Surgical And Radiologic Anatomy[JOURNAL]
Sun
200 papers
The prevalence of unclosed transverse foramina in the cervical spine of a South African population sample.
Nalla S, Noorbhai N, Paton GJ
Surg Radiol Anat · 2026 Feb · PMID 41697384 · Full text
PURPOSE: Unclosed transverse foramina (UTF) represent anatomical variations of the cervical vertebrae that may influence vertebral artery, vein or sympathetic nerves, particularly at the level of the atlas (C1). This stu...
PURPOSE: Unclosed transverse foramina (UTF) represent anatomical variations of the cervical vertebrae that may influence vertebral artery, vein or sympathetic nerves, particularly at the level of the atlas (C1). This study aimed to determine the prevalence and distribution of UTF in a South African skeletal population and to evaluate associations with age, biological sex, and population affinity. METHODS: A macroscopic osteological assessment of cervical vertebrae from 800 individuals was performed using a South African skeletal repository. UTF were identified based on incomplete osseous closure of the transverse foramen. Prevalence was assessed at individual and vertebral levels, and demographic associations were analyzed statistically. RESULTS: UTF were identified in 17.4% of individuals and 2.9% of total vertebrae. The highest prevalence occurred at C1, followed by C3 and C6. Unilateral UTF were more common than bilateral, with a right-sided predominance. UTF were observed more frequently in males, individuals younger than 50 years, and those of Black African population affinity, with the highest prevalence in the Sotho subgroup. A weak but significant association with younger age was noted at the C2 and C7 levels (p < 0.05). CONCLUSION: UTF are common anatomical variants in this South African population, with prevalence influenced by vertebral level and demographic factors. Recognition of UTF is important for accurate radiological interpretation and for surgical and manual procedures involving the cervical spine, where altered neurovascular anatomy may affect procedural planning and safety.
Anthropometric measurements of alar cartilage in the Turkish population sample: a comparative study.
Seyhan S, Erdogan MM
Surg Radiol Anat · 2026 Feb · PMID 41697369 · Publisher ↗
PURPOSE: Alar cartilage anatomy varies significantly across ethnic groups, and understanding these differences is crucial in nasal tip surgery. The aim of this descriptive study was to evaluate the anthropometric propert...
PURPOSE: Alar cartilage anatomy varies significantly across ethnic groups, and understanding these differences is crucial in nasal tip surgery. The aim of this descriptive study was to evaluate the anthropometric properties of the alar cartilage in the Turkish population sample and to compare these data with findings from various other ethnic groups. METHODS: Length, width, and thickness measurements were taken from 92 Turkish patients who underwent primary open rhinoplasty. These measurements included the maximum values for each of the lateral crus, middle crus, medial crus and the medial, middle, lateral distances between the caudal border of the lateral crus and the alar rim. The resulting data were statistically analyzed, and comparisons were made between genders and with findings from various ethnic groups. RESULTS: All measurements of the lateral crus, the length and thickness measurements of the middle crus, and the thickness measurements of the medial crus were found to be significantly greater in males (p < 0.002). It was found that the lengths of the lateral, middle, and medial crura were statistically significantly longer on the left side (p < 0.002). It was observed that in the Turkish population sample, the alar cartilages are generally long and wide, but thin, and the average distances between the caudal border of the lateral crus and the alar rim were moderate. CONCLUSION: This study presents baseline anthropometric data for the Turkish alar cartilage. Comparative analysis with other ethnic groups revealed both similarities and distinct differences. Acknowledging these specific ethnic differences is essential for preoperative planning.
Proximal origin variants of the plantaris muscle: a classification-based review with surgical and radiologic implications.
Olewnik Ł, Landfald IC, LaPrade RF
Surg Radiol Anat · 2026 Feb · PMID 41686284 · Publisher ↗
BACKGROUND: The plantaris muscle (PM) is a highly variable structure whose proximal origin demonstrates significant morphological diversity. While traditionally considered clinically insignificant, recent evidence highli...
