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To describe a rare case of bilateral mirror feet with varus deformity and review of literature. AP and oblique radiographs of both feet were taken. On radiographs, right foot showed eight toes and seven metatarsals while left foot showed eight toes and seven metatarsals, the three extra toes were present preaxially (on hallux side) in both feet, showing characteristics of postaxial toes termed as “mirror foot”. Varus deformity was noted at the subtalar joint, otherwise tarsal bones appeared normal. No any syndromatic association was present. Mirror foot is a very rare congenital anomaly, we put forward this case for its rarity and unusual late presentation at the age of 22.

Introduction Tarsal malformation is a skeletal malformation of unknown aetiology associated with a variety of morphologic changes to the tarsal and metatarsal bones of the dog. Objective The aim of this study was to determine if early diagnosis and prevalence of tarsal malformation could be obtained at approximately 8 to 9 weeks of age in multiple litters of Bernese Mountain dogs. Methods A prospective study of 51 Bernese Mountain dog puppies were evaluated from 12 litters in northern Italy. Dorsoplantar radiographic views of the tarsus were obtained at 60 ± 5 days of age. Tarsal malformation was defined as an abnormal extension of the central tarsal bone on its medial side, or the presence of ectopic bone located medially to the central tarsal bone, talus and second metatarsal bones (proximomedial, distomedial and metatarsal ossification sites respectively). Results All puppies were found to be clinically normal. Thirty-nine of the 51 puppies showed ossification sites medial to the tarsus as defined. A metatarsal ossification was present in all dogs with either a proximo- or distomedial ossification site. No central tarsal bone extensions were observed. The remainder of the tarsometatarsal joints were normal. Clinical Significance Tarsal malformation can be identified in the 8- to 9-week-old Bernese Mountain dog. The clinical significance of tarsal malformation remains to be determined, either as an incidental finding or a precursor to the development of other clinically relevant and related issues in the tarsus.

Little is known as to whether different operating voltages of X-ray fluorescence (XRF) can affect the accuracy rate for species identification. Here, we have addressed this question by comparing the rate of correct species identification using the elemental composition of either the carpal or tarsal bone obtained from a determination of the different energy values of XRF at 15 and 50 kV using energy-dispersive XRF (ED-XRF). Carpal bones were taken from 16 species and tarsal bones from 11 of these species. The data on the elemental profiles were analyzed by stepwise discriminant analysis for species discrimination. The classification results indicated that 94.1% and 63.7% of the originally grouped cases were correctly classified as carpal bones using 15 kV and 50 kV, respectively. Additionally, 69.4% and 77.3% of the originally grouped cases were correctly classified as tarsal bones using 15 kV and 50 kV, respectively. When the datasets of the elemental profiles obtained using two operating voltages were gathered, the classification results of the prediction rate appeared to be more accurate at 89.7% and 90.7% in the carpal and tarsal bones, respectively. In conclusion, our findings suggest that the elemental profiles of bones obtained using two operating voltages could effectively facilitate accurate species discrimination.

Both calcaneal and central tarsal bone fractures are commonly encountered in the racing greyhound. While isolated fractures of the numbered tarsal bones are uncommon, malleolar fractures are encountered frequently in small animal practice. Fractures of the central tarsal bone or calcaneal fractures in both dogs and cats may be either fatigue or stress fractures, or associated with Knees and Teeth Syndrome, which may alter the typically expected presentation and prompt assessment for additional fractures, both in the tarsus and elsewhere. Surgical stabilisation is often the treatment of choice, particularly for fractures with an articular component. In many cases, surgical stabilisation leads to a positive outcome, with Greyhounds often being able to return to racing. However, it is important to be aware that fractures in non-racing dogs tend to be more complex and that this good prognosis may not be appropriate to extrapolate. Depending on the nature and severity of injuries, joint preservation may not always be a realistic goal. If the joint cannot be preserved, arthrodesis may become necessary.

While fractures of the tarsal bones may not be common in non-racing dog and cat populations, an awareness of these injuries and the gold-standard treatment thereof remains important. Failure to diagnose these fractures and pursue appropriate treatment can have devastating consequences for long-term limb use; racing dogs may fail to return to racing and potentially be condemned to euthanasia while non-racing dogs may go on to suffer debilitating osteoarthritis. For many tarsal fractures, surgical stabilisation is indicated and in order to plan this, an accurate diagnosis must be made. While various radiographic views may assist in achieving this diagnosis, computed tomography is more sensitive for detection and classification of tarsal fractures. Fractures of the talus are generally classified as articular fractures of the body or non-articular fractures of the head or neck. Treatment of talar fractures depends on the site of the fracture and degree of comminution, with intra-articular and certain extra-articular fractures necessitating anatomical reconstruction with a lag screw or multiple K-wires. The prognosis is variable depending on fracture type and accuracy of reduction, but following articular fracture management, most patients will suffer from clinically relevant osteoarthritis later in life.

Miocene deposits of South America have yielded several species-rich assemblages of caviomorph rodents. They are mostly situated at high and mid- latitudes of the continent, except for the exceptional Honda Group of La Venta, Colombia, the faunal composition of which allowed to describe the late middle Miocene Laventan South American Land Mammal Age (SALMA). In this paper, we describe a new caviomorph assemblage from TAR-31 locality, recently discovered near Tarapoto in Peruvian Amazonia (San Martín Department). Based on mammalian biostratigraphy, this single-phased locality is unambiguously considered to fall within the Laventan SALMA. TAR-31 yielded rodent species found in La Venta, such as the octodontoid Ricardomys longidens Walton, 1990 (nom. nud.), the chinchilloids Microscleromys paradoxalis Walton, 1990 (nom. nud.) and M. cribriphilus Walton, 1990 (nom. nud.), or closely-related taxa. Given these strong taxonomic affinities, we further seize the opportunity to review the rodent dental material from La Venta described in the Ph.D. volume of Walton in 1990 but referred to as nomina nuda. Here we validate the recognition of these former taxa and provide their formal description. TAR-31 documents nine distinct rodent species documenting the four extant superfamilies of Caviomorpha, including a new erethizontoid: Nuyuyomys chinqaska gen. et sp. nov. These fossils document the most diverse caviomorph fauna for the middle Miocene interval of Peruvian Amazonia to date. This rodent discovery from Peru extends the geographical ranges of Ricardomys longidens, Microscleromys paradoxalis, and M. cribriphilus, 1,100 km to the south. Only one postcranial element of rodent was unearthed in TAR-31 (astragalus). This tiny tarsal bone most likely documents one of the two species of Microscleromys and its morphology indicates terrestrial generalist adaptations for this minute chinchilloid.

