Research Article
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Year 2015, Volume: 9 Issue: 3, 128 - 134, 01.02.2016

Abstract

References

  • Schweitzer ME, Karasick D. MR imaging of disorders of the Achilles tendon. AJR Am J Roentgenol 2000;175:613–25.
  • Koivunen-Niemelä T, Parkkola K. Anatomy of the Achilles tendon (tendo calcaneus) with respect to tendon thickness measurements.
  • Surg Radiol Anat 1995;17:263–8.
  • Levangie P, Norkin C. Joint structure and function: a comprehensive
  • analysis. 5th ed. New Delhi; Jaypee Brothers; 2011. Chapter
  • , The ankle and foot complex; p. 440–82.
  • Maffuli N, Almekinders LC. The Achilles tendon. London: Springer-Verlag; 2007. p. 36.
  • Apayd›n N, Ünlü S, Bozkurt M, Doral MN. Functional anatomy and biomechanical aspects of the Achilles tendon. [Article in Turkish]
  • TOTB‹D Dergisi 2011;10:61–8.
  • Mow VC, Huiskes R. Basic orthopaedic biomechanics and mechanobiology. Philadelphia: Lippincott Williams and Wilkins; 2005. p.
  • –41.
  • Fredberg U, Bolvig L, Andersen NT, Stengaard-Pedersen K.
  • Ultrasonography in evaluation of Achilles and patella tendon
  • thickness. Ultraschall Med 2008;29:60–5.
  • Nehrer S, Breitenseher M, Brodner W, Kainberger F, Fellinger
  • EJ, Engel A, Imhof F. Clinical and sonographic evaluation of the
  • risk of rupture in the Achilles tendon. Arch Orthop Trauma Surg
  • ;116:14–8.
  • Järvinen TA, Järvinen TL, Kannus P, Józsa L, Järvinen M. Collagen
  • fibres of the spontaneously ruptured human tendons display
  • decreased thickness and crimp angle. J Orthop Res 2004;22:1303–9.
  • Eriksen HA, Pajala A, Leppilahti J, Risteli J. Increased content of
  • type III collagen at the rupture site of human Achilles tendon. J
  • Orthop Res 2002;20:1352–7.
  • Karjalainen PT, Soila K, Aronen HJ, Pihlajamäki HK, Tynninen
  • O, Paavonen T, Tirman PF. MR imaging of overuse injuries of the
  • Achilles tendon. AJR Am J Roentgenol 2000;175:251–60.
  • O'Connor PJ, Grainger AJ, Morgan SR, Smith KL, Waterton JC,
  • Nash AF. Ultrasound assessment of tendons in asymptomatic volunteers:
  • a study of reproducibility. Eur Radiol 2004;14:1968–73.
  • Grassi W, Filippucci E, Farina A, Cervini C. Sonographic imaging
  • of tendons. Arthritis Rheum 2000;43:969–76.
  • van Schie HT, de Vos RJ, de Jonge S, Bakker EM, Heijboer MP,
  • Verhaar JA, Tol JL, Weinans H. Ultrasonographic tissue characterisation
  • of human Achilles tendons: quantification of tendon
  • structure through a novel non-invasive approach. Br J Sports Med
  • ;44:1153–9.
  • Fahlström M, Alfredson H. Ultrasound and Doppler findings in the
  • Achilles tendon among middle-aged recreational floor-ball players
  • in direct relation to a match. Br J Sports Med 2010;44:140– 3.
  • Mabuchi H, Tatami R, Haba T, Ueda K, Ueda R, Ito S, Karnetani
  • T, Koizurni J, Miyamoto S, Ohta M, Takeda R, Takegoshi T,
  • Takeshita H. Achilles tendon thickness and ischemic heart disease
  • in familial hypercholesterolemia. Metabolism 1978;27:1672–9.
  • Pang BS, Ying M. Sonographic measurement of achilles tendons in
  • asymptomatic subjects: variation with age, body height, and dominance
  • of ankle. J Ultrasound Med 2006;25:1291–6.
  • Kallinen M, Suominen H. Ultrasonographic measurements of the
  • Achilles tendon in elderly athletes and sedentary men. Acta Radiol
  • ;35:560–3.
  • Muraoka T, Muramatsu T, Fukunaga T, Kanehisa H. Elastic
  • properties of human Achilles tendon are correlated to muscle
  • strength. J Appl Physiol (1985) 2005;99:665–9.
  • Egwu O, Njoku CO, Ukoha UU, Eteudo AN, Elem BC. Calf muscle
  • (triceps surae complex) thickness in an adult Nigerian population:
  • an imaging based normographic study. Macedonian Journal of
  • Medical Sciences 2013;6:146–52.
  • Finni T, Kovanen V, Ronkainen PH, Pöllänen E, Bashford GR,
  • Kaprio J, Alén M, Kujala UM, Sipilä S. Combination of hormone
  • replacement therapy and high physical activity is associated with differences
  • in Achilles tendon size in monozygotic female twin pairs. J
  • Appl Physiol (1985) 2009;106:1332–7.
  • Bohm S, Mersmann F, Marzilger R, Schroll A, Arampatzis A.
  • Asymmetry of Achilles tendon mechanical and morphological
