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"Im Joo Rhyu"

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"Im Joo Rhyu"

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Electrodiagnosis

Which Approach Is Most Optimal for Needle Electromyographic Examination of the Biceps Femoris Short Head: Medial or Lateral?
Jong Heon Park, Im Joo Rhyu, Ha Kyoung Lim, Jae Hyun Cha, Gi Jun Shin, Hye Chang Rhim, Dong Hwee Kim
Ann Rehabil Med 2021;45(1):42-48.   Published online February 9, 2021
DOI: https://doi.org/10.5535/arm.20092
Objective
To investigate the anatomical characteristics of the biceps femoris short head (BS) and determine the optimal needle placement for BS examination.
Methods
Twenty-one lower limbs were dissected. The distances from the medial and lateral margins of the biceps femoris long head (BL) tendon to the common fibular nerve (CFN) (M_CFN_VD and L_CFN_VD, respectively) and the distance from the lateral margin of the BL tendon to the lateral margin of the BS (L_BS_HD) were measured 5 cm proximal to the tip of the fibular head (P1), four fingerbreadths proximal to the tip of the fibular head (P2), and at the upper apex of the popliteal fossa (P3).
Results
The BS was located lateral to the BL tendon. The CFN was located along the medial margin of the BL tendon. The median values were 2.0 (P1), 3.0 (P2), and 0 mm (P3) for M_CFN_VD; and 17.4 (P1), 20.2 (P2), and 21.8 mm (P3) for L_CFN_VD; and 8.1 (P1), 8.8 (P2), and 13.0 mm (P3) for L_BS_VD.
Conclusion
The lateral approach to the BL tendon was safer than the medial approach for examining the BS. Amore proximal insertion site around the upper apex of the popliteal fossa was more accurate than the distal insertion site. In this study, we propose a safer and more accurate approach for electromyography of the BS.

Citations

Citations to this article as recorded by  
  • Ultrasound Depiction of the Optimal Window for Needle Placement for Electromyography of the Short Head of the Biceps Femoris
    Reece M. Hass, Cecilia V. Mitchell, James B. Meiling, William J. Litchy, Andrea J. Boon
    Muscle & Nerve.2026; 73(4): 630.     CrossRef
  • Muscle dynamics analysis by clustered categories during jogging in patients with anterior cruciate ligament deficiency
    Haoran Li, Hongshi Huang, Si Zhang, Shuang Ren, Qiguo Rong
    BMC Musculoskeletal Disorders.2023;[Epub]     CrossRef
  • 7,250 View
  • 175 Download
  • 2 Web of Science
  • 2 Crossref
Branching Patterns and Anatomical Course of the Common Fibular Nerve
Goo Young Kim, Chae Hyeon Ryou, Ki Hoon Kim, Dasom Kim, Im Joo Rhyu, Dong Hwee Kim
Ann Rehabil Med 2019;43(6):700-706.   Published online December 31, 2019
DOI: https://doi.org/10.5535/arm.2019.43.6.700
Objective
To present the branching patterns and anatomical course of the common fibular nerve (CFN) and its relationship with fibular head (FH).
Methods
A total of 21 limbs from 12 fresh cadavers were dissected. The FH width (FH_width), distance between the FH and CFN (FH_CFN), and thickness of the nerve were measured. The ratio of the FH_CFN to FH_width was calculated as follows: <1, cross type and ≥1, posterior type. Angle between the CFN and vertical line of the lower limb 5 cm proximal to the tip of the FH was measured. Branching patterns of the lateral cutaneous nerve of the calf (LCNC) were classified into four types according to its origin and direction as follows: type 1a, lateral margin of the CFN; type 1b, medial margin of the CFN; type 2, lateral sural cutaneous nerve (LSCN); and type 3, CFN and LSCN.
Results
In the cross type (15 cases, 71.4%), the ratio of FH_CFN/FH_width was 0.83 and the angle was 13.0°. In the posterior type (6 cases, 28.6%), the ratio was 1.04 and the angle was 11.0°. In the branching patterns of LCNC, type 2 was the most common (10 cases), followed by types 1a and 1b (both, 5 cases).
Conclusion
Location of the CFN around the FH might be related to the development of its neuropathy, especially in the cross type of CFN. The LCNC showed various branching patterns and direction, which could be associated with difficulties of electrophysiologic testing.

