Juan Canoso

Centro Médico ABC · Department of Medicine

Purpose Depending on its axis, pronation varies from the radius rotation around the steady ulna to the reciprocal adduction of the radius and abduction of the ulna. While there is no question that pronator teres is a central pronation agonist, anconeus’s role is not settled. The current investigation comparing palpation and ultrasonography in these...

Background: Forearm intersection syndrome causes pain, swelling, and a rub at the dorsal distal forearm where the first extensor compartment muscles intersect with the second compartment tendons. Although primary care settings tend to treat mild cases, high-performance athletes may suffer from severe symptoms that require surgery. This proof-of-con...

Background: Palpation, a traditional haptic ability, is used daily by practitioners of all medical and surgical specialties to assess patients. In the current study, one of the authors, in a routine clinical setting, was able to deduce the dynamic features of the putative inferior belly of omohyoid. This led to a proof-of-concept study that yielde...

Clinicians use pain and tenderness elicited from local pressure at tendon, ligament, and capsular insertions to bone to identify enthesitis. 1,2,3,4,5 In addition, certain entheses have an adjacent bursa or synovial space that, when distended by synovial fluid, adds certainty to a clinical diagnosis of enthesitis. 6,7,8

This study aimed to determine by ultrasonography, and cadaveric dissection, whether the firm cords felt by palpation at the sides of the proximal phalanx (PP), actively flexing, and extending the proximal interphalangeal (PIP) joint while keeping the metacarpophalangeal (MCP) joint extended are the lateral bands (LBs) of the extensor apparatus. If...

Introducción: La anatomía musculoesquelética (AME) es la base del examen físico reumatológico. La AME, en asociación con la ecografía, son esenciales en la formación de reumatólogos. Los autores desarrollaron una pedagogía centrada en el alumno, la AME por autoexamen (AMEA), que combina la autoinspección, palpación y percepción, para suplementar pe...

Objective To determine the effect of knee flexion and submaximal isometric quadriceps muscle (Q) contraction on the patellar tendon (PT), the infrapatellar fat pad (IPFP), and the deep infrapatellar bursa (IPB) from extension to full flexion. Methods In Study 1, the dominant knee of seven healthy subjects was studied in full extension and at 60 de...

Background: The authors describe a series of learner-centered exercises, highlighting a technique in which the musculoskeletal anatomy is explored and learned through self-examination, with the examiner required to identify designated structures in both the static and dynamic state. Methods: The technique of musculoskeletal anatomy through self-...

To review the importance of physical examination in the diagnostic process of musculoskeletal conditions vis-a-vis the development of sensitive and powerful technologies such as MRI and high-resolution ultrasound. Because the physical examination of the musculoskeletal system is an exercise of applied clinical anatomy, the authors tested, in one-to...

This study aimed to generate a minimum list of structural and functional anatomical items about the pelvis/hip, knee, ankle/foot, gait, and lower limb innervation, which are most relevant to the practice of rheumatology. To determine their perceived relevance to clinical practice, seven members of the Mexican Clinical Anatomy Task Force compiled an...

This study aimed to identify the anatomical items of the upper extremity and spine that are potentially relevant to the practice of rheumatology. Ten rheumatologists interested in clinical anatomy who published, taught, and/or participated as active members of Clinical Anatomy Interest groups (six seniors, four juniors), participated in a one-round...

We aim to study the educational impact of a clinical anatomy workshop in 1st-year orthopedic and rheumatology fellows. First-year rheumatology fellows (N = 17) and a convenience sample of 1st-year orthopedic fellows (N = 14) from Mexico City in the 9th month of training participated in the study. The pre- and the post- workshop tests included the s...

Objective: To survey the efficacy of a practical workshop on clinical musculoskeletal anatomy held in five American countries. Methods: A self-assessment competence questionnaire sent to participants 1-3 months after the workshop. Results were compared to the results of a practical, instructor-assessed, pre-workshop test. Results: The response...

Objective To report the baseline knowledge of clinical anatomy of rheumatology fellows and rheumatologists from Argentina, Chile, Ecuador, El Salvador, Mexico, the US, and Uruguay. Methods The invitation to attend a workshop in clinical anatomy was an open call by national rheumatology societies in 4 countries or by invitation from teaching program...

Background The rheumatologic examination, which is based on a sound internal medicine examination, focuses predominantly on the musculoskeletal system. However, seasoned rheumatologists recognize the importance of the neurologic and vascular examination as well. Objectives The current survey is a group effort at listing musculoskeletal, neural and...

Please cite this article in press as: Saavedra MÁ, et al. Self-assessed efficacy of a clinical musculoskeletal anatomy workshop: A preliminary survey. Reumatol Clin. 2014. http://dx. a b s t r a c t Objective: To survey the efficacy of a practical workshop on clinical musculoskeletal anatomy held in five American countries. Methods: A self-assessme...

