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At least 19 recordsLinked to original sources
PubMed1993

Painful conditions affecting the first metatarsal sesamoid bones.

The sesamoid bones of the first metatarsal exhibit a special anatomic configuration, enveloped by the tendons of the flexor hallucis brevis and lying within the capsule of the first metatarsophalangeal joint. Painful conditions of the hallux sesamoid bones are many and include congenital, traumatic, arthritic, infectious, and ischemic conditions. Because of the complex anatomy and the numerous pain-sensitive structures in the region of the first metatarsophalangeal joint, a differential diagnosis can be challenging. The imaging examination should always begin with conventional radiography, including special axial and lateromedial views of the sesamoid bones. In cases in which results of routine radiography are inconclusive, scintigraphy, conventional or computed tomography, xeroradiography, or magnetic resonance imaging can be used. A thorough understanding of the anatomy; pathophysiology; and clinical, laboratory, and imaging findings is often helpful in the establishment of a diagnosis and management plan for painful conditions of the hallux sesamoid bones.

Adult↗
PubMed1996

[The pisiform bone: sesamoid or carpal bone?].

In man, the pisiform bone occupies an unusual place among the carpal bones. It is situated in an anterior plane to the other bones, sheathed within the tendon of the flexor carpi ulnaris, and ossifying almost four years the last of the carpal bones. Many theories have tried to explain the presence of this "exceptional" bone: the first theory, proposed by Flower and Mivart, suggested the possibility that this bone could be a sesamoid. The second theory supposes a polydactyl hand, assuming that polydactyly preceded pentadactyly; the pisiform would then be a post-minimus vestigial bone according to Bardeleben. Finally, Gegenbauer and Gillies, proposed a primary pentadactyl hand in which the carpus would be composed of three proximal elements, generally two central, and five distal. The pisiform would either be a derivative of the central series, or a distinct element in the carpus. This last theory appears to be the most likely. The primary carpus would therefore have consisted of 12 bones arranged in 3 distinct rows, a proximal row of 3 bones, a central row of 4 bones, and a distal row of 5 bones. According to this theory, the most ulnar of the central would have been displaced to the medial limit of the carpus, to become the pisiform.

Animals↗
PubMed1991

Lag screw and cancellous bone graft fixation of transverse proximal sesamoid bone fractures in horses: 25 cases (1983-1989).

Case records of 25 horses with transverse fractures of the proximal sesamoid bone were reviewed to evaluate the success of treatment. All fractures were repaired by use of lag screw fixation and an autogenous cancellous bone graft because the fracture fragments were considered too large for surgical removal and reconstruction of the suspensory apparatus was necessary. Radiography was performed in all cases, and the fractures were classified into 3 types: (1) proximal midbody fractures, which included all fractures in the proximal aspect of the sesamoid bone that resulted in fragments involving greater than one third but less than one half of the total mass of the sesamoid bone; (2) midbody fractures that divided the bone into 2 equal portions; and (3) distal midbody fractures, which included transverse fractures in the distal aspect of the sesamoid bone that resulted in fragments involving greater than one third but less than one half of the total mass of the sesamoid bone. Of these cases, race records were obtained for 9 Standardbreds and 5 Thoroughbreds. Postoperative performance criteria evaluated were the ability to train and start 1 race, ability to maintain preinjury class of racing, earnings per start, and the number of starts following surgery. In Thoroughbreds, fractures occurred most commonly in the right forelimb; in Standardbreds, the left hind limb was most commonly involved. The midbody fracture was the most common type in both breeds, and the distribution of fracture location within the sesamoid bone was similar for both breeds.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

[An anatomical study of the interphalangeal sesamoid bone of the hallux].

