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Obturator externus

Daniel Tawfik, Wendy L Hobson
A six-year-old previously healthy girl was seen in an outpatient pediatric clinic in the western United States for thigh pain. The pain was accompanied by an initial fever and was most severe after periods of prolonged rest. During the evaluation, her exam rapidly progressed with severe episodic pain and tenderness of the right anteromedial thigh. Magnetic resonance imaging (MRI) demonstrated signal enhancement at the insertion of the right obturator externus muscle. Blood culture was positive for Group A Streptococcus...
February 8, 2018: Curēus
A Serner, A Weir, J L Tol, K Thorborg, F Roemer, A Guermazi, E Yamashiro, P Hölmich
Acute adductor injuries account for the majority of acute groin injuries; however, little is known about specific injury characteristics, which could be important for the understanding of etiology and management of these injuries. The study aim was to describe acute adductor injuries in athletes using magnetic resonance imaging (MRI). Male athletes with acute groin pain and an MRI confirmed acute adductor muscle injury were prospectively included. MRI was performed within 7 days of injury using a standardized protocol and a reliable assessment approach...
February 2018: Scandinavian Journal of Medicine & Science in Sports
Takayuki Yoshida, Tatsuo Nakamoto, Takahiko Kamibayashi
This review outlines the anatomy of the obturator nerve and the indications for obturator nerve block (ONB). Ultrasound-guided ONB techniques and unresolved issues regarding these procedures are also discussed. An ONB is performed to prevent thigh adductor jerk during transurethral resection of bladder tumor, provide analgesia for knee surgery, treat hip pain, and improve persistent hip adductor spasticity. Various ultrasound-guided ONB techniques can be used and can be classified according to whether the approach is distal or proximal...
2017: BioMed Research International
Charlotte de Bodman, Dimitri Ceroni, Justine Dufour, Pierre-Alex Crisinel, Aline Bregou-Bourgeois, Pierre-Yves Zambelli
RATIONALE: Obturator pyomyositis is a rare condition in children. Diagnosis is often delayed because of its rarity, and the vagaries of its presentation cause it to be easily be missed. Physicians should therefore familiarize themselves with this condition and consider it as a possible differential diagnosis in patients presenting with an acutely painful hip. Inflammatory syndrome is also frequent among sufferers and the MRI is a very sensitive diagnostic tool for obturator pyomyositis...
March 2017: Medicine (Baltimore)
Richard J Hanly, Sabrina Sokolowski, Andrew John Timperley
INTRODUCTION: The Sparing Piriformis and Internus, Repair Externus (SPAIRE) technique allows a muscle sparing mini-posterior approach to the hip. METHOD: We present in this article a description of an adaptation of the familiar posterior approach (PA) in which the only tendon released is obturator externus. Termed SPAIRE, this muscle sparing technique enables preservation of the piriformis tendon and conjoint insertion of obturator internus and the gemelli. The technical description allows for safe and reliable replication by any surgeon familiar with the posterior approach (PA) to the hip without reliance on additional equipment, and without compromising the ability to convert into a more extensile approach...
March 31, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Manuel Wong-On, Antonio Turmo-Garuz, Rafael Arriaza, Jose Manuel Gonzalez de Suso, Luis Til-Perez, Xavier Yanguas-Leite, David Diaz-Cueli, Xavier Gasol-Santa
PURPOSE: Obturator externus and internus muscular tears are uncommon injuries. Only a few case reports exist, mainly in high-level athletes. Our aim is to describe a series of obturator externus and internus muscular tears in professional soccer players. METHODS: Injury data from four teams from the First Division of the Spanish Soccer League were collected over a total of four seasons. Any soccer player who sustained an injury to either the obturator externus or internus identified on magnetic resonance (MRI) was included...
February 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Priyanka Gupta, Michael Ehlert, Larry T Sirls, Kenneth Peters
INTRODUCTION: Women with pelvic floor dysfunction can have tender areas on vaginal examination, which can be treated with trigger-point injections. There are no publications to evaluate the accuracy of pelvic floor muscle injections. METHODS: Trigger-point injections were performed on 2 fresh cadaveric pelvises using a curved nasal cannula guide and 7-in spinal needle. This was performed using our standard template of 2 sets of injections at the 1-, 3-, and 5-o'clock positions distally and proximally...
