Foetal and postnatal equine articular cartilage development: magnetic resonance imaging and polarised light microscopy.

Adult articular cartilage (AC) has a well described multizonal collagen structure. Knowledge of foetal AC organisation and development may provide a prototype for cartilage repair strategies, and improve understanding of structural changes in developmental diseases such as osteochondrosis (OC). The objective of this study was to describe normal development of the spatial architecture of the collagen network of equine AC using 1.5 T magnetic resonance imaging (MRI) and polarised light microscopy (PLM), at sites employed for cartilage repair studies or susceptible to OC. T2-weighted fast-spin echo (FSE) sequences and PLM assessment were performed on distal femoral epiphyses of equine foetuses, foals and adults. Both MRI and PLM revealed an early progressive collagen network zonal organisation of the femoral epiphyses, beginning at 4 months of gestation. PLM revealed that the collagen network of equine foetal AC prior to birth was already organised into an evident anisotropic layered structure that included the appearance of a dense tangential zone in the superficial AC in the youngest specimens, with the progressive development of an underlying transitional zone. A third, increasingly birefringent, radial layer developed in the AC from 6 months of gestation. Four laminae were observed on the MR images in the last third of gestation. These included not only the AC but also the superficial growth plate of the epiphysis. These findings provide novel data on normal equine foetal cartilage collagen development, and may serve as a template for cartilage repair studies in this species or a model for developmental studies of OC.

Growth and development of the child's hip.

The child's hip begins in intrauterine development as a condensation of mesoderm in the lower limb bud that rapidly differentiates to resemble the adult hip by eight weeks of life. The developmental instructions are transmitted through complicated cell signaling pathways. From eight weeks of development to adolescence, further growth of the hip is focused on differentiation and the establishment of the adult arterial supply. The postnatal growth of the child's hip is a product of concurrent acetabular and proximal femoral growth from their corresponding growth plates. Absence of appropriate contact between acetabulum and proximal femur yields an incongruent joint. Multiple disease processes may be understood in light of this growth process, including Legg-Calvé-Perthes disease and developmental dysplasia of the hip.

Gluteus minimus muscle: Insertion to hip joint capsule in South Indian fetuses

The insertion of the gluteus minimus muscle to the superior aspect of the fibrous capsule of the hip joint, in addition to the anterolateral aspect of the greater trochanter has been reported in surgery, cadavers, and full term fetuses. The present study aimed to determine whether or not such an insertion was present in the South Indian fetuses. Seven young-to-full term fetuses were used. A firm attachment of the gluteus minimus muscle to the hip joint capsule was present in all the specimens. Sharp dissection was required to separate it from the capsule. Histological assessment of the junction of the muscle to capsule revealed that bundles of collagen linked the skeletal muscle to the capsule in all cases. Striated muscle fibres became densely collagenous at the site of attachment to the connective tissue of the capsule and the dense collagen fibres were arranged in a linear fashion. Functional role and clinical anatomy of the capsular attachment are presented (AU)

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Factores de riesgo en la etapa intrauterina que predisponen a la luxación congénita de cadera / Risk factor in intrauterine stage, that predispose to congenital dislocation of the hip

La luxación congénita de cadera es uno de las patologías más frecuentes en la etapa neonatal en la que se interactúan una serie de factores para su presentación algunos de estos factores pueden ser identificados desde el periodo prenatal e incluyen la presentación pélvica, el sexo y la cantidad de líquido amniótico, además la luxación puede ser parte de un complejo sindromático que presenta también una serie de alteraciones agregadas, el seleccionar a la población con un mayor riesgo puede conducir a una evaluación mas detallada al nacimiento e iniciar las maniobras terapéuticas para una corrección temprana

Anatomic study of the pre- and neonatal hip. Physiopathologic considerations on dysplasia and congenital dislocation of the hip.

Therapeutic success in dysplasia and congenital dislocation of the hip depends on an early diagnosis. The physiopathology remains very debatable and several concepts are propounded. For a better physiopathologic understanding, the authors have carried out a study of the morphology and development of 22 pre- and neonatal hips. At first, the acetabulum is cartilaginous and distorted by the moving femoral head; this acetabulum is histologically affected by the femoral pressure. The pathologic hip is characterized by defective posterior bony coverage of the femoral head by the acetabulum. The acetabulum ossifies during the 3 months following birth, forming a cup-like cavity under the pressure of the femoral head. Therefore, neonatal screening tests such as sonography must take place in the first weeks of life.

