Surgical and Radiologic Anatomy最新文献

{"title":"The prevalence, morphology and topography of fabella in knee joints in the polish population and its association with size of patella.","authors":"Tomasz Kozioł, Kacper Stolarz, Aleksander Osiowski, Maksymilian Osiowski, Barbara Jasiewicz, Dominik Taterra","doi":"10.1007/s00276-025-03655-3","DOIUrl":"https://doi.org/10.1007/s00276-025-03655-3","url":null,"abstract":"<p><strong>Purpose: </strong>The fabella is a sesamoid bone located posterior to the lateral femoral epicondyle within the gastrocnemius muscle. While commonly present in mammals, its prevalence in humans remains unclear, with reported rates ranging from 3 to 87%. Fabella is more frequently observed in Asian and Australian populations but is rare in European and American populations. Although often asymptomatic, it can sometimes cause knee pain, known as \"fabella syndrome,\" and may contribute to neurological symptoms when in proximity to the common fibular nerve. Given the limited awareness of fabella's presence, this study aims to assess its prevalence and anatomical characteristics to aid in the differential diagnosis of knee pain.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 500 knee radiographs from 383 patients experiencing knee pain. Data collected included patient age and sex, fabella presence and dimensions, fabella location (distances to surrounding bony structures), patella dimensions, and patellotibial ligament length.</p><p><strong>Results: </strong>Fabella was detected in 31 females (14.76%) and 29 males (25.66%). Among the examined knees, fabella was present in 40 (12.82%) of female and 39 (20.74%) of male knees. The mean fabella length was 8.85 mm (SD = 2.59), and thickness was 5.63 mm (SD = 1.88), with no significant sex differences. No correlation was found between fabella size and patella dimensions. Notably, patients with fabella were older on average, and bilateral fabellae were significantly larger than unilateral cases (p < 0.05).</p><p><strong>Conclusion: </strong>Fabella is a relatively common anatomical variant in Central European populations, present in one in six women and one in four men. Its increased prevalence in older individuals suggests a potential age-related development. A comprehensive understanding of fabella anatomy may aid clinicians in diagnosing and managing unexplained knee pain, particularly in elderly patients.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"149"},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphologic evaluation of the coccyx in the pediatric population.","authors":"Nevzat Meylani, Barış Ten, Gülhan Temel, Hasan Hüsnü Yüksek, Ali Danyal Cömert, Burhan Beger, Baran Can Alpergin, Orhan Beger","doi":"10.1007/s00276-025-03662-4","DOIUrl":"https://doi.org/10.1007/s00276-025-03662-4","url":null,"abstract":"<p><strong>Purpose: </strong>This computed tomography study aimed to display the alteration in the coccyx morphology (its ossification process, dimension and angulation) in children with advancing age.</p><p><strong>Methods: </strong>Pelvic radiologic scans of 180 children aged 1-18 years were retrospectively evaluated to observe changes in the coccyx morphology with age, and to measure the linear length (LL), curvilinear length (CLL), sacrococcygeal angle (SCA), and intercoccygeal angle (ICA).</p><p><strong>Results: </strong>The present study divides the postnatal evolution of the coccyx into three phases as follows: (a) in the first stage when the coccyx is of the shortest, it is completely cartilage until the age of 2 (infancy period) and its first segment begins to ossify by the age of 3 (early childhood period), (b) in the second stage when the coccyx is of medium size, its first segment is completely ossified by the age of 6 (late childhood period) and the ossification of its all segments is completed from the age of 11 (prepubescent period), and (c) in the third stage when the coccyx is of the longest, it reaches to adult size (postpubescent period). Linear functions were calculated as y = 15.647 + 1.145 × age (p < 0.001, R² = 0.561) for LL, and as y = 16.829 + 1.243 × age (p < 0.001, R² = 0.559) for CLL.</p><p><strong>Conclusion: </strong>Considering that morphological features of the coccyx, such as ICA, can be used in the diagnosis of coccydynia, our dataset may facilitate the identification of children with suspected coccydynia.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"147"},"PeriodicalIF":1.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osseous anatomy of the distal radius: a morphometric analysis of external groove and bony ridge.","authors":"Fatma Ok, Beyza Çelikgün, Gkionoul Nteli Chatzioglou, Ahmet Ertaş, Osman Coşkun","doi":"10.1007/s00276-025-03631-x","DOIUrl":"https://doi.org/10.1007/s00276-025-03631-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the presence and morphological and morphometric characteristics of the distal radius's external groove (EG) and bony ridge, which play a potential role in the pathogenesis and treatment difficulties of De Quervain's tenosynovitis.