Citations

Citations to this article as recorded by  
  • Axonal profiling of the common fibular nerve and its branches: Their functional composition and clinical implications
    Taeyeon Kim, Tae‐Hyeon Cho, Shin Hyung Kim, Hun‐Mu Yang
    Clinical Anatomy.2025; 38(7): 734.     CrossRef
  • Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers
    Elliot L.H. Le, Taylor H. Allenby, Marlie Fisher, Ryan S. Constantine, Colin T. McNamara, Caleb Barnhill, Anne Engemann, Orlando Merced-O’Neill, Matthew L. Iorio
    Plastic and Reconstructive Surgery - Global Open.2024; 12(10): e6258.     CrossRef
  • Fluoroscopically-guided therapeutic injection of the proximal tibiofibular joint in a patient with lateral knee pain
    Cooper Dean, Ivan Davis, David Alvarez
    Radiology Case Reports.2020; 15(12): 2510.     CrossRef
  • 14,247 View
  • 231 Download
  • 2 Web of Science
  • 3 Crossref
Optimal Placement of Needle Electromyography in Extensor Indicis: A Cadaveric Study
Jin Young Im, Hong Bum Park, Seok Jun Lee, Seong Gyu Lim, Ki Hoon Kim, Dasom Kim, Im Joo Rhyu, Byung Kyu Park, Dong Hwee Kim
Ann Rehabil Med 2018;42(3):473-476.   Published online June 27, 2018
DOI: https://doi.org/10.5535/arm.2018.42.3.473
Objective
To identify the center of extensor indicis (EI) muscle through cadaver dissection and compare the accuracy of different techniques for needle electromyography (EMG) electrode insertion.
Methods
Eighteen upper limbs of 10 adult cadavers were dissected. The center of trigonal EI muscle was defined as the point where the three medians of the triangle intersect. Three different needle electrode insertion techniques were introduced: M1, 2.5 cm above the lower border of ulnar styloid process (USP), lateral aspect of the ulna; M2, 2 finger breadths (FB) proximal to USP, lateral aspect of the ulna; and M3, distal fourth of the forearm, lateral aspect of the ulna. The distance from USP to the center (X) parallel to the line between radial head to USP, and from medial border of ulna to the center (Y) were measured. The distances between 3 different points (M1– M3) and the center were measured (marked as D1, D2, and D3, respectively).
Results
The median value of X was 48.3 mm and that of Y was 7.2 mm. The median values of D1, D2 and D3 were 23.3 mm, 13.3 mm and 9.0 mm, respectively.
Conclusion
The center of EI muscle is located approximately 4.8 cm proximal to USP level and 7.2 mm lateral to the medial border of the ulna. Among the three methods, the technique placing the needle electrode at distal fourth of the forearm and lateral to the radial side of the ulna bone (M3) is the most accurate and closest to the center of the EI muscle.

Citations

Citations to this article as recorded by  
  • Examining Motor Unit Properties of Upper Limb Muscles Near the Zone of Injury in Chronic Cervical Spinal Cord Injury
    Mathew I.B. Debenham, Emmanuel Ogalo, Harvey Wu, Chris J. McNeil, Brian H. Dalton, Daniel Stashuk, Michael J. Berger
    Journal of Neurotrauma.2026;[Epub]     CrossRef
  • Ultrasonographic Analysis of Optimal Needle Placement for Extensor Indicis
    Jin Young Kim, Hyun Seok, Sang-Hyun Kim, Yoon-Hee Choi, Jun Young Ahn, Seung Yeol Lee
    Annals of Rehabilitation Medicine.2020; 44(6): 450.     CrossRef
  • 12,129 View
  • 142 Download
  • 2 Web of Science
  • 2 Crossref
Anatomic Characteristics of Pronator Quadratus Muscle: A Cadaver Study
Phil Woo Choung, Min Young Kim, Hyung Soon Im, Ki Hoon Kim, Im Joo Rhyu, Byung Kyu Park, Dong Hwee Kim
Ann Rehabil Med 2016;40(3):496-501.   Published online June 29, 2016
DOI: https://doi.org/10.5535/arm.2016.40.3.496
Objective

To identify the anatomic characteristics of the pronator quadratus (PQ) muscle and the entry zone (EZ) of the anterior interosseous nerve (AIN) to this muscle by means of cadaver dissection.