Retardo do aparecimento do núcleo secundário de ossificaçäo da epífise femoral proximal: relato de caso / Delayed apperance of the secondary center of ossificarion of the proximal femoral epiphysis: case report

É muito difícil se determinar as condiçöes de normalidade, em relaçäo ao desenvolvimento do quadril desde, seu molde embrionário até a sua completa formaçäo. Existe muita controvérsia na literatura quanto ao aparecimento do núcleo de ossificaçäo secundário da epífise femoral nos quadris normais, visto que este pode aparecer desde os primeiros dias de vida (Jacobs, 1966), até um ano e meio após o nascimento (Paterson, 1976). Os autores apresentam o relato de um paciente de um ano e nove meses de idade, que näo apresentava a ossificaçäo da epífise femoral proximal, tratando-se provalvemente de um retardo do aparecimento do núcleo primário. O que foi comprovado após um seguimento clínico, ultra-sonográfico e por ressonância magnética, após um seguimento de um ano e nove meses

[Ultrasound anatomy of the fetal hip joint with special reference to the blood supply]. / Sonoanatomie des fetalen Hüftgelenks unter besonderer Berücksichtigung der Blutversorgung.

AIM: Study of the anatomy of the fetal hip joint in 115 pregnancies between 13. to 40.th weeks of gestation by ultrasound. METHOD: Sonoanatomy was studied by high resolution ultrasound (Acuson 128). For investigation of vascular supply of the fetal hip, colour-coded Doppler sonography was performed. In-vivo studies on vascular supply were correlated with histological sections of 34 fetal hip specimens, according to the conceptional age of 13-35 weeks. RESULTS: Vascular studies of the proximal end of the human femur showed a supply by the lateral and medial femoral circumflex arteries branched from the femoral artery or the deep femoral artery. After 22 weeks of gestation the acetabular artery supplied by the obturator artery was visible by means of Doppler sonography. At the end of pregnancy, large numbers of intraosseous blood vessels are demonstrable within the femoral head and neck. CONCLUSION: The basic arterial pattern of the hip joint is established at birth. Proximal end of the growing femur, acetabulum, os ilium and labrum acetabulare are clearly visible by ultrasound.

A sonographic study of the morphology of the preterm neonatal hip.

Preterm and low-birth-weight infants are reported to have an increased risk of late presentation of congenital dislocation of the hip (CDH). A sequential sonographic study of hip morphology was made of 82 live preterm infants. Eighty-two matched, term controls were scanned for comparison. The morphology of the hips was similar at birth. The increase in missed CDH cannot be explained in simple morphological terms. Abnormal birth sonograms resolved rapidly in the absence of clinical instability, casting doubt on the role of static sonographic appearances to predict the need for treatment in the immediate newborn period.

Morphological variants in the human fetal hip joint. Their significance in congenital hip disease.

In a study of 280 hips in 140 normal fetuses, sixty-five of the ninety-two hips of forty-six fetuses between the ages of twelve weeks and term showed morphological variants, yet they were neither subluxated nor dislocated and showed no statistically significant morphological differences from normal joints. The vazriants observed included flattening (fourteen hips) or rounding-off of the rim of the labrum (nine hips), localized dips in the labrum (twenty hips), folding of the labrum (six hips), capsular folds (four hips), extension of the pulvinar pad between the joint surfaces (six hips), and kinking of the ligament of the head of the femur (seven hips). The localization of these variants in the anterosuperior quadrant of the acetabulum was highly significant (p < 0.001), but there was no significant relationship to sex or side of involvement. A significant relationship to age, on the other hand, was evident since the frequency of these minor morphological variations in the fetal hip joint appeared to increase with age. Considering all 140 fetuses, the ones with variant hips formed 55 per cent of all of those older than twenty-eight weeks and only 23 per cent of those younger than twenty-eight weeks (p = 0.007). I suggest that some of these variants are subclinical manifestations of congenital hip disease.

[Age and changes in the fascial compartment structures in the coxofemoral joint region]. / Vozrastnye izmeneniia fastsial'no-kletchatochnykh obrazovanii.

Investigations performed on 66 corpses beginning from 5-month-old embryos up to 75 years of age by methods of anatomical preparations (sections were studied after N. L. Pirogov) and on total histotopographical preparations revealed anteromedial, anterolateral and posteroinferior fascial nodes in the area of the coxofemoral joint. The anteromedial node is formed by the network that consists of connective tissue fibres of fascial cases covering the lumboinguinal and pectinate muscles and the common sheaths for the artery and vein. The anterolateral node is formed by the network that consists of the connective tissue fibres of the rectal muscle case, the sheaths of the lateral vessels circumflexing the femur and fasciae of the musculus sartorius and m. tensor fasciae femoris. The posteroinferior node is formed by the network that consists of the connective tissue fibres of the fascial cases of the m. obturatorius, internal and external, fascial sheaths of the internal pudendal vessels and the ischiadic nerve. The fascial nodes in question morphologically complete their formation by the end of the fetal period. In young and adolescent age their components have abundant fibroblastic cells, collagenous and elastic fibres are correctly oriented. By 20 years of development, the fascial nodes are dense and their supporting-protective role is clearly evident. After 55 years of age, the fascial nodes are subjected to involutional alterations characterized by decreasing number of cells, rough collagenous fibre fasciculi, transformed elastic fibres. All these signs demonstrate that their protective and supporting functions decrease at this age.