Hamstring strains, particularly involving the long head of biceps femoris (BFlh) at the proximal musculotendinous junction (MTJ), are commonly experienced by athletes. With the use of diagnostic ultrasound increasing, an in‐depth knowledge of normal ultrasonographic anatomy is fundamental to better understanding hamstring strain. The aim of this study was to describe the architecture of BFlh, using ultrasonography, in young men and cadaver specimens. BFlh morphology was examined in 19 healthy male participants (mean age 21.6 years) using ultrasound. Muscle, tendon and MTJ lengths were recorded and architectural parameters assessed at four standardised points along the muscle. Measurement accuracy was validated by ultrasound and dissection of BFlh in six male cadaver lower limbs (mean age 76 years). Intra‐rater reliability of architectural parameters was examined for repeat scans, image analysis and dissection measurements. Distally the BFlh muscle had significantly (P < 0.05) shorter fascicles and larger pennation angles than proximal sites. Agreement between ultrasound and dissection (cadaver study) was excellent for all architectural parameters, except pennation angle (PA), and MTJ length. All other measures demonstrated good‐excellent repeatability. BFlh is not uniform in architecture when imaged using ultrasound. It is likely that its distal‐most segment is better suited for force production in comparison to the more proximal segments, which show excursive potential, traits which possibly contribute to the high rate of injury at the proximal MTJ. The data presented in this study provide specific knowledge of the normal ultrasonographic anatomy of BFlh, which should be of assistance in analysing BFlh injury via imaging. Clin. Anat. 29:738–745, 2016. © 2016 Wiley Periodicals, Inc.
Whole muscle mechanomyography (MMG) has gained considerable interest in recent years for its ability to noninvasively determine muscle contractile properties (ie, contraction time [Tc], half-relaxation time [1/2Tr], and maximal displacement [Dmax)]). The aim of this study was to evaluate the test-retest reliability of two fairly novel MMG transducers: a laser-displacement sensor (LDS) and contact-displacement sensor (CDS). MMG was conducted on the rectus femoris muscle of 30 healthy individuals on 4 separate occasions. Test-retest reliability was quantified using intraclass correlation coefficients (ICCs). Both sensors were reliable for time-derived parameters Tc (ICCs, 0.85-0.88) and 1/2Tr (0.77-0.89), with Dmax identified as the most reproducible parameter (0.89-0.94). The 2 sensors produced similar Tc and Dmax measures, although significant (P < .05) systematic bias was identified with the CDS recording higher mean values, on average. However, these differences may not be considered clinically significant. The wide limits of agreement identified between 1/2Tr measures (-19.0 ms and 25.2 ms) are considered unreliable from a clinical perspective. Overall, MMG demonstrated good-to-excellent reliability for the assessment of muscle contractile properties with no significant differences identified between sessions, thus further validating its applicability as a noninvasive measure of muscle contractile properties.
MMG detects changes in contractile properties during stages of exercise-induced hypertrophy and disuse atrophy suggesting its applicability as a clinical tool in musculoskeletal rehabilitation.
COVID-19 mRNA vaccinations have recently been implicated in causing myocarditis. Therefore, the primary aim of this systematic review and meta-analysis was to investigate the clinical characteristics of patients with myocarditis following mRNA vaccination. The secondary aims were to report common imaging and laboratory findings, as well as treatment regimes, in these patients. A literature search was performed from December 2019 to June 2022. Eligible studies reported patients older than 18 years vaccinated with mRNA, a diagnosis of myocarditis, and subsequent outcomes. Pooled mean or proportion were analyzed using a random-effects model. Seventy-five unique studies (patient n = 188, 89.4% male, mean age 18–67 years) were included. Eighty-six patients had Moderna vaccines while one hundred and two patients had Pfizer-BioNTech vaccines. The most common presenting symptoms were chest pain (34.5%), fever (17.1%), myalgia (12.4%), and chills (12.1%). The most common radiologic findings were ST-related changes on an electrocardiogram (58.7%) and hypokinesia on cardiac magnetic resonance imaging or echocardiography (50.7%). Laboratory findings included elevated Troponin I levels (81.7%) and elevated C-reactive protein (71.5%). Seven patients were admitted to the intensive care unit. The most common treatment modality was non-steroid anti-inflammatory drugs (36.6%) followed by colchicine (28.5%). This meta-analysis presents novel evidence to suggest possible myocarditis post mRNA vaccination in certain individuals, especially young male patients. Clinical practice must therefore take appropriate pre-cautionary measures when administrating COVID-19 mRNA vaccinations.
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