Аксессуальная кость
или Вспомогательная кость нештатная кость - это кость , которая обычно не присутствует в организме, но может быть найдена как вариант у значительного числа людей. Это представляет риск быть неправильной диагностикой в качестве переломов костей на рентгенографии . [ 2 ]
Запястье и рука
[ редактировать ]
| Аксессуальная кость | Распространенность справа (r) и левой (L) [ 5 ] |
|---|---|
| OS Ulnostyloideum | 1,5% r, 2,4% л |
| Централ | 1,3% r, 2,1% л |
| ОС ТРАПЕЗИЙ Вторичный | 0,5% r, 2,1% л |
| OS Styloideum | 1,2% r, 1,2% л |
| ОС радиальная внешняя | 1% r, 0,9% л |
| ОС ТРИУНГУЛИЧЕСКИЙ | 1% r, 0,9% л |
| Костный паратрапезий | 0,3% r, 0,9% л |
| ОС переоборудован | 0,8% r, 0,3% л |
| Os Hypotriquetrum | 0.5% R |
| Os hypolunatum | 0.3% L |
| Os epilunatum | 0.3% R, 0.3% L |
| Os ulnare externum | 0.3% L |
| Os pisiforme secundarium | 0.3% R |
| Os epitrapezium | 0.3% L |
| Os vesalianum manus | 0.3% L |
Os ulnostyloideum
[edit]The os ulnostyloideum is an ulnar styloid process that is not fused to the rest of the ulna bone.[6] On X-rays, an os ulnostyloideum is sometimes mistaken for an avulsion fracture of the styloid process. However, the distinction between these is extremely difficult.[6][7] It is alleged that the os ulnostyloideum has a close relationship with or is synonymous with the os triquetrum secundarium.[8]
Os centrale
[edit]The os carpi centrale (also briefly os centrale) is, where present, located on the dorsal side of the wrist between the scaphoid, the trapezoid and capitate, radially to the deep fossa of the capitate. The bone is present in almost every human embryo of 17–49 mm length, but then usually fuses with the ulnar side of the scaphoid. Sometimes it fuses with the capitate or the trapezoid. The literature also refers to an os centrale at the palm of the carpus, but this existence is questioned.[6]
In most primates, including orangutans and gibbons, the os centrale is an independent bone that is attached to the scaphoid by strong ligaments. Conversely, in African apes and humans, the os centrale normally fuses to the scaphoid early in development.[9] In chimpanzees, the bone fuses with the scaphoid first after birth, while in gibbons and orangutans this occurs first at older age.[10] A good number of scholars have construed the scaphoid-centrale fusion as a functional adaptation to knuckle-walking,[11] since a fused morphology would better cope with the increased shear stress on this joint during this kind of quadrupedal locomotion. The results from a simulation study have shown that fused scaphoid-centrales show lower stress values as compared to non fused morphologies, thus supporting a biomechanical explanation for the scaphoid-centrale fusion as a functional adaptation for knuckle-walking.[12]
Ankle
[edit]
Accessory bones at the ankle mainly include:
- Os subtibiale, with a prevalence of approximately 1%.[14] It is a secondary ossification center of the distal tibia that appears during the first year of life, and which in most people fuses with the shaft at approximately 15 years in females and approximately 17 years in males.[14]
- Os subfibulare, with a prevalence of approximately 0.2%.[15]
Os trigonum (further described below) may also be seen on an ankle X-ray.
Foot
[edit]
| Bone | Prevalence[17] |
|---|---|
| Sesamoid bones | |
| Sesamoids at the metatarsophalangeal (MTP) joint of the great toe | Always present |
| Sesamoid of the second metatarsal | 0.4% |
| Sesamoid of the third metatarsal | 0.2% |
| Sesamoid of the fourth metatarsal | 0.1% |
| Sesamoids of the fifth metatarsal | 4.3% |
| Sesamoid of the interphalangeal (IP) joint of the great toe | 2–13% |
| Ossicles | |
| Os trigonum (not visible in this dorsoplantar projection) | 7–25% |
| Os peroneum | Up to 26% |
| Accessory navicular | 2–21% |
| Os intermetatarseum | 1–13% |
| Os supranaviculare, also called the talonavicular bone | 1.0–3.5% |
| Os calcaneus secundarium | 0.6–7% |
| Os supratalare | 0.2–2.4% |
| Os vesalianum | 0.1–1% |
| Os talotibiale | 0.5% |
Accessory navicular
[edit]
An accessory navicular bone, also called os tibiale externum, occasionally develops in front of the ankle towards the inside of the foot. This bone may be present in approximately 2–21% of the general population and is usually asymptomatic.[18][19][20] When it is symptomatic, surgery may be necessary.
