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Przyklenk A, Hackl M, Leschinger T, Ott N, Harbrecht A, Müller LP, Wegmann K. Comprehensive analysis and classification of retrocondylar ulnar groove morphology using CT imaging in an average population of adults. Surg Radiol Anat 2024; 46:473-482. [PMID: 38329521 PMCID: PMC10995007 DOI: 10.1007/s00276-024-03297-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Anatomical variations of the concave shaped retrocondylar ulnar groove (RUG) can contribute to ulnar nerve instability. However, there are currently limited available standardized data describing the anatomy of the RUG based on radiologic imaging, such as computed tomography (CT). This study aims to provide a comprehensive description and classification of RUG anatomy based on RUG angle measurements. METHODS 400 CT scans of the elbows of adults showing no signs of osseous damage were evaluated. RUG angles were measured in four anatomically defined axial planes that spanned from the proximal to the distal end of the RUG. Furthermore, distance measurements at the medial epicondyle were conducted. A classification system for the RUG is proposed based on the acquired RUG angles, aiming to categorize the individual angles according to the 25th and 75th percentiles. RESULTS RUG angles were significantly larger in males compared to females (p < 0.001) accompanied by larger distances including the off-set and height of the medial epicondyle (p < 0.001). RUG angles decreased from proximal to distal locations (p < 0.05). CONCLUSION This study revealed that men exhibited larger RUG angles compared to women, indicating a less-concave shape of the RUG in men. Introducing an objective RUG classification system can improve our understanding of anatomical variations and potentially find application in diagnostics and preoperative planning.
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Affiliation(s)
- Axel Przyklenk
- Department of Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Michael Hackl
- Department of Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Tim Leschinger
- Department of Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Nadine Ott
- Department of Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Andreas Harbrecht
- Department of Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Lars Peter Müller
- Department of Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Kilian Wegmann
- Department of Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
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Krahe AM, Ketterer MC, Offergeld C, Hildenbrand T. [Evaluation of a structured e-learning-based approach to CT anatomy of the paranasal sinuses for medical students : A pilot study]. HNO 2022; 70:468-475. [PMID: 35041028 PMCID: PMC9160128 DOI: 10.1007/s00106-021-01141-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Computed tomography (CT) anatomy is not an integral part of undergraduate medical training in many countries. Radiology seems to be well suited for new online-based teaching methods. OBJECTIVE The aim of this study was to evaluate whether e‑learning is appropriate for introducing complex learning contents such as sinus CT anatomy to novices and to assess whether identification of relevant anatomical variants in sinus CT scans by medical students can be improved with a sinus CT checklist. MATERIALS AND METHODS Medical students were asked to assess sinus CT scans for anatomical variants before and after implementation of the CLOSE mnemonic (cribriform plate, lamina papyracea, Onodi cell, sphenoid sinus pneumatization, and [anterior] ethmoidal artery). Sinus CT anatomy and the CLOSE mnemonic were introduced by e‑learning. The rate of correctly identified variants and the results of the individual CLOSE items were recorded. A questionnaire was distributed for subjective evaluation of the usefulness of the checklist and e‑learning. RESULTS Ten students took part in this pilot study. The rate of correctly identified variants improved significantly, from 33.3 to 61.1%. The analysis of the individual CLOSE items showed a significant improvement for C, S, and E. The subjective evaluation of the CLOSE mnemonic and e‑learning was very positive. CONCLUSION E‑learning was able to transfer complex learning contents in previously non-trained medical students and was evaluated as an appropriate introduction to the topics. Structured assessment of paranasal sinus CT scans using the CLOSE criteria can significantly improve the recognition of anatomical variants.
