Difference between revisions of "Joints"

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*Neutrophils - '''key feature'''.
*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>
Notes:
*The definitions suffer from [[HPFitis]].
*Various criteria for the number of neutrophils exist (see below).<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]].
*Finding of plasma cells and lymphocytes is '''not''' contributory for the diagnosis of infection.<ref name=pmid17545426/>
 
====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>

Revision as of 07:01, 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.

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]

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.[3]

Microscopic

Features:[3]

  • Myxomatous stroma.
  • +/-Cystic changes.
  • Large nuclei with hyperchromasia and nuclear scalloping.[4]

DDx:

Images:

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. ↑ 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.
  4. ↑ URL: http://path.upmc.edu/cases/case38/micro.html. Accessed on: 2 January 2011.
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