</p><p><strong>Methods: </strong>The osseous anatomy of the distal radius was analyzed in detail on a total of 103 dry bone specimens (49 left and 54 right) obtained from the Department of Anatomy, Istanbul University, Turkiye. The frequency and morphology of the EG were analyzed. The EGs were categorized as Type 1, Type 2, and Type 3 with two EGs, one EG with depth, and an additional EG without depth, respectively. Finally, flat areas without clear groove boundaries were classified as Type 4.</p><p><strong>Results: </strong>The analyses showed variations in the morphology and dimensions of the EG and bony ridge. A total of 110 EGs were detected in 103 radii examined. Type 1, Type 2, Type 3 and Type 4 EGs were reported in 30 bones (30%), 38 bones (38%), 12 bones (12%) and 23 bones (23%), respectively. The depth of the EG of Type 1 was 0.26 ± 0.23 mm and 0.22 ± 0.16 mm on the lateral and medial sides, respectively. Also, the depth of the Type 2 was calculated as 0.49 ± 0.37 mm.</p><p><strong>Conclusion: </strong>The osseous variations of the distal radius are critical anatomical factors contributing to the pathogenesis of De Quervain's tenosynovitis and difficulties in the treatment process. It is essential to recognize these variations to improve diagnostic accuracy and optimize therapeutic interventions.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"146"},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The anatomy of the inferior mesenteric artery: a systematic review with meta-analysis.","authors":"George Triantafyllou, Nektarios Belimezakis, Orestis Lyros, Nikolaos Arkadopoulos, Fotis Demetriou, George Tsakotos, Maria Piagkou","doi":"10.1007/s00276-025-03657-1","DOIUrl":"10.1007/s00276-025-03657-1","url":null,"abstract":"<p><strong>Purpose: </strong>This evidence-based systematic review with meta-analysis aims to synthesize the inferior mesenteric artery (IMA) variants including their origin level, branching patterns, and morphometric characteristics.</p><p><strong>Materials and methods: </strong>The study adhered to the latest guidelines. Four online databases were used for the systematic review, and studies that reported the prevalence of IMA variants were considered eligible for inclusion. A statistical meta-analysis was conducted using R programming software with a random-effects model to calculate the pooled prevalence of the variants.</p><p><strong>Results: </strong>Twenty-three (23) studies were included in this analysis. The IMA typically originated at the 3rd lumbar vertebra (L3) level, occurring in 70.16% of cases. The most common branching pattern of the IMA was bifurcated, indicating a pooled prevalence of 63.89%. This predominant pattern involved the IMA bifurcating into the left colic artery (LCA) and a common trunk for both the superior rectal artery (SRA) and the sigmoid artery (SA), with a pooled prevalence of 46.09%. The IMA trifurcation and tetrafurcation had pooled prevalences of 27.35% and 11.62%, respectively. The diameter of the IMA had a pooled mean of 41.41 mm, and the distance from the IMA's origin to the LCA had a pooled mean of 40.67 mm.</p><p><strong>Conclusions: </strong>This review of existing literature delineates the IMA levels of origin, branching patterns, and morphometric characteristics. A comprehensive understanding of the surgical anatomy of this vessel is imperative during colorectal cancer procedures. Consequently, surgeons operating in this anatomical region must possess an in-depth knowledge of typical and variant anatomical structures.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"144"},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Absent right common carotid artery associated with left accessory middle cerebral artery diagnosed by computed tomography angiography.","authors":"Atsushi Hashio, Akira Uchino, Kaima Suzuki, Yasutaka Baba, Hiroki Kurita","doi":"10.1007/s00276-025-03658-0","DOIUrl":"10.1007/s00276-025-03658-0","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case involving congenital absence of the right common carotid artery (CCA) associated with a left accessory middle cerebral artery (MCA) that was diagnosed by computed tomography angiography (CTA).</p><p><strong>Methods: </strong>A 63-year-old woman with a narrow right internal carotid artery (ICA) incidentally detected on magnetic resonance imaging underwent CTA for further vascular evaluation.</p><p><strong>Results: </strong>CTA revealed absence of the right CCA, with the right external carotid artery (ECA) branching from the brachiocephalic trunk and the right ICA branching from the right subclavian artery. The ICA was hypoplastic. A left accessory MCA was also observed. Although blood flow in the right ICA was decreased, the patient was asymptomatic; thus, conservative treatment was administered, and her clinical course remained uneventful.