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Affiliation(s)
- Anna Marleen Krahe
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106 Freiburg, Deutschland
| | - Manuel Christoph Ketterer
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106 Freiburg, Deutschland
| | - Christian Offergeld
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106 Freiburg, Deutschland
| | - Tanja Hildenbrand
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106 Freiburg, Deutschland
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Alves-Pimenta S, Soares S, Colaço B, Ginja M. Effect Of Elbow Angle And Weight-Bearing On The Evaluation Of Joint Congruence In Dogs. Anat Rec (Hoboken) 2022; 305:3398-3409. [PMID: 35438239 DOI: 10.1002/ar.24937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/20/2022] [Accepted: 04/05/2022] [Indexed: 11/09/2022]
Abstract
Joint congruence is relevant for the assessment of elbow dysplasia, a development disorder in dogs. However, quantification of its variation with joint angle and weight bearing, important factors in quadrupedal locomotion, is lacking. Our objective was to estimate those effects on the alignment of humeroradioulnar joint surfaces. The usual protocol for screening elbow dysplasia, including mediolateral extended and flexed elbow views, was preceded by a weight-bearing lateromedial standing radiographic view, without sedation. Minimum distances were measured at established points of the humeroradioulnar joints classified with a grade zero of dysplasia. Sixty elbows (30 Portuguese Pointer dogs) were studied. The joint space between the anconeal process and the ulnar trochlear notch increased with flexion, decreasing with weight bearing (P<0.001). The distance between the humeral trochlea and the trochlear notch at the widest point, increased with weight bearing, while it decreased with flexion. Step and distance between the radial head and the base of the medial coronoid process increased with flexion and decreased with weight bearing. At this point, physiological changes occurred at the humeroulnar joint space. The methodology allowed to quantify the variations on joint spaces with the elbow angle and weight bearing, important for the interpretation of congruence in diagnosis and treatment of dysplasia. Reference absolute and indexed values obtained allow future comparisons with other breeds and dysplastic dogs. Physiological variations denoted that radioulnar joint became more incongruent under flexion, and more congruent under weight bearing, while humeroulnar joint became more congruent under flexion, and more incongruent under weight bearing.
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Affiliation(s)
- Sofia Alves-Pimenta
- Department of Animal Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Sofia Soares
- Department of Veterinary Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Bruno Colaço
- Department of Animal Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Mário Ginja
- Department of Veterinary Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Oertel M, Schmitz M, Becker JC, Eich HT, Schober A. Successful integration of radiation oncology in preclinical medical education : Experiences with an interdisciplinary training project. Strahlenther Onkol 2019; 195:1104-9. [PMID: 31309265 DOI: 10.1007/s00066-019-01492-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/27/2019] [Indexed: 01/20/2023]
Abstract
PURPOSE Modern impartation of both anatomic and radiation oncology (RO) knowledge in medical education enables a transfer of preclinical knowledge to clinical practice, which may be addressed by multidisciplinary concepts. The faculty's "Anatomy and imaging" course attempts to integrate RO, radiology and nuclear medicine into the preclinical curriculum. The present analysis focuses on the description of the course concept and discusses the potential didactic impact of the implementation of RO. METHODS In total 5 semester cohorts have undertaken the course since the introduction of RO in the winter semester of 2015/2016 with 682 students participating. It is designed as a small group circuit training with a teaching content of 8 h daily. Course evaluation was performed on a 100-item Likert scale. RESULTS General evaluation showed an average of 9.3-12.7 on a Likert scale (0 being the best, 100 being the worst grade). Use of media, relevance for medical training, gain of interest in medicine in general and overall satisfaction with the course received excellent mean values. For RO, there was a high degree of consent with the following statements: "the course was well organized", "subjects and presentation were well-structured", "topics were well chosen", "the time for exercises was sufficient" and "teaching by student tutors and physicians was adequate". CONCLUSION The present evaluation demonstrates the feasibility of introducing RO in the preclinical part of medical education. The course concept shows excellent results in evaluation and may help in broadening RO knowledge and in recruiting new doctoral candidates and residents.