Methods

We examined the PQ muscle and AIN in 20 forearms from 10 fresh cadavers. After identifying the PQ muscle and the EZ of the AIN, we measured the distances from the midpoint (MidP) of the PQ muscle and EZ to the vertical line passing the tip of the ulnar styloid process (MidP_X and EZ_X, respectively) and to the medial border of the ulna (MidP_Y and EZ_Y, respectively). Forearm length (FL) and wrist width (WW) were also measured, and the ratios of MidP and EZ to FL and of MidP and EZ to WW were calculated.

Results

The MidP was found to be 3.0 cm proximal to the ulnar styloid process or distal 13% of the FL and 2.0 cm lateral to the medial border of the ulna or ulnar 40% side of the WW, which was similar to the location of EZ. The results reveal a more distal site than was reported in previous studies.

Conclusion

We suggest that the proper site for needle insertion and motor point block of the PQ muscle is 3 cm proximal to the ulnar styloid process or distal 13% of the FL and 2 cm lateral to the medial border of the ulna or ulnar 40% side of the WW.

Citations

Citations to this article as recorded by  
  • Morphometric and anatomic characteristics of pronator quadratus muscle
    Nurşen Zeybek, Özcan Gayretli, Yüsra Nur Şanlıtürk, Ayşin Kale
    Chinese Journal of Traumatology.2025; 28(4): 252.     CrossRef
  • The Elias University Hospital Approach: A Visual Guide to Ultrasound-Guided Botulinum Toxin Injection in Spasticity: Part I—Distal Upper Limb Muscles
    Marius Nicolae Popescu, Claudiu Căpeț, Cristina Beiu, Mihai Berteanu
    Toxins.2025; 17(3): 107.     CrossRef
  • Ultrasonographic study for optimal volar needle approach technique for the pronator quadratus to avoid anterior interosseous nerve injury
    Hyun Jin Park, Kyung Hun Kang, Joon Shik Yoon
    Scientific Reports.2025;[Epub]     CrossRef
  • Quantitative analysis of radial torsion angle according to location with CT scan
    Eic Ju Lim, Seungyeob Sakong, Jeong Seok Choi, Wonseok Choi, Jong-Keon Oh, Jae-Woo Cho
    Injury.2025; 56(10): 112634.     CrossRef
  • Dorsal dry needling to the pronator quadratus muscle is a safe and valid technique: A cadaveric study
    Albert Pérez-Bellmunt, Carlos López-de-Celis, Jacobo Rodríguez-Sanz, César Hidalgo-García, Joseph M. Donnelly, Simón A Cedeño-Bermúdez, César Fernández-de-las-Peñas
    Physiotherapy Theory and Practice.2023; 39(5): 1033.     CrossRef
  • Anatomical depth parameters of pronator quadratus: a cadaveric study
    Joseph W. Duncumb, Fraser Chisholm, Enis Cezayirli
    Journal of Hand Surgery (European Volume).2023; 48(10): 1085.     CrossRef
  • Ultrasonographic Evaluation of the Needle Insertion Site for the Flexor Pollicis Longus Using the Flexor Carpi Radialis Tendon
    Hong Bum Park, Chae Hyeon Ryou, Ki Hoon Kim, Hang Jae Lee, Dong Hwee Kim
    Journal of Electrodiagnosis and Neuromuscular Diseases.2023; 25(3): 111.     CrossRef
  • The intra-muscular course and distribution of the anterior interosseous nerve within pronator quadratus: An anatomical study
    S. Trowbridge, M.L. Sagmeister, T.L. Lewis, H. Vidakovic, N. Hammer, D.C. Kieser
    Journal of Clinical Orthopaedics and Trauma.2022; 28: 101868.     CrossRef
  • The Dimensions of Pronator Quadratus and Its Neurovascular Structures – A Cadaveric Study with Its Clinical Implications in Distal Forearm Surgeries
    Sudha Ramalingam, Deepa Somanath
