Deltoid Contracture: MR Imaging Features

Ogawa, Kiyohisa; Takahashi, Masaaki; Naniwa, Toyohisa

doi:10.1053/crad.2000.0589

Cited by 9 publications

(1 citation statement)

References 14 publications

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“…Only the atrophy scores of the EDL muscle were entered in the equation because, according to the theory, this muscle acts in overpowering the intrinsic muscles at the MTP joint, which is the primary joint in claw toe deformity. The presence of intramuscular fibrosis indicating muscle contractures, which may also play a role in overpowering the intrinsic muscles (19,20), was scored as a hypointense (black) signal on the transverse plane images of the lower leg (21). …”

Section: Methodsmentioning

confidence: 99%

Role of Intrinsic Muscle Atrophy in the Etiology of Claw Toe Deformity in Diabetic Neuropathy May Not Be as Straightforward as Widely Believed

et al. 2009

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OBJECTIVEClawing of the toes in the diabetic neuropathic foot is believed to be caused by muscle imbalance resulting from intrinsic muscle atrophy. However, experimental data that support this mechanism are lacking. The aim of this study was to evaluate this hypothesis using magnetic resonance imaging (MRI).RESEARCH DESIGN AND METHODSIn 20 neuropathic diabetic patients, 10 with claw toe deformity and 10 with normally aligned toes, multiple plane images of the foot and lower leg were acquired using T1-weighted spin-echo MRI. Atrophy of the intrinsic and extrinsic muscles controlling the toes was assessed using a semiquantitative 5-point atrophy scale. An intrinsic-to-extrinsic foot muscle imbalance score was derived from these atrophy scores, and correlation coefficients were established.RESULTSThe mean ± SD intrinsic muscle atrophy score was 3.1 ± 1.1 for the toe deformity group and 2.6 ± 1.2 for the nondeformity group (not significantly different). The intrinsic muscle atrophy score was not significantly correlated with degree of toe deformity (r = −0.18). The muscle imbalance score was not significantly different between study groups and was not significantly correlated with degree of toe deformity (r = −0.14).CONCLUSIONSNeither intrinsic muscle atrophy nor muscle imbalance discriminated between neuropathic patients with or without claw toe deformity, suggesting that the role of these muscle factors in claw toe development may not be primary or as straightforward as previously believed. These findings shed new light on the etiology of foot deformity in diabetes and suggest a more complex nature of development, potentially involving anatomical and physiological predisposing factors.

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Section: Methodsmentioning

confidence: 99%

Role of Intrinsic Muscle Atrophy in the Etiology of Claw Toe Deformity in Diabetic Neuropathy May Not Be as Straightforward as Widely Believed

et al. 2009

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Deltoid contracture mimicking shoulder dislocation in a 7-year-old boy

2010

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Contracture of the deltoid muscle, a relatively uncommon disorder in children, can be caused by repeated intramuscular injection, trauma, or congenital disease. The typical clinical manifestations of deltoid contracture (i.e., a palpable fibrous cord within the deltoid muscle, abduction contracture of the shoulder, winged scapula, and skin dimpling over the fibrous bands), however, may be atypical or even lacking, thus, leading to misdiagnosis. The procedure going from misdiagnosis to recognition of the correct diagnosis is reviewed in a 7-year-old boy with deltoid contracture.

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Deltoid contracture: a case with multiple muscle contractures

Chen

Huang

Chou

et al. 2007

Arch Orthop Trauma Surg

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Deltoid contracture is relatively uncommon. The literature consists primarily of case reports and few articles on large case series. The pathogenesis has been well studied. Muscle contractures can occur in the deltoid, biceps, triceps, gluteus and quadriceps muscles; however, cases of multiple muscle contractures are rare. We reported a patient with multiple contractures of the bilateral deltoid, bilateral gluteus, and bilateral quadriceps muscles, who had received repeated intramuscular injections during childhood and adulthood. The radiographic, including magnetic resonance imaging (MRI), features of the bone and joint abnormalities are presented. Some literatures reported that damage to the structures of the body due to intramuscular injection is related to the site of injection, age of the patient, and the volume, pH, chemical composition, and diffusional capacity of the injectate. Our patient had muscular contracture induced by needle injection regardless of her age, medication and injection site.

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Deltoid Contracture: MR Imaging Features

Cited by 9 publications

References 14 publications

Role of Intrinsic Muscle Atrophy in the Etiology of Claw Toe Deformity in Diabetic Neuropathy May Not Be as Straightforward as Widely Believed

Role of Intrinsic Muscle Atrophy in the Etiology of Claw Toe Deformity in Diabetic Neuropathy May Not Be as Straightforward as Widely Believed

Deltoid contracture mimicking shoulder dislocation in a 7-year-old boy

Deltoid contracture: a case with multiple muscle contractures

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