for Ailurus. The hindlimbs of four cadavers from the National Zoological Park were dissected. Red pandas retain a number of muscles lost in other carnivore groups, including muscles and tendons related to their robust and weight-bearing hallux. Three features, including a single-bellied m. sartorius, a proximal insertion for m. abductor digiti V, and an absent m. articularis coxae, are found in all terrestrial arctoids, including Ailurus. In addition, red pandas are similar to ursids and canids in lacking a caudal belly of m. semitendinosus, while they resemble procyonids and mustelids in the degree of fusion observed between mm. gluteus medius and piriformis. Furthermore, Ailurus and procyonids are characterized by numerous subdivisions within the adductor compartment, while red pandas and raccoons share a variable m. semimembranosus, composed of one, two, or three bellies. Lastly, a deep plantar muscle inserting onto the metatarsophalangeal joint of the hallux is described for Ailurus. This muscle has not been previously described and is given the name m. flexor hallucis profundus. Additional dissections of the forelimb and axial musculature of red pandas may shed further light on the phylogeny of this species. In addition, the muscle maps presented here offer a valuable resource for interpreting the functional anatomy of fossil ailurids. [source] Long term efficacy of minimal incision osteotomy for hallux abducto valgusORTHOPAEDIC SURGERY, Issue 3 2010Wei-dong Sun MD Objective:, To observe and evaluate the long-term results of minimal incision osteotomy for hallux abducto valgus. Methods:, From February 1995 to May 1999, 372 cases (705 feet) with hallux abducto valgus were treated with minimal incision osteotomy. Seventy-nine patients (150 feet) were followed up for more than five years (mean 7.5; range, 5.3,13.2 years) after surgery. The preoperative and postoperative hallux abducto valgus angles (HVA), intermetatarsal angles (IMA), tibial sesamoid position (TSP), American Orthopaedic Foot And Ankle Society (AOFAS) score, range of movement of the first metatarsophalangeal joint and lateral metatarsalgia were observed, measured and evaluated. Results:, Based on clinic curative effect evaluation criterion, 56 feet (37.3%) were excellent, 88 feet (58.7%) good, 6 feet (4.0%) fair. The postoperative mean AOFAS score was 84.20 ± 4.32 points. The mean HVA decreased from 33.28o to 12.31o and the mean IMA1-2 from 11.75o to 6.80o. The TSP was corrected from an average preoperative grade of 4.29 to a grade of 3.07 by final follow-up. There was no nonunion or delayed union, no avascular necrosis, no infection, and no hallux varus. Numbness in the big toe was found in 4 feet (2.7%). The range of motion of the first metatarsophalangeal joint decreased from 70.20o to 69.53o. Of 97 feet (64.7%) with pre-operative 2,5 metatarsalgia, this had disappeared in 35 feet, improved in 54 feet and was aggravated in 8 feet postoperatively. Conclusion:, Minimal incision osteotomy is a simple and reliable technique for treating hallux abducto valgus with minimal complications. [source] Joint orientation and function in great ape and human proximal pedal phalangesAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 1 2010Nicole L. Griffin Abstract Previous studies have referred to the degree of dorsal canting of the base of the proximal phalanx as an indicator of human-like metatarsophalangeal joint function and thus a diagnostic trait of habitual bipedality in the fossil record. Here, we used a simple method to investigate differences in forefoot function on a finer scale. Building on Duncan et al.'s (Am J Phys Anthropol 93 [1994] 67,81) research, we tested whether dorsal canting reflects differences between sexes in locomotor behavior, whether habitual shoe wear influences dorsal canting in humans, and whether proximal joint morphology differs between rays in Pan and humans. Our results corroborate previous research in showing that humans have proximal phalanges with joint orientations that are significantly more dorsal than, but overlap with, those of great apes. We also found that male gorillas have significantly more dorsally canted second proximal phalanges than their female counterparts, while the opposite pattern between the sexes was found in Pan troglodytes. Inter-ray comparisons indicate that Pan have more dorsally canted first proximal phalanges than second proximal phalanges, while the opposite pattern was found in humans. Minimally shod humans have slightly but significantly more dorsally canted second proximal phalanges than those of habitually shod humans, indicating that phalanges of unshod humans provide the most appropriate comparative samples for analyses of early hominins. Overall, our analysis suggests that though the measurement of dorsal canting is limited in its sensitivity to certain intraspecific differences in function, phalangeal joint orientation reflects interspecific differences in joint function, with the caveat that different patterns of forefoot function during gait can involve similar articular sets of metatarsophalangeal joints. Am J Phys Anthropol, 2010. © 2009 Wiley-Liss, Inc. [source] Treatment of early rheumatoid arthritis: A randomized magnetic resonance imaging study comparing the effects of methotrexate alone, methotrexate in combination with infliximab, and methotrexate in combination with intravenous pulse methylprednisolone,ARTHRITIS & RHEUMATISM, Issue 12 2007Patrick Durez Objective To compare the effects of methotrexate (MTX), alone or in combination with intravenous (IV) methylprednisolone (MP) or infliximab, on magnetic resonance imaging (MRI),detected synovitis, bone edema, and erosive changes in patients with early rheumatoid arthritis (RA). Methods Forty-four patients with early RA were randomized to receive MTX alone (MTX group), MTX plus IV