We describe the case of a 73-year-old woman with a history of chronic low back pain and 2 previous lumbar fusions who presented with complaints of worsening back and leg pain. Having previously undergone multiple interventions, physical therapy, and oral analgesics with limited pain relief, the patient opted for endoscopic lysis of adhesions for severe scarring of the epidural space. Subsequently, the patient developed a neurogenic bladder with urinary retention. Three years later, she experienced resolution of the neurogenic bladder symptoms that coincided with the use of the antibiotic nitrofurantoin. Upon discontinuation of the antibiotic, the patient noted that she was unable to void spontaneously. With reinstitution of nitrofurantoin, the patient was once again able to void effectively and has been maintained on nitrofurantoin for >3 years.
IntroductionAs part of a series of dissections geared towards an improved anatomical understanding of Greater Trochanteric Pain Syndrome, it was observed that there were multiple tendons from the gluteus maximus inserting on the femur. In this study, the variability of the gluteus maximus tendon insertion was examined.MethodThe experiment was done on 40 partially dissected, embalmed bodies that were donated through the Willed Body Program at the University of North Texas Health Science Center. The gluteus maximus muscle belly was detached from the iliac crest. In addition, the iliotibial band was cut from the origin (ilium) and reflected to gain access to the gluteus maximus tendon. The fat in the area around the greater trochanter was cleaned until the tendon of the gluteus maximus was revealed.Results22 hips had only one tendon from the gluteus maximus inserting on the femur (13 on the right and 9 on the left), 19 hips had 2 tendons inserting (10 on the right and 9 on the left), 7 with 3 insertions (5 on the right and 2 on the left), and 1 with 4 insertions on the left side. When sex was separated, women had more insertions with 2 tendons than insertions with 1 tendon.ConclusionIt has been shown that there are multiple tendons from the gluteus maximus inserting into the femur.
The temporomandibular joint (TMJ) is characterized by mandibular condyles, capsule, lateral pterygoid, articular surface of the temporal bone, ligaments, and articular disc. For this study the focus is complex articular disc attachments. The main component of the disc is fibrocartilage while its extracellular matrix (ECM) is predominantly composed of collagen type II, sulfated glycosaminoglycan (GAG) and proteoglycans. The purpose is to use histological techniques to investigate components of TMJ disc attachments and quantify constituents of the disc using biochemical assays. Microscopic investigation of attachments provides information to understanding the mechanics of the TMJ disc and an understanding of the relationship between disc and attachments. Six (6) fresh un‐embalmed TMJ disc‐attachment complexes were dissected from willed body donors. TMJ discs were further dissected into five regions and disc attachments were dissected into six regions to emulate a previous study by Willard et al (2011), which used porcine TMJ. Histology and biochemical assays were performed on each region to quantify ECM components. Histological analysis provided information on distribution of components in the complex.Grant Funding Source: None
PurposeGreater trochanteric pain syndrome (GTPS) is commonly diagnosed, and is thought to be at least in part caused by repetitive friction between the greater trochanter (GT) and iliotibial tract (ITT). We propose that the ITT has an important insertion into the proximal femur, the ITT‐ Femoral Insertion (ITT‐FI), which is the major contributor to this friction, rather the tibial extension of the ITT.MethodHips (n=20) were dissected on embalmed cadavers. The ITT‐FI was identified as the ligamentous structure remaining after excising the gluteus maximus (GM) and tensor fasciae latae (TFL) muscle fibers from the ITT, transection of the ITT at mid femur, leaving the ITT origin at the iliac crest and insertion on the femur (near the GM) intact. Measurements recorded include: length from the iliac crest to the femoral insertion of the ITT, the width of the ITT‐FI fibers, and the relative width of the pelvis as determined by the distance from anterior superior iliac spine (ASIS) to ASIS. Photographs were taken.ResultsThe proposed structure originates at the iliac crest and inserts inferior to the GT. The pressure between the ITT and the GT changed little if at all as palpated before and after isolating the ITT‐FI. Average measurements of the structure in length was 21.3cm, and width at the iliac crest was 4.6cm. Average width of the pelvis was 25.3cm.ConclusionThe femoral insertion of the ITT is identified, measured in dimension, and appears to be the chief cause of ITT static pressure on the GT. Future studies are needed to quantify this assertion.Grant Funding Source: none
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