BACKGROUND: The plantaris muscle (PM) is a highly variable structure whose proximal origin demonstrates significant morphological diversity. While traditionally considered clinically insignificant, recent evidence highlights its role in sports injuries, Achilles tendinopathy, and even vascular entrapment syndromes. A structured classification-based approach is therefore essential to improve diagnostic accuracy and surgical safety. METHODS: A classification-focused narrative review of anatomical, radiological and clinical literature was performed using PubMed and Web of Science, supplemented by manual screening of reference lists. Nineteen key articles were synthesised qualitatively, and morphometric frequencies were taken from the original cadaveric classification study of 128 lower limbs. RESULTS: Eight distinct PM configurations were synthesised into a clinically oriented framework: six primary origin types (I–VI) and two special Type VI variants (double and bifurcated plantaris). Type II and the double PM variant have been reported most frequently in association with “tennis leg” and recurrent calf pain, whereas Type IV and bifurcated variants have been implicated in popliteal artery entrapment, mainly in case-based reports. Radiologically, PM variants may mimic neoplastic or cystic lesions, underscoring the need for classification-based interpretation to avoid misdiagnosis. Tables and an algorithmic workflow are presented to guide surgeons and radiologists through variant recognition and risk mitigation. CONCLUSIONS: Not all plantaris muscles are equal. Their anatomical variability directly influences orthopaedic, vascular, and radiological practice. Preoperative identification using MRI or ultrasound, combined with classification-based risk assessment, is critical to minimizing iatrogenic complications and improving patient outcomes. The Olewnik Classification provides a clinically applicable framework that bridges anatomy, surgery, sports medicine, and imaging.
Bilateral subclavius posticus innervated by the lateral pectoral nerve: a cadaveric and ultrasound case report.
Prommahom A, Jankham C, Duangsuwan P … +1 more , Suwannakhan A
Surg Radiol Anat · 2026 Feb · PMID 41686249 · Full text
PURPOSE: The subclavius posticus is a well-known variation of the subclavius muscle. This study aims to describe the morphology, innervation, and anatomical relationships of a bilateral subclavius posticus identified in...
PURPOSE: The subclavius posticus is a well-known variation of the subclavius muscle. This study aims to describe the morphology, innervation, and anatomical relationships of a bilateral subclavius posticus identified in a cadaver, to demonstrate its detection by high-resolution ultrasonography, and to discuss its anatomical and clinical implications. METHODS: Routine dissection of a soft-embalmed adult cadaver, a 54-year-old donor who died from rupture of a cerebral aneurysm, was performed. The infraclavicular and thoracic outlet regions were examined bilaterally. Morphometric data, muscle attachments, and neurovascular relationships were recorded. High-resolution ultrasonography was used to evaluate the contralateral side prior to dissection. Innervation and venous drainage patterns were identified through careful tracing of peripheral nerves and associated vessels. RESULTS: An accessory muscle consistent with the subclavius posticus was identified bilaterally. On both sides, the muscle originated near the junction of the first rib and costal cartilage and inserted onto the medial aspect of the coracoid process. Ultrasound successfully detected the left-sided muscle prior to dissection. Notably, both muscles were innervated by the lateral pectoral nerve, a finding not previously reported in the literature. Venous drainage was observed through a tributary to the cephalic vein. CONCLUSION: This report documents the first bilateral subclavius posticus innervated by the lateral pectoral nerve. These findings broaden the recognized spectrum of subclavius-related variants and highlight the utility of ultrasound for identifying accessory musculature in the thoracic outlet region.
A rare combination of anterior cerebral arterial ring with accessory middle and duplicated posterior cerebral arteries.
Triantafyllou G, Melissanidis S, Arkoudis NA … +3 more , Papadopoulos-Manolarakis P, Tsakotos G, Piagkou M
Surg Radiol Anat · 2026 Feb · PMID 41686247 · Full text
PURPOSES: To report a unique configuration of the cerebral arterial circle identified incidentally during magnetic resonance angiography (MRA). METHODS: An 87-year-old female patient was evaluated using MRA on a 3-Tesla...
PURPOSES: To report a unique configuration of the cerebral arterial circle identified incidentally during magnetic resonance angiography (MRA). METHODS: An 87-year-old female patient was evaluated using MRA on a 3-Tesla scanner with the time-of-flight (TOF) technique. RESULTS: On the anterior circulation, an arterial ring was identified at the junction of the left anterior cerebral and anterior communicating arteries, suggesting a double origin of the left A2 segment. An accessory middle cerebral artery originated from the proximal left A1 segment. Additionally, the right A1 segment was aplastic, with the right A2 segment supplied by the left anterior cerebral. In the posterior circulation, the left posterior cerebral artery exhibited a fetal-type origin with a hypoplastic P1 segment. On the right side, a duplicated posterior cerebral artery originated from the internal carotid artery and supplied the temporal branch. CONCLUSIONS: This case presents a rare combination of an A2 double origin, accessory MCA, and PCA duplication, highlighting the morphological complexity of the cerebral arterial circle. Detailed preoperative assessment using volume-rendered MRA is essential to identify such complex variants and minimize intraoperative complications.