  • properties between both legs. Scand J Med Sci Sports 2015;25:
  • e124–32.
  • Egwu OA, Ogbonna CO, Salami E, Eni OE, Besong E, Onwe CC.
  • Normal thickness of the tendo calcaneus (TCT) in an adult
  • Nigerian population: an imaging based normographic study. Br J
  • Med Med Res 2014;4:2100–11.
  • Balius R, Alomar X, Rodas G, Miguel-Pérez M, Pedret C, Dobado
  • MC, Blasi J, Koulouris G. The soleus muscle: MRI, anatomic and
  • histologic findings in cadavers with clinical correlation of strain
  • injury distribution. Skeletal Radiol 2013;42:521–30.
  • Egwu OA, Anibeze CIP, Akpuaka FC, Udoh BE. Activity related
  • differences in the thickness of achilles tendon among four different
  • occupational groups in nigeria: an ultrasound based study.
  • Bangladesh J Med Sci 2012;11:103–11.
  • Mathieson JR, Connell DG, Cooperberg PL, Lloyd-Smith DR.
  • Sonography of the Achilles tendon and adjacent bursae. AJR Am J
  • Roentgenol 1988;151:127–31.
  • Civeira F, Castillo JJ, Calvo C, Ferrando J, de Pedro C, Martínez-
  • Rodés P, Pocoví M. Achilles tendon size by high resolution sonography
  • in healthy population. Relationship with lipid levels. Med
  • Clin (Barc) 1998;111:41–4.
  • Cook JL, Khan KM, Harcourt PR, Kiss ZS, Fehrmann MW,
  • Griffiths L, Wark JD. Patellar tendon ultrasonography in asymptomatic
  • active athletes reveals hypoechoic regions: a study of 320
  • tendons. Victorian Institute of Sport Tendon Study Group. Clin J
  • Sport Med 1998;8:73–7.
  • Cook JL, Khan KM, Kiss ZS, Coleman BD, Griffiths L.
  • Asymptomatic hypoechoic regions on patellar tendon ultrasound:
  • A 4-year clinical and ultrasound followup of 46 tendons. Scand J
  • Med Sci Sports 2001;11:321–7.
  • Cook JL, Khan KM, Kiss ZS, Purdam CR, Griffiths L. Prospective
  • imaging study of asymptomatic patellar tendinopathy in elite junior
  • basketball players. J Ultrasound Med 2000;19:473–9.
  • Kongsgaard M, Aagaard P, Kjaer M, Magnusson SP. Structural
  • Achilles tendon properties in athletes subjected to different exercise
  • modes and in Achilles tendon rupture patients. J Appl Physiol
  • ;99:1965–71.
  • Rosager S, Aagaard P, Dyhre-Poulsen P, Neergaard K, Kjaer M,
  • Magnusson SP. Load-displacement properties of the human triceps
  • surae aponeurosis and tendon in runners and non-runners.
  • Scand J Med Sci Sports 2002;12:90–8.
  • Unal B, Bilgili MYK, Y›lmaz S, Caglayan O, Kara S. Smoking prevents
  • the expected postprandial increase in intestinal blood flow. J
  • Ultrasound Med 2004;23:647–53.
  • Jacobovicz J, Tolazzi AR, Timi JR. Doppler ultrasound evaluation
  • of facial transverse and infraorbital arteries: influence of smoking
  • and aging process. Aesthetic Plast Surg 2007;31:526–31.
  • Maffulli N, Ewen SW, Waterston SW, Reaper J, Barrass V.
  • Tenocytes from ruptured and tendinopathic achilles tendons produce
  • greater quantities of type III collagen than tenocytes from
  • normal achilles tendons. An in vitro model of human tendon healing.
  • Am J Sports Med 2000;28:499–505.
  • Whittaker P, Canham PB. Demonstration of quantitative fabric
  • analysis of tendon collagen using two-dimensional polarized light
  • microscopy. Matrix 1991;11:56–62.
  • Jorgensen LN, Kallehave F, Christensen E, Siana JE, Gottrup F.
  • Less collagen production in smokers. Surgery 1998;12:450–5.
  • Birk DE, Mayne R. Localization of collagen types I, III and V during
  • tendon development. Changes in collagen types I and III are correlated
  • with changes in fibril diameter. Eur J Cell Biol 1997;72: 352–61.
  • Stenroth L, Peltonen J, Cronin NJ, Sipilä S, Finni T. Age-related
  • differences in Achilles tendon properties and triceps surae muscle
  • architecture in vivo. J Appl Physiol (1985) 2012;113:1537–44.
  • Magnusson SP, Beyer N, Abrahamsen H, Aagaard P, Neergaard
  • K, Kjaer M. Increased cross-sectional area and reduced tensile
  • stress of the Achilles tendon in elderly compared with young
  • women. J Gerontol A Biol Sci Med Sci 2003;58:123–7.
  • Kinugasa R, Hodgson JA, Edgerton VR, Shin DD, Sinha S.
  • Reduction in tendon elasticity from unloading is unrelated to its
  • hypertrophy. J Appl Physiol (1985) 2010;109:870–7.

EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY

Year 2015, Volume: 9 Issue: 3, 128 - 134, 01.02.2016

Abstract

Objectives: The aim of this study was to reveal the normal morphometric values of Achilles tendon using ultrasound (US) imaging in subjects of different gender, age groups, smoking status, and physical exercise habits.
Methods: A total of 342 Achilles tendons were examined in the 171 volunteers (69 females, 102 males) with different age, gender, weight, height, smoking and physical exercise habits. Achilles tendon width, length, thickness, cross-sectional area and length were measured using a commercial ultrasound machine with a 9-15 mHz linear-array transducer.
Results: The average width, thickness, cross-sectional area and length of the Achilles tendon in male subjects were significantly higher than females. Tendon width, thickness, cross-sectional area and length showed no significant difference between the right and left side. With the exception of the left Achilles tendon thickness, measurements taken for non-smoking subjects were larger than smokers. Achilles tendon measurements of subjects engaged in sportive activities were significantly larger than those with sedentary lifestyle Weight and body mass index were the only anthropometric measurements in correlation with Achilles tendon size.
Conclusion: Achilles tendon size varies with age, gender, physical activity and smoking habits. The measurements presented in this study give normal variations of the tendon’s morphologic characteristics, which will be of use in clinical diagnosis.

References

  • Schweitzer ME, Karasick D. MR imaging of disorders of the Achilles tendon. AJR Am J Roentgenol 2000;175:613–25.
  • Koivunen-Niemelä T, Parkkola K. Anatomy of the Achilles tendon (tendo calcaneus) with respect to tendon thickness measurements.
  • Surg Radiol Anat 1995;17:263–8.
  • Levangie P, Norkin C. Joint structure and function: a comprehensive
  • analysis. 5th ed. New Delhi; Jaypee Brothers; 2011. Chapter
  • , The ankle and foot complex; p. 440–82.
  • Maffuli N, Almekinders LC. The Achilles tendon. London: Springer-Verlag; 2007. p. 36.
  • Apayd›n N, Ünlü S, Bozkurt M, Doral MN. Functional anatomy and biomechanical aspects of the Achilles tendon. [Article in Turkish]
  • TOTB‹D Dergisi 2011;10:61–8.
  • Mow VC, Huiskes R. Basic orthopaedic biomechanics and mechanobiology. Philadelphia: Lippincott Williams and Wilkins; 2005. p.
  • –41.
  • Fredberg U, Bolvig L, Andersen NT, Stengaard-Pedersen K.
  • Ultrasonography in evaluation of Achilles and patella tendon
  • thickness. Ultraschall Med 2008;29:60–5.
  • Nehrer S, Breitenseher M, Brodner W, Kainberger F, Fellinger
  • EJ, Engel A, Imhof F. Clinical and sonographic evaluation of the
  • risk of rupture in the Achilles tendon. Arch Orthop Trauma Surg
  • ;116:14–8.
  • Järvinen TA, Järvinen TL, Kannus P, Józsa L, Järvinen M. Collagen
  • fibres of the spontaneously ruptured human tendons display
  • decreased thickness and crimp angle. J Orthop Res 2004;22:1303–9.
  • Eriksen HA, Pajala A, Leppilahti J, Risteli J. Increased content of
  • type III collagen at the rupture site of human Achilles tendon. J
  • Orthop Res 2002;20:1352–7.
  • Karjalainen PT, Soila K, Aronen HJ, Pihlajamäki HK, Tynninen
  • O, Paavonen T, Tirman PF. MR imaging of overuse injuries of the
