Tubercle (bone)

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In the skeleton of humans and other animals, a tubercle, tuberosity or apophysis is a protrusion or eminence that serves as an attachment for skeletal muscles. The muscles attach by tendons, where the enthesis is the connective tissue between the tendon and bone. [1] A tuberosity is generally a larger tubercle.

Contents

Main tubercles

Humerus

The humerus has two tubercles, the greater tubercle and the lesser tubercle. These are situated at the proximal end of the bone, that is the end that connects with the scapula. The greater/lesser tubercule is located from the top of the acromion laterally and inferiorly.

Radius

The radius has two, the radial tuberosity and Lister's tubercle.[ citation needed ]

Ribs

On a rib, tubercle is an eminence on the back surface, at the junction between the neck and the body of the rib. It consists of an articular and a non-articular area. The lower and more medial articular area is a small oval surface for articulation with the transverse process of the lower of the two vertebrae which gives attachment to the head. The higher, non-articular area is a rough elevation which gives attachment to the ligament of the tubercle. The tubercle is much more prominent in the upper ribs than in the lower ribs.[ citation needed ]

Tibia

The most prominent tubercle of the tibia, a leg bone which is more commonly known as the shinbone or shankbone, is the tibial tuberosity. The tibial tuberosity is located on the tibia's anterior surface, distal to the medial condyle. It creates a bony prominence just below the patella, and can be easily located with the fingers. It creates an attachment point for the ligamentum patellae, or patellar ligament. Other tubercles of the tibia include the medial intercondylar tubercle, the lateral intercondylar tubercle, and Gerdy's tubercle.[ citation needed ]

Femur

A trochanter is one of up to three tubercles of the femur:

Fifth metatarsal

Proximal fractures of the fifth metatarsal bone:
- Proximal diaphysis, typically stress fracture.
- Metaphysis: Jones fracture
-Tuberosity: Pseudo-Jones fracture (avulsion fracture).
Normal anatomy:
- Apophysis: Normal at 10 - 16 years.
- Os vesalianum, an accessory bone. Proximal fractures of 5th metatarsal.jpg
Proximal fractures of the fifth metatarsal bone:
- Proximal diaphysis , typically stress fracture.
- Metaphysis : Jones fracture
-Tuberosity: Pseudo-Jones fracture (avulsion fracture).
Normal anatomy:
- Apophysis: Normal at 10 - 16 years.
- Os vesalianum, an accessory bone.

In the fifth metatarsal bone, the most proximal part of the bone is termed the "tuberosity", and the secondary ossification center that is normally present thereon in children is termed the "apophysis".

Fractures

The main type of fracture affecting tubercles is avulsion fracture, by pulling the attached tendon.

Apophysitis

Apophysitis is an inflammation of a tubercle. It mainly affects growing children, with overuse of the affected tubercle. [8] [9] [10] Examples include:

Enthesitis

Enthesitis is an anatomically close but separate condition, wherein there is inflammation of the entheses, the sites where tendons or ligaments insert into the bone. [12] [13] It is associated with HLA B27 arthropathies such as ankylosing spondylitis, psoriatic arthritis, and reactive arthritis. [14] [15]

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.

<span class="mw-page-title-main">Femur</span> Thigh bone

The femur, or thigh bone is the only bone in the thigh. The thigh is the region of the lower limb between the hip and the knee. In many four-legged animals the femur is the upper bone of the hindleg.

<span class="mw-page-title-main">Knee</span> Leg joint in primates

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

<span class="mw-page-title-main">Humerus</span> Long bone of the upper arm

The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.

<span class="mw-page-title-main">Tibia</span> Leg bone in vertebrates

The tibia, also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates ; it connects the knee with the ankle. The tibia is found on the medial side of the leg next to the fibula and closer to the median plane. The tibia is connected to the fibula by the interosseous membrane of leg, forming a type of fibrous joint called a syndesmosis with very little movement. The tibia is named for the flute tibia. It is the second largest bone in the human body, after the femur. The leg bones are the strongest long bones as they support the rest of the body.

<span class="mw-page-title-main">Fibula</span> Leg bone in vertebrates

The fibula or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity is small, placed toward the back of the head of the tibia, below the knee joint and excluded from the formation of this joint. Its lower extremity inclines a little forward, so as to be on a plane anterior to that of the upper end; it projects below the tibia and forms the lateral part of the ankle joint.

<span class="mw-page-title-main">Ankle</span> Region where the foot and the leg meet

The ankle, the talocrural region or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joint. The movements produced at this joint are dorsiflexion and plantarflexion of the foot. In common usage, the term ankle refers exclusively to the ankle region. In medical terminology, "ankle" can refer broadly to the region or specifically to the talocrural joint.

<span class="mw-page-title-main">Osgood–Schlatter disease</span> Inflammation of the patellar ligament

Osgood–Schlatter disease (OSD) is inflammation of the patellar ligament at the tibial tuberosity (apophysitis) usually affecting adolescents during growth spurts. It is characterized by a painful bump just below the knee that is worse with activity and better with rest. Episodes of pain typically last a few weeks to months. One or both knees may be affected and flares may recur.

<span class="mw-page-title-main">Avulsion fracture</span> Tearing away of a bone by physical trauma

An avulsion fracture is a bone fracture which occurs when a fragment of bone tears away from the main mass of bone as a result of physical trauma. This can occur at the ligament by the application of forces external to the body or at the tendon by a muscular contraction that is stronger than the forces holding the bone together. Generally muscular avulsion is prevented by the neurological limitations placed on muscle contractions. Highly trained athletes can overcome this neurological inhibition of strength and produce a much greater force output capable of breaking or avulsing a bone.