The existence of sesamoid bone on the interphalangeal joint of the hallux has not been sufficiently recognized. The frequency of this sesamoid bone has been described to be low probability in the orthopaedic and anatomical literature. We have, however, experienced some cases of the interphalangeal joint dislocation giving difficulty to usual manipulative reduction because of the presence of the sesamoid bone. In order to ascertain the existence of sesamoid bone on the interphalangeal joint of the hallux, anatomical and radiographic study have been performed with 144 feet of 73 adult cadavers, 32 feet of 16 fetal cadavers and 958 patients. The following results were obtained: The sesamoid bone was seen in 90.9% by radiographical examination and in 95.9% by macroscopic observation for 144 feet on 73 adult cadavers. Cartilagenous sesamoid bone was found in 93.8%, 32 feet of 16 fetal cadavers using stereoscopic microscope. In the radiographical examination of 958 feet of the patients, the sesamoid bones were approved in 56.3%, but it increased to 93.0% using 1/4 sensitivity intensifying screen. The sesamoid bone of the interphalangeal joint on adult cadavers was located at the central portion in parallel with interphalangeal joint space and buried in the fibrocartilagines plantares. This sesamoid bone had two cartilagenous joint surfaces against the base of distal phalanx and the head of proximal phalanx. The sesamoid bone had the shape of longitudinal ellipse and the length, width and thickness were measured. The size of sesamoid bone on the male cadaver were larger than that of the female on the three parameters and there were no special difference between the right and the left sides.

Adolescent↗
PubMed1994

[Pathology of the sesamoid bones of the hand].

Sesamoid bones are osseous parts of certain joints and can either be included in pathological changes of these joints or separately in those of the sesamoidal joint itself. The clinical relevance of such findings is described in the following examples: Rheumatoid variants, psoriasis, different types of hyperostotic forms, chronic sesamoiditis as well as post-trauma. In three out of four cases of fracture, the ulnar sesamoid bone of the metacarpophalangeal joint of the thumb was affected.

Arthritis, Rheumatoid↗
PubMed1998

[The proximal sesamoid bone of the horse; vascular and neurologic characteristics].

Sesamoiditis is characterized clinically by repeated lameness and radiologically by changes in the proximal sesamoid bones. This thesis, which was defended in June 1997, investigated two characteristics of sesamoiditis, namely the arterial blood supply and the innervation of the proximal sesamoid bones, in order to gain more insight into the etiopathogenesis of sesamoiditis. Experiments with patient material showed that the proximal sesamoid bones have an enormous arterial reserve, due in part to the formation of an arterial shift. Moreover, the sesamoid bones have their own sensory innervation, provided by a branch of the medial and lateral palmar nerve. This branch is called the sesamoid nerve in this article. A special technique was developed to anaesthetize this nerve and can be used for further differentiation of pastern lameness. That the sesamoid bones are sensitive to pain was demonstrated by detection of the so-called nociceptive neuropeptides, substance P and calcitonin gene-related peptide, which are specifically involved in pain sensation. However, the adjacent ligament appear to be even more sensitive. The etiopathogenesis of sesamoiditis is discussed, as are a number of clinical implications of pain in the sesamoid bones. A number of potential future developments are mentioned.

Animals↗
PubMed1984

The sesamoid bones of the hand and their pathology.

Three cases of sesamoid bone pathology are presented, including two cases of sesamoid fracture and a case of sesamoid periostitis. The literature is reviewed. Sesamoid bones probably function in the body as pulleys. Most people have five sesamoid bones in each hand. Two at the thumb metacarpophalangeal joint, one at the interphalangeal joint of the thumb, one at the metacarpophalangeal joint of the index finger on the radial side, and one at the metacarpophalangeal joint of the little finger on the ulnar side. Sesamoid bones have been seen with periostitis in Reiter's syndrome. The medial sesamoid bone of the thumb metacarpophalangeal is frequently enlarged in acromegaly. The sesamoid bones of the thumb have been fractured or trapped inside the joint during injury to the thumb metacarpophalangeal joint. The treatment of disabling pain in a sesamoid bone is enucleation of the bone.

Adult↗
PubMed1994

Nerve supply of the proximal sesamoid bone in the horse.