The current issue of Reumatología Clínica is devoted to the method of teaching clinical anatomy as it applies to rheumatology. This method was developed as a response to a perceived need. It is our belief that rheumatologists are at present insufficiently trained in clinical anatomy. As a result, our diagnostic skills may fall short of their potent...

This paper emphasizes the anatomical substrate of several foot conditions that are seldom discussed in this context. These include the insertional and non-insertional Achilles tendinopathies, plantar fasciopathy, inferior and posterior heel spurs, foot compartment syndromes, intermetatarsal bursitis and Morton's neuroma. It is a rather superficial...

The contents of this review may appear odd. After a brief description of the coxofemoral joint, the entities discussed include ilioinguinal neuropathy within the context of the nerves that may be damaged during lower abdominal surgery, meralgia paresthetica, piriformis syndrome with the appropriate caveats, trochanteric syndrome, "ischial bursitis"...

The elbow patients herein discussed feature common soft tissue conditions such as tennis elbow, golfers' elbow and olecranon bursitis. Relevant anatomical structures for these conditions can easily be identified and demonstrated by cross examination by instructors and participants. Patients usually present rotator cuff tendinopathy, frozen shoulder...

The clinical anatomy of several pain syndromes of the knee is herein discussed. These include the iliotibial tract syndrome, the anserine syndrome, bursitis of the medial collateral ligament, Baker's cyst, popliteus tendon tenosynovitis and bursitis of the deep infrapatellar bursa. These syndromes are reviewed in terms of the structures involved an...

This article reviews the underlying anatomy of trigger finger and thumb (fibrous digital pulleys, sesamoid bones), flexor tenosynovitis, de Quervain's syndrome, Dupuytren's contracture, some hand deformities in rheumatoid arthritis, the carpal tunnel syndrome and the ulnar nerve compression at Guyon's canal. Some important syndromes and structures...

To the Editor: Few would deny that the physical examination of patients is devalued today. There are several reasons for this. Crowded waiting rooms exert an abortive pressure on this time-honored art. Also, validated, simplified but “equally effective” instruments used in drug trials concentrate the rheumatologist’s attention on the joint homunc...

This paper emphasizes the anatomical substrate of several foot conditions that are seldom discussed in this context. These include the insertional and non-insertional Achilles tendinopathies, plantar fas-ciopathy, inferior and posterior heel spurs, foot compartment syndromes, intermetatarsal bursitis and Morton's neuroma. It is a rather superficial...

The differential diagnosis of heel pain is broad and can be overwhelming if a systematic approach is not used. Focused questions and physical examination can help identify heel pain as Achilles tendinopathy or plantar fasciitis, or as due to a less common cause such as gout, spondyloarthropathy, or hypercholesterolemia.

Present evidence indicates that the main cause of plantar talalgia (PT) is a noninflammatory derangement at the proximal insertion of the plantar fascia. In athletes, predisposing ankle and rear-foot biomechanical abnormalities have been identified; in nonathletes, risk factors for the condition remain controversial. PT diagnosis is largely clinica...

Anserine bursitis is a frequent cause of medial knee pain. Despite its name, the structure at fault causing the symptoms remains unknown. Diabetes mellitus is a known predisposing factor leading to the condition. Overweight and knee osteoarthritis are possible additional risk factors, but their role has yet to be assessed. Anserine bursitis is diag...

Trochanteric bursitis is a term used to name a syndrome that features pain and tenderness over the greater trochanter. Present evidence suggests that in the majority of cases, symptoms result from pathology of the gluteus medius or minimus muscles rather than a bursa. Lower limb length discrepancy, iliotibial band contracture, hip osteoarthritis an...

Lateral and medial epicondylitis represent overuse tendinopathies of wrist extensor and wrist flexor muscles, respectively. In lateral epicondylitis, a short-term therapeutic efficacy of glucocorticoid injection and limited evidence on the efficacy of acupuncture has been shown. De Quervain tendinopathy is caused by tendinous impingement by a thick...

Impingement into the coracoacromiohumeral space, a common cause of rotator cuff tendinopathy, may result from an impinging osteoligamentous upper boundary, abnormalities in the tendon itself, or failure of muscles that retain the humeral head on the glenoid. An overuse mechanism is clearly a risk factor in throwing athletes, whereas occupational ov...

Successful needle placement for joint and soft tissue aspiration and injection requires clear understanding of anatomy. Aspiration of joint and soft tissue fluids may be important for diagnosis and treatment. ■ Joint or soft tissue injections with corticosteroids may be beneficial for short- and long-term treatment.

Regional pain syndromes (1,2), which occur one time or another in most people past the age of 40 years, are central to primary care medicine. They are also fairly frequent in younger people; however, their true frequency and characteristics in the pediatric group have yet to be defined. Because regional pain syndromes are so diverse and ubiquitous,...