The exact anatomy of the bones and joints is of great importance to the clinician when examining the limbs and to the surgeon when operating on the bones and joints.
To understand deformities of the extremities, it is important to first understand and establish the parameters and limits of normal alignment.
Each long bone has a mechanical and an anatomic axis
both frontal and sagittal planes axis lines are applicable to any longitudinal projection of a bone.
The corresponding radiographic projections are the anteroposterior (AP) and lateral (LAT) views, respectively.
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Assessent and radiology of distal end radius fractureSusanta85
distal end radius is a common fracture in elderly groups and also in young by high velocity trauma its assessment and radiology should know for its management
Assessent and radiology of distal end radius fractureSusanta85
distal end radius is a common fracture in elderly groups and also in young by high velocity trauma its assessment and radiology should know for its management
Differences between the lengths of the upper and/or lower arms and the upper and/or lower legs.
Except in extreme cases, arm length differences cause little
or no problem in how the arms function.
Lower limb neurological examination frequently appears in OSCEs. You’ll be expected to pick up the relevant clinical signs using your examination skills. This lower limb neurological examination OSCE guide provides a clear, concise, step-by-step approach to performing a neurological examination of the lower limb
Hallux rigidus:
A condition characterized by loss of motion of first MTP joint in adults due to degenerative arthritis
second most common condition affecting the big toe after hallux valgus
most common arthritic condition in the foot.
Hallux valgus contiene; definición, etiología, anatomía, características, diagnóstico, tratamento, cirugía, anatomía patológica y sus características. De igual forma, incluye los factores desencadenantes, clasificación roger mann y sus complicaciones.
The generation of numbers derived
manually or from a computer does not in
itself make cephalometrics a science, and
C
ephalometrics should not
necessarily be considered
as a science.
Management of facial asymmetries /certified fixed orthodontic courses by I...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Evolution of tunnel placement in ACL reconstructionDhananjaya Sabat
One of my talks at Delhi Arthroscopy Club....... this presentation provides a insight regarding the conceptual evolution in tunnel placement during ACL reconstruction.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Vertebral osteomyelitis( spondylodiskitis )
usually seen in adults (median age is 50 to 60 years)
Location
50-60% of cases occur in lumbar spine
30-40% in thoracic spine
~10% in cervical spine
Outcome of Mitchell's procedure in the treatment of hallux valgusAbdulla Kamal
Presentation of my thesis in IBFMS committee under supervision of pro. Dr. Omer Barawi.
Hallux valgus is a complex deformity of medial ray that often coexist with deformities and symptoms within the other toes.
commonest foot and all musculoskeletal deformities.
worldwide prevalence = 23% (18- 65 years) 35% > 65 years
Onset (46% up to 92%) before skeletal maturation
Female predominance up to 90%
Bilateral HV up to 84%
Shoulder examination frequently appears in OSCEs.Shoulder complaints are fairly common presentations to Accident and Emergency, general practice, and orthopaedic clinics. The examination of all joints follows the general pattern of “look, feel, move” as well as occasionally special tests, in which this station has many.
EBM is the practice of integrating individual clinical expertise with the best available clinical evidence from systematic research to maximize the quality and quantity of life for individual patients.
The menisci are crescents, roughly triangular in cross section, that cover one half to two thirds of the articular surface of the corresponding tibial plateau. They are composed of dense, tightly woven collagen fibers arranged in a pattern providing great elasticity and ability to withstand compression.
A fingertip injury is defined as any soft tissue, nail or bony injury distal to the dorsal and volar skin creases at the distal interphalangeal joint and insertions of long flexor and extensor tendons of a finger or thumb.
The fingertips are exposed to all aspects of daily living,
recreation and work and it is perhaps no surprise they
are the most commonly injured part of the hand
Bone physiology and calcium homeostasisAbdulla Kamal
Bone is a highly specialized supporting framework of the body, characterized by its rigidity, hardness, and power of regeneration and repair.
It protects the vital organs, provides an environment for marrow ,acts as a mineral reservoir for calcium homeostasis and a reservoir of growth factors and cytokines, and also takes part in acid–base balance.
Bone constantly undergoes modeling (reshaping) during life to help it adapt to changing biomechanical forces, as well as remodeling to remove old, micro-damaged bone and replace it with new, mechanically stronger bone to help preserve bone strength.
Peripheral nerve damage affecting the upper extremities can vary widely in cause and extent.