The equine tarsus is the most common area of the hind limb associated with lameness. Tarsal function is probably directly related to its conformation. Previous conformational measurement methods and radiological data are either limited or too specific to explain the complex tarsus conformation in different loading conditions. This study aimed to develop a consistent method to evaluate equine tarsal conformation from lateromedial radiographs. Twenty cadaveric hind limbs from 15 adult horses of different breeds were cut at the distal one third of the tibia. Hind limbs mounted in a loading rig and positioned with the metatarsus vertical were digitally radiographed. The zero-degree lateromedial (ZLM) was defined by vertical and horizontal landmarks including overlapping of the lateral and medial trochlea of the talus and a contact point between the dorsal edges of lateral and medial borders of the distal central tarsal bone. Radiographs missing these features were retaken to achieve consistent ZLM views. Specific radiographic features were selected as landmarks to develop tarsal parameters based on their clarity and their being consistently identifiable. The intra-rater repeatability of ten measurable morphometric parameters was evaluated with each radiograph measured twice with an interval of at least one month and Bland-Altman plots developed from this data. Repeat measurements did not differ significantly (Intraclass correlation coefficients (ICC) ranged from 0.731-0.966). This study provides a base for evaluation of the tarsal conformation by radiography.

[Purpose] Foot arches are evaluated using radiographic morphometry and body surface somatometry. While several studies have examined the correlations between these methods and the medial longitudinal arch, very few studies have investigated the same for transverse arches. In this study, we analyzed the correlation between radiographic morphometry and body surface somatometry at medial longitudinal and transverse arches. [Participants and Methods] Fifty healthy adults were included in the study. Six medial longitudinal and three transverse arch evaluation methods were evaluated for the correlation, including the foot posture index. [Results] A correlation was found between the evaluation methods for the medial longitudinal arch, except the lateral talocalcaneal angle; however, no correlation was found between the navicular-metatarsal angle and transverse arch-length ratio in transverse arch evaluation. Additionally, there was no correlation between the evaluation methods for the medial longitudinal and transverse arches. The foot posture index was particularly correlated with radiographic medial longitudinal arch evaluation methods. [Conclusion] During evaluation with radiographic morphometry, it is difficult to set bone markers and differences in tarsal bone arrangement affect the relationship between them; in body surface somatometry, there were differences in measurement at sites with excessive soft tissue. Elucidating the cause for the lack of correlation between the medial longitudinal and transverse arches requires further investigation.

Tarsal coalition is an abnormal connection between 2 or more tarsal bones, with the most common sites being between the talus and the calcaneus and between the navicular and the calcaneus. The occurrence of multiple and massive tarsal coalitions is rare. We describe a rare case of nonsyndromic bilateral tarsal coalition involving most of the tarsal bones and extending to the metatarsal bones in a 4-year-old female. The condition was not painful and did not affect her gait. The main concern was the abnormal shape of her feet. Tarsal coalition can occur as an isolated anomaly or in association with other congenital disorders, usually presenting around the age of 12 years. The coexistence of nonsyndromic bilateral multiple tarsal coalitions is seldom reported. Regardless of the presentation, treatment is not indicated in cases of asymptomatic tarsal coalition. Our patient had a unique presentation of tarsal coalition, involving both the tarsal and tarsometatarsal bones. To our knowledge, this is the first report of this type of presentation.

One pelvic limb skeleton of the Lumholtz Tree-Kangaroo (Dendrolagus lumholtzii) was used in this study. Bones were prepared from the cadaver, morphologically described and the dimensions of each bone were measured. Moreover, plane X-ray images were done for the Os coxae, femur, tibia and fibula and the femur was chosen to estimate the cortical thickness index (CTI) and canal flare index (CFT). The results cleared the presence of the epipubic bones, seven tarsal bones and absence of the patella. Between the tibia and fibula there are two interosseous spaces and that the digits II, III are the smallest, while the digit IV is the largest.

This paper describes the morphology of the feet of a population of elite women from the Ming dynasty (1368-1644 CE) in Shaanxi province. This is a social stratum, time, and place in which foot binding was practiced. Among a group of 31 skeletons exhumed from the cemetery, eight were women with well-preserved foot bones. Macroscopic examination revealed that half these women (4/8) had clearly altered foot bones: the metatarsal bones, and the few observable phalanges, were gracile and small, while the tarsal bones exhibited a slight reduction in size but no dramatic change in morphology. The other half of the women (4/8) had apparently unmodified metatarsal bones. T-tests comparing linear measurements of the foot bones between the two groups revealed that metatarsal bones were the most affected by binding, and among the tarsal bones, the talar trochlea and calcaneal dimensions were most impacted. This small group of skeletons reveals that some elite women in Shaanxi apparently still did not practice foot binding in the late Ming dynasty, or practiced a much milder form of foot binding, and that there was considerable variation even among those who did practice it.

The aneurysmal bone cysts, usually found in the tibia, femur, pelvis, or humerus, are expansile pseudotumor lesions of unknown etiology. An aneurysmal bone cyst is rarely seen in the medial cuneiform. In this case report, a 43-year-old man with an aneurysmal bone cyst in the left medial cuneiform is presented. The cyst was curetted, and the defect was filled with an en bloc iliac crest graft. A screw was placed to fix the graft in the proper position. In the 2-year follow-up of the patient, recurrence was not detected radiologically.

Background Osteochondrosis occurs due to failure of the blood supply to growth cartilage. Osteochondrosis lesions have been identified in small tarsal bones and suggested to cause distal tarsal osteoarthritis, however; it has not been determined whether distal tarsal osteochondrosis lesions were the result of vascular failure. Objectives To perform post-mortem arterial perfusion and micro-computed tomography (CT) of the central (CTB) and third tarsal bones (TIII) of foetuses and foals up to 5 months old, to describe tarsal development and any lesions detected. Study design Descriptive, non-consecutive case series. Methods Twenty-three animals that died or were euthanased from 228 days of gestation to 5 months old were collected, comprising 2 foetuses and 9 foals of miscellaneous breeds and 12 Icelandic Horse foals; a breed with high prevalence of distal tarsal osteoarthritis. One hindlimb from each foal was perfused arterially with barium, and the CTB and TIII were examined with micro-CT. Results Perfusion yielded partial information from 41% of the animals. The CTB and TIII were supplied by nutrient arteries and perichondrial vessels with vertical, transverse and circumferential configurations. Fourteen of the 23 (61%) animals had focal defects in the ossification front, i.e. radiological osteochondrosis. The majority of lesions matched the configuration and development of vertical vessels. Additionally, full-thickness, cylindrical defects matched transverse vessels, and the long axes of some dorsal lesions matched circumferential vessels. Main limitations Lack of histological validation. Conclusions Post-mortem perfusion was poor for examination of the blood supply to the growth cartilage of the CTB and TIII. Radiological osteochondrosis lesions were compatible with vascular failure because they were focal, and because lesion geometry matched vessel configuration. The relationship between osteochondrosis and distal tarsal osteoarthritis warrants further investigation.