January 2017: Female Pelvic Medicine & Reconstructive Surgery
Lalit Maini, Santosh Kumar, Sahil Batra, Rajat Gupta, Sumit Arora
Avascular necrosis (AVN) of femoral head is a recognised complication of fracture dislocation of the hip joint but is not studied frequently in relation to acetabulum fractures. The aim was to establish the relationship between obturator externus and piriformis muscle morphology in acetabulum fractures and potenital development of AVN of the femoral head. Twenty-five fractures were included in this prospective study and were subjected to radiological assessment and computed tomography of the pelvis. Magnetic resonance imaging (MRI) of the hip was performed to assess the morphology of obturator externus and piriformis, and findings were compared intraoperatively (in 15 cases)...
August 2016: Strategies in Trauma and Limb Reconstruction
Taner Arpaci, Ilgen Sasmaz, Tugana Akbas, Alper Eken, Anil Ozgur, Bulent Antmen
Following joint hemorrhages, intramuscular hemorrhages are the second most prevalent bleeding pattern in hemophiliac patients. Hematomas of the iliopsoas muscle are a well-known complication of hemophilia; however, obturator muscle hematomas are rare. We herein report a case of spontaneous bleeding of the bilateral external obturator muscles, which occured three times within a period of 9 months in a hemophilia patient with factor VIII inhibitors. To the best of our knowledge, this is the first published case of an obturator externus muscle hematoma in hemophilia...
April 2016: Molecular and Clinical Oncology
Peter K Sculco, Lionel E Lazaro, Edwin P Su, Craig E Klinger, Jonathan P Dyke, David L Helfet, Dean G Lorich
BACKGROUND: Surgical hip dislocation allows circumferential access to the femoral head and acetabulum and is utilized in the treatment of intra-articular hip disorders. Surgical hip dislocation is currently performed with a trochanteric osteotomy that reliably preserves the femoral head arterial supply; however, trochanteric nonunion or painful hardware requiring removal may occur. In a cadaveric model, using gadolinium-enhanced magnetic resonance imaging (MRI) and gross dissection, we evaluated whether modifications to the posterior approach preserve the femoral head arterial supply after a posterior surgical hip dislocation...
March 16, 2016: Journal of Bone and Joint Surgery. American Volume
T Yoshida, T Onishi, K Furutani, H Baba
We evaluated an alternative technique for ultrasound-guided proximal level obturator nerve block that might facilitate needle visualisation using in-plane ultrasound guidance. Twenty patients undergoing transurethral bladder tumour resection requiring an obturator nerve block were enrolled into a prospective observational study. With the patient in the lithotomy position, the transducer was placed on the medial thigh along the extended line of the inguinal crease, and aimed cephalad to view a thick fascia between the pectineus and obturator externus muscles that contains the obturator nerve...
March 2016: Anaesthesia
Marc J Philippon, Max P Michalski, Kevin J Campbell, Mary T Goldsmith, Brian M Devitt, Coen A Wijdicks, Robert F LaPrade
BACKGROUND: Hip endoscopy facilitates the treatment of extra-articular disorders of the proximal femur. Unfortunately, current knowledge of proximal femur anatomy is limited to qualitative descriptions and lacks surgically relevant landmarks. PURPOSE: To provide a quantitative and qualitative analysis of proximal femur anatomy in reference to surgically relevant bony landmarks. STUDY DESIGN: Descriptive laboratory study. METHODS: Fourteen cadaveric hemipelvises were dissected...
June 2014: Orthopaedic Journal of Sports Medicine
Morteza Khodaee, Daniel Jones, Jack Spittler
INTRODUCTION: Buttock pain is a relatively common complaint among adolescent athletes and can have a very broad differential diagnosis. CASE PRESENTATION: The authors present a previously unreported case of acute obturator internus and obturator externus strain in an adolescent male American football player. The diagnosis was made by MRI. The patient was treated with relative rest, physical therapy, and gradual return to physical activities as tolerated. CONCLUSIONS: Despite rarity of the hip external rotator muscles strains, it should be considered in the differential diagnosis of athletes with proximal posterior thigh and buttock pain...