The importance of perfusion pressure and fluid viscosity parameters for relevant vascular mapping of the mandible.
Serra C, Boisson J, Kadlub N … +1 more , Nokovitch L
Surg Radiol Anat · 2026 Feb · PMID 41670728 · Publisher ↗
While traditional anatomical studies provide valuable vascular maps, their reliance on uncontrolled perfusion parameters (pressure, flow rate, viscosity) risks bias in defining vascular territories. This letter addresses...
While traditional anatomical studies provide valuable vascular maps, their reliance on uncontrolled perfusion parameters (pressure, flow rate, viscosity) risks bias in defining vascular territories. This letter addresses these limitations with pressure-controlled perfusion, demonstrating that mandibular vascular saturation occurs at 75–95 mmHg, aligning with physiological arterial pressure. These findings call for a dynamic, pressure-driven redefinition of angiosome.
Microanatomy and spatial analysis of the muscular triangle involving the vertebral artery's third segment.
Zhang L, Liang H, Ni X … +6 more , Fang W, Wei Z, Sun L, Li Q, Jiang X, Di G
Surg Radiol Anat · 2026 Feb · PMID 41670727 · Full text
PURPOSE: This study aims to characterize in detail the spatial relationships between the vertebral artery’s third segment (V3) and newly described posterior occipital muscle‑bounded triangles, and to evaluate the potenti...
PURPOSE: This study aims to characterize in detail the spatial relationships between the vertebral artery’s third segment (V3) and newly described posterior occipital muscle‑bounded triangles, and to evaluate the potential of combining multiple triangles for precise localization and exposure of V3. METHODS: Five cadaveric head specimens (ten sides) were subjected to layer-by-layer dissection to sequentially expose the subatlantic triangle (SAT), the superficial suboccipital triangle (SST), the deep suboccipital triangle (DST), the condylar triangle (CT), and the suboccipital triangle (SOT). VA within each triangle was visualized. The area of each triangle and the length of the VA exposed within each triangle were measured. RESULTS: The subatlantic triangle (SAT), superficial suboccipital triangle (SST), deep suboccipital triangle (DST), condylar triangle (CT), and suboccipital triangle (SOT) all allowed clear exposure of the vertebral artery. The horizontal segment length exposed by SOT was (10.81 ± 0.90) mm; the horizontal segment length exposed by CT was (5.89 ± 0.62) mm; the vertical segment length exposed by the SST triangle was (11.35 ± 1.22) mm; the vertical segment length exposed by the DST triangle was (15.56 ± 1.15) mm; and the vertical segment length exposed by SAT was (6.82 ± 0.72) mm. CONCLUSION: We propose the “SOT + CT double-triangle exposure” technique and the “SAT + SST+DST serial-exposure” technique as novel, non–bone landmark–dependent methods for localizing the horizontal and vertical segments of V3.
Development of the dorsum sellae in children: a CT study.
Atadağ A, Çetin CŞ, Şencan Z … +5 more , Artaş A, Aşantoğrol F, Sönmezışık S, Cihan ÖF, Beger O
Surg Radiol Anat · 2026 Feb · PMID 41670706 · Publisher ↗
OBJECTIVE: The study aimed to determine alterations in the size and pneumatization pattern of the dorsum sellae (DS) in children aged 1–18 years. METHODS: Computed tomography views of 360 subjects were included in the st...
OBJECTIVE: The study aimed to determine alterations in the size and pneumatization pattern of the dorsum sellae (DS) in children aged 1–18 years. METHODS: Computed tomography views of 360 subjects were included in the study. DS width (SB-W) and thickness (ML-T) were measured. The angle between DS and the floor of the hypophyseal fossa (DS-A) were measured. Furthermore, DS heights at the middle part (ML-H), at the left lateral margin (LLM-H), and at the right lateral margin (RLM-H) were measured. DS pneumatization was classified as four types: type 0: no pneumatization, type 1: pneumatization < 50%, type 2: pneumatization > 50%, and type 3: total pneumatization. RESULTS: SB-W increased up to prepubescent period (p < 0.001), but thereafter showed no statistically significant change. RLM-H, LLM-H, and ML-H increased until the postpubescent period (p < 0.001). ML-T showed a pattern of first decreasing and then increasing with advancing age (p < 0.001). DS-A decreased until the postpubescent period (p < 0.001). Four configurations related to DS pneumatization were defined as follows: type 0 in 289 cases (80.3%), type 1 in 57 cases (15.8%), type 2 in 10 cases (2.8%), and type 3 in four cases (1.1%). The incidence of DS pneumatization was affected by age (p < 0.001), but not sex (p = 0.596). CONCLUSIONS: DS dimensions continue to change up to adulthood, likely due to increasing pneumatization. DS anatomy should be considered by neurosurgeons to reduce the risk of complications while performing posterior clinoidectomy.