Many disorders, ranging from mild carpal tunnel syndrome to severe brachial plexopathy, need to be considered in a patient presenting with pain, sensory loss, or weakness involving the shoulder, arm, or hand.
28,000 ankle sprains occur daily in the US (Kaminski 2013)
Ankle is the 2nd most commonly injured body site. (Ferran 2006)
Ankle sprains are the most common type of ankle injury. (Ferran 2006)
A sprained ankle can happen to athletes and non-athletes,
children and adults.
Inversion injury most common mechanism (Ferran 2006)
Only risk factor is previous ankle sprain (Ferran 2006)
Sex , generalized joint laxity or anatomical foot types are
not risk factors. (Beynnon et al. 2002 )
The term ‘cerebral palsy’ includes a group of disorders that result from permanent non-progressive brain damage during early development and are characterized by abnormalities of movement and posture.
Also Known As…
Nargile
Argile (Lebanon, Syria)
Hubble Bubble (Saudi Arabia, United Arab
Emirates)
Shisha (Egypt, Morocco)
.............
History of the Hookah
- Originated in India, made from a coconut shell
- Arrived in Turkey about 500 years ago.
Became popular with intellectuals and upper class.
Grew in size and complexity, similar to hookahs
seen today.
- Gained popularity and quickly spread to Iran and
the rest of the Arab world
......................
Height below 3rd centile or less than 2
standard deviations below the median
height for that age & sex according to
the population standard.
Or
Even if the height is within the normal percentiles but growth velocity is consistently below 25th percentile over 6-12 months of observation
Arthrocentesis: A bedside procedure in which a sterile needle and syringe are used to drain fluid from the joint, and in some conditions, medication is injected into the joint after fluid removal.
AMPUTATION: Cutting of the extremity or part of the extremity through the bone
While ………..
DISARTICULATION: Cutting of the extremity or part of the extremity through the joint
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. NORMAL LIMB
ALIGNMENT AND JOINT
ORIENTATION
Prepared by: Supervised by:
Dr. Abdullah K. Ghafour Dr. Hamid Ahmed Jaff
3rd year IBFMS trainee
2. Introduction
The treatment of skeletal deformity is the
heart of our specialty. Indeed, the very
name of our specialty, ORTHOPAEDICS,
was coined by Nicholas Andry in 1741 as
a word derived from two Greek words,
orthos (meaning straight) and paedis
(meaning child) to indicate his goal "to
teach the different methods of preventing
and correcting deformities of children" .
(from Mercer Rang's Anthology of Orthopaedics,
1966)
3. Introduction
[ It is not hard to learn, but it does take some effort and
practice. The method is mercifully low-tech: the only
tools required are a pencil, ruler, and goniometer.]
DROR PALEY MD,FRCSC
4. Introduction
The exact anatomy of the bones and joints is of great
importance to the clinician when examining the limbs
and to the surgeon when operating on the bones and
joints.
To understand deformities of the extremities, it is
important to first understand and establish the
parameters and limits of normal alignment.
Each long bone has a mechanical and an anatomic axis
both frontal and sagittal planes axis lines are applicable
to any longitudinal projection of a bone.
The corresponding radiographic projections are the
anteroposterior (AP) and lateral (LAT) views,
respectively.
5. Mechanical axis
It is defined as the straight line connecting the joint
center points of the proximal and distal joints.
The mechanical axis is always a straight line, whether in
the frontal or sagittal plane.
6. Anatomic axis
The anatomic axis of a bone is the mid-diaphyseal line.
The anatomic axis line may be straight in the frontal
plane but curved in the sagittal plane, as in the femur.
7. Joint Center Points
It is the point of any joint which the mechanical axis
passes through in frontal plane.
For the hip, the joint center point is the center of the
circular femoral head.
Mose circles goniometer
8. Joint Center Points
the center of the knee joint is approximately the same
using these points:
The ankle joint center point is the same using these
points:
9. Joint Orientation Lines
line which represent the orientation of a joint in a
particular plane or projection.
At the ankle, the joint orientation line in the frontal plane
is drawn across the flat subchondral line of the tibial
plafond. In the sagittal plane the line is drawn across the
distal tips of both lips of the tibia.
frontal plane sagittal plane
10. Joint Orientation Lines
The frontal plane knee joint line of the proximal tibia is
drawn across the subchondral line of the two tibial
plateaus.