  • Achilles tendon. AJR Am J Roentgenol 2000;175:251–60.
  • O'Connor PJ, Grainger AJ, Morgan SR, Smith KL, Waterton JC,
  • Nash AF. Ultrasound assessment of tendons in asymptomatic volunteers:
  • a study of reproducibility. Eur Radiol 2004;14:1968–73.
  • Grassi W, Filippucci E, Farina A, Cervini C. Sonographic imaging
  • of tendons. Arthritis Rheum 2000;43:969–76.
  • van Schie HT, de Vos RJ, de Jonge S, Bakker EM, Heijboer MP,
  • Verhaar JA, Tol JL, Weinans H. Ultrasonographic tissue characterisation
  • of human Achilles tendons: quantification of tendon
  • structure through a novel non-invasive approach. Br J Sports Med
  • ;44:1153–9.
  • Fahlström M, Alfredson H. Ultrasound and Doppler findings in the
  • Achilles tendon among middle-aged recreational floor-ball players
  • in direct relation to a match. Br J Sports Med 2010;44:140– 3.
  • Mabuchi H, Tatami R, Haba T, Ueda K, Ueda R, Ito S, Karnetani
  • T, Koizurni J, Miyamoto S, Ohta M, Takeda R, Takegoshi T,
  • Takeshita H. Achilles tendon thickness and ischemic heart disease
  • in familial hypercholesterolemia. Metabolism 1978;27:1672–9.
  • Pang BS, Ying M. Sonographic measurement of achilles tendons in
  • asymptomatic subjects: variation with age, body height, and dominance
  • of ankle. J Ultrasound Med 2006;25:1291–6.
  • Kallinen M, Suominen H. Ultrasonographic measurements of the
  • Achilles tendon in elderly athletes and sedentary men. Acta Radiol
  • ;35:560–3.
  • Muraoka T, Muramatsu T, Fukunaga T, Kanehisa H. Elastic
  • properties of human Achilles tendon are correlated to muscle
  • strength. J Appl Physiol (1985) 2005;99:665–9.
  • Egwu O, Njoku CO, Ukoha UU, Eteudo AN, Elem BC. Calf muscle
  • (triceps surae complex) thickness in an adult Nigerian population:
  • an imaging based normographic study. Macedonian Journal of
  • Medical Sciences 2013;6:146–52.
  • Finni T, Kovanen V, Ronkainen PH, Pöllänen E, Bashford GR,
  • Kaprio J, Alén M, Kujala UM, Sipilä S. Combination of hormone
  • replacement therapy and high physical activity is associated with differences
  • in Achilles tendon size in monozygotic female twin pairs. J
  • Appl Physiol (1985) 2009;106:1332–7.
  • Bohm S, Mersmann F, Marzilger R, Schroll A, Arampatzis A.
  • Asymmetry of Achilles tendon mechanical and morphological
  • properties between both legs. Scand J Med Sci Sports 2015;25:
  • e124–32.
  • Egwu OA, Ogbonna CO, Salami E, Eni OE, Besong E, Onwe CC.
  • Normal thickness of the tendo calcaneus (TCT) in an adult
  • Nigerian population: an imaging based normographic study. Br J
  • Med Med Res 2014;4:2100–11.
  • Balius R, Alomar X, Rodas G, Miguel-Pérez M, Pedret C, Dobado
  • MC, Blasi J, Koulouris G. The soleus muscle: MRI, anatomic and
  • histologic findings in cadavers with clinical correlation of strain
  • injury distribution. Skeletal Radiol 2013;42:521–30.
  • Egwu OA, Anibeze CIP, Akpuaka FC, Udoh BE. Activity related
  • differences in the thickness of achilles tendon among four different
  • occupational groups in nigeria: an ultrasound based study.
  • Bangladesh J Med Sci 2012;11:103–11.
  • Mathieson JR, Connell DG, Cooperberg PL, Lloyd-Smith DR.
  • Sonography of the Achilles tendon and adjacent bursae. AJR Am J
  • Roentgenol 1988;151:127–31.