Peronea Arteria Magna: a rare but surgically important variant for prevention of post-surgical limb loss.
Dwivedi A, Chandak S, Kumar A … +1 more , Malhotra A
Surg Radiol Anat · 2026 Feb · PMID 41670703 · Publisher ↗
PURPOSE: A large number of anatomic variants occur in the lower limb arteries and the Peronea Arteria Magna (PAM) is a rare congenital variant where the fibular/peroneal artery becomes the dominant arterial supply to the...
PURPOSE: A large number of anatomic variants occur in the lower limb arteries and the Peronea Arteria Magna (PAM) is a rare congenital variant where the fibular/peroneal artery becomes the dominant arterial supply to the leg foot, replacing hypoplastic anterior and posterior tibial arteries. It is imperative that the operative surgeon be aware of this anomaly prior to obtaining the fibula osteocutaneous free tissue flap (OFF) so that post-surgical limb loss can be prevented. METHODS: We present a case of a young male who was posted for reconstructive surgery with OFF, after undergoing right hemi-mandibulectomy for Juvenile ossifying fibroma. On examination, he had bilateral distal feeble pulses and was advised CT Angiography (CTA). RESULTS: Preoperative CTA showed patent bilateral popliteal arteries with a Type III C branching pattern, characteristic of PAM. The patient was hence advised against OFF. CONCLUSION: This case report highlights the incidental detection of PAM during preoperative evaluation for OFF. The identification of PAM through CTA proved critical in preventing potential limb-threatening complications, underscoring the essential role of CTA for vascular imaging in pre-surgical planning for OFF.
Anatomic safety profile of a novel mini external fixator for proximal crescentic osteotomy in hallux valgus correction: a cadaveric study.
Coşkun O, Nteli Chatzioglou G, Gürses İA … +3 more , Ok F, Gayretli Ö, Erdil M
Surg Radiol Anat · 2026 Feb · PMID 41670686 · Publisher ↗
PURPOSE: The proximal crescentic osteotomy is an effective procedure for hallux valgus correction, but stable fixation remains challenging. Our previous biomechanical study suggested that the MEF may offer comparable or...
PURPOSE: The proximal crescentic osteotomy is an effective procedure for hallux valgus correction, but stable fixation remains challenging. Our previous biomechanical study suggested that the MEF may offer comparable or greater stability than a specific cannulated screw fixation construct in a cadaveric model. This study aims to evaluate the anatomical safety of the MEF by investigating its relationship with critical neurovascular structures and tendons. METHODS: An anatomical dissection study was performed on ten foot cadaveric specimens. The MEF was applied using five mini-Schanz pins inserted in predefined positions. Following fixation, a layer-by-layer dissection was conducted to expose the dorsalis pedis artery, superficial cutanous branches of the foot, the superficial venous arch, and the extensor hallucis longus and brevis tendons. The distance from each pin to these structures and any iatrogenic injuries were recorded. RESULTS: The superficial venous arch was injured at low rates by the medial distal pin (20%), the medial proximal pin (10%), and the lateral distal pin (20%). Tendon injury was more frequent, with the extensor hallucis longus tendon being injured by 20–30% of pins, and the extensor hallucis brevis tendon by the lateral intermediate and distal pins (20% each). CONCLUSION: The application of the MEF for first metatarsal fixation appears anatomically safe with respect to major arteries and nerves. The consistent avoidance of the dorsalis pedis artery and key sensory nerves is a significant advantage over some established techniques. However, surgeons should be aware of the potential risk to the superficial venous arch and extensor tendons during pin placement. These findings support further investigation of the MEF for proximal crescentic osteotomy fixation.
Morphometrıc evaluatıon of patıents wıth mandıbular hypomobılıty due to coronoıd process hyperplasıa usıng cone beam computed tomography.