In the sagittal plane, the proximal joint line of the tibia is
drawn along the flat subchondral line of the plateaus
frontal plane sagittal plane
11. Joint Orientation Lines
The frontal plane knee joint orientation line of the distal
femur is drawn as a line tangential to the most distal
points on the convexity of the two femoral condyles
In the sagittal plane, the distal femoral joint orientation
line drawn as a straight line connecting the two points
where the femoral condyles meet the metaphysis of the
femur.
frontal plane sagittal plane
12. Joint Orientation Lines
A line from the proximal tip of the greater trochanter to
the center of the femoral head represents the hip joint
orientation line of the hip joint in the frontal plane.
Alternatively, the mid-diaphyseal line of the femoral
neck can represent the orientation of the hip joint.
hip joint orientation line
13. Joint Orientation Angles
The angle formed between the joint line and either the
mechanical or anatomic axis. each axis line and joint
orientation line intersection forms two angles. Either
angle could be named with this nomenclature.
The name of each angle specifies whether it is
measured relative to a mechanical (m) or an anatomic
(a) axis. The angle may be measured medial (M),lateral
(L), anterior (A), or posterior (P) to the axis line. The
angle may refer to the proximal (P) or distal (D) joint
orientation angle of a bone (femur [F] or tibia [T]).
14. Joint Orientation Angles
Therefore, the mechanical lateral distal femoral angle
(mLDFA) is the lateral angle formed between the
mechanical axis line of the femur and the knee joint line
of the femur in the frontal plane.
Similarly, the anatomic LDFA (aLDFA) is the lateral
angle formed between the anatomic axis of the femur
and the knee joint line of the femur in the frontal plane.
16. Joint Orientation Angles
The angle formed between joint
orientation lines on opposite sides
of the same joint is called the joint
line convergence angle (JLCA)
In the knee and ankle joints, these
lines are normally parallel.
17. Joint Orientation Angles
In the frontal plane, the
distance between the
intersection of the anatomic
axis line with the joint center
point is called the anatomic
axis to joint center distance
(aJCD)
the anatomic axis: joint
center ratio (aJCR) is the
ratio of the aJCD and the
total width of the joint.
18. Joint Orientation Angles
In the sagittal plane, the
distance between the point of
intersection of the anatomic
axis line with the joint line and
the anterior edge of the joint is
called the anatomic axis to
joint edge distance (aJED).
The anatomic axis: joint edge
ratio (aJER) is the ratio
between the aJED and the
total width of the joint.
19. Alignment and Orientation
In the frontal plane, the
line passing from the
center of the femoral head
to the center of the ankle
plafond is called the
mechanical axis of the
lower limb.
There are two
considerations when
evaluating the frontal
plane of the lower
extremity: joint alignment
and joint orientation.
20. Alignment and Orientation
Alignment refers to the
collinearity of the hip, knee,
and ankle
Orientation refers to the
position of each articular
surface relative to the axes of
the individual limb segments
(tibia and femur)
Alignment and orientation are
best judged using long
standing AP radiographs of the
entire lower extremity on a
21. malalignment occurs when
the center of the joint does
not lie close to mechanical
axis line.
The distance between the
mechanical axis line and the
center of the knee in the
frontal plane is the MAD.
The MAD is described as
either medial (varus) or
lateral (valgus) MADs.
Alignment and Orientation
22. Alignment and Orientation
Mechanical tibiofemoral angle
(1.3 ± 2° varus ) or anatomical
(tibiofemoral angle (6° ± 2°
valgus) also can be use for
evaluating knee joint
alignment
23. Alignment and Orientation
hip joint orientation can be evaluated by using the
neck shaft angle (MNSA)125°-131°. Or lateral
proximal femoral angle (LPFA) 89.9° ± 5.2°
frontal plane
24. In knee joint mechanical lateral distal femoral angle
(mLDFA = 87.8°±1.6° valgus) is used for evaluating
distal femoral knee joint orientation in the frontal plane.
To consider the proximal tibial joint orientation in the
frontal plane mechanical medical proximal tibial angle
(MPTA = 87.2°±1.5° varus)
Alignment and Orientation
frontal plane
25. In the sagittal plane (PDFA
= 83.1±3.6°) is used for
evaluating distal femoral
knee joint orientation. And
(PPTA = 80.4± 1.6°) for
evaluating proximal tibial
knee joint orientation
Alignment and Orientation
sagittal plane
26. Alignment and Orientation
The normal frontal plane joint line orientation of the
ankle is slight valgus using (LDTA = 88.6 ± 3.8°) and the
normal sagittal plane joint line orientation of the ankle
has anterior tilt of the distal tibia using ( ADTA = 79.8±
1.6°)
frontal plane sagittal plane