AN OBSERVATIONAL STUDY OF ENTHESOPATHY IN DRIED HUMAN SCAPULAE
Objectives: An abnormal ossification process in soft tissues at the attachment site to a bone is called enthesopathy due to biomechanical movements of bone. The present study aimed to observe the calcification of the transverse scapular ligament (TSL) with complete or partial ossification, the presence of the triangular bony growth at the lateral border of scapula and to observe vascular foramen/foramina piercing at the bases of the spine of scapulae.
Methods: An observational study was conducted on dried human scapulae 140 in number (70 right and 70 left) of unknown sex and age, procured from the Department of Anatomy, People’s College of Medical Science and Research Center, Bhopal, and Government Doon Medical College, Dehradun, India. These scapulae were studied to observe enthesopathic changes in them. Measurements were taken with Vernier calipers.
Results: In the present study, we observed the presence of completely ossified TSL with formation of complete suprascapular foramina in 8.57% scapulae. The incidence of triangular bony growth at the lateral border of scapula was found in 40% scapulae of the right side and 32.85% of the left. The incidence of vascular foramina piercing at the bases of the spine of scapulae was 17.14% on the right side and 21.42% on the left side scapulae.
Conclusion: The study provides the descriptive knowledge of enthesopathy in scapulae. The study is of great significance for neurosurgeons and orthosurgeons to carry out various reconstructive surgeries.
2. Standring S, Ellis H, Healy J, Johnson D, Williams A. Pectoral girdle, shoulder region and axilla. In: Standring S, editor. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 39th ed. New York: Elsevier Churchill Livingstone; 2005. p. 821-2.
3. Breathnach AS. Frazer’s Anatomy of the Human Skeleton. 6thed. London: J & A Churchill Ltd.; 1965. p. 64.
4. Hrdlicka A. The scapula: Visual observations. Am J Phys Anthropol 1942;2:73-94.
5. Ticker JB, Djurasovic M, Strauch RJ, April EW, Pollock RG, Flatow EL, et al. The incidence of ganglion cysts and other variations in anatomy along the course of the suprascapular nerve. J Shoulder Elbow Surg 1998;7:472-8.
6. Mestdagh M, Drizenko A, Ghestem P. Anatomical basis of suprascapular nerve syndrome. Anat Clin 1981;3:67-71.
7. Tubbs RS, Smyth MD, Salter G, Oakes J. Anomalous traversement of the suprascapular artery through the suprascapular notch: A possible mechanism for undiagnosed shoulder pain? Med Sci Monit 2003;9:BR116-9.
8. Moriggl B, Jax P, Milz S, Buttner A, Benjamin M. Fibrocartilage at the entheses of the suprascapular (superior transverse scapular) ligament of man-a ligament spanning two regions of a single bone. J Anat 2001;199:539-45.
9. Polguj M, Jedrzejewski K, Podgorski M, Majos A, Topol M. A proposal for classification of the superior transverse scapular ligament: Variable morphology and its potential influence on suprascapular nerve entrapment. J Shoulder Elbow Surg 2013;22:1265-73.
10. Benjamin M, Toumi H, Suzuki D, Redman S, Emery P, McGonagle D. Microdamage and altered vascularity at the enthesis-bone interface provides an anatomic explanation for bone involvement in the HLA-B27-associated spondylarthritides and allied disorders. Arthritis Rheum 2007;56:224-33.
11. Thounaojam K, Karam R, Singh NS. Ossification of transverse scapular ligament. J Evol Med Dent Sci 2013;2:1790-1.
12. Jadhav SD, Patil RJ, Roy PP, Ambali MP, Doshi MA, Desai RR. Supra-scapular foramen in Indian dry scapulae. Natl J Clin Anat 2012;1:133-5.
13. Das S, Suri R, Kapur V. Ossification of superior transverse scapular ligament and its clinical implications. Sultan Qaboos Univ Med J 2007;7:157-60.
14. Poirier P, Charpy A. Traite d’Anatomie Humaine. 3rd ed. Paris: Wentworth Press; 1911. McMurrich JP. Quain’s Elements of Anatomy. 11th ed. New York: Longmans, Green & Co.; 1915. p. 140.
15. Gray DJ. Variations in the human scapulae. Am J Phys Anthropol 1942;29:57-72.
16. Silva JG, Abidu-Figueiredo M, Fernandesetal RM. High incidence of complete ossification of the superior transverse scapular ligament in Brazilians and its clinical implications. Int J Morphol 2007;25:855-9.
17. Singh R. Bony projection from lateral border of scapula. OA Case Rep 2014;3:36.
18. Goswami IP, Yadav Y. Bony projection along lateral border of scapula-a case report. J Res Hum Anat Embryol 2017;3:7-8.
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