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Macchi V, Porzionato A, Morra A, Picardi EEE, Stecco C, Loukas M, Tubbs RS, De Caro R. The triangles of Grynfeltt and Petit and the lumbar tunnel: an anatomo-radiologic study. Hernia 2016; 21:369-376. [PMID: 27215430 DOI: 10.1007/s10029-016-1509-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/09/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Lumbar hernias are protrusions of intra-abdominal contents classically through the superior (Grynfeltt) and inferior (Petit) lumbar triangles. The anatomy of the triangles is variable and quantitative data are few. No radiological data on the anatomy of the triangles are available. METHODS Fifty computed tomography angiography of the upper abdomen (M25, F25, mean age 72.5-year-old) were analyzed. The dimensions and the contents of the lumbar triangles were analyzed. The characteristics of the space between the two triangles were also documented. RESULTS The superior lumbar triangle showed a mean surface area of 5.10 ± 2.6 cm2. In the area of the triangle, the 12th intercostal pedicle and the 1st lumbar branches of the iliolumbar vessels were found in 42 and 46 %, respectively. The inferior lumbar triangle had a mean surface of area 18.7 ± 8.4 cm2. In this area, the 2nd, 3rd, and 4th lumbar branches were found in 9, 67, and 8 %, respectively. On oblique coronal images, a direct tunnel between the superior and the inferior lumbar triangles was found, showing an oblique course, with a postero-anterior direction (mean length 36.5 ± 5.8 mm, mean caliber 7.4 ± 3.1 mm). CONCLUSIONS Among the anatomical factors of weakening of the abdominal wall, the course of branches of the lumbar vessels was documented not only in the superior but also in the inferior lumbar triangle. A real musculoaponeurotic tunnel between the superior and the inferior lumbar triangles located in the oblique coronal plane was found, that could play a role in the development of incarceration or strangulation of lumbar hernias.
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Affiliation(s)
- V Macchi
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
| | - A Porzionato
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
| | - A Morra
- Section of Radiology, Euganea Medica Center, Via Colombo 3, Sant'Agostino Di Albignasego, Padua, Italy
| | - E E E Picardi
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
| | - C Stecco
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy
| | - M Loukas
- Department of Anatomical Sciences, School of Medicine, St. George's University, True Blue, Grenada
| | - R S Tubbs
- Seattle Science Foundation, Seattle, WA, USA
| | - R De Caro
- Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy.
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Abstract
PURPOSE Medical anatomy instruction has been an important issue of debate for many years and imaging anatomy has become an increasingly important component in the field, the role of which has not yet been clearly defined. The aim of the paper was to assess the current deployment of medical imaging in the teaching of anatomy by means of a review of the literature. MATERIALS A systematic search was performed using the electronic database PubMed, ScienceDirect and various publisher databases, with combinations of the relevant MeSH terms. A manual research was added. RESULTS In most academic curricula, imaging anatomy has been integrated as a part of anatomical education, taught using a very wide variety of strategies. Considerable variation in the time allocation, content and delivery of medical imaging in teaching human anatomy was identified. Given this considerable variation, an objective assessment remains quite difficult. DISCUSSION In most publications, students' perceptions regarding anatomical courses including imaging anatomy were investigated by means of questionnaires and, regardless of the method of teaching, it was globally concluded that imaging anatomy enhanced the quality and efficiency of instruction in human anatomy. More objective evaluation based on an increase in students' performance on course examinations or on specific tests performed before and after teaching sessions showed positive results in numerous cases, while mixed results were also indicated by other studies. CONCLUSION A relative standardization could be useful in improving the teaching of imaging anatomy, to facilitate its assessment and reinforce its effectiveness.
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Affiliation(s)
- Bruno Grignon
- Département d'Anatomie Faculté de Médecine Université de Lorraine, Service Imagerie Guilloz, CHU Nancy, 29 av de Lattre de Tassigny, 54035, Nancy Cedex, France.
| | - Guillaume Oldrini
- Service de Radiologie, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, France
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