The Geist classification divides the accessory navicular bones into three types.[20]
- Type 1: An os tibiale externum is a 2–3 mm sesamoid bone in the distal posterior tibialis tendon. Usually asymptomatic.
- Type 2: Triangular or heart-shaped ossicle measuring up to 12 mm, which represents a secondary ossification center connected to the navicular tuberosity by a 1–2 mm layer of fibrocartilage or hyaline cartilage. Portions of the posterior tibialis tendon sometimes insert onto the accessory ossicle, which can cause dysfunction, and therefore, symptoms.
- Type 3: A cornuate navicular bone represents an enlarged navicular tuberosity, which may represent a fused Type 2 accessory bone. Occasionally symptomatic due to bunion formation.
Os trigonum
[edit]The os trigonum or accessory talus represents a failure of fusion of the lateral tubercle of the posterior process of the talus bone. Is estimated to be present in 7–25% of adults.[17] It can be mistaken for an avulsion fracture of lateral tubercle of talus (Shepherd fracture) or a fracture of the Stieda process. In most cases, Os Trigonum will go unnoticed, but with some ankle injuries it can get trapped between the heel and ankle bones which irritates the surrounding structures, leading to Os Trigonum Syndrome.[21]
Less common accessory bones
[edit]
Other locations
[edit]
Neck
[edit]- Nodules in the posterior margin of the nuchal ligament form bone tissue in approximately 11% of males and 3–5% in females after the third decade of life, and may then be regarded to be sesamoid bones.[22]
Shoulder
[edit]
- An os acromiale forms when any of its four ossification centers fail to fuse. These four ossification centers are called (from tip to base) pre-acromion, meso-acromion, meta-acromion, and basi-acromion. In most cases, the first three fuse at 15–18 years, whereas the base part fuses to the scapular spine at 12 years. Such failure to fuse occurs in between 1% and 15% of cases.[23][24] It rarely causes pain.
Vertebral column
[edit]- An Oppenheimer ossicle is found in approximately 4% (range 1–7%) of individuals.[25] It is associated with the facet joints of lumbar spines. It usually occurs as a single, unilateral ossicle at the inferior articular processes, but can also occur at the superior articular processes.[25]
Knee
[edit]See also
[edit]References
[edit]- ^ Jump up to: a b Luijkx, Tim; Knipe, Henry. "Fabella". Radiopaedia. Retrieved 2015-09-18.
- ^ T.E. Keats, M.W. Anderson, Atlas of normal roentgen variants that may simulate disease. 7th edition, Mosby Inc. 2001, ISBN 0323013228
- ^ Reference list for image is located at Commons:Template:Accessory bones of the wrist – references.
- ^
- Location and structure: Erica Chu, Donald Resnick. "MRI Web Clinic — June 2014: Sesamoid Bones: Normal and Abnormal". Retrieved 2017-11-04.
- Prevalences: Chen W; Cheng J; Sun R; Zhang Z; Zhu Y; Ipaktchi K; et al. (2015). "Prevalence and variation of sesamoid bones in the hand: a multi-center radiographic study". Int J Clin Exp Med. 8 (7): 11721–6. PMC 4565393. PMID 26380010. - ^ "Poster Abstracts" (PDF). Association for Sports Medicine of Serbia (Udruženje za medicinu sporta Srbije). 2006. Retrieved 2017-11-03., citing: Natsis K.; Beletsiotis A.; Terzidis I.; Gigis P. "A study of the accessory bones of the foot. Incidence in the Greek population-clinical significance" (PDF).
- ^ Jump up to: a b c R. O'Rahilly. A survey of carpal and tarsal anomalies. J Bone Joint Surg Am. 1953; 35: 626–642
- ^ T.E. Keats, M.W. Anderson. Atlas of normal roentgen variants that may simulate disease. 7th edition, Mosby Inc. 2001 ISBN 0323013228
- ^ A. Köhler. Röntgenology. Пограничные земли нормального и раннего патологического в Skiagram. Перевод Артура Тернбулла. Редакция 2. Baillière, Tindall & Cox, Londen, 1935
- ^ Шульц, Адольф Х. (1936-12-01). «Персонажи, общие для более высоких приматов и персонажей, специфичных для человека (продолжение)». Ежеквартальный обзор биологии . 11 (4): 425–455. doi : 10.1086/394517 . ISSN 0033-5770 .