Mirror foot is a rare abnormality which presents as a preaxial, postaxial, or central polydactyly of the foot. The latter is encountered infrequently. We describe the case of a central mirror foot. Our patient had eight digits of a central ray pattern type with fully developed metatarsal, proximal, middle, and distal phalanges, as well as a medial toe syndactyly. He had no tarsal bone duplications. He was treated by central ray resection via double V-shaped incisions on the dorsal and plantar aspects of the foot, while preserving the medial and lateral rays. The results were satisfactory. We describe the technique and attempt a review of the literature.

There is no previously reported information on the morphological characteristics of pelvic limb long bones (femur, tibiotarsus and tarsometatarsus) in crested serpent eagle and brown wood owl. Thus, this study aimed to evaluate morphological and biometrical characteristics of pelvic limb long bones in crested serpent eagle and brown wood owl. The femur consisted of a curved shaft and two extremities. The shaft was wider proximally and distally and presented medial, lateral, anterior and lateral surfaces. The anterior, medial and lateral surfaces were smooth and continuous in both the species. An intermuscular line called linea aspera was present on the anterior and posterior surfaces in both the species. The proximal and distal extremities of the femur were almost of equal size. The proximal extremity presented a distinct, hemispherical head which was located in the level of the trochanter major in both the species. The distal extremity furnished a trochlea anteriorly for patella and medial, lateral condyles posteriorly for tibiotarsus bone. The patella was small and triangular and consisted of two surfaces, two borders, a base and an apex in both the species. Tibiotarsus was the longest bone in both the species which was formed by the fusion of distal extremity of the tibia with the proximal row of the tarsal bones. The proximal and distal extremity of the tibiotarsus consisted of medial and lateral condyles. In both the species, the fibula was a rod-shaped bone and reached up to distal third of the lateral border of the tibiotarsus. The tarsometatarsus was a long bone but smaller than tibiotarsus in both the species. Various biometrical parameters of the pelvic limb long bones were more in the crested serpent eagle as compared to the brown wood owl due to species differences.

This study aimed to describe the radiographic anatomy and osteology and to evaluate angular radiographic measurements-Norberg angle, inclination angle and anteversion angle-of the pelvic limbs in free-ranging capybaras. Twenty cadavers of free-ranging capybaras (Hydrochoerus hydrochaeris), including five adults and 15 subadults, were studied. Ventrodorsal, craniocaudal, dorsoplantar and mediolateral radiographic views of the pelvic limbs were obtained. The radiographic features were described together with bone samples. The hip bone (os coxae), shaped like an isosceles trapezoid, was elongated and narrow with the presence of an oblong obturator foramen, sagittal ilial wing and rectilinear ilial body. The femoral shaft was relatively straight, while the greater trochanter was projected above the femoral head. No sesamoid bones of the gastrocnemius and popliteus muscles were observed radiographically or for those animals used in gross macroscopy. The fibula was located lateral and parallel to the tibia. Eight tarsal bones, four metatarsal bones and three digits were identified. The mean radiographic measurements included Norberg angle of 125.9°; respective angles of femoral inclination by the Hauptman B and Tomlinson methods of 139.9 and 141°; anteversion angle of the femoral head and neck of 29.80°. The bones of the pelvic limbs in capybaras have several anatomical characters and radiological features that are shared with members of the caviomorph superfamily Cavioidea. The radiographic angles measured in this study help characterize the functional morphology of this species.

OBJECTIVES Vibrational spectroscopy is a valuable tool for the study of burned skeletal remains. Nonetheless, most investigations have been focused on a limited number of samples as well as on faunal bones rather than human bones. Conclusions based on those investigations may lack representativeness, namely about the intrabone, intra- and interskeleton variability of several chemometric indices. We aimed to investigate this issue on a large sample of human bones. MATERIAL AND METHODS Powder samples were collected from 168 bones from four human skeletons. The sampling targeted 47 long bones, 72 short bones, and 49 tarsal bones as well as different bone regions in a total of 638 powder samples. Bones were experimentally burned in an electric muffle furnace for two hours to maximum temperatures ranging from 400°C to 1000°C. Another 623 burned samples were then collected totaling 1261 samples subjected to FTIR-ATR analysis. The CI, BPI, C/C, and OH/P indices were calculated. RESULTS An important intrabone, intra- and interskeleton variation was observed, especially for the BPI. The CI, C/C, and OH/P indices revealed much less variation so site-specific sampling may not be as critical in these cases. Clear differences between our results and those from previous investigations were observed, namely on the temperature increment evolution of the CI and C/C indices. DISCUSSION The relatively large heterogeneity, especially at the intrabone level, is possibly the consequence of microstructural bone differences. The dissimilarities observed between our investigation and other published studies are probably due to the fact that the samples used here came from human rather than faunal bones. Also, our samples were buried previously to the experimental burning so this may also partly explain our contrasting results, since previous research was mostly performed on fresh bone. Future inferences based on vibrational spectroscopy analyses should take into account the possible effect of all these sources.

Conradi–Hunermann syndrome is a common form of chondrodysplasia punctata, inherited as X-linked dominant disorder of cholesterol metabolism due to mutation of emopamil-binding protein gene resulting in a spectrum of skeletal, cutaneous, and ocular abnormalities. One-day-old premature, cesarean-delivered female neonate admitted with xerotic, featherlike yellow-to-white hyperkeratotic scale all over the body with craniofacial defect, coarse hair, patches of cicatricial alopecia, and absent eyebrows. Baby had rhizomelic shortening of proximal limb, clinodactyly, club foot, talipes equinovarus, and bilateral congenital cataract. Radiological skeletal survey revealed punctate stippled calcification involving left femoral head epiphysis, bilateral tarsal bones, vertebral bodies of multiple thoracolumbar vertebrae, and sternum. Serum level of 8-dehydrocholesterol was elevated. Diagnosis of rare disease can be made on clinical suspicion and radiological survey in resource-limited setting.

Introduction Sex, age and racial affinity are the three most vital determinations that must be made when dealing with skeletal remains. Success in sex determination from skeletal remains is limited as most of the bones are available in fragments. The calcaneus, the largest tarsal bone, is apt for studying sexual dimorphism as it is relatively well preserved due to its density. Methods Eleven measurements of 51 adult human calcanei (31 male and 20 female) have been taken to determine accuracy of calcaneus in sex determination and to derive sex discriminant function equations specific for Gujarati population. Results The correct sex classification rate after the direct discriminant function analysis of all parameters is 94.25%. Subsequent to stepwise analysis, two parameters (dorsal articular facet length and middle breadth) have been selected as the best sex determinants with an accuracy of 94.3%. Among the dimensional groups, the breadth dimensional group has the highest accuracy. The sex discriminant function equations specific for Gujarati population have been derived. Discussion The accuracy rate in sex determination obtained in the present study is comparable to the accuracy rates reported by previous researchers.

