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Par SPINNEUR - Publié dans : HANCHE . HIP .
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Samedi 9 septembre 2006 6 09 /09 /Sep /2006 10:33

The LOMBARD' s  Paradox


When you stand up from a sitting position, both the hamstrings and quadriceps contract at the same time.

But they are antagonistic, which means that they should not contract at the same time.

The Rectus Femoris biarticular muscle acting over the hip, when compared to the Hamstrings has a smaller hip moment arm.

 But, the rectus femoris moment arm is greater over the knee, than the Hamstrings knee moment.

This means that contraction from both Rectus femoris and Hamstrings will result in hip extension, and knee extension.

 Also, Hip extension will add a passive strech component to Rectus Femoris, and will also result in a knee extension force.

 This paraox allows for efficient movement especially during gait.

Source: [1]
.****************

MR parameters divulge depth of acute hamstring injuries
7/13/2007
By: Shalmali Pal

In an article last year, Australian radiologists asserted that MRI was unnecessary for estimating the duration of rehabilitation of an acute hamstring injury in professional athletes. In a subsequent commentary, Dr. Alison Sponge of the University of Western Ontario in London, Canada, praised the group results as "refreshing," because it championed the "increasingly lost art of a high-quality clinical examination ... in an era (dominated) by advanced imaging technology" (American Journal of Sports Medicine, June 2006, Vol. 34:6, pp. 1008-1015; Clinical Journal of Sports Medicine, January 2007, Vol. 17:1, pp. 81-82).

While the clinical exam is certainly the cornerstone of injury assessment, two newer studies affirm the major role MR plays in defining hamstring injuries. First, Australian and British researchers evaluated whether MR features of a strain can assist in risk stratification for reinjury. Then, Swedish sports medicine specialists looked at hamstring strains during slow-speed stretching. While MR results didn't hold all the answers, the imaging exam was still worth performing, according to the experts.

Caution: ACL reconstruction zone

Dr. George Koulouris and colleagues enrolled 41 Australian rules footballers who had sustained hamstring injuries (10 had recurrent injuries during the study period). Symptoms included the onset of posterior thigh pain or stiffness and the inability to train or play.

Koulouris is from Victoria House Hospital in Melbourne, Australia. His co-authors are from institutions in London and Victoria, Australia. MRI of hamstring injuries has been an ongoing focus for the group.

For this research, imaging was done on a 1.5-tesla unit (Sigma LX, GE Healthcare, Chalfont St. Giles, U.K.) using a phased-array surface coil on the thigh and centered on the region of maximal tenderness. Those who sustained a reinjury were imaged twice. Sequences included axial and coronal oblique fast spin-echo (FSE) imaging, as well as axial and coronal oblique FSE inversion-recovery imaging. Two musculoskeletal radiologists read the images and came to a consensus on the injured area (longitudinal length and cross-section).

"An acute injury was considered to be present if abnormal increased signal intensity on the fluid-sensitive sequences was detected," they explained. "Changes in injury parameters between the first and second injury were analyzed using the Wilcoxon signed-rank test" (American Journal of Sports Medicine, April 17, 2007).

According to the results, 24 of 31 (74.2%) players with a first-time injury reported a history of hamstring strain. On the other hand, 100% of the 10 players with repeat injuries were positive for a history of strain. In addition, those who had previously undergone an anterior cruciate ligament (ACL) reconstruction (40%) had an association with reinjury within the same competition season, the authors reported. The hamstring strain occurred on the same side as the ACL surgery and may be related to hamstring tendon autograft, they hypothesized.

Those players with reinjuries had a mean injury length of 98.7 mm, compared to the 83.8 mm sustained by first-timers. Nine of the 10 players with repeat injuries also demonstrated muscle damage extending over 60 mm. This finding led the authors to suggest that "injuries > 60 mm in length should be managed with caution because such injuries appear to have a higher likelihood of restraining."

Dancers: So you think you can stretch

While football players may be more likely to sustain hamstrings injuries during high-speed running, slow stretching -- with the joint in an extreme position -- can also do damage, according to Swedish sports medicine specialists.

Physical therapist Carl Askling and colleagues enrolled 15 professional modern and classical dancers in their study, conducted at the Swedish School of Sport and Health Sciences, Karolinksa Institute, and Sophiahemmet Hospital, all in Stockholm. Radiologist Dr. Magnus Tengvar is a co-author.

The subjects confirmed a history of first-time, acute sudden pain from the posterior thigh. In addition, all 15 dancers reported that they sustained their injuries during a slow-speed stretching exercise -- 11 were in a sagittal split and four were in a side split.

