Novel Muscle in Infraspinous Fossa

The infraspinatus muscle (IS) makes a minor contribution to lateral rotation of the arm but mainly serves to stabilize the glenohumeral (GH) joint as part of the rotator cuff. Although reports of variations in the rotator cuff muscles have been documented previously, specific discussions of IS variants are lacking. In this report, we present a novel case of an accessory muscle in the infraspinous fossa and its relationship to the IS, which was normally located. We describe the observed physical features of the muscles and their innervation patterns.

Anatomical analysis of the motor endplate zones of the suprascapular nerve to the infraspinatus muscle and its clinical significance in managing pain disorder

Myofascial pain syndrome caused by myofascial trigger points is a musculoskeletal disorder commonly encountered in clinical practice. The infraspinatus muscle is the region most frequently involved in the myofascial pain syndrome in the scapular region. The characteristics of the myofascial trigger points are that they can be found constantly in the motor endplate zone. However, localizing myofascial trigger points within the motor endplate zone and establishing an accurate injection site of the infraspinatus muscle has been challenging because the anatomical position of the motor endplate zone of the infraspinatus muscle is yet to be described. Therefore, this cadaveric study aimed to scrutinize the motor endplate zone of the infraspinatus muscle, propose potential myofascial trigger points within the muscle, and recommend therapeutic injection sites. Twenty specimens of the infraspinatus muscle for nerve staining and 10 fresh frozen cadavers for evaluation of the injection were used in this study. The number of nerve branches penetrating the infraspinatus muscle and their entry locations were analyzed and photographed. Modified Sihler's staining was performed to examine the motor endplate regions of the infraspinatus muscle. The nerve entry points were mostly observed in the center of the muscle belly. The motor endplate was distributed equally throughout the infraspinatus muscle, but the motor endplate zone was primarily identified in the B area, which is approximately 20-40% proximal to the infraspinatus muscle. The second-most common occurrence of the motor endplate zone was observed in the center of the muscle. These detailed anatomical data would be very helpful in predicting potential pain sites and establishing safe and effective injection treatment using botulinum neurotoxin, steroids, or lidocaine to alleviate the pain disorder of the infraspinatus muscle.

Parsonage-Turner Syndrome

Teaching Point: Magnetic resonance imaging is a valuable imaging tool in Parsonage-Turner syndrome, a rare neurological disorder that presents as acute denervation in the distribution of the brachial plexus.

Myositis ossificans in the infraspinatus muscle: The key to diagnosis

The zone phenomenon is the most important diagnostic feature in differentiating myositis ossificans from malignancies such as osteosarcomas, which calcify from the center to the periphery and its presence in our late-stage lesion was the key to diagnosis.

Effect of the Rearing Managements Applied during Heifers' Whole Life on Quality Traits of Five Muscles of the Beef Rib

The aim of this work was to study the effects of four different rearing managements applied during the heifers’ whole life period (WLP) on muscles from ribs in the chuck sale section. The characteristics of meat studied were the sensory, rheological, and color of the longissimus muscle (LM) and the rheological traits of four other muscles: complexus, infraspinatus, rhomboideus, and serratus ventralis. The main results showed that WLP rearing managements did not significantly impact the tenderness (sensory or rheological analyses) of the rib muscles. The LM had high (p ≤ 0.05) typical flavor and was appreciated when heifers received a WLP rearing management characterized by a short pasture duration during the heifers’ whole life (WLP-E). The heifers’ management characterized by a long pasture duration during their life (WLP-A) or by a diet composed mainly of hay during the growth and fattening periods (WLP-F), had lower typical flavor and were less appreciated than those with WLP-E management. Moreover, the LM color was redder for heifers of WLP-E than those of the WLP-A and WLP-F groups. This study confirmed that it is possible to obtain similar meat qualities with different rearing managements.

Effects of Self-Myofascial Release on Shoulder Function and Perception in Adolescent Tennis Players

CONTEXT

Tennis induces a decreased internal rotation range of motion at the dominant glenohumeral joint. The effects of self-myofascial release have not yet been investigated to restore glenohumeral range of motion.

OBJECTIVE

This study aimed at investigating the effects of self-myofascial release on shoulder function and perception in adolescent tennis players.

DESIGN

Test-retest design.

SETTING

Tennis training sport facilities.

PARTICIPANTS

Eleven male players participated in this study (age: 15 [3] y; height: 173.1 [11.1] cm; mass: 56.0 [15.1] kg; International Tennis Number: 3).

INTERVENTION

During 5 weeks, the players performed their regular tennis training. During 5 additional weeks, self-myofascial release of the infraspinatus and pectoralis muscles was implemented 3 times per week after the warm-up of the regular training session.

MAIN OUTCOME MEASURES

The primary outcome was glenohumeral internal rotation range of motion. The secondary outcomes were perceived shoulder instability and tennis serve accuracy and velocity.