  • Civeira F, Castillo JJ, Calvo C, Ferrando J, de Pedro C, Martínez-
  • Rodés P, Pocoví M. Achilles tendon size by high resolution sonography
  • in healthy population. Relationship with lipid levels. Med
  • Clin (Barc) 1998;111:41–4.
  • Cook JL, Khan KM, Harcourt PR, Kiss ZS, Fehrmann MW,
  • Griffiths L, Wark JD. Patellar tendon ultrasonography in asymptomatic
  • active athletes reveals hypoechoic regions: a study of 320
  • tendons. Victorian Institute of Sport Tendon Study Group. Clin J
  • Sport Med 1998;8:73–7.
  • Cook JL, Khan KM, Kiss ZS, Coleman BD, Griffiths L.
  • Asymptomatic hypoechoic regions on patellar tendon ultrasound:
  • A 4-year clinical and ultrasound followup of 46 tendons. Scand J
  • Med Sci Sports 2001;11:321–7.
  • Cook JL, Khan KM, Kiss ZS, Purdam CR, Griffiths L. Prospective
  • imaging study of asymptomatic patellar tendinopathy in elite junior
  • basketball players. J Ultrasound Med 2000;19:473–9.
  • Kongsgaard M, Aagaard P, Kjaer M, Magnusson SP. Structural
  • Achilles tendon properties in athletes subjected to different exercise
  • modes and in Achilles tendon rupture patients. J Appl Physiol
  • ;99:1965–71.
  • Rosager S, Aagaard P, Dyhre-Poulsen P, Neergaard K, Kjaer M,
  • Magnusson SP. Load-displacement properties of the human triceps
  • surae aponeurosis and tendon in runners and non-runners.
  • Scand J Med Sci Sports 2002;12:90–8.
  • Unal B, Bilgili MYK, Y›lmaz S, Caglayan O, Kara S. Smoking prevents
  • the expected postprandial increase in intestinal blood flow. J
  • Ultrasound Med 2004;23:647–53.
  • Jacobovicz J, Tolazzi AR, Timi JR. Doppler ultrasound evaluation
  • of facial transverse and infraorbital arteries: influence of smoking
  • and aging process. Aesthetic Plast Surg 2007;31:526–31.
  • Maffulli N, Ewen SW, Waterston SW, Reaper J, Barrass V.
  • Tenocytes from ruptured and tendinopathic achilles tendons produce
  • greater quantities of type III collagen than tenocytes from
  • normal achilles tendons. An in vitro model of human tendon healing.
  • Am J Sports Med 2000;28:499–505.
  • Whittaker P, Canham PB. Demonstration of quantitative fabric
  • analysis of tendon collagen using two-dimensional polarized light
  • microscopy. Matrix 1991;11:56–62.
  • Jorgensen LN, Kallehave F, Christensen E, Siana JE, Gottrup F.
  • Less collagen production in smokers. Surgery 1998;12:450–5.
  • Birk DE, Mayne R. Localization of collagen types I, III and V during
  • tendon development. Changes in collagen types I and III are correlated
  • with changes in fibril diameter. Eur J Cell Biol 1997;72: 352–61.
  • Stenroth L, Peltonen J, Cronin NJ, Sipilä S, Finni T. Age-related
  • differences in Achilles tendon properties and triceps surae muscle
  • architecture in vivo. J Appl Physiol (1985) 2012;113:1537–44.
  • Magnusson SP, Beyer N, Abrahamsen H, Aagaard P, Neergaard
  • K, Kjaer M. Increased cross-sectional area and reduced tensile
  • stress of the Achilles tendon in elderly compared with young
  • women. J Gerontol A Biol Sci Med Sci 2003;58:123–7.
  • Kinugasa R, Hodgson JA, Edgerton VR, Shin DD, Sinha S.
  • Reduction in tendon elasticity from unloading is unrelated to its
  • hypertrophy. J Appl Physiol (1985) 2010;109:870–7.
There are 134 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Mustafa Canbolat This is me