In chronical proximal sesamoid bone lameness it is difficult to localise the exact site of pain. A specific diagnostic analgesia is not available because of a deficiency of detailed information about the nerve supply to the proximal sesamoid bones and surrounding area. A macroscopic study of the nerve distribution to the proximal sesamoid bones of 10 foals and 5 adult horses revealed that these bones are innervated by two branches, in this study called the medial and lateral sesamoidean nerve, respectively, originating from the medial and lateral palmar nerve. Histology of the left forelimbs of two fetuses and one foal confirmed the macroscopic findings. Additionally, histology of ten proximal sesamoid bones of adult horses showed that myelinated nerve fibres are present in the nutrient foramina and in the trabecular bone, accompanying the larger arteries. This study provides possibilities for future diagnostics of proximal sesamoid bone lameness by specific local perineural analgesia.

Animals↗
PubMed1999

Influence of exercise on bone mineral density of immature cortical and trabecular bone of the equine metacarpus and proximal sesamoid bone.

Bone mineral density (BMD) and cross-sectional area (CSA), measured using peripheral quantitative computed tomography, were determined in the left third metacarpal bone (MCIII) and left medial proximal sesamoid bone (psb) in 3 differently exercised groups of foals. Group(box) (n = 14) was confined to a box stall from birth to age 5 months, Group(training) (n = 14) was kept in similar box stalls but additionally given a daily exercise programme consisting of an increasing number of gallop sprints and Group(pasture) (n = 15) remained at pasture. At 5 months of age, 8 foals from each group were randomly selected and subjected to euthanasia, the remaining 19 foals were given an identical light exercise regimen for an additional 6 months and were killed at age 11 months. In MCIII CSA increased with age and was also significantly (P<0.05) larger in Group(pasture) compared to Group(box) at age 5 months. At 11 months this difference had disappeared. In the dorsal cortex, BMD was significantly (P<0.05) higher in Group(box) than in both other groups. At age 11 months all significant differences had disappeared. In the psb, CSA increased with age, but there were no differences between the exercise groups. At the apical level, trabecular BMD was higher in Group(training) than in Group(box) and Group(pasture) (P<0.001 and P<0.01, respectively). At 11 months, trabecular BMD in the foals that had belonged to Group(training) was less than in the foals that had belonged to Group(box) (P<0.05). It is concluded that box-rest during the first months of life results in a retardation of normal development which is compensated for when the restriction on exercise is lifted. Exercise during the first months of life induces an increase in CSA in the third metacarpal bone. In the psb exercise increases BMD, principally in trabecular bone. There is an indication that the specific training regimen used in this study led to an overstimulation of the bone resulting in less active mineral deposition in the longer term.

Animals↗
PubMed2003

In vitro action of combinations of selected antimicrobial agents and adult bovine articular cartilage (sesamoid bone).

Anatomically intact articular cartilage in form of sesamoid bones from metacarpophalangeal joints of 2-year-old cows was tested for its influence on the microbicidal effect of the iodophore Betaisodona, the bispyridinamine Octenisept, and the biguanide Lavasept. Comparisons were carried out in Ham's F12 medium with and without 0.2% bovine serum albumin as organic matter loading. The expected abolition of the microbicidal effect of these antiseptics against the test organisms Escherichia coli or Staphylococcus aureus in the presence of sesamoid bone was not evident. Furthermore, sesamoid bone alone demonstrated antibacterial activity against Staphylococcus aureus, which may involve adherence of bacteria to surface constituents of articular cartilage. Final concentrations of 2.5-5% Betaisodona, 5% Octenisept as well as 0.025% Lavasept are effective in killing of 10(8)-10(9) cfu/ml Escherichia coli or Staphylococcus aureus in the presence of sesamoid bone without the reduction of antimicrobial activity expected from binding to CS, which has previously been demonstrated for CS in solution.

Animals↗
PubMed1981

Fracture of the medial sesamoid bone of the hallux.

Fracture of the sesamoid bones of the hallux is rare. A case of fracture of the medial sesamoid bone is presented. The X-ray finding of an irregular line dividing the medial sesamoid bone together with typical local symptoms and signs established the diagnosis in a 17-year-old female athlete. Nonunion of the fractured sesamoid was successfully treated by extraction of the sesamoid fragments. Complete relief of pain was followed by the patients' return to full athletic activity. The diagnostic criteria and indications for operation are discussed briefly.

