Identification of medial coraco-clavicular (Caldani's) ligament by magnetic resonance imaging. Original procedure and clinical applications.
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Published:
Feb 12, 2017
Keywords:
Medial coracoclavicular ligament, Caldani, Magnetic Resonance Imaging, Procedure, Thoracic Outlet, Acromioclavicular dislocation
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Abstract
Goals:Although Caldani´s ligament or medial coraco-clavicular ligament (MCCL) has been anatomically studied, we have not found any publication regarding its identification in image studies. The aim of this research it to present an original technique to locate the MCCL on magnetic resonance imaging (MRI), as well as to describe the pertinent findings.Materials and Methods Seven volunteer patients without any known shoulder pathology were studied by means of this original protocol. A PHILLIPS INGENIA 1.5 Tesla MRI equipment was used, Magnetic field intensity 1,5.Gantry diameter: 70cm, It featured an 8-Channel coil for shoulder study. The sequences to locate the ligament were performed in three planes. The length and thickness of the MCCL were measured.Results The MCCL was observed in all cases. It presented a similar arrangement as described in previous anatomical description consulted. The origin was at the coracoid process, with an oblique path to reach its insertion at the clavicle. The mean length was 41.14 (range 34-47 mm), Standard Deviation: 4.40. The mean thickness was 2.11 mm (range 1.3-3.2 mm), Standard Deviation: 0.66.ConclusionThe MCCL can be observed in MR images utilizing this original procedure. The ability to display the MCCL ligament in MRI allows for future investigations on its possible role in both thoracic outlet syndrome and traumatic acromioclavicular dislocations, especially the Rockwood type V.
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Azulay, G., Mamone, A., Moya, D., Poitevin, L., & Postan, D. (2017). Identification of medial coraco-clavicular (Caldani’s) ligament by magnetic resonance imaging. Original procedure and clinical applications. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 82(1), 71-77. https://doi.org/10.15417/640
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Basic Research
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References
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13. Dolan CM, Hariri S, Hart ND et al. An anatomic study of the coracoid process as it relates to bone transfer procedures. J Shoulder Elbow Surg. 2011; 20:497–501. DOI: 10.1016/j.jse.2010.08.015
14. Ockert B, Braunstein V, Sprecher C et al. Attachment sites of the coracoclavicular ligaments are characterized by fibrocartilage differentiation: a study on human cadaveric tissue. ScandJMedSci Sports. 2010;22(1): 12-17. DOI: 10.1111/j.1600-0838.2010.01142.x.
15. Rockwood CA Jr, Matsen FA, Wirth MA, Lippitt SB. The Shoulder, 4th ed. W. B. Saunders, Philadelphia, 2009: 216–386.
16. Lädermann A, Grosclaude M, Lubbeke A et al Acromioclavicular and coracoclavicular cerclage reconstruction for acute acromio-clavicular joint dislocations. J Shoulder ElbowSurg. 2011, 20:401–408. DOI: 10.1016/j.jse.2010.08.007.
17. Klassen JF, Morrey BF, An Kn. Surgical anatomy and function of the acromioclavicular and coracoclavicular ligaments. Op Tech Sport Med. 1997;5(2):60-64.
18. Stoller DW: Magnetic Resonance Imaging in Orthopaedics and Sports Medicine Philadelphia: Lippincott-Raven Publishers, Third Edition, Nov 2006. ISBN-13: 978-0781773577
19. Vahlensieck M: MRI of the shoulder. Eur Radiol. 2000;10(2):242-9.
20. Ho CP. Applied MRI anatomy of the shoulder. J Orthop Sports Phys Ther. 1993 Jul;18(1):351-9.
21. Lee JC, Guy S, Connell D, Saifuddin A, Lambert S. Ho CP: MRI of the rotator interval of the shoulder. Clin Radiol. 2007, 62(5):416-23. DOI: 10.1016/j.crad.2006.11.017
22. Nakata W, Katou S, Fujita A, Nakata M, Lefor AT, Sugimoto H. Biceps pulley: normal anatomy and associated lesions at MR arthrography. Radiographics. 2011, 31(3):791-810. DOI: 10.1148/rg.313105507
2. Rouvière H. Anatomie Humaine Descriptive et Topographique, Masson, Paris; 1927 (2). p.36.
3. StedmanT L. A practical medical dictionary, New York, W. Wood and company; 1920. P. 153.
4. Poitevin L, Postan D. Moya, D, Valente S, Azulay G.; Mamone A, Giacomelli Anatomía del Ligamento Córaco-clavicular Medial. Primera Parte: Investigación Anatómica.. Rev. Arg. Anat. Onl.2014, Vol. 5, Nº 4: 119 – 126.