Kurt Akgül Ş, Boylu ÖF
Surg Radiol Anat · 2026 Feb · PMID 41670684 · Full text
PURPOSE: Mandibular hypomobility is a condition in which the jaw joint is restricted due to various causes, including temporomandibular joint disorders (TMD), ankylosis, head and neck infections and tumors, coronoid proc...
PURPOSE: Mandibular hypomobility is a condition in which the jaw joint is restricted due to various causes, including temporomandibular joint disorders (TMD), ankylosis, head and neck infections and tumors, coronoid processes hyperplasia (CPH), and trismus. The aim of this study is to evaluate the relationship between the coronoid processes (CP) of patients diagnosed with CPH and other anatomical structures and to investigate how this affects temporomandibular hypomobility. METHODS: The study included cone beam computed tomography (CBCT) images of 10 patients diagnosed with mandibular hypomobility due to bilateral CPH and 30 healthy individuals who underwent CBCT for other reasons (implant placement, impacted teeth, etc.). CBCT sections were used to measure condyle length (H1), CP length (H2), CP length over the zygomatic arch (H3), ramus length (H4), horizontal distance between CP and zygomatic arch (D), and the angle between CP and the mandibular plane (MP). RESULTS: A statistically significant difference was found between the mean Cr-MP angles on the right and left sides in the study group (p = 0.031). Significant differences were observed between the study and control groups in H2, H2/H1, H3, H3/H2, H2/H4, and D distance measurements (p < 0.001). Additionally, a significant difference in the CP-MP angle was found between the groups (p = 0.003). CONCLUSIONS: Our study demonstrates that, in addition to CP length, factors such as the H2/H1 ratio, CP-MP angle, D distance, and H3 also influence mouth opening restriction.
An anatomical study of anterior spinal artery patterns in the Thai population.
Matusiak PB, Kamnate A, Chaiyamoon A … +4 more , Chaiyakram R, Khanthiyong B, Suwannakhan A, Berkban T
Surg Radiol Anat · 2026 Feb · PMID 41670678 · Publisher ↗
PURPOSE: The precise anatomy of the anterior spinal artery is clinically important for surgical and endovascular procedures. Therefore, this study aims to investigate variations in the anterior spinal artery, including i...
PURPOSE: The precise anatomy of the anterior spinal artery is clinically important for surgical and endovascular procedures. Therefore, this study aims to investigate variations in the anterior spinal artery, including its origin, morphometry and formation patterns, in the Thai population. METHODS: Twenty-six adult cadaveric brains (52 sides) were examined. In each brain, the site of origin, external diameter and formation patterns of the anterior spinal artery were recorded. The distances between the site of origin and both the vertebrobasilar junction and the posterior inferior cerebellar artery were measured on the left and right sides. RESULTS: The anterior spinal artery most commonly originated from a posteromedial (62.5%), followed by a medial origin (37.5%). A classification of anterior spinal artery morphology in Thai population was proposed, comprising three main types (I to III) and subtypes (Ia to Ic, IIa to IIc). Type III (independent bilateral anterior spinal artery) was most frequent (34.5%), followed by Type Ia (23.6%) and Type IIa (15.4%). The left vertebral artery showed a significantly larger diameter (p < 0.05). Several arterial diameters demonstrated strong positive correlations, all statistically significant (p < 0.05). CONCLUSION: The present study delineates the origin and formation patterns of the anterior spinal artery in the Thai population, demonstrating type III as the predominant configuration. These findings provide a robust foundation for subsequent investigations. Comprehensive knowledge of anterior spinal artery anatomical variation is critical for reducing the risk of vascular complications during surgical interventions.
An unusual subhepatic cecum identified during cadaveric dissection: relevance for clinical diagnosis and anatomy education.
Clayton J, Krews J, Fouchi G … +2 more , Smith D, Overturf MD
Surg Radiol Anat · 2026 Feb · PMID 41649580 · Publisher ↗
PURPOSE: Subhepatic cecums are rare conditions (0.3-0.5% of live births) that result from a malrotation event during embryologic development. Although this condition is uncommon, it presents unique challenges for diagnos...