</p><p><strong>Conclusion: </strong>Absence of the CCA is associated with the development of the aorta and various vascular variations; however, to our knowledge, this is the first report of an association with a contralateral accessory MCA, the existence of which may be considered incidental. Preoperative knowledge of this rare variation is important when considering endovascular treatment of cerebral aneurysms and other arterial lesions.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"142"},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare unilateral variation of extensor digitorum longus and fibularis tertius muscles.","authors":"Burcu Kamaşak Arpaçay, Emre Uğuz, Tufan Ulcay, Kenan Aycan","doi":"10.1007/s00276-025-03633-9","DOIUrl":"https://doi.org/10.1007/s00276-025-03633-9","url":null,"abstract":"<p><strong>Purpose: </strong>Both the extensor digitorum longus (EDL) and fibularis tertius (FT) muscles exhibit a wide range of morphological variations.</p><p><strong>Methods: </strong>A 70-year-old male cadaver was subjected to routine anatomical dissection for research and teaching purposes.</p><p><strong>Results: </strong>The EDL had a markedly smaller fleshy belly, whereas the FT appeared hypertrophic. The EDL tendon displayed an atypical elongation and bifurcated into only three distinct slips, which inserted into the dorsal digital expansions of the second, third, and fourth toes. In contrast, the FT tendon was remarkably well-developed and divided into two slips. The lateral slip attached to the dorsal aspect of the base of the fifth metatarsal, while the medial slip extended distally to integrate into the dorsal digital expansion of the fifth toe.</p><p><strong>Conclusion: </strong>In injuries involving tendon incisions, clinicians should consider EDL variations to ensure proper tendon restoration. The FT muscle flap and tendon grafts are commonly used to correct ankle joint laxity and foot drop. Understanding variations in the EDL and FT is crucial for surgical planning.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"143"},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cautionary tale of anatomical variations of the extrahepatic biliary system and their implications for surgical procedures: a systematic literature review.","authors":"Andrew Chiagozie Ekwesianya, Boluwatife Oladapo Ayantunde, Abraham Abiodun Ayantunde","doi":"10.1007/s00276-025-03660-6","DOIUrl":"https://doi.org/10.1007/s00276-025-03660-6","url":null,"abstract":"<p><strong>Background: </strong>The hepatobiliary system has the most associated anatomical variations in the body and they are a direct reflection of the complexity of its embryological development. The anatomical pattern commonly described as 'normal' occurs only in 57-72% of the population. The objective of the study is to review the English Language published literature on the prevalence of the anatomical extra-hepatic biliary system variations and their potential implications for surgical and endoscopic procedures. This will assist both practicing and trainee surgeons in preventing biliary tract injuries while operating in this area.</p><p><strong>Methodology: </strong>A comprehensive literature search was conducted using the PICO framework across SCOPUS, PubMed, MEDLINE, and Cochrane databases. Study characteristics and relevant data were collated. The prevalence of the most clinically important anatomical variations is presented.</p><p><strong>Results: </strong>Seventy studies, encompassing 17,207 subjects, were included: 27 studies (9,738 subjects) on cystic duct variations, 17 studies (2,633 subjects) on gallbladder variations, and 26 studies (4,836 subjects) on cystic artery variations. Notable findings include low insertion (11.2%), medial insertion (9.8%), and parallel course (7.4%) of the cystic duct, Hartmann's pouch in 12.2% of gallbladders, and the cystic artery originating from the right hepatic artery in 83.6% or other sources in 16.4%. Moynihan's hump of the right hepatic artery was found in 1.8%.</p><p><strong>Conclusion: </strong>These variations are frequent and surgically relevant. Understanding them is critical to avoiding complications. Employing the critical view of safety in laparoscopic cholecystectomy ensures proper visualization of anatomical structures, reducing the risk of injury.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"145"},"PeriodicalIF":1.