RESULTS

Adding self-myofascial release allowed an increase of 11° (2°) of internal rotation range of motion at the dominant glenohumeral joint (P < .001) and a decreased perception of shoulder instability (P = .03), while maintaining tennis serve velocity and accuracy.

CONCLUSIONS

Implementing self-myofascial release on infraspinatus and pectoralis muscles 3 times per week during 5 weeks improved dominant glenohumeral internal rotation range of motion in tennis players. It can be used as a strategy to preserve the mobility of this joint.

The posterior ridge of the greater tuberosity of the humerus: a suitable landmark for the posterior approach to the shoulder joint?

BACKGROUND

The purpose of this study was to evaluate the posterior ridge of the greater tuberosity, a palpable prominence during surgery, as a landmark for the posterior approach to the glenohumeral joint.

METHODS

Twenty-five human cadaveric shoulders were dissected. In 5 cases, a full-thickness rotator cuff tear was present. The posterior surgical anatomy was defined, and the distance from the ridge to the interval between the infraspinatus (IS) and teres minor (TM) muscle, the distance from the ridge to the inferior border of the glenoid (IBG), and the distance between the IS-TM interval and the IBG were determined.

RESULTS

In all specimens, a prominent ridge on the posterior greater tuberosity lateral to the articular margin could be identified. The IS-TM interval was located, on average, 3 mm proximal to this ridge. The IS-TM interval corresponded to a point 5 mm proximal to the IBG. In all shoulders, the ridge was located, on average, 8 mm proximal to the IBG. The plane of the IS-TM interval showed a vertically oblique direction.

CONCLUSION

The posterior ridge of the greater tuberosity is a suitable landmark to locate the internervous plane between the IS and TM and should not be crossed distally. Unlike other landmarks, the ridge moves with the humeral head, making it is less dependent on the patient's size, sex, and arm position and the quality of the rotator cuff. The ridge is always located proximal to the insertion of the TM and IBG.

Hypertrophic changes of the teres minor muscle in rotator cuff tears: quantitative evaluation by magnetic resonance imaging

BACKGROUND

Few reports have assessed the teres minor (TM) muscle in rotator cuff tears. This study aimed to quantitatively analyze the morphologic changes of the TM muscle in patients with or without rotator cuff tears by magnetic resonance imaging (MRI).

METHODS

This retrospective study consisted of 279 subjects classified on the basis of interpretations of conventional MRI observations into 6 groups: no cuff tear; partial-thickness supraspinatus (SSP) tear; full-thickness SSP tear; SSP and subscapularis tears; SSP and infraspinatus (ISP) tears; and SSP, ISP, and subscapularis tears. With use of ImageJ software (National Institutes of Health, Bethesda, MD, USA) for oblique sagittal MRI, we measured the areas of ISP, TM, and anatomic external rotation (ISP + TM) muscles on the most lateral side in which the scapular spine was in contact with the scapular body. The occupational ratios of the TM muscle area to the anatomic external rotation muscle area were calculated. Ratios above the maximum of the 95% confidence intervals of the occupational ratio in the no-tear group were defined as hypertrophy of the TM muscle.

RESULTS

Occupational ratios of the TM muscle in the no-tear group followed a normal distribution, and ratios >0.288 were defined as hypertrophic. Hypertrophic changes of the TM muscle were confirmed in rotator cuff tears involving the ISP tendon. A negative correlation was found between the occupational ratios of TM and ISP (P < .001).

CONCLUSION

The TM muscle appeared hypertrophic in rotator cuff tears involving the ISP, and the progression of ISP muscle atrophy seemed to induce the development of this compensatory hypertrophy.

A reliability of electromyographic normalization methods for the infraspinatus muscle in healthy subjects

The purpose of this study was to examine the test-retest reliability of normalization methods for the infraspinatus muscle in a group of healthy subjects. Twelve healthy subjects (male=8, female=4) performed the maximal voluntary isometric contraction (MVIC) with examiner`s resistance, MVIC with a digital tension-meter (MVIC-DT), and sub-MVIC methods. Surface electromyography (EMG) signals were recorded from the infraspinatus muscles according to normalization methods. Reliability was analyzed using the intra-class coefficient (ICC), standard error of measurement (SEM), and minimal detectable difference (MDD). The results of the present study demonstrated that the sub-MVIC method has excellent test-retest reliability (ICC=0.92) with a relatively small SEM (5.9 mV) and MDD₉₅ (16.4 mV), compared to MVIC-DT (ICC=0.73; SEM=11.2 mV; MDD₉₅: 31 mV) and MVIC-E (ICC=0.5; SEM=15.7 mV; MDD₉₅: 43.6 mV). These findings provide evidence that sub-MVIC is more appropriate for comparing the EMG activity for the infraspinatus muscle as a normalization method. If MVIC for normalization is needed, MVIC-DT is more appropriate than MVIC-E.