Difference between revisions of "Joints"

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==Morton neuroma==
==Morton neuroma==
{{Main|Morton neuroma}}
{{Main|Morton neuroma}}
==Ganglion cyst==
===General===
*Very common.
**Most common tumour of the hand.<ref>URL: [http://emedicine.medscape.com/article/1253223-overview http://emedicine.medscape.com/article/1253223-overview]]. Accessed on: 8 February 2012.</ref>
*Classically on the wrist.<ref name=pmid17488856>{{Cite journal  | last1 = Hasham | first1 = S. | last2 = Burke | first2 = FD. | title = Diagnosis and treatment of swellings in the hand. | journal = Postgrad Med J | volume = 83 | issue = 979 | pages = 296-300 | month = May | year = 2007 | doi = 10.1136/pgmj.2005.043992 | PMID = 17488856 }}</ref>
===Microscopic===
Features:
*Cystic spaces.
*Fibrotic wall.
Image:
*[http://commons.wikimedia.org/wiki/File:Ganglion_Cyst,_Hand.jpg Ganglion cyst of the hand (WC/Uthman)].


=See also=
=See also=

Revision as of 21:38, 8 February 2012

Joints are important for locomotion. This article collects tidbits about their pathology.

Prosthetic joint infection

General

  • Bits of tissue come for frozen section to r/o infection.
  • The interface membrane (not the pseudocapsule) should be sampled to obtain a high sensitivity.[1]

Microscopic

Features:

  • Neutrophils - key feature.

Notes:

  • Various criteria for the number of neutrophils exist (see below).[2]
    • The definitions suffer from HPFitis.
  • Finding of plasma cells and lymphocytes is not contributory for the diagnosis of infection.[2]
  • Granulomatous inflammation that isn't of a foreign-body type should get the usual work-up.[3]

Feldman criteria

  • >= Five neutrophils / HPF (x400) in at least five separate microscopic fields.[2][1]

Athanasou criterion

  • >= Ten neutrophils / ten HPF (x400).[2]

Juxta-articular myxoma

General

  • Classically present as a mass or with pain.[4]

Microscopic

Features:[4]

  • Myxomatous stroma.
  • +/-Cystic changes.
  • Large nuclei with hyperchromasia and nuclear scalloping.[5]

DDx:

Images:

Morton neuroma

Main article: Morton neuroma

Ganglion cyst

General

  • Very common.
    • Most common tumour of the hand.[6]
  • Classically on the wrist.[7]

Microscopic

Features:

  • Cystic spaces.
  • Fibrotic wall.

Image:

See also

References

  1. ↑ 1.0 1.1 Bori, G.; Muñoz-Mahamud, E.; Garcia, S.; Mallofre, C.; Gallart, X.; Bosch, J.; Garcia, E.; Riba, J. et al. (Apr 2011). "Interface membrane is the best sample for histological study to diagnose prosthetic joint infection.". Mod Pathol 24 (4): 579-84. doi:10.1038/modpathol.2010.219. PMID 21131917.
  2. ↑ 2.0 2.1 2.2 2.3 Bori, G.; Soriano, A.; García, S.; Mallofré, C.; Riba, J.; Mensa, J. (Jun 2007). "Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection.". J Bone Joint Surg Am 89 (6): 1232-7. doi:10.2106/JBJS.F.00741. PMID 17545426.
  3. ↑ URL: http://path.upmc.edu/cases/case174.html. Accessed on: 8 January 2012.
  4. ↑ 4.0 4.1 Meis, JM.; Enzinger, FM. (Jun 1992). "Juxta-articular myxoma: a clinical and pathologic study of 65 cases.". Hum Pathol 23 (6): 639-46. PMID 1592386.
  5. ↑ URL: http://path.upmc.edu/cases/case38/micro.html. Accessed on: 2 January 2011.
  6. ↑ URL: http://emedicine.medscape.com/article/1253223-overview]. Accessed on: 8 February 2012.
  7. ↑ Hasham, S.; Burke, FD. (May 2007). "Diagnosis and treatment of swellings in the hand.". Postgrad Med J 83 (979): 296-300. doi:10.1136/pgmj.2005.043992. PMID 17488856.
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