<span class="mw-page-title-main">Lower extremity of femur</span>

The lower extremity of femur is the lower end of the femur in human and other animals, closer to the knee. It is larger than the upper extremity of femur, is somewhat cuboid in form, but its transverse diameter is greater than its antero-posterior; it consists of two oblong eminences known as the lateral condyle and medial condyle.

<span class="mw-page-title-main">Tuberosity of the tibia</span> Slight protrusion at the top front end

The tuberosity of the tibia, tibial tuberosity or tibial tubercle is an elevation on the proximal, anterior aspect of the tibia, just below where the anterior surfaces of the lateral and medial tibial condyles end.

<span class="mw-page-title-main">Enthesitis</span> Medical condition

Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone. It is an enthesopathy, a pathologic condition of the entheses. Early clinical manifestations are an aching sensation akin to "working out too much", and it gets better with activity. It is worse in the morning. The muscle insertion hurts very focally as it joins into the bone, but there is little to no pain at all with passive motion. There are some cases of isolated, primary enthesitis which are very poorly studied and understood. It is known to be associated with other autoimmune diseases, like spondyloarthropathies and psoriasis. A common autoimmune enthesitis is at the heel, where the Achilles tendon attaches to the calcaneus.

<span class="mw-page-title-main">Malleolus</span> Ankle bone protrusion

A malleolus is the bony prominence on each side of the human ankle.

<span class="mw-page-title-main">Fifth metatarsal bone</span>

The fifth metatarsal bone is a long bone in the foot, and is palpable along the distal outer edges of the feet. It is the second smallest of the five metatarsal bones. The fifth metatarsal is analogous to the fifth metacarpal bone in the hand.

<span class="mw-page-title-main">Diffuse idiopathic skeletal hyperostosis</span> Medical condition

Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by abnormal calcification/bone formation (hyperostosis) of the soft tissues surrounding the joints of the spine, and also of the peripheral or appendicular skeleton. In the spine, there is bone formation along the anterior longitudinal ligament and sometimes the posterior longitudinal ligament, which may lead to partial or complete fusion of adjacent vertebrae. The facet and sacroiliac joints tend to be uninvolved. The thoracic spine is the most common level involved. In the peripheral skeleton, DISH manifests as a calcific enthesopathy, with pathologic bone formation at sites where ligaments and tendons attach to bone.

<span class="mw-page-title-main">Tibial plateau fracture</span> Medical condition

A tibial plateau fracture is a break of the upper part of the tibia (shinbone) that involves the knee joint. This could involve the medial, lateral, central, or bicondylar. Symptoms include pain, swelling, and a decreased ability to move the knee. People are generally unable to walk. Complication may include injury to the artery or nerve, arthritis, and compartment syndrome.

<span class="mw-page-title-main">Medial knee injuries</span> Medical condition

Medial knee injuries are the most common type of knee injury. The medial ligament complex of the knee consists of:

<span class="mw-page-title-main">Intercondylar area</span>

The intercondylar area is the separation between the medial and lateral condyle on the upper extremity of the tibia. The anterior and posterior cruciate ligaments and the menisci attach to the intercondylar area.

<span class="mw-page-title-main">Anatomical terms of bone</span>

Many anatomical terms descriptive of bone are defined in anatomical terminology, and are often derived from Greek and Latin. Bone in the human body is categorized into long bone, short bone, flat bone, irregular bone and sesamoid bone.

References

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  3. "5th Metatarsal". Emergency Care Institute, New South Wales. 2017-09-19.
  4. "Toe and Forefoot Fractures". OrthoInfo - AAOS. June 2016. Archived from the original on 16 October 2017. Retrieved 15 October 2017.
  5. 1 2 Silbergleit R. "Foot Fracture". Medscape.com. Retrieved 19 October 2011.
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  7. Nwawka OK, Hayashi D, Diaz LE, Goud AR, Arndt WF, Roemer FW, et al. (October 2013). "Sesamoids and accessory ossicles of the foot: anatomical variability and related pathology". Insights into Imaging. 4 (5): 581–93. doi:10.1007/s13244-013-0277-1. PMC   3781258 . PMID   24006205.
  8. 1 2 "OrthoKids - Osgood-Schlatter's Disease".
  9. 1 2 "Sever's Disease". Kidshealth.org. Retrieved 2014-04-29.
  10. 1 2 Hendrix CL (2005). "Calcaneal apophysitis (Sever disease)". Clinics in Podiatric Medicine and Surgery. 22 (1): 55–62, vi. doi:10.1016/j.cpm.2004.08.011. PMID   15555843.
  11. "Sinding-Larsen-Johansson Syndrome - Knee & Sports - Orthobullets". www.orthobullets.com. Retrieved 2019-08-05.
  12. Maria Antonietta D'Agostino, MD; Ignazio Olivieri, MD (June 2006). "Enthesitis". Best Practice & Research Clinical Rheumatology. Clinical Rheumatology. 20 (3): 473–86. doi:10.1016/j.berh.2006.03.007. PMID   16777577.
  13. The Free Dictionary (2009). "Enthesitis" . Retrieved 2010-11-27.
  14. Schett, G; Lories, RJ; D'Agostino, MA; Elewaut, D; Kirkham, B; Soriano, ER; McGonagle, D (November 2017). "Enthesitis: from pathophysiology to treatment". Nature Reviews Rheumatology (Review). 13 (12): 731–41. doi:10.1038/nrrheum.2017.188. PMID   29158573. S2CID   24724763.
  15. Schmitt, SK (June 2017). "Reactive Arthritis". Infectious Disease Clinics of North America (Review). 31 (2): 265–77. doi:10.1016/j.idc.2017.01.002. PMID   28292540.