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duplicate origin of the middle cerebral artery: a rare variant.","authors":"George Triantafyllou, Panagiotis Papadopoulos-Manolarakis, Panagiotis Papanagiotou, George Tsakotos, Maria Piagkou","doi":"10.1007/s00276-025-03654-4","DOIUrl":"10.1007/s00276-025-03654-4","url":null,"abstract":"<p><p>The cerebral arterial circle exhibits considerable morphological variability. Variations in the middle cerebral artery (MCA) are infrequent occurrences that can be readily identified via imaging techniques. The current imaging report describes a rare variant of the MCA consisting of a duplicate origin, which was incidentally discovered in a 42-year-old female patient through computed tomography angiography. The duplicated origin of the MCA was identified on the left side of the cerebral arterial circle, forming an arterial ring with the temporopolar branch of the MCA originating from one of its limbs. The remainder of the arterial circle demonstrated no variants. It is essential to distinguish variants of the MCA without conflating them. The present variant is accurately characterized as a 'duplicate origin\", it should not be confused with fenestrations, and has a reported prevalence of 0.1%. Comprehending such arterial variations is vital prior to undertaking endovascular or neurosurgical procedures in the region.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"140"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common origin of the right vertebral artery and the right costocervical trunk diagnosed by magnetic resonance angiography.","authors":"Akira Uchino, Kenzo Minamimura","doi":"10.1007/s00276-025-03652-6","DOIUrl":"https://doi.org/10.1007/s00276-025-03652-6","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of common origin of the right vertebral artery (VA) and the right costocervical trunk (CCT) diagnosed by magnetic resonance angiography (MRA).</p><p><strong>Methods: </strong>A 74-year-old woman with cerebral infarctions underwent cranial magnetic resonance imaging (MRI) and head and neck MRA using a 3-Tesla scanner. MRA was performed using a standard 3-dimensional time-of-flight technique.</p><p><strong>Results: </strong>Cranial MRI showed an acute infarction of the posterior limb of the right internal capsule. MRA of the intracranial region revealed no significant pathological lesions. MRA from the aortic arch (AA) to the craniovertebral junction level also showed no pathological lesions; however, there was a common origin of the right VA and CCT. The right VA normally enters the C6 transverse foramen (TF).</p><p><strong>Conclusion: </strong>Using MRA, we diagnosed a case of a common origin of the right VA and CCT, an extremely rare arterial variation. This type of right VA is considered to result from the same embryonic developmental variation as the left VA arising from the AA distal to the left subclavian artery. Usually, this type of right VA enters the 7th TF, however, the right VA of our patient entered the normal 6th TF. We cannot explain why the right VA of our patient did not enter the 7th TF. The image quality of MRA is not excellent; however, the creation of both partial VR images and reformatted images is useful and important for the identification of rare arterial variations.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"139"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral variations in the branching of the external carotid artery: a case report.","authors":"Robert Abbott, Sarah Ward, Maya Jodidio, George Holan, Jeremy J Grachan","doi":"10.1007/s00276-025-03653-5","DOIUrl":"10.1007/s00276-025-03653-5","url":null,"abstract":"<p><strong>Purpose: </strong>Various anatomical variations in the branching pattern of the external carotid arteries are known to occur with significant frequency and have been documented in published literature. The purpose of this case report is to document and discuss variations in the branching patterns of the external carotid artery as seen in an anatomical donor and determine the clinical relevance of these variations.</p><p><strong>Case presentation: </strong>A routine dissection of an 89-year-old female anatomical donor, whose cause of death was reported as acute myocardial infarction and atherosclerotic heart disease, revealed variations in the branching patterns of both external carotid arteries. Bilaterally, the common carotid arteries bifurcated at the C4 vertebral level. On the left side, an occipitoauricular trunk originated 0.5 mm superior to the common carotid artery's bifurcation, whereas, on the right side, an occipitoauriculopharyngeal trunk branching 0.8 mm superior to the bifurcation of the common carotid artery was observed before branching into an occipitoauricular trunk and ascending pharyngeal artery.</p><p><strong>Conclusion: </strong>This case report reinforces previous publications on arterial branching patterns and the importance of imaging prior to procedures. Clinically, these variations may impact surgical approaches, endovascular procedures within the neck, and vascular pathology management.</p>","PeriodicalId":49461,"journal":{"name":"Surgical and Radiologic Anatomy","volume":"47 1","pages":"141"},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}