PURPOSE: Subhepatic cecums are rare conditions (0.3-0.5% of live births) that result from a malrotation event during embryologic development. Although this condition is uncommon, it presents unique challenges for diagnosing appendicitis due to the appendix being displaced to the right upper quadrant instead of its typical right lower quadrant location. METHODS: An 85-year-old male cadaver with a medical history significant for type 2 diabetes mellitus, atrial fibrillation, systolic congestive heart failure, and severe protein malnutrition was used during routine dissections of the gastrointestinal system. RESULTS: A subhepatic cecum was identified with a vermiform appendix situated just below the liver. Further examination revealed a unique variation in the pathways of the ileocecal artery to accommodate the malrotation. CONCLUSION: Despite being rare, understanding this developmental variation is beneficial for the accurate diagnosis and treatment of patients with unusual presentations of appendiceal and colonic pathologies.
Anatomical study of the superficial and deep circumflex iliac arteries: morphology, variability, and surgical relevance.
Ok F, Nteli Chatzioglou G, Karip B … +4 more , Önal V, Yıldız N, Tatar BE, Gayretli Ö
Surg Radiol Anat · 2026 Feb · PMID 41649573 · Publisher ↗
PURPOSE: The vascular anatomy of the groin region plays an important role in reconstructive surgery and regional anesthesia, yet data on the precise morphology and topography of the superficial and deep circumflex iliac...
PURPOSE: The vascular anatomy of the groin region plays an important role in reconstructive surgery and regional anesthesia, yet data on the precise morphology and topography of the superficial and deep circumflex iliac arteries remain limited. METHODS: 28 lower extremities of fourteen formalin-fixed male cadavers were dissected to examine the superficial and deep circumflex iliac arteries. Their origins, branching patterns, diameters, and spatial relationships to the inguinal ligament and femoral triangle were recorded. Morphometric distances were measured with a digital caliper, and correlations between parameters were analyzed statistically. RESULTS: The superficial circumflex iliac artery arose exclusively from the femoral artery in all cases and was consistently located within the femoral triangle. Its mean origin diameter was 1.83 ± 0.46 mm. The deep circumflex iliac artery showed greater variability, originating from the external iliac artery in half of the cases and from the femoral artery in the other half. Its mean origin diameter was 2.25 ± 0.40 mm, and it was located outside the femoral triangle in 71.4% of cases. Multiple significant correlations were identified between vessel diameters, bifurcation points, and their spatial relationships with the inguinal ligament. CONCLUSION: The superficial circumflex iliac artery displays consistent anatomy, whereas the deep circumflex iliac artery demonstrates notable variability in origin and topography, though with stable vessel caliber. These findings provide detailed morphometric insights that may support safer flap design and improve surgical and anesthetic planning in the groin region.
Performance of large language models on neuroanatomy-based medical riddles: a comparative study.
Kaçar H, Turamanlar O, Emir B … +1 more , Yakıncı C
Surg Radiol Anat · 2026 Feb · PMID 41649564 · Publisher ↗
PURPOSE: The integration of large language models (LLMs) into medical education has gained significant momentum in recent years. These models have demonstrated highly effective performance in medical board examination qu...
PURPOSE: The integration of large language models (LLMs) into medical education has gained significant momentum in recent years. These models have demonstrated highly effective performance in medical board examination questions. However, their ability to comprehend, analyze, and reason through information has not yet been evaluated using medical riddles as an alternative assessment approach. Therefore, the aim of this study is to assess the performance of commercially available, general-purpose LLMs in solving medical riddles. METHODS: Responses generated by ChatGPT-5, ChatGPT-4, AnatomyGPT, Gemini 2.5, Claude, and DeepSeek for 20 neuroanatomy-related riddles were evaluated across two trials. Additionally, the riddles were presented in a different language to assess the impact of linguistic variation. Statistical analyses were conducted using Cochran’s Q test and chi-square tests to compare the performance of the models. Response consistency was assessed using McNemar’s test and Cohen’s kappa coefficient. RESULTS: All models demonstrated strong performance on the riddles. Near-perfect accuracy was observed when the models were tested in English (ChatGPT-5 100%, ChatGPT-4 100%, AnatomyGPT 100%, Gemini 2.5 100%, DeepSeek 100%, Claude 95%). When tested in Turkish, Gemini 2.5 (80%) and DeepSeek (85%) showed relatively lower accuracy; however, overall correct response rates remained high across models. In terms of response consistency, five models demonstrated high agreement, while only Gemini 2.5 (κ = 0.347) showed moderate agreement. CONCLUSION: This study demonstrates that LLMs can successfully solve medical riddles with comparable levels of performance. These findings provide valuable insights into the current capabilities of LLMs in understanding, analyzing, and reasoning through domain-specific problem-solving tasks.
