This report describes the case of a 32-year-old patient admitted to the emergency room for polytrauma following a suicide attempt. During the clinical and radiographic examination of the right elbow, Patella cubiti (PC) was fortuitously discovered. This rare anatomical anomaly raises questions about its origin and its impact on the patient\'s clinical presentation. Despite the generally asymptomatic nature of PC, its association with severe polytrauma in this case underlines the importance of comprehensive radiographic evaluation when managing traumatic injuries. This clinical case contributes to our understanding of this rare anatomical variation and underscores the need for further research on its clinical implications as well as therapeutic management.

Sesamoid and accessory bones are small, oval-shaped structures that develop within tendons that pass over bony prominences. Although rare, accessory bones in the elbow region hold clinical significance because they can cause diagnostic uncertainty. We present the case of a 47-year-old previously healthy female patient who presented with left elbow pain and was discovered to have a sesamoid bone distal to the medial epicondyle of the humerus. On examination, the patient\'s left elbow was tender, but her range of motion was in normal range. Plain radiographs identified a small, oval-shaped bony fragment; further radiographic investigations were conducted. Computed tomography and ultrasound were performed to rule out diagnostic uncertainties. A diagnosis of os subepicondylare mediale, a rare sesamoid bone, was established through a thorough investigation of the well-circumscribed structure in accordance with the most current literature.

OBJECTIVE: The position of sesamoid of thumb metacarpophalangeal (MCP) joint changed clearly when the joint was dislocated dorsally. However, the significance of sesamoid location in diagnosing joint dislocation was unclear. The present study aimed to explore the positional relationship between sesamoid bone and thumb metacarpophalangeal joint in normal and dorsal dislocation joints.
METHODS: Between January 2018 and August 2023, we collected 60 isometric plain films from sixty outpatients and reviewed 56 anisometric plain films from twenty-eight emergency patients with dorsal dislocation of thumb MCP joint at Tianjin Hospital, then took measurements on the hand X-ray images. The sesamoid length on its longitudinal axis was defined as DP, the distance between the distal edge of sesamoid and thumb MCP joint was defined as DJ, and the ratio of DJ and DP was R. An independent-samples t-test and paired-samples t-test was utilized to analyze difference among data groups.
RESULTS: The 60 isometric images were from 30 male and 30 female outpatients with normal bone structure in their hands, and the 56 anisometric images of the 28 emergency patients included both preoperative and postoperative materials. Among the outpatients, the actual distance between the distal edge of sesamoid and thumb MCP joint space (DJ) was 2.09 mm and 1.40 mm in males and females, respectively. The authentic average length of sesamoid (DP) was 4.46 mm in males and 4.22 mm in females. The average value of R (the ratio of DJ and DP) in males and females was 0.49 and 0.34, respectively. There were gender-related statistical differences in DJ (p < 0.01) and R (p=0.01), but no statistical difference in DP (p > 0.05). For the 28 emergency patients, the mean value of R was -0.47 before joint reduction and 0.58 after joint reduction, with statistical difference between them (p < 0.01).
CONCLUSIONS: There was significant difference in the relative position between sesamoid and thumb MCP joint when joint dislocation and joint reduction. The distal edge of sesamoid beyond thumb MCP joint could be an evidence in diagnosing joint dorsal dislocation. The distal edge of sesamoid below thumb MCP joint could be an evidence of joint reduction.

Dorsal dislocation of the toes is an infrequent injury that can result in severe pain and deformity. Timely diagnosis and appropriate management are paramount for optimizing patient outcomes. This case report illustrates a 53-year-old male patient who suffered dorsal dislocation of the first and second metatarsophalangeal (MTP) joints due to a crush injury. We present the clinical manifestation, radiographic findings, and management approach for this unique isolated first and second ray MTP joint dorsal dislocation, without any associated fractures. This case report underscores several critical observations: firstly, hallux dorsal dislocation can potentially coincide with other injuries; secondly, it can stem from crushing trauma to the big toe; and thirdly, successful closed reduction, when followed by effective immobilization and early rehabilitation, can yield outstanding outcomes. Additionally, the report emphasizes the importance of pursuing another closed reduction attempt under general anesthesia, if the initial attempt in the emergency room proves unsuccessful, before contemplating open reduction.