All participants had clinical exams on four occasions, ranging from two days to 42 days after injury. MR studies were done at the same time for a total of four exams, on 1-tesla unit (Magnetom Expert, Siemens Medical Solutions, Erlangen, Germany). MR sequences included longitudinal, sagittal, and frontal STIR imaging, transverse T1-weighted, T2-weighted, and STIR imaging on both legs.

"A muscle was considered injured when it contained high signal intensity, as compared with the uninjured side, and a tendon was deemed injured if it was thickened and/or had a collar of high signal intensity around it on the STIR images," they wrote. The two independent readers also assessed the size of the injury based on length, width, and depth (American Journal of Sports Medicine, June 13, 2007).

According to the MR results, the semimembranosus muscle was injured in 87% of the cases, as was the quadratus femoris muscle (also 87%). Eleven of the 13 semimembranosus muscle injuries showed a collar of high signal intensity around the thickened tendon, the authors reported. After six weeks, MRI signs of injury still remained for 10 of these dancers.

Eleven of 13 quadratus femoris injuries showed intrafascial and extrafascial edema. After six weeks, MR injury signs remained for six subjects. In addition, one out of five adductor magnus injuries persisted over the long term. Finally, changes in length, width, and depth of sustained injuries ranged from 7% to 52% over six weeks.

"Even though the current injury is referred to as a 'hamstring strain,' it clearly involved more than just hamstring muscles," Askling's group wrote, noting in particular the injuries to the quadratus femoris, given that the anatomy is different than the semimembranosus muscle. One possible explanation for quadratus femoris injuries could be that the extreme hip movement and adduction at the end of a split, they hypothesized.

Recovery time from a slow-stretch hamstring injury could not be predicted based on the MRI parameters of length, width, and depth, the authors concluded. Also, because the effects of the injuries on the dancers were small, they ran the risk of returning to activity prematurely. But this type of strain can be serious and require attention, they stated. In this setting, MR can be used to confirm the specific muscle that is involved, with results playing a role in what is bound to be a prolonged rehabilitation.

By Shalmali Pal
AuntMinnie.com staff writer
July 13, 2007

Related Reading

From tears to TKA: The ins and outs of knee MRI, September 5, 2006

Focused exams suitable for some musculoskeletal US studies, March 26, 2006

Par SPINNEUR - Publié dans : HANCHE . HIP .
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Vendredi 8 septembre 2006 5 08 /09 /Sep /2006 19:45

 

http://encyclopedia.thefreedictionary.com/HAMSTRING

 

 

 

 

 

 

Hamstring originally refers to the common tendon of the muscles making up the ham in animals. In man, it refers to the muscles of the back of the thigh, primarily the semitendinosus and biceps femoris. The function of these muscles is to straighted the hip and bend the knee.

The hamstrings include:
  • semitendinosus - attaches proximally to the ischial tuberosity of the pelvis, and distally to the medial tibial condyle.
  • semimembranosus - also attaches proximally to the ischial tuberosity and distally to the medial tibial condyle.
  • biceps femoris - It has a long and a short head, and only the long head is considered a hamstring. It attaches proximally to the ischial tuberosity and distally to the lateral side of the head of the fibula. The short head, while not actually a 'hamstring', has the same action as theses muscles. Its proximal attachment is to the linea aspera near the head of the femur, and it attaches distally via a common tendon with the long head, to the lateral tibial condyle.
These four muscles of the posterior thigh that flex (bend) the knee and extend (straighten) the hip, three of which comprise the hamstrings, are weaker than the quadratus femoris muscle of the anterior thigh, which performs the opposite actions.

Innervation

Semitendinosus, semimembranosus and long head of biceps femoris - tibial division of sciatic nerve (L5, S1, S2)

Short head of biceps femoris - common fibular division of sciatic nerve (L5, S1, S2)

Functions

The hamstrings cross and act upon two joints - the hip and the knee. Semitendinosus and semimembranosus extend the hip when the trunk is fixed or extend the trunk when the hip is fixed; they also flex the knee and medially (inwardly) rotate the lower leg when the knee is bent. Biceps femoris extends the hip as when beginning to walk; it also flexes the knee and laterally (outwardly) rotates the lower leg when the knee is bent. The hamstring plays a crucial role in many daily activities, such as, walking, running, jumping, and controlling some movement in the trunk. In walking, it is most important when contracting eccentrically (controlled lengthening of a muscle) to decelerate the forward swing of the leg.