A 14-year-old boy reported with congenital deformity of the left lower limb, with gross shortening, hip and knee flexion deformities, ankle with equinus deformity, and polydactyly of the left foot. Radiologic examination showed proximal femoral focal deficiency, double fibula, and duplication of the tarsal bones, and a diagnosis of 'proximal femoral focal deficiency associated with fibular duplication and diplopodia with complete agenesis of tibia' was made. Such association of deformities is very rare and poses difficulties in rehabilitation of the case. This patient was managed with elective knee disarticulation, early prosthetic fitment, and gait training.

Caviomorph rodents represent a major adaptive radiation of Neotropical mammals. They occupy a variety of ecological niches, which is also reflected in their wide array of locomotor behaviors. It is expected that this radiation would be mirrored by an equivalent disparity of tarsal-metatarsal morphology. Here, the tarsal-metatarsal complex of Erethizontidae, Cuniculidae, Dasyproctidae, Caviidae, Chinchillidae, Octodontidae, Ctenomyidae, and Echimyidae was examined, in order to evaluate its anatomical variation and functional-adaptive relevance in relation to locomotor behaviors. A qualitative study in functional morphology and a geometric morphometric analysis were performed. We recognized two distinct tarsal-metatarsal patterns that represent the extremes of anatomical variation in the foot. The first, typically present in arboreal species, is characterized by features that facilitate movements at different levels of the tarsal-metatarsal complex. The second pattern, typically present in cursorial caviomorphs, has a set of features that act to stabilize the joints, improve the interlocking of the tarsal bones, and restrict movements to the parasagittal plane. The morphological disparity recognized in this study seems to result from specific locomotor adaptations to climb, dig, run, jump and swim, as well as phylogenetic effects within and among the groups studies.

One case of biplanar isolated fracture and dorsal dislocation of the tarsal navicular is reported in a 72-year-old male. We had analyzed the mechanism of injury which suggested that the dislocation of the navicular cannot occur without a fracture because of anatomical considerations. These types of injury always require anatomical reduction and stable fixation, and it is mandatory to restore the keystone function of the navicular to the longitudinal arch of the foot.

Background Patients with hallux valgus present a variety of symptoms that may be related to the type of deformity. Weightbearing affects the deformities, and the evaluation of the load response of tarsal bones has been mainly performed using two-dimensional plane radiography. The purpose of this study was to investigate and compare structural changes in the medial foot arch between patients with hallux valgus and normal controls using a computer image analysis technique and weightbearing computed tomography data. Methods Eleven patients with hallux valgus and eleven normal controls were included. Computed tomograms were obtained with and without simulated weightbearing using a compression device. Computed tomography data were transferred into a personal computer, and a three-dimensional bone model was created using image analysis software. The load responses of each tarsal bone in the medial foot arch were measured three-dimensionally and statistically compared between the two groups. Findings Displacement of each tarsal bone under two weightbearing conditions was visually observed by creating three-dimensional bone models. At the first metatarsophalangeal joint, the proximal phalanges of the hallux valgus group showed significantly different displacements in multiple directions. Moreover, opposite responses to axial loading were also observed in both translation and rotation between the two groups. Interpretation Weightbearing caused deterioration of the hallux valgus deformity three-dimensionally at the first metatarsophalangeal joint. Information from the computer image analysis was useful for understanding details of the pathology of foot disorders related to the deformities or instability and may contribute to the development of effective conservative and surgical treatments.

The talus secundarius is one of the rarest accessory tarsal bones, being present in 0.01% of all ankles. It is located at the lateral side of the talus, distally to the tip of the fibula. Hitherto, only five cases of a symptomatic talus secundarius have been described in literature. We presented a case of bilateral symptomatic talus secundarius in a young gymnast. There was a difference in size of the two accessory bones. The large talus secundarius in the left ankle was fixated, in the right ankle the fragment was excised. Both excision and fixation in the presented patient led to satisfactory results, both in the short and long term outcome. (C) 2017 Published by Elsevier Ltd on behalf of European Foot and Ankle Society

Cleidocranial dysplasia is a rare syndrome that has as main clinical findings changes in bones of the neurocranium and viscerocranium, clavicular, and teeth, although it can affect other bones. Its etiology originates from a defect of the gene CBFA1 of chromosome 6 p21, whose function is the differentiation of osteoblasts. Evidence suggests that this gene also acts in the participation of odontoblasts differentiation. The main clinical alterations are short stature, enlarged head, prolonged retention of deciduous teeth, delayed eruption of permanents, and presence of innumerable supernumeraries. The objective of this study is to report the diagnosis of cleidocranial dysplasia in a 4-year-old female patient with light brown skin color in a family health unit. The main clinical findings were prominence of the frontal and parietal bosses, ocular hypertelorism, and depressed nasal bridge and shoulders with hypermobility. The imaging examinations showed clavicular hypoplasia and changes in tarsal bones without major abnormalities in facial radiograph.

Mueller-Weiss disease is an alteration of the tarsal navicular that is primarily due to anomalous ossification of the bone and lateral deviation of the talar head associated with screw-like movement through the axis of the subtalar joint. This syndrome tends to be associated with various degrees of flatfoot and hindfoot valgus combined with subtalar joint varus. Ancient cases of Mueller-Weiss disease have not been described in specialized literature. We present the case of an adult male from the Hellenistic period (Ptolemaic dynasty; fourth to first century BC), the skeleton for which was found inside a sarcophagus in the archaeological site of Sharuna (middle Egypt) with Mueller-Weiss disease. The specimen is, in all likelihood, the earliest case of this type of foot pathology in the archaeological record.

Memorising human anatomy structures remains a challenge for nursing students. Educators endeavour to make human anatomy interesting and easy to memorise. Various instructional approaches can be used to help students enhance their memory. Mnemonics, for example, are well-established educational strategies that have proven useful in the encoding, retention and retrieval of anatomical terms. The carpal and tarsal bones are some of the anatomical structures that prove challenging to nursing students’ study of anatomy. Although available online to students, most of the accessible mnemonics are in English and non-native English-speaking students (students who are native Arabic-speakers) might find them difficult to understand. Therefore, we have created two simple Arabic mnemonics that can simplify the memorisation of the carpal and tarsal bones. We believe that Arabic mnemonics effectively enhance memorisation by linking the new learning material to familiar information.Keywords: Learning; Memory; Anatomy; Nursing; Carpal bones; Tarsal Bones; Oman.