- ^ Ах Шульц. Персонажи, общие для более высоких приматов и персонажей, специфичных для человека. Кварт Rev Biol. 1936; 11: 259–283; 425–455
- ^ Ричмонд, Брайан Дж.; Начал, Дэвид Р.; Пролив, Дэвид С. (2001). «Происхождение человеческого двуногих: гипотеза о том, что гипотеза с сутью» . Американский журнал физической антропологии . 116 (S33): 70–105. doi : 10.1002/ajpa.10019 . ISSN 0002-9483 . PMID 11786992 .
- ^ Пюшель, Томас А.; Марсе-Ногуэ, Джорди; Чемберлен, Эндрю Т.; Йоксалл, Аластер; Продавцы, Уильям И. (2020-02-26). «Биомеханическая важность слияния скафоид-центры во время моделируемого кустарника и его последствий для эволюции в движении человека» . Научные отчеты . 10 (1): 3526. DOI : 10.1038/S41598-020-60590-6 . ISSN 2045-2322 . PMC 7044280 . PMID 32103129 .
- ^ Список ссылок для форм и местоположений для включенных костей находится по адресу: Commons: Шаблон: Кости аксессуаров лодыжки - ссылки .
- ^ Подпрыгнуть до: а беременный Фрэнк Гайярд; Мохаммад Таги Никнеджад; и ал. "Тонко " Рентгенопедия Получено 2017-11-0
- ^ Шампанское, я; Кук, DL; Кестнер, Южная Каролина; Понтиссо, JA; Сизел, К.Дж. (1999). «ОС субфибулар. Исследование вспомогательной кости». Журнал Американской поддиатрической медицинской ассоциации . 89 (10): 520–524. doi : 10.7547/87507315-89-10-520 . ISSN 8750-7315 . PMID 10546424 .
- ^ Подпрыгнуть до: а беременный Список ссылок для форм, местоположений и распространенности для включенных костей находится в Commons: шаблон: аксессуары и кости сесамоида ноги - ссылки .
- ^ Подпрыгнуть до: а беременный Нвавка, О. Кенечи; Хаяси, Даичи; Диас, Луис Э.; Goud, Ajay R.; Arndt, William F.; Roemer, Frank W.; Малгурия, Нагина; Гумази, Али (2013). «Сезамоиды и вспомогательные осексы стопы: анатомическая изменчивость и связанная с ним патология» . Понимание визуализации . 4 (5): 581–593. doi : 10.1007/s13244-013-0277-1 . ISSN 1869-4101 . PMC 3781258 . PMID 24006205 .
- ^ «Аксессуарный морец» . Учебник из ортопедии .
- ^ «Презентации по телерадиологии Macrorad Telerology - симптоматическая аксессуальная кость нависсятеля» .
- ^ Подпрыгнуть до: а беременный Miller TT, Staron RB, Feldman F, Parisien M, Glucksman WJ, Gandolfo LH (июнь 1995 г.). «Симптоматическая аксессуальная кость лапулера: оценка с помощью МР -визуализации». Радиология . 195 (3): 849–853. doi : 10.1148/рентгенология.195.3.7754020 . PMID 7754020 .
- ^ Уилсон, Хлоя (3 ноября 2021 г.). «Синдром OS Trigonum: причины, симптомы и лечение» . Боль в ногах исследуется .
- ^ Scapinelli R (1963). «Сесамоидные кости в связках Nuchae of Man» . J anat . 97 : 417–22. PMC 1244202 . PMID 14047360 .
- ^ Уорнер, Джон Дж.П.; Бейм, Глория М.; Хиггинс, Лоуренс (сентябрь 1998 г.). «Лечение симптоматического акромиала». Журнал хирургии костей и суставов . 80 (9): 1320–6. doi : 10.2106/00004623-199809000-00011 . PMID 9759817 .
- ^ Саммарко, VJ (март 2000 г.). «ОС Acromiale: частота, анатомия и клинические последствия». J Bone Count Surg Am . 82 (3): 394–400. doi : 10.2106/00004623-200003000-00010 . PMID 10724231 .
- ^ Подпрыгнуть до: а беременный Доктор Генри Книп; и др. «Оппенгеймер Осикул» . Рентгенопедия . Получено 2017-11-05 .