Injuries

The first of which is the strain, which is also known as a pulled hamstring. Straining of the hamstring is defined as an excessive stretch of muscle fibers and related tissues. Hamstring strain are classified as either first, second, or third degree, depending on how severe the strain is.
  • A first degree is excessive or minor tearing of a few muscle fibers. There will be weakness and stiffness that occur, with some pain.
  • The second degree strain of the hamstring is when there is moderate tearing of muscle fibers. The pain is more intense than that of a first degree strain. There is discoloration due to the bleeding underneath the skin (bruising).
  • Third degree is the final stage and most intense, of hamstring strains. It includes a complete tear of the hamstring muscles. The tear can be felt with an individual’s hand. There is discoloration and intense pain. Third degree strains are a rare occurrence.
Hamstring strains occur in many different ways, but most often when the muscles are weakened. A hamstring strain most likely occurs during some athletic activity or some sort of exercise. If there is strain on the hamstring and the individual continues athletic activity or exercise on it, the hamstring continues to strain further and further. An example of this is when a basketball player will not sit out of a game to allow a hamstring strain to heal properly because he is afraid his team will miss him. By doing this he is more likely to injure it worse.

Treating a hamstring strain can differ depending upon the severity of the injury. For a first degree strain, ice and resting it with some elevation is the best way to treat it. For a second degree strain, ice, rest, and elevation are also necessary. However, a second degree strain will take around two to three weeks to heal. A third degree strain should be treated the same as first and second degree strains but may take longer to heal, around three to six weeks. Crutches may be necessary for a third degree strain. Waiting until completely healed before athletics or exercise is the best way to insure that an injury will not recur.

Another injury to the hamstring is the high hamstring tendinopathy. This condition consists of pain in the thigh or buttock. This injury is commonly seen in middle and long distance runners. The pain experienced with high hamstring tendinopathy is experienced when accelerating.

Although there are many ways a hamstring can be injured, it can be summed up by two words, strain or tear.

Not only does the hamstring help humans by running and flexing their knees, it helps in many other ways. One of those ways in which the hamstring helps is, arthroscopic surgery. With the new technology that is available in today’s society the hamstring is one of the most widely used assets in surgery. There is one major surgery that is becoming more popular that involves using the hamstring although it does not have to be injured to get use from it, in fact it has to be healthy. This surgery is called ACL reconstruction. The anterior cruciate ligament (ACL) is a ligament in the knee that helps hold the knee in place. During this procedure, doctors will take a sliver of the hamstring and put in the place of a torn ACL. The success rate of this surgery is very high because the hamstring is such a strong muscle and can have many different uses. When a hamstring is used to replace an ACL, it takes a few weeks to recover from the surgery. After the few weeks are up, it takes many months of physical therapy to insure that the hamstring is at full strength. This is done so that the hamstring can heal properly.

There are many ways that the hamstring can be strengthened. The main way is to exercise the hamstring. This can be done by running or lifting weights.

Hamstringing

Hamstringing is the hampering or crippling of any effort, eg. a person may be hamstrung in his studies by not being too bright. The origin of this concept of hamstringing is probably the crippling of an animal by cutting the hamstring tendon, thereby making it incapable of using its rear legs, even for standing up, thus making it easier to kill.

References

External links

A tendon (or sinew) is a tough band of fibrous connective tissue that connects muscle to bone. They are similar to ligaments except that ligaments join one bone to another.
..... Click the link for more information.
Muscle (from Latin musculus "little mouse", referring to muscles like the biceps which pop up as though a mouse were scurrying about under the skin [1] )
..... Click the link for more information.
tibia is the larger of the two bones in the leg below the knee in humans and other vertebrates.

In humans

The tibia or shin bone
..... Click the link for more information.
tibia is the larger of the two bones in the leg below the knee in humans and other vertebrates.

In humans

.
tibia is the larger of the two bones in the leg below the knee in humans and other vertebrates.

 

The tibia or shin bone
..... Click the link for more information.
Surgery (from the Greek cheirourgia meaning "hand work") is the medical specialty that treats diseases or injuries by operative manual and instrumental treatment.
..... Click the link for more information.


This article is copied from an article on Wikipedia.org - the free encyclopedia created and edited by online user community. The text was not checked or edited by anyone on our staff. Although the vast majority of the wikipedia encyclopedia articles provide accurate and timely information please do not assume the accuracy of any particular article. This article is distributed under the terms of GNU Free Documentation License.


