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Anatomy of the lower extremity arteries and bones: angiographic 3D view

Antoine Micheau, MD, Denis Hoa, MD

Published on Monday 25 August 2008

SECTION: Musculoskeletal anatomy (upper and lower extremities)

Images and anatomical references

Anatomy of the arteries and bones of the lower limb based on 3D pictures and angiogram (angiography).

 

This part of the interactive anatomic atlas of the human body is devoted to the arterial vasculature of the pelvic girdle, pelvis, thigh, knee, leg and foot and to the study of bones and joints. It includes a 3D reconstruction of bones and arteries from angioCT with injection of a contrast agent (iodine), an angiographic view correlated with the 3D view and digital radiography of the skeleton of the lower limb.

 

Bone and artery of the pelvic girdle : anatomy based on medical imaging (3D images and angiogram adapted from computed tomography)

 

Procedure details of this interactive atlas of the lower limb anatomy:

We have selected a normal angioCT (Computed Tomography) exam of lower limbs: acquisition was made with helical multidetector CT (MDCT) after injection of iodized contrast. The axial images were post-processed using software post-treatment on a workstation for a multimodal reconstruction and a three-dimensional visualization of bone and blood vessels, then a similar angiographic view was created.

 

Angiography (angiogram) adapted from angioCT showing all pelvic arteries labeled : internal and external artery, pudendal artery, gluteal artery, femoral artery...

 

The DICOM images were exported and then integrated into the software Adobe CS3 Professional Flash to create this anatomic module. The anatomical structures were labelled on the 3D view.

 
 Radiography of the skeleton : all anatomical structures (bones and joints) of the pelvic girdle  labeled on a radiographic image (X-Rays)

 

We also selected non pathologic digital X-rays: pelvis, hip, knee, ankle and foot, labelling the skeletal structures and joints.

 

Normal arteriography of the leg : image adapted from MDCT (MIP) showing  popliteal ,fibular, anterior tibial artery and posterior tibial artery

 
All anatomical structures of the Terminologia Anatomica are translated in French, English, Spanish, Portuguese, Russian, Czech, Japanese and Chinese. This module may be used as a medical dictionary.

 

Radiography of the hip joint : anatomy of the whole human body based on medical imagin : femur, coxal bone, acetabulum, femoral head, iliac crest...

 

Peripheral vascular imaging of the lower limb:  

 

Anteroposterior radiology (X-ray) of the knee : anatomy of the femur, patella, tibia, fibula, lateral and medial condyle, intercondylar tubercle...

 

We preferred to use an angioCT of the lower limb rather than a digital arteriography because it allowed the user to make a correlation between angiographic views of arteries with three-dimensional structures.

The 3D/angiographies tab can be used to select these two kinds of view.

 

radiological atlas of the lower limb : radiograph of the knee (lateral view) showing joints (femoropatellar joint, femororibial joint, tibiofibular joint) and bones

 

The fields of view are the ones routinely used for angiography: a global vision of the entire arterial vasculature (from the aorta to the foot) and then 3 specific fields of view: iliac, femoral and tripod arteries

We have segmented the legends of the arteries into different groups: aorta and its branches, internal iliac artery and its branches, external iliac artery and its branches. This decreases the number of labels shown on each image and provides a better educational approach.

Only the arteries visible on the 3D view were labelled, this explains why on the angiographic view some arteries are visible only under particular rotation angles.

 

This module is designed for teachers in anatomy, including vascular disease, medical students and paramedical students (nurses, radiology technicians), but also practitioners in vascular medicine, ultrasound and Doppler examination, vascular surgery, interventional radiology, cardiology, angiology and endocrinology. It facilitates the study of arterial diseases of the lower limbs (atheroma, atherosclerosis), embolizations in emergencies, balloon angioplasties or stents, vascular bypass, gynaecologic embolizations (uterine fibroids, Primary Post-Partum Haemorrhages (note: the patient is male so there are some differences with the female pelvis vasculature).

 

Skeletal imaging of the lower limb

Joints and bones of the skeleton pelvis, thigh, hip, knee, leg, ankle and foot were also labelled. At the end this module please note that anatomical conventional radiology could be useful for usual practice, which is why you may find some labelled digital radiographies at the end of this module.

 

Radiograph (X-ray) of the ankle : anatomy on an anterior view showing tibia, fibula, talus, lateral and medial malleolus.

 

Radioanatomy of the ankle : radiology of the ankle (lateral view) with anatomical structures labeled as calcaneus, talus, navicular, talo-crural joint.

 

The left side menu provides access to various exams.

Long bones and joints are featured so that each structure can be followed throughout its extent.
We had to use groups of anatomical structures: sacrum, coxal bone, femur, patella, tibia, fibula, bones of the feet (tarsus and metatarsus). For technical reasons, the legends of the bone structures appear on the angiographic views and some bones do not appear; please forgive us for this problem.

The joints have also been labelled, although their study is easier on such exams as CT or MR arthrography.

 

Superior radiograph of the foot with all anatomical structures labeled (bones, joints)

 

This module is less specific than slice imaging modules, so it is helpful for all who are curious about skeletal and vascular anatomy and pathology of the lower limb:

  • Medical students studying medical degrees and bachelor degrees (MBBS, MBChB, MD, DO, MDCM, BMed, etc) or United States Medical Licensing Examination.
  • Nursing assistants, orderlies, auxiliary nurses, medical assistants, registered nurses or licensed practical nurses
  • Hospital volunteers.
  • EMTs and Paramedics
  • Technicians, phlebotomy technicians, surgical technologists, and technicians trained to operate equipment such as X-ray machines.
  • Medical practitioners
  • Pharmacists
  • Medical technologists and physical therapists working with nursing staff.
  • Anatomy teachers or professors from medical universities, medical schools or faculty of medicine
  • Surgery residents or fellows, orthopaedic surgeons
  • Rheumatologists, podiatrists
  • Any Medical Doctor who wishes to explain a musculoskeletal pathology to a patient: fracture, sprain, arthritis, arthritis.

Lateral view of the foot on radiography (X-ray) : metatarsals, phalanx, cuboid, navicular, cuneiform bones...

 

References :

  • Atlas of Human Anatomy, Professional Edition by Frank H. Netter · Publisher: Saunders; 4 edition (July 13, 2006) Language: English · ISBN-10: 1416036997 · ISBN-13: 978-1416036999
  • Terminologia Anatomica: International Anatomical Terminology by FCAT · Publisher: Thieme Medical Publishers; Bilingual edition (January 1, 2000) · Language: Latin/english · ISBN-10: 0865778086 · ISBN-13: 978-0865778085
  • Diagnostic and Surgical Imaging Anatomy: Musculoskeletal (International Edition): Published by Amirsys · Publisher: Lippincott Williams & Wilkins; 1 edition (December 1, 2006) · Language: English · ISBN-10: 1931884323 · ISBN-13: 978-1931884327

Anatomical parts

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