Cases reported "Osteoarthritis"

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1/10. Loose bodies of the temporo-mandibular joint, synovial chondromatosis or osteoarthritis.

    A patient is presented with multiple intra-articular loose bodies of the temporo-mandibular joint, the aetiology and management is discussed. In the absence of histological proof of metaplasia within the synovium the mechanism of cartilage production is open to question. attention is drawn to the diagnostic problem in long-standing cases when osteo-arthritis supervenes. The clinical picture presented may represent the late stages of synovial chondromatosis or degenerative joint disease from another cause.
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keywords = synovium
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2/10. corynebacterium pyogenes septic arthritis with plasma cell synovial infiltrate and monoclonal gammopathy.

    A chronic septic process developed in the right knee of an elderly man with advanced degenerative arthritis of both knees. Open exploration, culture, and biopsy of the joint found that the pathogen was corynebacterium pyogenes and that the synovium was involved with a remarkable perivascular infiltrate of plasma cells. serum protein electrophoresis demonstrated a prominent M component. Following antimicrobial therapy, the M protein level has gradually declined, and no evolution of multiple myeloma has become apparent. The findings are consistent with a benign monoclonal gammopathy and localized plasmacytic reaction in the knee associated with infection by an unusual diphtheroid organism.
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keywords = synovium
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3/10. Unusual metacarpophalangeal osteoarthritis in a jackhammer operator.

    Severe, atypical osteoarthritis of the metacarpophalangeal and elbow joints in a jackhammer operator is reported. Articular tissue resected at surgery demonstrated gross fibrillation and histologic evidence of calcification of articular cartilage, and multiple, bony fragments embedded in the synovium. Operation of a pneumatic drill may accentuate a tendency toward development of osteoarthritis in workers who are predisposed to the disease and may also cause it to localize at unusual sites such as the elbow, shoulder, wrist, and metacarpophalangeal joints.
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keywords = synovium
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4/10. Immune pathology in polyarticular osteoarthritis.

    Although osteoarthritis (OA) generally is considered a disorder of mechanical origin, the common occurrence of chronic mononuclear cell infiltrates in the synovium in conjunction with immunofluorescent evidence for immune-reactant products in cartilage of surgical case specimens (knees, hips, and peripheral joints) has suggested the local involvement of immune processes in the arthritis. Further, the findings of polyarthropathy in the majority of these cases have indicated the propensity for a systemic disorder. Wide variations were noted in both synovial and cartilage immune changes, quite different to those found in rheumatoid arthritis, along with the frequent asymptomatology of the many joints involved. These features, with and without other causative factors, suggest that immune reactions of local and/or systemic origin occur at times in a population at risk for joint degradation.
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keywords = synovium
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5/10. The articular diversity of early haemochromatosis.

    This report details seven patients who had an arthropathy at presentation of their haemochromatosis. The spectrum ranged from arthralgia and normal radiographs to classic polyarthritis and the typical radiological triad of joint-space narrowing, sclerosis and cysts. Some atypical presentations are highlighted. An early diagnosis of haemochromatosis requires clinical suspicion; support can be obtained from serum iron studies, particularly saturation of iron-binding capacity and ferritin, and from biopsy of liver and/or synovium.
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keywords = synovium
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6/10. Acute synovitis with intra-articular apatite deposits in an osteoarthritic metacarpophalangeal joint.

    A patient was shown to have acute arthritis in a metacarpophalangeal joint, with local calcification indicated by x-rays. Surgical and pathological examinations showed strictly intra-articular apatite crystal deposits and an erosive osteoarthritis. These crystal deposits could account for the synovial inflammation; they are thought to be related to bone fragments embedded in the synovium. The predisposing role of previous local injections of corticosteroids is debatable.
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keywords = synovium
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7/10. Diffuse chondrolytic arthritis in sickle cell disease.

    A young black man with sickle cell disease with recurrent painful vasoocclusive crises developed at 16 years of age a rapid disabling polyarticular chondrolysis leading to a bilateral hip arthroplasty in 1 year. light microscopy showed erosion and chondrocyte loss with deep clones in the cartilage and congested vessels with extravasation of red blood cells and mononuclear cells in the synovium. Electron microscopy of the synovium disclosed partially occluded blood vessels and phagocytic cells containing red blood cell debris and crystalline hemoglobin-like material. These observations suggest a role for the phagocytic cells in the joint destruction.
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keywords = synovium
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8/10. Synovial chondromatosis: Report of a rare surgical problem of the temporomandibular joint.

    Synovial chondromatosis of the joint is a rare benign condition characterized by the formation of metaplastic cartilage in the synovium of the joint resulting in numerous attached and unattached osteocartilagenous bodies. It may recur after surgical intervention. For this reason removal of the synovium and the bodies is advocated. This is a report of a case which occurred in the temporomandibular joint which had numerous loose bodies and exhibited features of degenerative joint disease as well. The loose bodies were removed, a high condylar shave performed and the synovium left intact. The patient is still free from joint problems five years later.
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keywords = synovium
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9/10. Articular cartilage transplantation.

    This report describes the biopsy findings in four of 30 patients treated with cadaver osteochondral shell allografts for osteoarthritis in the knee. This study demonstrates that graft cartilage cells can survive in excess of 25 months, and that host bone can completely replace graft bone by creeping substitution. An inflammatory reaction in synovium and bone marrow was found in only one of four cases. Graft failure was related to prolonged down time of donor cartilage in one case and mechanical factors related to osteoarthritis in the apposing femoral surface in other cases. The clinical success of these grafts is attributed to the prolonged viability of cartilage cells, the capacity of host bone to join graft cartilage without histologic reaction, and the host's immunologic tolerance, which obviates the need for immunosuppressive therapy.
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keywords = synovium
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10/10. Rapid development of severe osteoarthritis associated with osteoid osteoma in a young girl.

    In a 14-year-old girl with a 5 month history of left sided thigh pain, x-rays demonstrating osteoarthritis and a bone scintigraphy showing increased focal uptake in the femoral neck led to the diagnosis of an osteoid osteoma. The protuberant bone at the femoral neck was removed en-bloc and the diagnosis histologically confirmed. The synovium was extensively infiltrated with lymphocytes. Postoperatively the girl experienced neither the expected pain relief nor improvement of her hip function over the next 4 months. MRI and CT results indicated development of a severe osteoarthritis even though no residual lesion could be found.
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ranking = 1
keywords = synovium
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