Purpose To investigate the feasibility of increasing the stiffness of human tarsal tissue following treatment with riboflavin and ultraviolet A (UVA) to induce cross-linking of collagen fibers. Methods In this case control study, 18 right and left upper eyelids were excised en bloc from 18 fresh-frozen cadavers. One side served as the control while the samples from the opposite side were cross-linked. Four 2 × 6-mm vertical strips of central tarsus were cut from the superior to inferior border of each tarsal plate. Sample tissue was irradiated with UVA at 6 mW/cm2 for 18 minutes. A microtensile load cell and an optical coherence tomography scanner allowed calculation of stiffness (Young's modulus). Six cross-linked samples and corresponding controls were stained with hematoxylin and eosin (H&E) and Masson trichrome stains. Four controls and four cross-linked samples were also reviewed with a transmission electron microscope. Results Mean Young's modulus in the linear region for controls was 28 ± 9 MPa and was much higher at 138 ± 8 MPa for cross-linked samples (P < 0.001), yielding a 493% mean stiffness increase. Staining with H&E and Masson did not reveal any histologic changes. Transmission electron microscopy showed a decrease in average diameter of 50 randomly selected collagen fibers from 47.2 ± 1.9 nm prior to cross-linking to 34.2 ± 1.1 nm post cross-linking (P < 0.001). Qualitatively, the collagen fibers appeared more closely packed following cross-linking. Conclusions The findings of this study suggest that collagen cross-linking is a viable and effective modality for increasing the stiffness of human tarsal plates. Translational Relevance This work provides proof that collagen cross-linking produces stiffening of the human tarsal plate and may be used in disorders that cause eyelid laxity.

Embryological differentiation of the foot is noticeable by the fifth intrauterine week. By the end of the fifth week, condensation of the mesenchymal tissue has resulted in the formation of tarsal bone anlage (earliest developmental models). Tissue differentiation to precartilage and cartilage follows and all skeletal elements of the foot have begun to chondrify by 7 weeks with the exception of the distal phalanx of the little toe. By the end of the second month, the outline of each bone is becoming distinct [1–3]. Homogenous interzones develop at the ankle and between all tarsal, tarsal-metatarsal, metatarsal-phalangeal, and interphalangeal joints with the three-layered interzone developing earliest at the ankle and metatarsal-phalangeal joints at the end of the embryonic period (8 weeks). Cavitation with vascularized synovial tissue is seen in most joints of the foot at 9–11 weeks (early fetal period). A proximodistal sequence of development unfolds. By the end of the embryonic period (8 weeks), the foot resembles that of the adult in most details. All elements of the foot destined to become bone have begun to chondrify (except the distal phalanx of the little toe) by 7 weeks of embryonic life. Anomalies of the skeletal elements (such as tarsal coalition) form very early. The articular surfaces of the ankle joint and of the other joints of the foot reach a high degree of differentiation before the resorption phase of the interzone begins around 8 weeks of age. Hesser noted that the articular surfaces of the ankle joint reach a high degree of differentiation even before joint cavitation is complete [4]. The talonavicular and calcaneocuboid joints also reach close to their final shapes very early. Straus also stated that the joints of the foot are laid down in their definitive form by the ninth intrauterine week [5]. Cavitation of the interzone to form the synovial joints begins first at the ankle and progresses distally, forming last in the interphalangeal joints. O’Rahilly et al. further reviewed the skeletal development of the foot [6]. The prenatal development of the human foot has been well studied and described by Gardner et al. who reviewed the extensive developmental literature as well as assessing 184 human embryos and fetuses.

Rodent models are used for a variety of orthopedic research applications; however, anatomy references include mostly artistic representations. Advanced imaging techniques, including micro-computed tomography (microCT), can provide more accurate representations of subtle anatomical characteristics. A recent microCT atlas of laboratory mouse (Mus musculus) anatomy depicts the central and tarsal bone III (T3) as a single bone, differing from previous references. Fusion of tarsal bones is generally characterized as pathological secondary to mutations associated with growth factors, and normal variation has not been documented in the mouse tarsus. Therefore, it is unclear if this fusion is a normal or a pathological characteristic. The aim of this study is to characterize the tarsus of the laboratory mouse and compare it to the rat and selected outgroup species (i.e., white-footed mouse) via microCT and histology to determine if the central and T3 are separate or fused into a single bone. Laboratory mice (C57/Bl6 [n = 17] and BalbC [n = 2]) and rats (n = 5) were scanned with microCT. A representative laboratory mouse from each strain was evaluated histologically via serial sagittal sections through the mid-tarsus. General pedal anatomy was similar between all species; however, the central and T3 bones were fused in all laboratory mice but not the rat or white-footed mouse. A band of hyaline cartilage was identified within the fused bone of the laboratory mice. We conclude that the fusion found is a normal characteristic in laboratory mice, but timing of the fusion remains ambiguous. Anat Rec, 300:450-459, 2017. © 2016 Wiley Periodicals, Inc.

Giant cell tumor (GCT) or Osteoclastoma of the tarsal bone is very rare as compared to that of long bones. The involvement of talus becomes unique in its presentation as it remains undiagnosed for a long time. The tumor usually occurs in younger age especially in small bones of hands and feet. We present a case of 34-years old male who presented with sprain of left foot and was finally diagnosed as giant cell tumor of the talus. This was possible with the help of various radiological modalities like plain X-ray, computerised tomography (CT) and magnetic resonance imaging (MRI). GCT of talus may be found as an incidental finding but the subsequent management depends upon the staging of the tumor as per the radiological evaluation.

OBJECTIVE To determine and compare mean standing extension and maximum flexion angles of various joints in healthy adult alpacas and llamas, and determine the reliability of goniometric data within and between 2 observers for each joint of interest. SAMPLE 6 healthy adult llamas and 6 healthy adult alpacas. PROCEDURES The shoulder joint, elbow joint, carpal, and metacarpophalangeal (MCP) joints of the forelimbs and the hip joint, stifle joint, tarsal, and metatarsophalangeal (MTP) joints of the hind limbs were investigated. Each articulation was measured with a universal goniometer by 2 observers, who each obtained 2 measurements when each joint was maintained in standing extension and in maximal passive flexion. Two sample (unpaired) t tests were performed for comparisons of mean standing extension and maximum passive flexion angles between alpacas and llamas. Intraclass correlation coefficients were calculated for each articulation to assess interobserver and intra-observer reliability of measurements. RESULTS Llamas had larger mean standing extension angles than alpacas for the tarsal and elbow joint, but there were no significant differences between species for all other joints. For all joints, flexion measurements did not differ significantly between the 2 species. For most joints, the reliability of goniometric data between observers was good to excellent (intraclass correlation coefficients, 0.6 to 0.95) CONCLUSIONS AND CLINICAL RELEVANCE Except for the elbow joint and tarsus in extension, the angle of limb articulations during flexion and extension can be considered similar for alpacas and llamas. These measurements have relevance for veterinary surgeons when assessing joint mobility and conformation and determining appropriate angles for arthrodesis.