    Journal of Orthopedics, Traumatology and Rehabilitation.2022; 14(1): 46.     CrossRef
  • Calcific tendinopathy of the pronator quadratus muscle: A rare site and cause of ulnar sided wrist pain
    Karthikeyan. P. Iyengar, J.A. Yusta-Zato, Botchu R
    Journal of Clinical Orthopaedics and Trauma.2022; 32: 101968.     CrossRef
  • Use of free radial forearm and pronator quadratus muscle flap: Anatomical study and clinical application
    Tomas Kempny, Zuzana Musilova, Martin Knoz, Marek Joukal, Lipový Břetislav, Holoubek Jakub, Wolfgang Paul Pöschl, Hsu-Tang Cheng
    Journal of Plastic, Reconstructive & Aesthetic Surgery.2022; 75(12): 4393.     CrossRef
  • An anatomical and biomechanical assessment of the interosseous membrane of the cadaveric forearm
    Hamid Rahmatullah Bin Abd Razak, Khye-Soon Andy Yew, Irwan Shah Bin Mohd Moideen, Xian-Khing Kenny Tay, Tet-Sen Howe, Suang-Bee Joyce Koh
    Journal of Hand Surgery (European Volume).2020; 45(4): 369.     CrossRef
  • Rotational Corrective Osteotomy for Malunited Distal Diaphyseal Radius Fractures in Children and Adolescents
    Toshiyuki Kataoka, Kunihiro Oka, Tsuyoshi Murase
    The Journal of Hand Surgery.2018; 43(3): 286.e1.     CrossRef
  • Partial Wrist Denervation for Idiopathic Dorsal Wrist Pain in an Active Duty Military Population
    Nicole M. Sgromolo, Mickey S. Cho, Joseph T. Gower, Peter C. Rhee
    The Journal of Hand Surgery.2018; 43(12): 1108.     CrossRef
  • Safety Window for the Volar Needle Approach for Examination of the Pronator Quadratus Using Ultrasonography
    Seok Jun Lee, Ki Hoon Kim, In Yae Cheong, Byung Kyu Park, Dong Hwee Kim
    Archives of Physical Medicine and Rehabilitation.2017; 98(12): 2553.     CrossRef
  • 8,568 View
  • 80 Download
  • 16 Web of Science
  • 15 Crossref
Branching Patterns of Medial and Inferior Calcaneal Nerves Around the Tarsal Tunnel
Beom Suk Kim, Phil Woo Choung, Soon Wook Kwon, Im Joo Rhyu, Dong Hwee Kim
Ann Rehabil Med 2015;39(1):52-55.   Published online February 28, 2015
DOI: https://doi.org/10.5535/arm.2015.39.1.52
Objective

To demonstrate the bifurcation pattern of the tibial nerve and its branches.

Methods

Eleven legs of seven fresh cadavers were dissected. The reference line for the bifurcation point of tibial nerve branches was an imaginary horizontal line passing the tip of the medial malleolus. The distances between the reference line and the bifurcation points were measured. The bifurcation branching patterns were categorized as type I, the pattern in which the medial calcaneal nerve (MCN) branched most proximally; type II, the pattern in which the three branches occurred at the same point; and type III, in which MCN branched most distally.

Results

There were seven cases (64%) of type I, three cases (27%) of type III, and one case (9%) of type II. The median MCN branching point was 0.2 cm (range, -1 to 3 cm). The median bifurcation points of the lateral plantar nerves and inferior calcaneal nerves was -0.6 cm (range, -1.5 to 1 cm) and -2.5 cm (range, -3.5 to -1 cm), respectively.

Conclusion

MCN originated from the tibial nerve in most cases, and plantar nerves were bifurcated below the medial malleolus. In all cases, inferior calcaneal nerves originated from the lateral plantar nerve. These anatomical findings could be useful for performing procedures, such as nerve block or electrophysiologic studies.