Variant popliteus tendon anatomy in knee surgery: implications for imaging, biomechanics, and operative strategy.
Olewnik Ł, Landfald IC, Cavalcante JC … +2 more , Abreu BJ, LaPrade RF
Surg Radiol Anat · 2026 Feb · PMID 41649560 · Publisher ↗
PURPOSE: The popliteus tendon (PLT) exhibits considerable anatomical variability with direct implications for surgical procedures involving the posterolateral corner (PLC) of the knee. This review aims to translate the m...
PURPOSE: The popliteus tendon (PLT) exhibits considerable anatomical variability with direct implications for surgical procedures involving the posterolateral corner (PLC) of the knee. This review aims to translate the morphological classification proposed by Olewnik et al. (Sci Rep 11:14434, 2021 https://doi.org/10.1038/s41598-021-93778-5 ) into a clinically oriented framework for orthopaedic and sports surgeons, integrating imaging, biomechanical, and procedural perspectives. METHODS: A comprehensive synthesis of anatomical, radiological, and surgical literature was performed, structured around the four primary PLT types and ten subtypes defined by Olewnik et al. (Sci Rep 11:14434, 2021 https://doi.org/10.1038/s41598-021-93778-5 ). Surgical risks, imaging features (MRI and ultrasound), and biomechanical consequences were analysed. Case-based models and operative recommendations were formulated based on variant morphology. RESULTS: Each PLT variant demonstrates distinct surgical relevance. Accessory bands especially in Types IIe and IVe pose a risk of misidentification, iatrogenic injury, and graft misplacement. MRI and dynamic ultrasound are complementary tools for preoperative mapping. A structured surgical algorithm, imaging protocol, and educational recommendations were developed. Clinical scenarios underscore the importance of intraoperative recognition. CONCLUSION: The Olewnik classification provides a reliable anatomical roadmap with direct clinical applicability. Integrating PLT variant identification into preoperative imaging and intraoperative decision-making enhances safety, optimises graft positioning, and supports anatomical restoration. Further biomechanical and surgical validation is warranted.
Interobserver variability in assessing anterior cruciate ligament anatomy: comparing gross and microanatomical observations.
Reschenberg E, Ruth AA
Surg Radiol Anat · 2026 Feb · PMID 41649559 · Full text
PURPOSE: Most commonly, the ACL is described as having two distinct anatomical bundles: anteromedial and posterolateral. These bundles have been observed in a gross anatomical setting, but not as closely observed histolo...
PURPOSE: Most commonly, the ACL is described as having two distinct anatomical bundles: anteromedial and posterolateral. These bundles have been observed in a gross anatomical setting, but not as closely observed histologically. Here, we sought to compare observations of ACL bundle number when observed anatomically versus histologically to determine if the double bundle ACL is a reliably observed structure. METHODS: Nineteen knees were dissected to expose the intracapsular ligaments. Bundle number was assessed in three ways: Via gross anatomical observation, histological observation, and via the presence of a connective tissue septum when observed histologically. Inter-rater agreements were calculated for each of the three modes. Cronbach’s alpha was calculated to assess the consistency of double-bundle observations across all three modes of observation. RESULTS: Prevalence of a double-bundle ACL under gross observation was 68.4%. Inter-rater agreement was fair (Fleiss’s kappa = 0.202). Under histological observation, prevalence of a double-bundle ACL was 47.4%, with only 26.4% demonstrating a connective tissue septum that could be said to divide the ligament. CONCLUSION: These results suggest that the human ACL may exhibit more anatomical variation than has been previously appreciated in human cadaveric studies. Inter-rater agreement was fair, indicating that the demarcation of ACL bundles is not an obvious feature, even under gross observation. Additionally, our histological observations support the idea that ACL bundles exhibit substantial variation in terms of degree of distinct separation. This is, to our knowledge, the first study that has directly compared gross and microscopic observations of ACL bundle number.
Morphometric analysis of hand sesamoid bones using computed tomography and assessment of sex-related differences.
Cakir O, Uzel M, Cankorur MA … +2 more , Kanik İ, Keskin N
Surg Radiol Anat · 2026 Feb · PMID 41649546 · Publisher ↗
PURPOSE: This study aims to conduct a comprehensive morphometric analysis of the sesamoid bones in the hand using computed tomography (CT) images. METHODS: This retrospective analysis examined the data of 211 patients wh...