The tarsal bones articulate with each other and demonstrate complicated kinematic characteristics. The in vivo motions of these tarsal joints during normal gait are still unclear. Seven healthy subjects were recruited and fourteen feet in total were tested in the current study. Three dimensional models of the tarsal bones were first created using CT scanning. Corresponding local 3D coordinate systems of each tarsal bone was subsequently established for 6DOF motion decompositions. The fluoroscopy system captured the lateral fluoroscopic images of the targeted tarsal region whilst the subject was walking. Seven key pose images during the stance phase were selected and 3D to 2D bone model registrations were performed on each image to determine joint positions. The 6DOF motions of each tarsal joint during gait were then obtained by connecting these positions together. The TNJ (talo-navicular joint) exhibited the largest ROMs (range of motion) on all rotational directions with 7.39±2.75°of dorsi/plantarflexion, 21.12±4.68°of inversion/eversion, and 16.11±4.44°of internal/external rotation. From heel strike to midstance, the TNJ, STJ (subtalar joint), and CCJ (calcaneao-cuboid joint) were associated with 5.97°, 5.04°, and 3.93°of dorsiflexion; 15.46°, 8.21°, and 5.82°of eversion; and 9.75°, 7.6°, and 4.99°of external rotation, respectively. Likewise, from midstance to heel off, the TNJ, STJ, and CCJ were associated with 6.39, 6.19°, and 4.47°of plantarflexion; 18.57°, 11.86°, and 6.32°of inversion and 13.95°, 9.66°, and 7.58°of internal rotation, respectively. In conclusion, among the tarsal joints, the TNJ exhibited the greatest rotational mobility. Synchronous and homodromous rotational motions were detected for TNJ, STJ, and CCJ during the stance phase.

An enlarged and hard right hind limb of a condemned lame pig from a local slaughterhouse was submitted to National Chung Hsing University for pathological examination on 29 May 2015. Gross examination revealed brush burn and skin abscess. The radiography of the affected foot showed enlarged hock joint, collapsed tarsal joint with bony proliferation, and a soft tissue mass extending from the lateral to the tarsal bones. After the sample was split between the third and fourth metatarsal bone longitudinally, the calcaneus, talus, and the fourth tarsal bone were shown to be broken and damaged. Histopathological findings were as follows. First, the fractured bones showed the formation of callus and multiple small bone fragments were found. Second, osteoclasts and osteogenesis with bone remodeling were discovered at the edge of the bone fragments. Third, the skin abscess showed well-encapsulated clumps of bacteria and cellular debris. Trueperella pyogenes was identified from skin abscess and bone marrow. We speculate that the neglected fractures might have been related to crush injury inflicted by a sow or possible damage caused by the floor of the crate. This case highlights the importance of maintaining a high standard of animal welfare and once a lesion has occurred in food-producing animals, medication or elimination should be considered to avoid the long-term suffering of the animals.

The longitudinal arch is a unique characteristic of the human foot, yet the timing and pattern of its evolution remain controversial, in part due to the disagreement among researchers over which skeletal traits are the best indicators of its presence or absence. The small size of the human navicular tuberosity has previously been linked to the presence of a longitudinal arch, implying that the large tuberosity of early hominins such as Australopithecus afarensis reflects a flat foot. However, this hypothesis is at odds with other evidence of pedal form and function, such as metatarsal, tarsal, and footprint morphology, which show that a longitudinal arch was probably present in A. afarensis. This study reevaluates the morphometric affinities of the A. afarensis naviculars among other Plio-Pleistocene fossil hominins and anthropoid primates (N = 170). Multivariate cluster analyses show that all fossil hominin naviculars, including those attributed to A. afarensis, are most similar to modern humans. A measure of navicular tuberosity size quantified as the ratio of the tuberosity volume to the surface area of the talar facet shows that Ateles has the largest navicular tuberosity among the anthropoid sample and that there is no difference between highly arboreal and terrestrial taxa in this metric (e.g., Hylobates and Gorilla beringei). Instead, a relatively large navicular tuberosity may reflect the development of leg musculature associated with ankle plantarflexion. The functional inferences derived from the morphology of the A. afarensis naviculars are consistent with the morphology of the Laetoli footprints.

Objective The aim of the study was to assess and compare the knowledge of fourth-year medicine, physiotherapy (PT), nursing, and podiatry students in carpal and tarsal bone anatomy. Methods A cross-sectional study was carried out. Based on a nonprobability convenience sampling, 177 fourth-year students (117 women and 60 men, mean age of 23.16 ± 3.82 years) from the podiatry (n = 39), nursing (n = 26), PT (n = 73), and medicine (n = 39) schools at a large Spanish university were included. Measurements were taken of their gross anatomy knowledge by means of the carpal and the tarsal bone tests. Students were asked to identify all carpal and tarsal bones in an illustration of the bony skeleton of both regions and were given a maximum of 5 minutes per test. Results Of a total of 15 bones to be labeled, the PT (11.07 ± 3.30) and podiatry (9.36 ± 2.93) students had the highest rate of correct answers compared with the medicine (6.13 ± 3.27) and nursing (4.04 ± 3.72) undergraduates. When assessing academic degrees and test scores, significant differences were observed between PT and podiatry participants vs those from the medicine and nursing schools ( P Conclusion Fourth-year students from the PT and podiatry programs correctly identified a higher number of carpal and tarsal bones than students from the nursing and medicine schools.

We report the case of a 32-year-old Japanese female with a giant cell tumor of bone involving multiple midfoot bones. Giant cell tumors of bone account for approximately 5% of all primary bone tumors and most often arise at the ends of long bones. The small bones, such as those of the hands and feet, are rare sites for giant cell tumors. Giant cell tumors of the small bones tend to exhibit more aggressive clinical behavior than those of the long bones. The present patient underwent en bloc tumor excision involving multiple tarsals and metatarsals. We reconstructed the longitudinal arch of the foot with a free vascularized fibular graft. At the 2-year follow-up visit, bony union had been achieved, with no tumor recurrence.