UNASSIGNED: Human growth shows considerable variation. In addition to constitutional differences in the timing of maturation, there are diseases, systemic disorders and environmental factors that may affect a child\'s physiologic maturity. Interrelationships among skeletal, somatic and sexual maturity have been shown to be consistently strong. The study was conducted to evaluate the relationship between dental calcification stages and skeletal maturity indicators.
UNASSIGNED: The hand wrist radiographs, the lateral cephalogram and the orthopantomogram (OPG) of 120 patients (60 males and 60 females, age group 8-14 years) were taken. The hand wrist radiographs were analyzed using Fishman\'s skeletal maturity index (SMI), and the cephalograms analyzed by cervical vertebrae maturation (CVM) by Baccetti. OPG was analyzed according to the Demirjian\'s system.
UNASSIGNED: On assessment, cervical vertebrae maturation indicator (CVMI) staging showed significant results with a correlation coefficient of 0.716 being the highest in canines in males while assessment of dental calcification stages and its comparison with skeletal maturity indicator showed insignificant results. The correlation coefficient values were 0.11, 0.09, 0.09 and 0.13 for canine, first premolar, second premolar and second molar respectively.
UNASSIGNED: There is a strong correlation between the maturation stage of cervical vertebrae and calcification stages of canine, first premolar, second premolar and second molar as determined by Demirjian\'s method.

Background and Objectives: Hallux valgus is one of the most common chronic foot complaints, with prevalences of over 23% in adults and up to 35.7% in older adults. However, the prevalence is only 3.5% in adolescents. The pathological causes and pathophysiology of hallux valgus are well-known in various studies and reports. A change in the position of the sesamoid bone under the metatarsal bone of the first toe is known to be the cause of the initial pathophysiology. Purpose: The relationships between the changes in the location of the sesamoid bone and each radiologically measured angle and joint congruency in the hallux valgus remain as yet unknown. Therefore, this study investigated the relationships of sesamoid bone subluxation with the hallux valgus angle, intermetatarsal angle, and metatarsophalangeal joint congruency in hallux valgus patients. The goal is to know the hallux valgus angle, the intermetatarsal angle, and metatarsophalangeal joint congruency\'s correlation with hallux valgus severity and prognosis by revealing the relationship between each measured value and sesamoid bone subluxation. Materials and Methods: We reviewed 205 hallux valgus patients who underwent radiographic evaluation and subsequent hallux valgus correction surgery in our orthopedic clinic between March 2015 and February 2020. Sesamoid subluxation was assessed using a new five-grade scale on foot radiographs, and other radiologic measurements were assessed, such as hallux valgus angle, the intermetatarsal angle, distal metatarsal articular angle, joint congruency, etc. Conclusions: Measurements of the hallux valgus angle, interphalangeal angle, and joint congruency exhibited high interobserver and intraobserver reliabilities in this study. They also showed correlations with sesamoid subluxation grade.

Recurrence of the hallux valgus deformity has various causes, and the incomplete reduction of sesamoids may be one of the important issues. However, we have seen several patients with postoperative lateral sesamoid displacement on anteroposterior (AP) standing radiographs who did not experience hallux valgus recurrence. Therefore, we hypothesized that lateral displacement of the sesamoid on AP standing radiographs does not cause hallux valgus recurrence.
The study included 269 feet (185 patients) with hallux valgus treated with distal chevron metatarsal osteotomy. Mean patient age was 64.26 (range, 15-80) years. Patients were followed up for an average of 33.85 (range, 12-228) months between April 2002 and December 2019. The patients were divided into 4 groups, according to the presence or absence of hallux valgus recurrence and sesamoid reduction.
During outpatient follow-up, we discovered 99 feet (42.1%) in which hallux valgus did not recur despite lateral sesamoid displacement (grade IV-VII) on AP standing radiographs. Hallux valgus angle (HVA, 2.7 to 7.9 degrees), intermetatarsal angle (IMA, 4.6 to 6.2 degrees), and sesamoid grades (2.1 to 3.5) all deteriorated over time after surgery, and each indicator was statistically significantly altered, and changes in the 3 indicators had a statistically significant positive correlation. Changes in HVA and IMA between feet with and without sesamoid reduction on AP standing radiographs increased over time, with the differences in HVA (2.9 degrees) and IMA (0.9 degrees) being significant at final follow-up (P < .05 for each). Regardless of whether sesamoid reduction was achieved on AP standing radiographs, the final analysis showed that HVA and IMA in both groups worsened over time. Further, there were no differences between the 2 groups in the patterns of change over time.
In our cohort, postoperative sesamoid position on AP standing radiographs was not associated with hallux valgus recurrence based on radiographic criteria.
Level III, retrospective comparative study.

