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Lower Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Malynda Williams
Variations in the insertion of the tibialis posterior tendon may lead to hallux valgus (Bozant et al. 1994; Gunal et al. 1994). Accessory or duplicated tibialis posterior tendons can cause posterior tibial tenosynovitis (Ghormley and Spear 1953).
Principles of foot and ankle orthoses
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
The clinical presentation is variable dependent on the stage of tibialis posterior dysfunction. Functional loss includes eccentric control of the hindfoot, and of pronation during initial contact. Also, loss of concentric contraction, which supinates the foot so as to achieve the rigid foot needed for push off (13).
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The posterior muscles of the ankle and foot are gastrocnemius, soleus, plantaris, flexor digitorum longus, flexor hallucis longus, and tibialis posterior. As a group, these muscles cross the back of the ankle and plantarflex the ankle. Gastrocnemius is the large two-headed muscle that forms the bulk of the calf and also flexes the knee (see knee – muscles) and supinates the foot. The next largest muscle of the calf is soleus, which lies deep to the gastrocnemius; its action is purely plantarflexing the ankle. Between these two muscles lies the small plantaris muscle, which makes a minor contribution to flexing the knee and plantarflexing the ankle. Deep to these muscles lies popliteus; this muscle contributes to flexing the knee and internally rotating the tibia. Flexors digitorum and hallucis longus flex the four lesser toes and great toe respectively. Tibialis posterior supinates the foot in addition to plantarflexing the ankle. Two muscles are situated laterally on the leg, peroneus longus and peroneus brevis. Their role is pronating the foot and plantarflexing the ankle. The intrinsic muscles of the foot contribute to movement of the toes. There are many muscles within the foot, with the muscles of the dorsum of the foot being four layers deep.
Muscle MRI in motor neuron diseases: a systematic review
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2022
Alexander Kriss, Thomas Jenkins
Two studies assessing SMA patients taking nusinersen were published in 2020/21. The first investigated whole-body qualitative T1-weighted MRI and lower-limb quantitative diffusion tensor imaging (DTI) changes in two siblings with molecularly-confirmed SMA IIIb (39). No T1 signal changes were observed but DTI demonstrated increased number, length, and organization of muscle fiber tracts at follow-up. The second study assessed thigh FF and quantitative water-T2 signal in three female genetically-confirmed SMA IIIa patients and 11 healthy controls (44). Mean FF in patients increased by 6.7% and the average water-T2 signal decreased by 4.7%. Despite small sample sizes, these studies provided proof-of-concept for muscle MRI applications in therapeutic trials. In 2021, fatty infiltration and atrophy were qualitatively assessed in 20 genetically-confirmed SMA IV patients (34). Relative preservation of tibialis posterior, fibular and extensor digitorum longus, and sparing of the medial thigh compartment was seen. Atrophy and fatty infiltration scores correlated with clinical measures including walking speed, ALSFRSr, HFMSE, and disease duration.
Isolating the Superficial Peroneal Nerve Motor Branch to the Peroneus Longus Muscle with Concentric Stimulation during Diagnostic Motor Nerve Biopsy
Published in The Neurodiagnostic Journal, 2022
Ashley Rosenberg, Rachel Pruitt, Sami Saba, Justin W. Silverstein, Randy S. D’Amico
Arising from the sciatic nerve, the CPN travels in the posterior thigh to cross the lateral head of the gastrocnemius muscle to enter the anterolateral portion of the leg just below the fibular head. Here, the CPN divides into articular, deep, and superficial divisions (Figure 3A). The articular division innervates the joint capsule. The DPN innervates the anterior leg muscles responsible for dorsiflexion and terminates in a cutaneous branch between the first and second toe. The SPN provides motor innervation to the peroneus longus and the peroneus brevis only. Otherwise, the SPN provides cutaneous innervation to the lateral leg below the knee (D’Amico and Winfree 2017). The peroneus longus and peroneus brevis are located in the lateral portion of the leg and function primarily to evert the ankle, with the peroneus brevis considered more effective as an evertor than the peroneus longus (Lee et al. 2011). Both muscles also function in conjunction with the tibialis posterior in plantar flexion of the foot at the ankle (D’Amico and Winfree 2017).
Major reduction of ultrasound-detected synovitis during subcutaneous tocilizumab treatment: results from a multicentre 24 week study of patients with rheumatoid arthritis
Published in Scandinavian Journal of Rheumatology, 2021
HB Hammer, IMJ Hansen, P Järvinen, M Leirisalo-Repo, M Ziegelasch, B Agular, L Terslev
The participating ultrasonographers had to have at least 3 years of experience and, in most cases, the same person performed the ultrasound scoring throughout the study. The ultrasonographers were blinded to the clinical assessments and laboratory markers. GS and power/colour Doppler of 36 joints [bilateral wrist (radiocarpal, midcarpal, and radioulnar joints scored separately), metacarpophalangeal joints 1–5, proximal interphalangeal joints 2–3, elbow, knee, ankle (tibiotalar), and metatarsophalangeal joints 1–5] were scored semi-quantitatively on a four-point scale (0 = no, 1 = minor, 2 = moderate, 3 = major presence), with the Norwegian ultrasound atlas as reference (16). In addition, ultrasound assessment of the extensor carpi ulnaris tendon and tibialis posterior tendon (scored as previously described) was performed bilaterally (21). Sum scores of arthritis and tenosynovitis from all regions were combined into an overall score: the ultrasound sum score for GS and Doppler, respectively. The range for GS and Doppler sum score was 0–120 for each. A separate tenosynovitis score for GS and for Doppler had a range of 0–12 each.