Objective To evaluate the frequency of inadvertent penetration of the digital flexor tendon sheath (DFTS) and/or distal interphalangeal joint (DIPJ) when using a direct endoscopic approach to the navicular bursa, and to evaluate an alternate direct approach to the navicular bursa. Study Design Cadaveric study. Sample Population Equine cadaver limbs (n = 40 for direct; n = 12 for alternate approach). Methods Four surgeons performed the direct endoscopic approach to the navicular bursa on 10 limbs each. Frequencies of inadvertent synovial penetration and iatrogenic damage were compared between surgeons. Use of an alternate direct approach, adopting a straight parasagittal trajectory, was evaluated by 2 surgeons. Results Inadvertent synovial penetration occurred in 45% of limbs (DFTS 37.5%; DIPJ 17.5%; and both structures 10%). Successful bursa entry was achieved on the first attempt in 45% of limbs. Significant variation in frequency of inadvertent synovial penetration was observed between surgeons (range 10–80%). Inadvertent synovial penetration did not occur when using the alternate direct technique. Iatrogenic damage to navicular bone fibrocartilage and/or deep digital flexor tendon occurred in 55% of limbs using the direct endoscopic approach and in 0% of limbs using the alternate direct approach. Conclusion Because of the considerable risk of inadvertent penetration of the DFTS and/or the DIPJ when making a direct endoscopic approach to the navicular bursa, it is advisable to investigate for inadvertent penetration when treating navicular bursa sepsis using a direct approach. The alternate direct technique may reduce the risk of inadvertent penetration; however, the view within the bursa may be restricted.

Rationale Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve and its branches. Tarsal coalition is defined as a fibrous, cartilaginous, or osseous bridging of 2 or more tarsal bones. TTS with tarsal coalition is uncommon. Here, we present a rare example of successful surgical management of TTS with posterior facet talocalcaneal coalition. Patient concerns A 74-year-old woman presented with hypoesthesia, numbness, and an intermittent tingling sensation on the plantar area over the right forefoot to the middle foot area. The hypoesthesia and paresthesia of the right foot began 6 years previously and were severe along the lateral plantar aspect. The symptoms were mild at rest and increased during daily activities. Tinel sign was positive along the posteroinferior aspect of the medial malleolus. Diagnosis Lateral ankle radiography showed joint-space narrowing and sclerotic bony changes with a deformed C-sign and humpback sign. Oblique coronal and sagittal computed tomography revealed an irregular medial posterior facet, partial coalition, narrowing, and subcortical cyst formation of the posterior subtalar joint. Magnetic resonance imaging showed an abnormal posterior talocalcaneal coalition compressing the posterior tibia nerve. Electromyography and nerve conduction velocity studies were performed, and the findings indicated that there was an incomplete lesion of the right plantar nerve, especially of the lateral plantar nerve, around the ankle level. Interventions Surgical decompression was performed. Intraoperatively, the lateral plantar nerve exhibited fibrotic changes and tightening below the posterior facet talocalcaneal coalition. The coalition was excised, and the lateral plantar nerve was released with soft-tissue dissection. Outcomes The patient's symptoms of tingling sensation and hypoesthesia were almost relieved at 4 months postoperatively, but she complained of paresthesia with an itching sensation when the skin of the plantar area was touched. The paresthesia had disappeared almost completely at 8 months after surgery. She had no recurrence of symptoms at the 1-year follow-up. Lessons The TTS with tarsal coalition is rare. Supportive history and physical examination are essential for diagnosis. Plain radiographs and computed tomography or magnetic resonance imaging are helpful to determine the cause of TTS and verify the tarsal coalition. After diagnosis, surgical excision of the coalition may be appropriate for management with a good outcome.

Introdução: A coalizão tarsal representa uma comunicação anormal entre ossos do tarso e pode ser óssea, cartilaginosa ou fibrosa, se desenvolvendo de forma secundária a insuficiência da diferenciação e segmentação do mesênquima primitivo nas primeiras fases do desenvolvimento, diminuindo a mobilidade e deformando os pés, quando congênita. Quando adquirida ocorre devido à artrite inflamatória, infecção, trauma, neoplasia, entre outras causas. Relato de Caso: Relatamos o caso de uma mulher de 37 anos com queixa há um mês, desmontando a importância da investigação da causa e a necessidade de atenção por parte do radiologista para a avaliação das coalizões tarsais visto que, uma coalizão, independentemente de quais ossos envolvidos, pode levar a uma sintomatologia limitante. Palavras chave: Ossos do tarso, Coalizão tarsal, Imagem por ressonância magnética, Deformidades do péAbstractIntroduction: Tarsal coalitions represent abnormal bridging between tarsal bones and can be osseous, cartilaginous, or fibrous, developing secondary to failure of differentiation and segmentation of the primitive mesenchyme in the first stages of development, decreasing mobility and deforming the feet, when is congenital. When acquired it occurs due to inflammatory arthritis, infection, trauma, neoplasia and other causes. Case report: We report the case of a 37-year- -old woman with a complaint a month ago, dismantling the importance of investigating the cause and the need for attention by the radiologist for the evaluation of tarsal coalitions since, a coalition, regardless of which bones involved, can lead to limiting symptoms.Keywords: Tarsal bones, Tarsal coalition, Magnetic resonance imaging, Foot def

Foot-binding was a widespread custom in China for hundreds of years, though the severity and type of binding varied considerably over time and space. To examine the morphological consequences of extremely severe foot-binding, this paper uses 35 sets of bound and 33 sets of unbound foot bones, from the remains of women excavated from the Xinzhi cemetery in northern Shandong Province. Based on macroscopic observation, CT slices, and measurements of bound foot bones, multiple distinctive consequences of foot-binding were identified. Compared with normal bones, bound foot bones have severely reduced overall size and weight. The density of trabecular mesh was reduced and its structure was altered in all tarsal bones. While the talus and navicular bones of bound feet retained all major groups of trabeculae, the calcaneus experienced massive trabecular loss, suggesting that in a bound foot the calcaneus lost its weight bearing function and its role in plantarflexion. The severity of changes was greater in the laterally positioned foot bones, i.e. the lateral cuneiform, the cuboid, and 4th and 5th metatarsals, than in the medial ones, showing that most of the body weight in the bound foot was transmitted along the first ray. Degenerative osteoarthritic changes affected articular surfaces of the foot bones, even in young individuals. These changes suggest that the biomechanics of bipedal locomotion were considerably affected in all females with severely bound feet.

