Towards defining muscular regions of interest from axial magnetic resonance imaging with anatomical cross-reference: a scoping review of lateral hip musculature.

BACKGROUND: Measures of hip muscle morphology and composition (e.g., muscle size and fatty infiltration) are possible with magnetic resonance imaging (MRI). Standardised protocols or guidelines do not exist for evaluation of hip muscle characteristics, hindering reliable and valid inter-study analysis. This scoping review aimed to collate and synthesise MRI methods for measuring lateral hip muscle size and fatty infiltration to inform the future development of standardised protocols. METHODS: Five electronic databases (Medline, CINAHL, Embase, SportsDISCUS and AMED) were searched. Healthy or musculoskeletal pain populations that used MRI to assess lateral hip muscle size and fatty infiltration were included. Lateral hip muscles of interest included tensor fascia late (TFL), gluteus maximus, gluteus medius, and gluteus minimus. Data on MRI parameters, axial slice location, muscle size and fatty infiltrate measures were collected and analysed. Cross referencing for anatomical locations were made between MRI axial slice and E-12 anatomical plastinate sections. RESULTS: From 2684 identified publications, 78 studies contributed data on volume (n = 31), cross sectional area (CSA) (n = 24), and fatty infiltration (n = 40). Heterogeneity was observed for MRI parameters and anatomical boundaries scrutinizing hip muscle size and fatty infiltration. Seven single level axial slices were identified that provided consistent CSA measurement, including three for both gluteus maximus and TFL, and four for both gluteus medius and minimus. For assessment of fatty infiltration, six axial slice locations were identified including two for TFL, and four for each of the gluteal muscles. CONCLUSIONS: Several consistent anatomical levels were identified for single axial MR slice to facilitate muscle size and fatty infiltration muscle measures at the hip, providing the basis for reliable and accurate data synthesis and improvements in the validity of future between studies analyses. This work establishes the platform for standardised methods for the MRI assessment of lateral hip musculature and will aid in the examination of musculoskeletal conditions around the hip joint. Further studies into whole muscle measures are required to further optimise methodological parameters for hip muscle assessment.

Historical perspective-Anatomy down the ages in Australasia; lessons for the future.

Is anatomy a dying discipline? This article explores the history and current state of human anatomy in Australasia, and considers the changing nature of the discipline, and possibilities for the future. A web-based search of all tertiary institutions in Australasia was performed to identify which taught anatomy. Those identified were invited to provide further information about postgraduate student numbers, external courses and public outreach. Forty-one institutions across Australasia teach anatomy. There are seven identifiable anatomy departments and nine disciplines of anatomy. From 1900 to 2014, the number of medical schools has increased (from 4 to 20), however a concomitant increase in the number of anatomy departments (2014, n = 7) was not observed. Twenty-one institutions, without medical schools, currently teach anatomy but none have a stand-alone anatomy department. Anatomy is taught in more than 18 different undergraduate and postgraduate programs. From the 28 institutions that provided current data, 310 postgraduate research students were identified. Predominantly, they came from longer-established institutions with an identifiable anatomy department. Similarly, those with anatomy departments/disciplines offered external professional courses. Many institutions engaged in public outreach. The evidence suggests that anatomy is alive and possibly even growing in Australasia. However, the structures around the discipline and the students who are learning anatomy are changing. Our challenge is to prepare the next generation of anatomy faculty to be both researchers and teachers.