Adolescent↗
PubMed1993

[Biomechanical investigation of the sesamoid bones of the hallux].

Extensive research has been done on disorders of the sesamoid bone of the hallux. However, reports on the mechanism of the disorder are few and a comprehensive assessment of the biomechanical role played by the sesamoid bone has not been done. In an effort to elucidate the role of the sesamoid bone, we have developed a force sensor which utilizes the capacitance method, and evaluated the biomechanical aspects of fatigue fracture associated with it. Three frozen stored human limbs were thawed at room temperature. The force between the sesamoid bone and the first metatarsal head was measured using force sensors which were placed on the bilateral sesamoid bones. Measurements were also taken at varying loads and angles of dorsiflexion of the MTP (metatarsophalangeal) joint of the hallux from 0 degrees to 60 degrees at increments of 10 degrees. This was done by applying weights ranging from 0 to 4 kg to the first metatarsal head at increments of 1 kg. Load and angle of dorsiflexion of the MTP joint were found to be correlated with the degree of compression force between the hallux sesamoid bone and the first metatarsal head; the load applied affected the force to a greater extent than did the angle. Dorsiflexion of the MTP joint of the hallux had no effect on the amount of compression force between the medial and lateral sesamoid bones, but the increase in compression force became pronounced when the angle of dorsiflexion exceeded 30 degrees.

Biomechanical Phenomena↗
PubMed1991

Osteomyelitis of the axial border of the proximal sesamoid bones in seven horses.

Destructive lesions of the axial region of the proximal sesamoid bones were identified by radiography in eight fetlocks and seven lame adult horses. Lameness ranged from 2 to 5 (mean 4; scale 1 to 5) at the time of examination, with a duration of 10 days to two years (mean 5.6 months). Destructive lesions involved both proximal sesamoid bones when examined radiographically and were situated primarily at the level of the mid-body and apical region of the axial borders. Some lesions were cystic, whereas others eroded the axial border more diffusely. Scintigraphy revealed markedly increased activity within the proximal sesamoid bones of the clinically lame limb of four of the five horses examined. In four horses, post mortem computed tomography revealed axial border bone destruction and cavitary lesions within cancellous bone of affected proximal sesamoid bones. Lesions seen by computed tomography were larger than those identified on radiographic examination. Cavitary lesions not seen radiographically were identified in the proximal sesamoid bones of two clinically unaffected fetlocks examined for comparison in two of the seven horses. Evidence of acute, subacute or chronic/reparative osteomyelitis of the axial region of the proximal sesamoid bones was seen in the 10 fetlocks identified as abnormal from radiography or computed tomography. Also, three horses had septic synovitis of the flexor sheath of the clinically affected limb; of these, two had septic arthritis of the fetlock joint.

Animals↗
PubMed2001

Radiographic appearance of sesamoid bones in the hands and feet of Malawian subjects.

Our aim was to determine the prevalence of sesamoid bones in adult black Malawians from radiographs of the hands and feet. A total of 255 radiographs from 85 men and 45 women aged 16-66 years were used: 126 of the hands and 129 of the feet. All the hand films revealed one sesamoid bone at the interphalangeal joint and two at the metacarpophalangeal joint of the thumb. All the foot films showed two sesamoid bones at the metatarsophalangeal joint of the big toe. Occasional sesamoid bones were found at the metacarpophalangeal and metatarsophalangeal joints of the index finger and the small toe, respectively. Only 4.8% of the hands had sesamoid bones at the metacarpophalangeal joint of the index finger, compared with reported percentages of between 35% and 64.2% in Caucasians. The present study also records, probably for the first time in Africans, an incidence of 10.8% of sesamoid bones occurring at the metatarsophalangeal joint of the small toe, which again is at variance with the reported range of 5.5-10% in Caucasians. This study provides anatomical data that will help in the diagnosis and management of disorders of sesamoid bones which are often overlooked in Africans.