5. Vallois, HV; Thomas, L: Les formations fibreuses du triangle clavipectoral. Arch Anato Hist Embr.1942; 3: 363-396.
6. Souteyrand-Boulanger. Les formations fibreuses et les ligaments du triangle clavi-coraco-pectoral chez les primates. Mammalia. 1966;30: 645-666.
7. Stimec et al. Medial coraco-clavicular ligament revisted: an anatomic study and review of the literature. Arch Orthop Trauma Surg. 2012;132(8):1071-5. doi: 10.1007/s00402-012-1512-9.
8. Poitevin L: Compressions à la confluence cervico-braquiale. En: Tubiana R. Traité de Chirurgie de la Main. Masson, Paris, Volume 4, 1991:368-369.
9. Poitevin L: Proximal compressions of the upper limb neurovascular bundle. An anatomic research study. Hand Clinics. 1988 (l4). 4:575-584.
10. Poitevin L: Proximal compressions of the upper limb neurovascular bundle. En Tubiana R: The Hand. WB Saunders Volume IV, 1993 Chapter 20: 338-339.
11. Poitevin, LA. Bases anatómicas de las compresiones cervicobraquiales. Parte I: factores estáticos. Rev. Asoc. Argent. Ortop. Traumatol; 1988, 53(2): 175-88.
12. Poitevin, LA. Bases anatómicas de las compresiones cervicobraquiales. Parte II: Factores dinámicos. Patogenia de las compresiones. Rev. Asoc. Argent. Ortop. Traumatol; 1988, 53(2): 199-212.
13. Dolan CM, Hariri S, Hart ND et al. An anatomic study of the coracoid process as it relates to bone transfer procedures. J Shoulder Elbow Surg. 2011; 20:497–501. DOI: 10.1016/j.jse.2010.08.015
14. Ockert B, Braunstein V, Sprecher C et al. Attachment sites of the coracoclavicular ligaments are characterized by fibrocartilage differentiation: a study on human cadaveric tissue. ScandJMedSci Sports. 2010;22(1): 12-17. DOI: 10.1111/j.1600-0838.2010.01142.x.
15. Rockwood CA Jr, Matsen FA, Wirth MA, Lippitt SB. The Shoulder, 4th ed. W. B. Saunders, Philadelphia, 2009: 216–386.
16. Lädermann A, Grosclaude M, Lubbeke A et al Acromioclavicular and coracoclavicular cerclage reconstruction for acute acromio-clavicular joint dislocations. J Shoulder ElbowSurg. 2011, 20:401–408. DOI: 10.1016/j.jse.2010.08.007.
17. Klassen JF, Morrey BF, An Kn. Surgical anatomy and function of the acromioclavicular and coracoclavicular ligaments. Op Tech Sport Med. 1997;5(2):60-64.
18. Stoller DW: Magnetic Resonance Imaging in Orthopaedics and Sports Medicine Philadelphia: Lippincott-Raven Publishers, Third Edition, Nov 2006. ISBN-13: 978-0781773577
19. Vahlensieck M: MRI of the shoulder. Eur Radiol. 2000;10(2):242-9.
20. Ho CP. Applied MRI anatomy of the shoulder. J Orthop Sports Phys Ther. 1993 Jul;18(1):351-9.
21. Lee JC, Guy S, Connell D, Saifuddin A, Lambert S. Ho CP: MRI of the rotator interval of the shoulder. Clin Radiol. 2007, 62(5):416-23. DOI: 10.1016/j.crad.2006.11.017
22. Nakata W, Katou S, Fujita A, Nakata M, Lefor AT, Sugimoto H. Biceps pulley: normal anatomy and associated lesions at MR arthrography. Radiographics. 2011, 31(3):791-810. DOI: 10.1148/rg.313105507