MP (IV MP group), or MTX plus infliximab (infliximab group), infused on day 0 and weeks 2, 6, 14, 22, 30, 38, and 46. Gadolinium-enhanced MRI scans of the metacarpophalangeal joints, wrists, and metatarsophalangeal joints were performed at baseline, week 18, and week 52. Results Scores for MRI-detected synovitis and bone edema improved over time in the 3 groups, with significantly lower synovitis scores in the infliximab group compared with the MTX group and significantly lower bone edema scores in the infliximab group compared with the MTX and the IV MP groups. Scores for MRI-detected erosion significantly increased over time in all groups. There were no differences in erosion scores between the MTX group and the other groups. It is of note that patients treated with IV MP showed more significant progression in MRI-detected erosions compared with patients treated with infliximab. At week 22, response rates according to the American College of Rheumatology 20% improvement criteria (ACR20), the ACR50, and the ACR70 were significantly higher in both the IV MP group and the infliximab group compared with the MTX group. At week 52, remission was achieved in 40% of patients in the MTX group and in 70% of patients in the IV MP and infliximab groups. Health Assessment Questionnaire scores improved significantly over time in all groups, with patients receiving IV MP experiencing significantly more improvement compared with patients treated with MTX alone. No severe side effects were observed, except 1 case of MTX-related pneumonitis. Conclusion The combination of MTX and infliximab is superior to MTX alone for reducing MRI-detected signs of synovitis and bone edema in patients with early RA. Progression of MRI-detected erosion was greater in patients treated with MTX plus IV MP compared with that in patients who received MTX plus infliximab. [source] How to diagnose rheumatoid arthritis early: A prediction model for persistent (erosive) arthritisARTHRITIS & RHEUMATISM, Issue 2 2002Henk Visser Objective To develop a clinical model for the prediction, at the first visit, of 3 forms of arthritis outcome: self-limiting, persistent nonerosive, and persistent erosive arthritis. Methods A standardized diagnostic evaluation was performed on 524 consecutive, newly referred patients with early arthritis. Potentially diagnostic determinants obtained at the first visit from the patient's history, physical examination, and blood and imaging testing were entered in a logistic regression analysis. Arthritis outcome was recorded at 2 years' followup. The discriminative ability of the model was expressed as a receiver operating characteristic (ROC) area under the curve (AUC). Results The developed prediction model consisted of 7 variables: symptom duration at first visit, morning stiffness for ,1 hour, arthritis in ,3 joints, bilateral compression pain in the metatarsophalangeal joints, rheumatoid factor positivity, anti,cyclic citrullinated peptide antibody positivity, and the presence of erosions (hands/feet). Application of the model to an individual patient resulted in 3 clinically relevant predictive values: one for self-limiting arthritis, one for persistent nonerosive arthritis, and one for persistent erosive arthritis. The ROC AUC of the model was 0.84 (SE 0.02) for discrimination between self-limiting and persistent arthritis, and 0.91 (SE 0.02) for discrimination between persistent nonerosive and persistent erosive arthritis, whereas the discriminative ability of the American College of Rheumatology 1987 classification criteria for rheumatoid arthritis was significantly lower, with ROC AUC values of 0.78 (SE 0.02) and 0.79 (SE 0.03), respectively. Conclusion A clinical prediction model was developed with an excellent ability to discriminate, at the first visit, between 3 forms of arthritis outcome. Validation in other early arthritis clinics is necessary. [source] A radiologic and histologic study of the os peroneum: Prevalence, morphology, and relationship to degenerative joint disease of the foot and ankle in a cadaveric sampleCLINICAL ANATOMY, Issue 6 2009C. Muehleman Abstract The present study investigated the prevalence of an os peroneum (OP, a sesamoid bone) in a cadaveric sample and its relationship to the shape of the cuboid tuberosity, and cartilage degeneration at the cuboid tuberosity and in regional joints within the foot (first metatarsophalangeal and calcaneocuboid) and ankle. The fibularis longus tendon of 33 embalmed human cadavers (mean age 81 years) were obtained from the anatomy laboratory. Nineteen of 64 tendons (30%) displayed an OP both radiographically and histologically. The os peronei ranged in size from small spicules to prominent masses: mean area 2.48 mm2 (left) and 2.70 mm2 (right). Histologically, the os peronei were cancellous bone, the largest occupying most of the tendon at the point of contact with the cuboid tuberosity. Fibrocartilage was present at their borders, merging with dense regular fibrous tissue and peritenon. The talocrural, calcaneocuboid, and first metatarsophalangeal joints were examined for cartilage integrity and osteophytes based on an earlier suggestion that there may be an association between degenerative joint disease and endochondral bone formation. There was no statistical correlation between presence of an OP with any of the following parameters: age, gender, body size, cartilage degeneration, or osteophytes within any of the joints examined. Therefore, the presence of an OP does not appear to be associated with increased endochondral ossification or degenerative joint disease. This study does not preclude the possibility that sesamoid bone formation may be associated with biomechanical functions within the foot; thus, future studies may be warranted. Clin. Anat. 22:747,754, 2009. © 2009 Wiley-Liss, Inc. [source] | |||||||||||||