PURPOSE: This study aims to conduct a comprehensive morphometric analysis of the sesamoid bones in the hand using computed tomography (CT) images. METHODS: This retrospective analysis examined the data of 211 patients who had undergone upper extremity CT imaging, retrieved from the Picture Archiving and Communication System (PACS). Image evaluation was conducted by two independent radiologists using three-dimensional CT reconstructions. The assessment criteria included the presence, number, anatomical location, dimensions (length and width), and volume of the sesamoid bones. For statistical analysis, the Mann-Whitney U test was used to examine morphometric differences between sexes, while ANOVA was employed to assess differences among age groups. RESULTS: The metacarpophalangeal (MCP) and interphalangeal (IP) joints of the thumb are the most common sites for sesamoid bones. While the prevalence and size of these bones do not show statistically significant differences between genders, their volumes differ in the MCP II and IP I-R joints. The largest sesamoid volume is found in the thumb MCP joint, while the volume generally tends to decrease from the radial side of the hand towards the ulnar side. CONCLUSION: Morphometric analysis of hand sesamoid bones through CT has unveiled notable anatomical variations and gender-specific differences. These findings are essential for diagnosis and treatment in hand surgery, traumatology, and forensic medicine. For instance, understanding sex-related differences in sesamoid bone sizes can significantly improve identification methods and surgical approaches, ultimately resulting in enhanced patient outcomes.
Anatomical fusion of the arcuate popliteal and popliteofibular ligaments: a rare variant with implications for knee stabilization-a case report.
Olewnik Ł, Landfald IC, Zielinska N … +2 more , Triantafyllou G, LaPrade RF
Surg Radiol Anat · 2026 Feb · PMID 41632321 · Publisher ↗
PURPOSE: The posterolateral corner (PLC) of the knee joint is composed of a complex arrangement of static and dynamic stabilizing structures, crucial for maintaining varus and external rotation stability. Among these, th...
PURPOSE: The posterolateral corner (PLC) of the knee joint is composed of a complex arrangement of static and dynamic stabilizing structures, crucial for maintaining varus and external rotation stability. Among these, the arcuate popliteal ligament (APL) and the popliteofibular ligament (PFL) are key components. Although their individual anatomy is well described and partial fusion between these ligaments has been reported previously, a direct fusion at the popliteus musculotendinous junction has not been specifically detailed. This study reports a direct fusion between the APL and a tripartite variant of the PFL. METHODS: Routine anatomical dissection was performed on the right lower limb of a 79-year-old male cadaver. Posterior and posterolateral approaches were used to expose the knee joint and surrounding soft tissues. A detailed morphological assessment was conducted to examine the course and topographic relationships of the APL and PFL. RESULTS: A direct anatomical fusion between the APL and the PFL was identified at the popliteus musculotendinous junction. The PFL consisted of three distinct bundles. CONCLUSION: A direct anatomical fusion between the APL and a tripartite PFL was identified in a single embalmed right knee. This observation may assist radiological recognition and operative orientation; functional effects and management implications cannot be determined from this case and require confirmation in larger anatomical, imaging, and biomechanical studies.
Anatomical variations of the sciatic nerve and its relationship to the pelvic bone: a systematic review.
Ollivier I, Dannhoff G, Garnon J … +2 more , Koch G, Clavert P
Surg Radiol Anat · 2026 Jan · PMID 41612052 · Publisher ↗
PURPOSE: - As a potential cause of compression resulting in neuropathic pain or using to secure coxal bone procedure, the proximity of sciatic nerve against coxal bone inside the infra-piriform foramen was unclear. METHO...
PURPOSE: - As a potential cause of compression resulting in neuropathic pain or using to secure coxal bone procedure, the proximity of sciatic nerve against coxal bone inside the infra-piriform foramen was unclear. METHODS: - This systematic review focused on the relationship between pelvic bone and sciatic nerve based on PRISMA methodology. RESULTS: - A total of 26 studies involving 4,813 lower limbs were included in the meta-analysis. The variations of the sciatic nerve in relation to the piriform muscle were described in 14.5% of cases. The variation involving division of the sciatic nerve in the pelvis, with the common fibular nerve passing over the piriformis muscle and the tibial nerve passing through it, was never observed. However, a variation in which the sciatic nerve divided in the pelvis, with its two terminal branches (the common fibular nerve and the tibial nerve) passing separately under the piriformis muscle, was described in 0.81% of cases. CONCLUSION: - There was no data available to analyse the distance between the sciatic nerve and the coxal bone as it exited the pelvis.
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