September 2015: Asian Journal of Sports Medicine
Ravindra Gudena, Abdullah Alzahrani, Pamela Railton, James Powell, Reinhold Ganz
There is limited knowledge regarding the anatomic relationships and functional anatomy of the Obturator Externus muscle (OE). It is described as a muscle which originates from the external bony margin of the obturator foramen with a cylindrical tendon which passes like a sling under the femoral neck and inserts in the trochanteric fossa. The primary aim of this study is to describe the OE morphology and its anatomic relationship to the acetabulum. A secondary aim is to postulate its action. Eighteen fresh human cadaveric hips were dissected to investigate the anatomy of the OE...
September 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Kjartan Vaarbakken, Harald Steen, Gunnar Samuelsen, Hans A Dahl, Trygve B Leergaard, Britt Stuge
BACKGROUND: The small muscles of the pelvis and hip are often implicated in painful conditions. Although the quadratus femoris and obturator externus are usually described as external rotators of the hip, little is known about how they change their lengths and moment arms during human movement. Therefore, more precise measurements defining the positions and directions for their maximal strength and stretch are needed to better describe their functions and guide the clinical approach to pain...
March 2015: Clinical Biomechanics
Soo-Jung Choi, Kevin M Koch, Brian A Hargreaves, Kathryn J Stevens, Garry E Gold
OBJECTIVE: The objective of our study was to compare the multiacquisition variable-resonance image combination selective (MAVRIC SL) sequence with the 2D fast spin-echo (FSE) sequence for metal artifact reduction on 3-T MRI in patients with hip arthroplasty (HA). MATERIALS AND METHODS: Matched 2D FSE and MAVRIC SL images of 21 hips (19 patients with HA) were included in the study group. Paired image sets, composed of 13 coronal and 12 axial slices (total, 25 image sets), of the 21 hips were evaluated...
January 2015: AJR. American Journal of Roentgenology
Yoshiro Kiyoshige, Emi Watanabe
The cause of falls is multifactorial, however, hip fractures in elderly would be prevented if accidental falls are predictable. We assessed magnetic resonance images of 38 patients with groin pain after taking a fall whose fracture could not be detected by plain X-rays, and 45 patients with no episode of falls. Their ages were over 65 years. Fatty degeneration of muscles, gluteus maximus, gluteus medius, gluteus minimus, obturator externus, adductor longus, rectus femoris and iliopsoas muscles, were evaluated by Goutallier's staging...
January 2015: Archives of Gerontology and Geriatrics
Xl Chong, M Ashik, M Arjandas
UNLABELLED: Obturator internus pyomyositis is a rare disease that is more commonly found in tropical countries. Due to its infrequent occurrence, it is a differential of hip pain that has not been sufficiently considered, which often results in delayed diagnosis. We present a case report of a 4 year old boy with pyomyositis of obturator internus as well as externus. He was treated successfully with intravenous antibiotics. A comparison is made with other case reviews to identify symptoms and signs that could help in diagnosing the condition early and accurately so as to initiate intravenous antibiotics, the mainstay treatment in a timely fashion, eventually avoiding surgical drainage of the sequelae when it becomes an abscess...
March 2014: Malaysian Orthopaedic Journal
Timothy Slade, Robert Hawkes, Guy Atherton, Nicholas Sargant
Pyomyositis of the obturator externus muscle is a rare cause of limp and hip pain in children. The exact etiology of the condition remains poorly understood, although a mechanism of transient bacteremia in association with increased muscle susceptibility has been proposed. This case describes the course of a rather than 1 child from presentation to diagnosis and demonstrates the requirement for magnetic resonance imaging in establishing a diagnosis.
September 2014: Pediatric Emergency Care
Brian L Walters, John H Cooper, José A Rodriguez
PURPOSE: The purpose of this investigation was to provide a detailed description of the anatomy of the hip capsule and pericapsular structures. METHODS: Dissections were performed on 11 nonpaired, fresh-frozen cadaveric hips by 2 independent observers: 1 fellowship-trained orthopaedic total joint surgeon and 1 chief orthopaedic surgery resident. Documentation of capsular thickness, origins, insertions, and attachments to pericapsular structures including the abductors, rectus femoris, piriformis, short external rotators, and iliocapsularis muscles was performed...
October 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
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