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Jem Arnold
Jem Arnold
@jemarnold.bsky.social
2 months ago
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British Medical Journal: 1 (4668)

www.bmj.com/content/1/46...

Found hiding in the references of a 2013 Brazilian review paper as Martijn is reviewing the literature for an important upcoming consensus study on #FLIA #endofibrosis in cycling

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Jem Arnold
Jem Arnold
@jemarnold.bsky.social
2 months ago
image text extracted by LLM: Case 2 This patient, a man aged 23, gave no history of any definite traumatic incident, but explained that his hobby was sprint cycling. In August, 1944, after walking a distance estimated at... Histology.—The histological report on the excised segment of artery read as follows: “The artery is much decreased in size, and in consequence the internal and external elastic lamellae are tortuous and thickened. There is a slight increase in the amount of medial elastic tissue. The lumen is filled with fibrous tissue which has incorporated the intima. In this fibrous tissue are a few blood spaces which are lined by a simple epithelium. There is no evidence of any inflammatory reaction. There is nothing to suggest the cause for this now quiescent thrombosis” (Plate, Figs. 1, 2, and 3). A similar lesion or an intimal tear may be due to a “stretch-strain” or may be the result of traction on a muscular branch. The external iliac artery has been shown to be fixed to the ilio-psoas muscle at the level of Poupart’s ligament by the fusion of the iliac and transversalis fascia with the adventitia of the artery (Panton, 1923). The causes of the thrombosis in the above two cases would seem to be direct trauma in Case 1, who was struck by the falling tree, and indirect trauma due to stretch-strain from repeated flexion of the hip-joint in Case 2, the sprint cyclist. Prognosis In both cases, at the post-operative review, exercise caused the limb pulses to become palpably stronger, whereas pre-operatively the converse had been observed. Subjectively, both patients considered their condition to be much improved. The follow-up period cannot, however, be taken as sufficient for judgment of the long-term results.

image text extracted by LLM: Case 2 This patient, a man aged 23, gave no history of any definite traumatic incident, but explained that his hobby was sprint cycling. In August, 1944, after walking a distance estimated at... Histology.—The histological report on the excised segment of artery read as follows: “The artery is much decreased in size, and in consequence the internal and external elastic lamellae are tortuous and thickened. There is a slight increase in the amount of medial elastic tissue. The lumen is filled with fibrous tissue which has incorporated the intima. In this fibrous tissue are a few blood spaces which are lined by a simple epithelium. There is no evidence of any inflammatory reaction. There is nothing to suggest the cause for this now quiescent thrombosis” (Plate, Figs. 1, 2, and 3). A similar lesion or an intimal tear may be due to a “stretch-strain” or may be the result of traction on a muscular branch. The external iliac artery has been shown to be fixed to the ilio-psoas muscle at the level of Poupart’s ligament by the fusion of the iliac and transversalis fascia with the adventitia of the artery (Panton, 1923). The causes of the thrombosis in the above two cases would seem to be direct trauma in Case 1, who was struck by the falling tree, and indirect trauma due to stretch-strain from repeated flexion of the hip-joint in Case 2, the sprint cyclist. Prognosis In both cases, at the post-operative review, exercise caused the limb pulses to become palpably stronger, whereas pre-operatively the converse had been observed. Subjectively, both patients considered their condition to be much improved. The follow-up period cannot, however, be taken as sufficient for judgment of the long-term results.

Wow! My colleague Dr. Martijn van Hooff just found a medical description of #endofibrosis in the iliac artery of a cyclist in the UK, published 1950!

Many of the same observed features and speculations on mechanisms, 35 years before the modern condition was described in Switzerland and France

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