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Examination of Pediatric Shoulder
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
The length of the arm is measured from the angle of the acromion to the lateral epicondyle of the humerus. Using a fixed bony point like the lateral epicondyle, circumferential measurement of the mid-arm should also be done to document muscle wasting at the same distance on both sides.
Musculoskeletal and Soft-Tissue Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Tennis elbow causes pain over the lateral epicondyle of the humerus from a partial tear of the extensor origin of the forearm muscles used in repetitive movements (e.g. using a screwdriver or playing tennis).
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The elbow joint includes the ulnohumeral, radiohumeral and proximal radioulnar joints. This complex joint is held together by several extracapsular ligaments (Figure 9). On the sides of the joint are the medial and lateral collateral ligaments, which are also referred to as the ulnar and radial collateral ligaments. The medial collateral ligament runs from the medial humeral epicondyle to the coronoid process and olecranon of the ulna. The lateral collateral ligament runs from the lateral epicondyle of the humerus to the anular ligament. These two ligaments check movement of the ulnohumeral and radiohumeral joints in flexion and extension, as well as checking the small amount of abduction and adduction which occurs at the elbow.
Reverse vascularized bone graft of the lateral distal humerus for non-union of the radial neck fracture: anatomical study and case report
Published in Journal of Plastic Surgery and Hand Surgery, 2019
Akito Nakanishi, Kenji Kawamura, Shohei Omokawa, Takamasa Shimizu, Yasuaki Nakanishi, Akio Iida, Kanit Sananpanich, Pasuk Mahakkanukrauh, Yasuhito Tanaka
There were two to four PRCA branches (mean: 3.3) entering the bone through the periosteum. The distances from the branches to the lateral epicondyle of the humerus ranged from 2.5 to 10.8 cm. The distances from the most proximal and distal branches to the lateral epicondyle of the humerus were 4.5–10.8 cm (mean: 7.6) and 2.5–5.5 cm (mean: 3.4), respectively. The distances between the lateral epicondyle of the humerus and the radial neck were 2.8–3.5 cm (mean: 3.2). These results suggested that the most distal branch of the PRCA was unsuitable to use in harvesting a pedicled vascularized bone graft for the treatment of radial neck fracture non-union. In order to make enough length of the vascular pedicle of the bone graft to reach the radial neck, the more proximal branch should be selected. From this anatomical study, the vascularized bone graft can be transferred to the radial neck in 100% when the most proximal branch is used.
‘J’ brachioplasty technique in massive weight loss patients
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Maria A. Bocchiotti, Erind Ruka, Luca Spaziante, Umberto Morozzo, Elisabetta A. Baglioni, Stefano Bruschi
We first trace a line along the axis of the arm, from the lateral epicondyle of the humerus (point A) to the coracoids articulation projection (point B), in order to place the final scar position in an anterior position and straight shape. At the level of the coracoids articulation the line is extended caudally in a medial convex shape, following the natural axillary anterior pillar. This line is drawn as a smooth Italic S shape and may be prolonged caudally depending on axillary skin excess (point C). Patients with thoracical skin excess may require great extension of this line along lateral aspect of thorax proportional to the amount of tissue to be removed. A second line is then marked starting from the elbow (point A) and running inferiorly to the previous one, based on the prior pinch test and the subcutaneous tissue thickness evaluation. This line ends when crossing an imaginary line connecting coracoids articulation (point B, the most superior point of anterior axillary pillar) to the most inferior point of posterior axillary pillar (point D). Points D and C are then joined in a slightly posterior convex shape until final marking is completed. Point B results to be at the maximum convexity point of ABC line, while point B’ is located in the maximum concavity of the AD line. Segment CD’ and CD are approximately equal in length as well as segment BD’ and B’D. Point B’ and D’ are placed depending on the degree and main direction of the desired lifting (Figure 1).
Focussing on the foot in psoriatic arthritis: pathology and management options
Published in Expert Review of Clinical Immunology, 2018
Aimie Patience, Philip S. Helliwell, Heidi J. Siddle
The insertion of the Achilles tendon at the heel is the most prevalent site affected (3, 6) (Figure 3); however, enthesitis can also typically be detected in the foot at the insertion of the plantar fascia at the calcaneus, tibialis posterior at the navicular tuberosity, and peroneus brevis tendon at the base of the fifth metatarsal. A clinical enthesitis index, specific to PsA, has been developed which examines tenderness at six points of the body: bilateral lateral epicondyle of the humerus, medial condyle of the femur, and the Achilles tendons at the posterior prominence of the calcaneus [22]; however, the location and presentation of enthesitis in the foot can make it challenging to differentiate clinically from synovitis, bursitis, and other inflammatory joint manifestations [23] (Figure 4). Enthesitis was typically underdiagnosed in patients with PsA; however, the routine use of ultrasound and magnetic resonance imaging (MRI) for assessing and monitoring the disease has increased the detection of enthesitis and enables more detailed investigation. Both modalities provide different, valuable information: MR imaging allows assessment of soft-tissue, entheseal and bone edema, bone erosion, and enthesophyte formation while ultrasound assesses vascularization (power Doppler ultrasound [PDUS]), echogenicity, fluid, ligament abnormalities, and tendon thickening [24]. The severity of enthesitis detected by ultrasound is a potential marker for peripheral and axial radiographic joint damage [25]; however, a recent study found no correlation at the insertion of the Achilles tendon [26].