Anatomical Variants of “Short Head of Biceps Femoris Muscle” Associated with Common Peroneal Neuropathy in Korean Populations : An MRI Based Study

Yang, Jin Seo; Cho, Yongjun; Cho, Jaeho; Choi, Hyukjai; Jeon, Jinpyeong; Kang, Suk Hyung

doi:10.3340/jkns.2018.0018

Cited by 7 publications

(8 citation statements)

References 11 publications

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“…This suggests that the prevalence of certain anatomic features may vary geographically (possibly related to genetic, environmental, and historical factors). In this study ( Yang et al, 2018 ), type II subjects had significantly greater BFsh thickness. The functional relevance of these anatomic variations is not straightforward.…”

Section: Part 2: Anatomic and Physiologic Variations Of The Hamstrings And Potential Implications For Injury Risksupporting

confidence: 43%

“…A similar study retrospectively analyzed 1.5-T knee MRI scans of 93 Korean subjects, divided into types according to the course of the common peroneal nerve: type I (no tunnel) and type II (tunnel) (Yang et al, 2018): ∼40% of subjects were classified as type II, which is superior to the percentage observed in the aforementioned study (Vieira et al, 2007). This suggests that the prevalence of certain anatomic features may vary geographically (possibly related to genetic, environmental, and historical factors).…”

Section: Innervation Patternsmentioning

confidence: 99%

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The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

et al. 2021

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The incidence and recurrence of hamstrings injuries are very high in sports, posing elevated performance and financial-related costs. Attempts to identify the risk factors involved in predicting vulnerability to hamstrings injury is important for designing exercise-based programs that aim to mitigate the rate and severity of hamstrings injuries and improve rehabilitation strategies. However, research has shown that non-modifiable risk factors may play a greater role than modifiable risk factors. Recognizing non-modifiable risk factors and understanding their implications will afford the prescription of better suited exercise programs, i.e., that are more respectful of the individual characteristics. In a nutshell, non-modifiable risk factors can still be acted upon, even if indirectly. In this context, an underexplored topic is how intra and inter- individual anatomic and physiologic variations in hamstrings (e.g., muscle bellies, fiber types, tendon length, aponeurosis width, attachment sites, sex- and age-related differences) concur to alter hamstrings injuries risk. Some anatomic and physiologic variations may be modifiable through exercise interventions (e.g., cross-sectional area), while others may not (e.g., supernumerary muscle bellies). This apparent dichotomy may hide a greater complexity, i.e., there may be risk factors that are partially modifiable. Therefore, we explored the available information on the anatomic variations of the hamstrings, providing a deeper insight into the individual risk factors for hamstrings injuries and contributing with better knowledge and potential applications toward a more individualized exercise prescription.

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Section: Part 2: Anatomic and Physiologic Variations Of The Hamstrings And Potential Implications For Injury Risksupporting

confidence: 43%

Section: Innervation Patternsmentioning

confidence: 99%

The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

et al. 2021

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“…In our study, the average length of the popliteal tunnel formed by the SHBFM and the LGCM was 3.07 cm (range 2.3 to 4.4 cm). Also, the length of the popliteal intermuscular tunnel in symptomatic patients with anatomical variation of the distal BFM related to the CPNe was 24 mm, which was confirmed by MRI [ 14 ]. Therefore, compared to the length of the fibula tunnel, the length of the popliteal tunnel is sufficient for the nerve to be compressed, so it is thought that this tunnel can be a predisposing clinical factor in CPNe.…”

Section: Discussionmentioning

confidence: 90%

“…These authors suggested investigating the course of the CPN between popliteal muscles, including the short head of the biceps femoris muscle (SHBFM) and the LGCM, using magnetic resonance imaging (MRI). We also reviewed an MRI study about an anatomical variation of the distal BFM related to the CPNe with a clinical case illustration [ 14 ]. However, due to limitations of MRI-based imaging studies, these studies have failed to completely establish morphological characteristics of BFM variation-related entrapment neuropathy.…”

Section: Introductionmentioning

confidence: 99%

A Cadaveric Study of the Distal Biceps Femoris Muscle in relation to the Normal and Variant Course of the Common Peroneal Nerve: A Possible Cause of Common Peroneal Entrapment Neuropathy