BACKGROUND: This study aimed to evaluate and analyze the prevalence and radiological characteristics of the fabella in the Turkish population, detecting differences between genders by examining magnetic resonance imaging (MRI) images of subjects.
METHODS: A total number of 504 patients aged >18 years who were admitted to the orthopedics and traumatology clinic between November 2018 and October 2020 were included in this retrospective cross-sectional study. Bilateral MRI images that were taken from each patient were randomly selected. Age, sex, laterality (right or left knee), and size of the fabella were retrieved from institutional database records. P-value<0.05 is considered statistically significant.
RESULTS: A total of 504 patients were included with 213 males and 291 females. The overall prevalence of fabella was 20.63%. The mean length, thickness, and width of the fabella were 6.05 mm, 4.63 mm, and 5.92 mm, respectively, in the overall population. The fabella was significantly wider, thicker, and longer in males compared to females in the Turkish population.
CONCLUSIONS: This study revealed similar prevalence rates of the fabella in the Turkish population with Caucasian populations and similar size of the fabella in the Asian population. When different prevalence rates and sizes of the fabella among different ethnic populations are considered, it is critical to understand the prevalence or radiological features of the fabella in Turkish subjects to avoid misinterpretation of fabella diseases.

This study was aimed to provide anatomical atlas of the ovine metacarpo/metatarsophalangeal joints using computed tomography (CT) scan and magnetic resonance imaging (MRI), as well as to investigate bone mineral density (BMD) and morphometric features of this joint. The limbs of twenty adult Sanjabi sheep were examined. Imaging was performed using a 16-slice multi-detector CT scanner and a 1.5 Tesla MRI scanner. The obtained images were correlated with corresponding anatomical sections. BMD was measured by Dual Energy X-ray Absorptiometry (DEXA) method. Also morphometric features included distance between metacarpal and metatarsal heads, width of metacarpal and metatarsal head, length, width and the height of the proximal sesamoid bones were measured. In MRI images, compact bones, ligaments and tendons showed less signal intensity (hypointense). The fatty tissue and bone marrow had more signal intensity (hyperintense), but articular cartilage and synovial fluid showed moderate signal intensity. BMD in the left hind limb was significantly higher than other three limbs (p ≤ 0.05). The length of proximal sesamoid bones in left forelimb was higher than right forelimb (p ≤ 0.05). The thickness of proximal sesamoid bones in left limbs was higher than those in their counterparts (p ≤ 0.05). The width of the medial head in the forelimbs was significantly greater than the hind limbs (p ≤ 0.05). The present results might be useful in managing the clinical techniques on this joint. Larger volume of the proximal sesamoid bones and wider medial head in the forelimbs compared to the hindlimbs impel this speculation that the centre of gravity is closer to the forelimbs.

BACKGROUND: The present study evaluated the frequency of supinator sesamoid bones (SSB) on radiography and computed tomography (CT). Interobserver agreement was evaluated in the detection of the SSBs in both methods. A correlation between the existence of SSBs and elbow diseases (ED) was assessed. For these purposes, radiographs, and CT scans of 100 dogs were scored by 3 observers.
RESULTS: The SSB was identified as a round to oval-shaped opacity and measured 0.5-6.56 mm × 0.5-6.2 mm. SSBs were reported in an average of 8,33% of dogs on radiographs and 26% of dogs on CT; a bilateral sesamoid bone was present in 43,52% and 76,92% of these dogs, respectively. Seventy-two percent of the SSBs was identified on CT were not detected on radiographs. The Kappa test showed a substantial agreement (κ = 0.691) and a perfect agreement (κ = 1) between the observers in the detection of SSBs on radiography and on CT scans respectively. Additionally, a weak positive correlation was detected between ED and the existence of SSBs.
CONCLUSIONS: A supinator sesamoid bone can be detected occasionally in the evaluation of the canine elbow joints by routine radiography. CT is superior to radiography for assessing SSBs with a higher interobserver agreement. The correlation of the existence of the SSBs and ED, needs further evaluations to prove a probable pathophysiological connection.