Citations

Citations to this article as recorded by  
  • Unravelling the spatial relationships and inconsistencies of the tarsal tunnel: a comprehensive review and analysis
    G. K. Bruechert, C. G. Thorpe Lowis, W. H. B. Edwards, Q. A. Fogg
    Discover Medicine.2025;[Epub]     CrossRef
  • Anatomical variations of the medial calcaneal nerve: a cadaveric study
    D. G. Agafonov, G. A. Ayrapetov, M. S. Serdobintsev, N. I. Karpovich, R. A. Khanmuradov, D. G. Naumov, M. A. Djeriev
    Genij Ortopedii.2025; 31(5): 551.     CrossRef
  • Ultrasound Assessment of the Tibial Nerve at the Retromalleolar Level: Influence of Anthropometric Characteristics and Clinical Implications
    María Benimeli-Fenollar, Cecili Macián-Romero, Lucía Carbonell-José, María José Chiva-Miralles, José Maria Montiel-Company, José Manuel Almerich-Silla, Rosa Cibrian, Vicent Tomás-Martínez
    Clinics and Practice.2025; 15(12): 227.     CrossRef
  • Morphometric assessment of tibial nerve and its branches around the ankle
    Jeha Kwon, Hong Bum Park, Soonwook Kwon, Im Joo Rhyu, Dong Hwee Kim
    Medicine.2024; 103(15): e37745.     CrossRef
  • Clinical Results Following Conservative Management of Tarsal Tunnel Syndrome Compared With Surgical Treatment: A Systematic Review
    Neeraj Vij, Heather N. Kaley, Christopher L. Robinson, Peter P. Issa, Alan D. Kaye, Omar Viswanath, Ivan Urits
    Orthopedic Reviews.2022;[Epub]     CrossRef
  • An MRI study of the tibial nerve in the ankle canal and its branches: a method of multiplanar reformation with 3D-FIESTA-C sequences
    Yan Zhang, Xucheng He, Juan Li, Ju Ye, Wenjuan Han, Shanshan Zhou, Jianzhong Zhu, Guisheng Wang, Xiaoxia Chen
    BMC Medical Imaging.2021;[Epub]     CrossRef
  • The Study of Anatomy of Tarsal Tunnel in Human Fetuses by Dissection Method
    B. R. Chaithra Rao, Sucharitha Annam, Sreepadma Sunkeswari, Sandeep Patil
    National Journal of Clinical Anatomy.2021; 10(2): 66.     CrossRef
  • Tibial Nerve Block: Supramalleolar or Retromalleolar Approach? A Randomized Trial in 110 Participants
    María Benimeli-Fenollar, José M. Montiel-Company, José M. Almerich-Silla, Rosa Cibrián, Cecili Macián-Romero
    International Journal of Environmental Research and Public Health.2020; 17(11): 3860.     CrossRef
  • Anatomical study and branching point of neurovascular structures at the medial side of the ankle
    Chanatporn Inthasan, Tanawat Vaseenon, Pasuk Mahakkanukrauh
    Anatomy & Cell Biology.2020; 53(4): 422.     CrossRef
  • Cryoanalgesia. Review
    Dmitrii A. Svirskii, E. E. Antipin, N. A. Bochkareva, A. T. Ibragimov, M. P. Yakovenko, E. V. Nedashkovskii
    Annals of Critical Care.2020; (4): 58.     CrossRef
  • Fine dissection of the tarsal tunnel in 60 cases
    Y. Yang, M. L. Du, Y. S. Fu, W. Liu, Q. Xu, X. Chen, Y. J. Hao, Z. Liu, M. J. Gao
    Scientific Reports.2017;[Epub]     CrossRef
  • MR Imaging Findings in Heel Pain
    Ching-Di Chang, Jim S. Wu
    Magnetic Resonance Imaging Clinics of North America.2017; 25(1): 79.     CrossRef
  • Nervenengpasssyndrome des Ramus calcanearis lateralis (Baxter-Nerv) und Nervus plantaris medialis (Jogger-Nerv)
    Andreas Elsner, Timm Filler, Alexej Barg, Jonas Andermahr
    Fuß & Sprunggelenk.2015; 13(4): 237.     CrossRef
  • 8,104 View
  • 124 Download
  • 9 Web of Science
  • 13 Crossref
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