? Mentioned in   ? References in classic literature
 
"Not a step further," said the man, who appeared to be the captain, "or I will hamstring your horses.
It is sometimes the custom when fast to a whale more than commonly powerful and alert, to seek to hamstring him, as it were, by sundering or maiming his gigantic tail-tendon.
Shall we cry shame on the brutality of those who hamstring cattle: and spare the lights of Freedom upon earth who notch the ears of men and women, cut pleasant posies in the shrinking flesh, learn to write with pens of red-hot iron on the human face, rack their poetic fancies for liveries of mutilation which their slaves shall wear for life and carry to the grave, breaking living limbs as did the soldiery who mocked and slew the Saviour of the world, and set defenceless creatures up for targets
 
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LOMBARD' s PARADOX 

 When you stand up from a sitting position, both the hamstrings and quadriceps contract at the same time. But they are antagonistic, which means that they should not contract at the same time.

The Rectus Femoris biarticular muscle acting over the hip, when compared to the Hamstrings has a smaller hip moment arm. But, the rectus femoris moment arm is greater over the knee, than the Hamstrings knee moment. This means that contraction from both Rectus femoris and Hamstrings will result in hip extension, and knee extension. Also, Hip extension will add a passive strech component to Rectus Femoris, and will also result in a knee extension force. This paraox allows for efficient movement especially during gait.

Source: [1]


This article is copied from an article on Wikipedia.org - the free encyclopedia created and edited by online user community. The text was not checked or edited by anyone on our staff. Although the vast majority of the wikipedia encyclopedia articles provide accurate and timely information please do not assume the accuracy of any particular article. This article is distributed under the terms of GNU Free Documentation License.

 

 

http://encyclopedia.thefreedictionary.com/HAMSTRING

Par SPINNEUR - Publié dans : HANCHE . HIP .
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Samedi 19 août 2006 6 19 /08 /Août /2006 20:36

 

 IRM  DERMATOMYOSITE  POLYMYOSITE

 

 Polymyosite/Dermatomyosite :

 

 <<  

  <  

      

  >  

  >>  

http://www.images.cri-net.com/display_img.asp?rubrique=dermato&img_nbr=14

 

  14/25     

 

 

T1
 

Commentaire :

IRM musculaire de cuisse,

T1 avec injection de Gadolinium objectivant de nombreuses plages inflammatoires au cours d'une polymyosite.

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[img05.jpg]

 

 

T2  
 

Commentaire :

IRM musculaire de cuisse,

T2 avec suppression de graisse

(fat-sat T2) : nombreuses plages inflammatoires au cours d'une polymyosite.

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[img07.jpg]

 

 

 

Par SPINNEUR - Publié dans : HANCHE . HIP .
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Mercredi 5 juillet 2006 3 05 /07 /Juil /2006 11:43

 

AGGRESSIVE GRANULOMATOSIS

 

PROSTHETIC HIP
FEMORAL
PROSTHESE
GRANULOMATOUS PSEUDOTUMOR  

CT


 

http://education.auntminnie.com/QMachine.ASP?UID=18T0QFHC&PageId=1&Sess=9876825

 

 

 

 

.

Par SPINNEUR - Publié dans : HANCHE . HIP .
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Mardi 4 juillet 2006 2 04 /07 /Juil /2006 19:52
Par SPINNEUR - Publié dans : HANCHE . HIP .
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Dimanche 2 juillet 2006 7 02 /07 /Juil /2006 21:08
Par SPINNEUR - Publié dans : HANCHE . HIP .
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Dimanche 2 juillet 2006 7 02 /07 /Juil /2006 11:21

 

LEGG-PERTHES-CALVE  IRM 

très bon mémoire

IRM OSTEOCHONDRITE de HANCHE http://irmresonance.over-blog.com/


 

http://www.utc.fr/~farges/dess_tbh/02-03/Projets/osteo/osteochondrite.html

 

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Par SPINNEUR - Publié dans : HANCHE . HIP .
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Vendredi 16 juin 2006 5 16 /06 /Juin /2006 13:46
Par SPINNEUR - Publié dans : HANCHE . HIP .
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Vendredi 16 juin 2006 5 16 /06 /Juin /2006 13:36

ONA

 


.

 

 

 ONA  Osteonecrose aseptique Hanche  

 


 

 

 

 

http://oswald.peruta.free.fr/irm-hanche/osteonecrose.htm

 

 

 

 

 

 

 

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Par SPINNEUR - Publié dans : HANCHE . HIP .
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