Park

Yang

Park

et al. 2020

BioMed Research International

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The most frequent mononeuropathy in the lower extremity has been reported as the common peroneal nerve entrapment neuropathy (CPNe) around the head and neck of the fibula, although the mechanism of the neuropathy in this area cannot be fully explained. Therefore, the aim of this cadaveric study was to evaluate the relationship between morphologic variations of the distal biceps femoris muscle (BFM) and the course of the common peroneal nerve (CPN) and to investigate the incidence and morphological characteristics of anatomical variations in the BFM associated with CPNe. The popliteal region and the thigh were dissected in 115 formalin-fixed lower limbs. We evaluated consensus for (1) normal anatomy of the distal BFM, (2) anatomic variations of this muscle, and (3) the relationship of the muscle to the CPN. Measurements of the distal extents of the short and long heads of the BFM from insertion (fibular head) were performed. Two anatomic patterns were seen. First, in 93 knees (80.8%), the CPN ran obliquely along the lateral side of the BFM and then superficial to the lateral head of the gastrocnemius muscle. Second, in 22 cases (19.2%), the CPN coursed within a tunnel between the biceps femoris and lateral head of the gastrocnemius muscle (LGCM). There was a positive correlation between the distal extents of the short heads of the biceps femoris muscle (SHBFM) and the presence of the tunnel. The “popliteal intermuscular tunnel” in which the CPN travels can be produced between the more distal extension variant of the SHBFM and the LGCM. This anatomical variation of BFM may have a clinical significance as an entrapment area of the CPN in the patients in which the mechanism of CPNe around the fibula head and neck is not understood.

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“…The CPN enters the anterior and lateral muscle compartments of the leg and gives branches. These include superficial peroneal nerve, which innervates peroneus longus and brevis for ankle eversion; deep peroneal nerve, which innervates the tibialis anterior for ankle dorsiflexion as well as the extensor digitorum longus and brevis for toe extension 1,7,13,14) . We thought the connection between the CPN and the muscles might lead to the diagnostic potential of MRI by identifying alterations in muscles.…”

Section: Discussionmentioning

confidence: 99%

Applicability of Magnetic Resonance Imaging for Early Diagnosis of Common Peroneal Neuropathy

Choi

Yang

Cho

et al. 2021

Nerve

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Objective: This study aimed to assess the clinical applicability of magnetic resonance imaging (MRI) for the early diagnosis of common peroneal neuropathy (CPNe).Methods: Over three years, the authors have treated 58 patients with CPNe. All patients had clinical or neurophysiological confirmation of CPNe. Among them, 35 (60%) patients underwent axial knee MRI with a 1.5-Tesla scanner. These 35 patients were selected for study and were classified into three groups according to the time of examination after the occurrence of dropped foot―acute, subacute, and chronic onset groups. According to muscle appearances (normal, edematous change, and atrophy), we diagnosed them with CPNe, except for those with normal morphology. We evaluated the applicability of MRI in the diagnosis of CPNe compared to that of electromyography (EMG).Results: The 18, 11, and six cases were included in the acute, subacute, and chronic onset groups, respectively. In the acute onset group, three cases had normal muscle appearance, while 15 cases had edematous changes in the affected muscles. In the subacute onset group, eight cases had edematous changes, while three cases showed muscle atrophy. In the chronic onset group, six cases had muscle atrophy. CPNe could be diagnosed using MRI in about 91% (32/35) of all the cases. Excluding the chronologically chronic stage, diagnosis rate was approximately 89%(26/29) of all the cases. However, only in 27 cases (77%) denervation potentials were presented on EMG.Conclusion: According to our results, MRI is a helpful diagnostic modality, especially in the early stage of CPNe, and may lead to proper management.

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Anatomical Variants of “Short Head of Biceps Femoris Muscle” Associated with Common Peroneal Neuropathy in Korean Populations : An MRI Based Study

Cited by 7 publications

References 11 publications

The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

A Cadaveric Study of the Distal Biceps Femoris Muscle in relation to the Normal and Variant Course of the Common Peroneal Nerve: A Possible Cause of Common Peroneal Entrapment Neuropathy

Applicability of Magnetic Resonance Imaging for Early Diagnosis of Common Peroneal Neuropathy

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