Davut Özbağ

Zeynep Özdemir This is me

Gökhan Demirtaş This is me

Armağan Şahin Kafkas

Publication Date February 1, 2016
Published in Issue Year 2015 Volume: 9 Issue: 3

Cite

APA Canbolat, M., Özbağ, D., Özdemir, Z., Demirtaş, G., et al. (2016). EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY. Anatomy, 9(3), 128-134.
AMA Canbolat M, Özbağ D, Özdemir Z, Demirtaş G, Kafkas AŞ. EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY. Anatomy. February 2016;9(3):128-134.
Chicago Canbolat, Mustafa, Davut Özbağ, Zeynep Özdemir, Gökhan Demirtaş, and Armağan Şahin Kafkas. “EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY”. Anatomy 9, no. 3 (February 2016): 128-34.
EndNote Canbolat M, Özbağ D, Özdemir Z, Demirtaş G, Kafkas AŞ (February 1, 2016) EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY. Anatomy 9 3 128–134.
IEEE M. Canbolat, D. Özbağ, Z. Özdemir, G. Demirtaş, and A. Ş. Kafkas, “EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY”, Anatomy, vol. 9, no. 3, pp. 128–134, 2016.
ISNAD Canbolat, Mustafa et al. “EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY”. Anatomy 9/3 (February 2016), 128-134.
JAMA Canbolat M, Özbağ D, Özdemir Z, Demirtaş G, Kafkas AŞ. EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY. Anatomy. 2016;9:128–134.
MLA Canbolat, Mustafa et al. “EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY”. Anatomy, vol. 9, no. 3, 2016, pp. 128-34.
Vancouver Canbolat M, Özbağ D, Özdemir Z, Demirtaş G, Kafkas AŞ. EFFECTS OF PHYSICAL CHARACTERISTICS, EXERCISE AND SMOKING ON MORPHOMETRY OF HUMAN ACHILLES TENDON: AN ULTRASOUND STUDY. Anatomy. 2016;9(3):128-34.

Anatomy is the official journal of Turkish Society of Anatomy and Clinical Anatomy (TSACA).