Difference between revisions of "Joints"
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==Prosthetic joint infection== | ==Prosthetic joint infection== | ||
===General=== | ===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]].<ref name=pmid21131917/> | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
*Neutrophils. | *Neutrophils - '''key feature'''. | ||
Various criteria exist.<ref name=pmid17545426>{{Cite journal | last1 = Bori | first1 = G. | last2 = Soriano | first2 = A. | last3 = García | first3 = S. | last4 = Mallofré | first4 = C. | last5 = Riba | first5 = J. | last6 = Mensa | first6 = J. | title = Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection. | journal = J Bone Joint Surg Am | volume = 89 | issue = 6 | pages = 1232-7 | month = Jun | year = 2007 | doi = 10.2106/JBJS.F.00741 | PMID = 17545426 }}</ref> | Various criteria exist.<ref name=pmid17545426>{{Cite journal | last1 = Bori | first1 = G. | last2 = Soriano | first2 = A. | last3 = García | first3 = S. | last4 = Mallofré | first4 = C. | last5 = Riba | first5 = J. | last6 = Mensa | first6 = J. | title = Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection. | journal = J Bone Joint Surg Am | volume = 89 | issue = 6 | pages = 1232-7 | month = Jun | year = 2007 | doi = 10.2106/JBJS.F.00741 | PMID = 17545426 }}</ref> | ||
* | *The definitions suffer from [[HPFitis]]. | ||
====Feldman criteria==== | ====Feldman criteria==== | ||
*>= Five neutrophils / [[HPF]] (x400) in at least five separate microscopic fields.<ref name=pmid17545426/><ref name=pmid21131917>{{Cite journal | last1 = Bori | first1 = G. | last2 = Muñoz-Mahamud | first2 = E. | last3 = Garcia | first3 = S. | last4 = Mallofre | first4 = C. | last5 = Gallart | first5 = X. | last6 = Bosch | first6 = J. | last7 = Garcia | first7 = E. | last8 = Riba | first8 = J. | last9 = Mensa | first9 = J. | title = Interface membrane is the best sample for histological study to diagnose prosthetic joint infection. | journal = Mod Pathol | volume = 24 | issue = 4 | pages = 579-84 | month = Apr | year = 2011 | doi = 10.1038/modpathol.2010.219 | PMID = 21131917 | URL = http://www.nature.com/modpathol/journal/v24/n4/full/modpathol2010219a.html }}</ref> | *>= Five neutrophils / [[HPF]] (x400) in at least five separate microscopic fields.<ref name=pmid17545426/><ref name=pmid21131917>{{Cite journal | last1 = Bori | first1 = G. | last2 = Muñoz-Mahamud | first2 = E. | last3 = Garcia | first3 = S. | last4 = Mallofre | first4 = C. | last5 = Gallart | first5 = X. | last6 = Bosch | first6 = J. | last7 = Garcia | first7 = E. | last8 = Riba | first8 = J. | last9 = Mensa | first9 = J. | title = Interface membrane is the best sample for histological study to diagnose prosthetic joint infection. | journal = Mod Pathol | volume = 24 | issue = 4 | pages = 579-84 | month = Apr | year = 2011 | doi = 10.1038/modpathol.2010.219 | PMID = 21131917 | URL = http://www.nature.com/modpathol/journal/v24/n4/full/modpathol2010219a.html }}</ref> | ||
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====Athanasou criterion==== | ====Athanasou criterion==== | ||
*>= Ten neutrophils / ten [[HPF]] (x400).<ref name=pmid17545426/> | *>= Ten neutrophils / ten [[HPF]] (x400).<ref name=pmid17545426/> | ||
==Juxta-articular myxoma== | ==Juxta-articular myxoma== | ||
Revision as of 06:55, 2 January 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.
Various criteria exist.[2]
- The definitions suffer from HPFitis.
Feldman criteria
Athanasou criterion
Juxta-articular myxoma
General
- Classically present as a mass or with pain.[3]
Microscopic
Features:[3]
- Myxomatous stroma.
- +/-Cystic changes.
- Large nuclei with hyperchromasia and nuclear scalloping.[4]
DDx:
Images:
See also
References
- ↑ 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.
- ↑ 2.0 2.1 2.2 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.
- ↑ 3.0 3.1 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.
- ↑ URL: http://path.upmc.edu/cases/case38/micro.html. Accessed on: 2 January 2011.