Objective To evaluate and differentially diagnose erosive skeletal lesions located on multiple joints of an individual archaeologically recovered in 2017. Materials Skeletal remains of a well-preserved skeleton dating to the 12th–13th centuries from the medieval church of San Biagio in Cittiglio (Varese, northern Italy). Methods Macroscopic and radiographic imaging. Results Erosive marginal symmetrical lesions are present on the metatarsophalangeal, metacarpophalangeal and interphalangeal joints of an adult male, aged 55–75 years. Osteolytic changes, in the form of pocket erosions, surface resorptions and pseudocyst formations, are also macroscopically observed on some carpal and tarsal bones and on several large peripheral joints. Conclusions A careful differential diagnosis of the lesions and their macroscopic and radiological appearance is suggestive of a case of rheumatoid arthritis-like polyarthropathy. Significance This case contributes to the debate regarding the antiquity of erosive polyarthropathies, providing additional evidence for the existence of these diseases in the Old World prior to the European discovery of the Americas. Limitations Small sample size limits discussion of the scope of the disease in antiquity. Suggestions for further research This case highlights the need for further macroscopic, radiographic, and biomolecular studies of pre-modern European skeletal samples to investigate the hypothesized pre-existence of these pathological conditions in Europe prior to 1492.

Synovitis of the navicular bursa is common in performance horses. The objective of this study was to describe an ultrasound-guided technique to inject a distended navicular bursa and to evaluate its feasibility for use by a clinician not trained in the technique. Twenty distal limbs of horses of various breeds and sizes were used. To produce synovial distension, the navicular bursa of each limb was injected with contrast medium using a lateral approach and radiography was performed to confirm that the contrast medium was distending the bursa. The digit was positioned with the distal interphalangeal joint in hyperextension. A microconvex ultrasound probe was placed in the hollow of the pastern, palmar to the middle phalanx and the region was assessed in a transverse plane slightly oblique to the horizontal plane. The ultrasound probe was rotated to visualize both the lateral and medial recesses and to select which side was more distended to inject. A 21G 0.8 × 50 mm needle was inserted abaxially to the probe in the plane of the ultrasound beam into the proximal recess of this navicular bursa and a methylene blue solution was injected. Following injection, dissection was performed to assess whether the navicular bursa had been successfully injected. This ultrasound-guided technique was reliably performed with a success rate of 68%. The success of injection is influenced by hyperextension of the foot, quality of ultrasound images and degree of distension of the bursa.

Osteopoikilosis (OPK) is a very rare and primarily benign autosomal dominant disorder of unknown etiology. Genetic studies showed heterozygous mutations of the LEMD3 gene. It is characterised by the occurrence of hyperostotic spots throughout the skeleton, with the most frequent localizations in the epiphyses and metaphyses of long bones, as well as in the carpal and tarsal bones. The clinical features of osteopoikilosis are poorly represented; consequently the condition is usually diagnosed incidentally on radiological examination or due to the association with other medical disorders (articular pain, fractures, joint dislocations, etc.). We report a case of osteopoikilosis in a 44 year-old man who presented with left hip joint pain and low back pain irradiated in left leg. Radiographs showed typical features of osteopoikilosis. Necessary investigations were done to exclude osteoblastic metastasis. The patient was treated with drugs and physiotherapy with significant improvement of the symptoms.

Tarsometatarsal osseous coalition is extremely rare. Herein, we present a case of osseous coalition between the base of the third metatarsal and the lateral cuneiform. The patient is a 38-year-old male who presented with an acute episode of foot pain following strenuous activity. Radiographs of the left foot demonstrated an osseous coalition between the third metatarsal base and the lateral cuneiform. Tarsal coalition is a congenital defect that results when adjacent tarsals fail to separate during embryonic development. According to the literature, total osseous coalition is less common than cartilaginous coalition. This case serves as only the second known documented case of osseous coalition between the third metatarsal and the lateral cuneiform, with the first case published in an orthopedic journal. To our knowledge, no case of third metatarsal-lateral cuneiform coalition has been published in the literature otherwise. The intent of this publication is to add to the database of tarsometatarsal coalition cases with a specific emphasis on bony coalition between the third metatarsal and lateral cuneiform.

In very fragmentary remains, the thorough inventory of skeletal elements is often impossible to accomplish. Mass has been used instead to assess the completeness of the skeleton. Two different mass-based methods of assessing skeleton completeness were tested on a sample of experimentally burned skeletons with the objective of determining which of them is more reliable. The first method was based on a simple comparison of the mass of each individual skeleton with previously published mass references. The second method was based on mass linear regressions from individual bones to estimate complete skeleton mass. The clavicle, humerus, femur, patella, metacarpal, metatarsal and tarsal bones were used. The sample was composed of 20 experimentally burned skeletons from 10 males and 10 females with ages-at-death between 68 and 90years old. Results demonstrated that the regression approach is more objective and more reliable than the reference comparison approach even though not all bones provided satisfactory estimations of the complete skeleton mass. The femur, humerus and patella provided the best performances among the individual bones. The estimations based on the latter had root mean squared errors (RMSE) smaller than 300g. Results demonstrated that the regression approach is quite promising although the patella was the only reasonable predictor expected to survive sufficiently intact to a burning event at high temperatures. The mass comparison approach has the advantage of not depending on the preservation of individual bones. Whenever bones are intact though, the application of mass regressions should be preferentially used because it is less subjective.

The purpose of this brief chapter is to take a look at the five most distal tarsal bones in the foot, review the basic anatomy of these structures, and review the types of fractures, treatment methods, and some complications postoperatively. This brief review will give a quick insight into these anatomically small and sometimes forgotten bones of the midfoot.

Background: It has remained controversial on whether excessive loadings imposed on the ankle and foot complex during long-distance running have a deleterious effect. The aim of this systematic review is to determine whether long-distance running causes any visible changes of the ankle and foot on magnetic resonance imaging (MRI). Methods: Scopus, Web of Science, Embase and Ovid Medline were searched using key terms in relation to MRI findings of the ankle and foot in response to long-distance running, published between 1990 and 2016. The final search was conducted on 19 September, 2016. Studies were identified using inclusion and exclusion criteria. Methodological quality was assessed using a modified Quality Index. Results: The database search initially produced 551 articles and it was screened based on inclusion and exclusion criteria, finally resulting in four articles. Edema was reported in the talus, tibia, calcaneus, navicular, cuboid and cuneiforms. A significant alteration in signal intensity and/or edema was appeared in the calcaneus at the Achilles insertion point, intraosseous and subcutaneous over long-distance running. The diameter of Achilles tendon was also significantly increased. However, when comparing between race finishers and non-finishers, the plantar aponeurosis and subcutaneous were only significantly different, reporting a high rate of edema in non-finishers. Additionally, one study adopted T2* mapping and found significant alteration in T2* values in tibiotalar cartilage, but the value was unexpectedly decreased in the middle of long-distance running. Conclusion: This is the first systematic review to determine the effect of long-distance running on the ankle and foot using MRI. It shows that long-distance running may cause subtle pathological and biochemical changes in the ankle and foot, including the talus, tibia, the distal and proximal group of tarsal bones, 5th metatarsals, soft tissues and the Achilles tendons. However, there is no evidence that these changes have clinical relevance.