Imaging in Calcific Tendinitis of Linea Aspera: A Case Report and Review of Literature

Linea aspera, the osseous ridge in the upper posterior femur, offers attachment to multiple muscles and tendons forming a fibroentheses. Deposition of calcium hydroxyapatite crystal and subsequent inflammation leads to tendinitis and calcification. This process is relatively rare at linea aspera but is a cause of pain and movement restriction. Radiographs are many times misleading as the linea aspera irregularity and calcific proliferation mimic irregular periosteal reaction associated with surface bone malignancies. MRI and CT are complementary and problem-solving. Awareness of the specific location and imaging features aids in the diagnosis of this condition which is frequently managed by a conservative approach avoiding the need for invasive procedures like biopsy for diagnosis. This case report depicts classical imaging features of this entity on multiple modalities.

Anatomical study of nutrient foramen in lower limb dry long bones

Background: Nutrient artery gain access through nutrient foramen and provide vascular supply to bone. Number, size and location of nutrient foramen has significant medical as well as surgical importance. Any insult to nutrient artery during surgical procedure or during trauma may lead to devascualarization or poor prognosis.Methods: The present study consist of 50 femurs, 50 tibia and 50 fibula, collected from department of anatomy, BPKIHS. Mean length of bone, number, position and size and foraminal index of nutrient foramen was observed and recorded accordingly.Results: In femur 62% bone shows single nutrient foramen. Nutrient foramen was commonly located in medial lip of linea aspera and in upper third of bone which was noted in 80% of bone. In tibia 82% of total bone shows single foramen with absent of foramen in 6% bone. Foramen was commonly located above the soleal line and middle third of bone which was noted in 56% of bone. In fibula 6% of total bone shows absent of nutrient foramen and majority of bone shows single nutrient foramen (82%). Foramen was commonly located in lower part of posterior surface (60%) and in middle third of bone.Conclusions: This study provides details topographic knowledge about nutrient foramen which is important clinically for proper planning of surgery and its outcome.

Comparative Gross Anatomical Studies on Pelvic Limb Long Bones of Crested Serpent Eagle (Spilornis cheela) and Brown Wood Owl (Strix leptogrammica)

There is no previously reported information on the morphological characteristics of pelvic limb long bones (femur, tibiotarsus and tarsometatarsus) in crested serpent eagle and brown wood owl. Thus, this study aimed to evaluate morphological and biometrical characteristics of pelvic limb long bones in crested serpent eagle and brown wood owl. The femur consisted of a curved shaft and two extremities. The shaft was wider proximally and distally and presented medial, lateral, anterior and lateral surfaces. The anterior, medial and lateral surfaces were smooth and continuous in both the species. An intermuscular line called linea aspera was present on the anterior and posterior surfaces in both the species. The proximal and distal extremities of the femur were almost of equal size. The proximal extremity presented a distinct, hemispherical head which was located in the level of the trochanter major in both the species. The distal extremity furnished a trochlea anteriorly for patella and medial, lateral condyles posteriorly for tibiotarsus bone. The patella was small and triangular and consisted of two surfaces, two borders, a base and an apex in both the species. Tibiotarsus was the longest bone in both the species which was formed by the fusion of distal extremity of the tibia with the proximal row of the tarsal bones. The proximal and distal extremity of the tibiotarsus consisted of medial and lateral condyles. In both the species, the fibula was a rod-shaped bone and reached up to distal third of the lateral border of the tibiotarsus. The tarsometatarsus was a long bone but smaller than tibiotarsus in both the species. Various biometrical parameters of the pelvic limb long bones were more in the crested serpent eagle as compared to the brown wood owl due to species differences.

Bioarchaeological Analysis of Remains

Presumably in constructing the sidewalk, the bones from these shallow burials were disposed of elsewhere. Remains of five adults and one child were excavated. Seven subadult teeth were surface-collected around a hole at the western edge of the site. Being buried in moist sand meant that most bones excavated were fragmented. Bones and teeth were examined for evidence of pathologies. This small sample is not representative of the community, but the pathologies provide insight on these persons’ lives. The linea aspera on the only femur excavated is fairly robust. The individual’s sex was indeterminate, but this ambiguity reinforced the point that both men and women in this community engaged in physically demanding work. Cranial fragments from two individuals were thickened, an indicator of anemia resulting from nutritional deficiency or disease. Cribra orbitalia was noted in the eye socket of one individual, another indicator of nutritional deficiency. Two of the child’s incisors have transverse lines, evidence of enamel hypoplasia, an indicator of infectious disease and nutritional stress. Individuals buried in this cemetery were likely of low social status, living in congested and unsanitary conditions with limited food. These pathologies raise questions about the extent these conditions existed among African-Bahamian communities. Economic opportunities for free and enslaved workers would have been limited.

Morphological and topographic study of diaphyseal nutrient foramen of femur and its clinical implications in North Indian population

Background: Nutrient foramen of long bones defines the extent of bone vascularisation. Information regarding nutrient foramen is necessary to conserve circulation during orthopaedic and surgical procedures. The present study was conducted to examine the position, number and calibre of nutrient foramina in 100 dry femora belonging to North Indian population.Methods: The total length (TL) of each femur was measured by taking the measurement between the most proximal aspect of the head of the femur and the most distal aspect of the medial condyle. Number of nutrient foramina was determined by using a magnifying lens. Distance of nutrient foramen from upper end was measured. Direction and obliquity of nutrient foramina were noted. Position of nutrient foramina was determined in relation to length of femur and linea aspera. Caliber of nutrient foramen was measured using 18, 20, 22 and 24-gauge needles.Results: Length of femur on right side was 435.2 mm (Range 393-523 mm). Length of femur on left side was 437 mm (range 369-524). 78 (78%) femora had single nutrient foramen, 11 (11%) had double nutrient foramen and 11 (11%) had no nutrient foramen. All foramina were directed upwards. Maximum foramina were located in middle third of femur (84%) followed by upper third of femur (8%). Most common location was on the intermediate area between two lips of linea aspera (42%) followed closely by medial lip of linea aspera (36%).Conclusions: This study has provided additional data on the subject which will help in resection, surgical procedures and transplantation techniques by orthopedician in North Indian population.

Topography of diaphyseal nutrient foramina of femora and their implications in bone grafting

Background : Long bones derive their nutrition through a nutrient artery that enters the bone through a foramen in its diaphysis. An orthopedic surgeon must be familiar with the topography of the nutrient foramina to avoid vascular compromise during surgery. Aim :This study attempts to analyze the topography of primary nutrient foramina of femora. Materials and method : One hundred dry adult femora were used for this study. The primary diaphyseal nutrient foramina were identified macroscopically using hand lens. The number of foramina and their position were noted and the foramina! index was calculated. Results : It was observed that 79% of femora had single primary nutrient foramen, 20% had double foramina and I% had three foramina. All the foramina were located between 30.8%-89.6% of total length of femur. 11.47 % of foramina were in the upper third, 1.64% in the lower third and the majority 86.88% of foramina were in the middle third of femur. The mean foramina!index was 46.01. 82.78% of foramina were located on the linea aspera, 14.75% on the medial surface and2.46% on the lateral surface. Conclusion : An orthopedic surgeon operating on femur must be careful in the middle 1/3rd, especially over the linea aspera as majority of primary diaphyseal foramina were observed in this region. A cogent knowledge of vascular topography ensures preservation of vasculature of the bone during surgeries. This enables rapid healing of surgical wound increasing the success rates of fracture fixation, bone grafting, vascularized microscopic surgeries and hip and knee replacement procedures.