Joints
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
Athanasou criterion
Juxta-articular myxoma
- Abbreviated JAM.
General
- Classically present as a mass or with pain.[4]
- May recur.
- Described as (microscopically) indistinguishable from intramuscular myxoma.[5]
Gross
Features:
- Close to large joints - classically around the knee.
- >85% of cases around the knee in one large series.[4]
Microscopic
Features:[4]
- Myxomatous stroma.
- +/-Cystic changes.
- Large nuclei with hyperchromasia and nuclear scalloping.[6]
DDx:
- Ganglion cyst.
- Intramuscular myxoma - surrounded by muscle.
Images:
Morton neuroma
Main article: Morton neuroma
Ganglion cyst
General
Microscopic
Features:[7]
- Empty space(s); usually multiple.
- Fibrotic wall.
- No epithelial lining.†
† The entity is really a pseudocyst.[7]
DDx:
- Synovial cyst - has epithelial lining.
- Juxta-articular myxoma.
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 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.
- ↑ URL: http://path.upmc.edu/cases/case174.html. Accessed on: 8 January 2012.
- ↑ 4.0 4.1 4.2 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.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 624. ISBN 978-0781765275.
- ↑ URL: http://path.upmc.edu/cases/case38/micro.html. Accessed on: 2 January 2011.
- ↑ 7.0 7.1 7.2 URL: http://emedicine.medscape.com/article/1253223-overview]. Accessed on: 8 February 2012. Cite error: Invalid
<ref>tag; name "emed_gc" defined multiple times with different content - ↑ 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.