Adolescent↗
PubMed1995

Clinical relevance of the microvasculature of the equine proximal sesamoid bone.

The blood supply to the proximal sesamoid bone of the equine forelimb was examined in 18 cadaver limbs from adult horses, using x-ray computed tomography and a tissue-clearing (Spalteholz) technique. Results of the study indicated that the proximal sesamoid bones were supplied by multiple branches of the medial and lateral palmar digital arteries, which entered the proximal half of the bones on their non-articular, abaxial surface. After entering the bone, the vessels traverse dorsally, axially, and distally, arborizing into several smaller branches that appear to supply the entire bone. The major branches of these vessels reside in bony canals, the orientation and distribution of which parallel the radiographic lucencies seen in horses with sesamoiditis and correspond to the configuration of apical fracture patterns.

Animals↗
PubMed1997

Ossification of the sesamoid bone at the base of the first finger in Czech boys and girls.

Ossification of the sesamoid bone of the first finger was studied in left hand-and-wrist X-rays of 296 Czech boys and 272 girls 9 to 15 years old using data collected between 1962 and 1966. The logit and the YES or NO methods were used in treating the data. A sesamoid bone, clearly visible to the naked eye, was considered as positive and when it was not yet visible, as negative. The sesamoid bone was developed in 50 per cent of boys at the age of 13.6 years and in 50 per cent of girls at the age of 11.2 years. This stage preceded the age at onset of menarche in Czech girls by 1.9 years. Boys showed a greater variability (SD = 1.4) than girls (SD = 0.8). Both sexes with clearly visible (ossified) sesamoid bones in their first fingers showed to be, on the average, taller and heavier in comparison with the Czech standard and with those boys and girls of corresponding ages without the sesamoid bone. In contrast to the still continuing secular trend in stature in Czech youths, the age of menarche remained in the last cca 30 years unchanged. In view of the close link between bone age and onset of menarche which remained unchanged for the past 30 years, we may consider our finding as still applicable to present-day adolescents.

Adolescent↗
PubMed2003

Correlation of racing performance with radiographic changes in the proximal sesamoid bones of 487 Thoroughbred yearlings.

REASONS FOR PERFORMING STUDY: Proximal sesamoiditis has been a common and confusing radiographic diagnosis in Thoroughbred yearling surveys. This study categorised the radiographic appearance of yearling proximal sesamoid bones and determined their effect on the number of races started and earning potential for racing at ages 2 and 3 years. HYPOTHESIS: Yearlings with moderate to severe proximal sesamoiditis have decreased performance at age 2 and 3 years. METHODS: Survey radiographs of 487 Thoroughbred yearlings were reviewed. Proximal sesamoid bones were examined and findings placed into 7 categories, 5 of which measured size, shape, and number of vascular canals, and 2 examined the radiographic shape of the sesamoid abaxial surface. Records of horses age 2 and 3 years were reviewed to obtain the number of races completed and money won in those races. RESULTS: Vascular canals with parallel sides < 2 mm in width in any number were normal. Yearlings with 1 or 2 abnormally conformed vascular canals (nonparallel sides and > 2 mm in width) had a decrease in number of race starts at age 2 years when compared to normal horses. This same change in the fore- or hindlimbs was associated with decreases in starts and earnings at age 2 years. If uniformly present in both fore- and hindlimbs there was no difference from normal horses. Yearlings with > 2 irregular vascular canals had a decrease in number of race starts and earnings at age 2 and 3 years. Changes in proximal sesamoid bone contour did not affect performance. CONCLUSIONS: Horses with enlarged vascular canals, within their sesamoids as yearlings, start fewer races and earn less prize money than horses with normal vascular canals. POTENTIAL RELEVANCE: One or two enlarged canals affected horses as 2-year-olds. Three or more enlarged vascular canals affected horses at ages 2 and 3 years, which should be taken into account when examining radiographs for potential purchase of young horses.

Age Factors↗