Difference between revisions of "Femoral head"
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*Cartilage (thinning/eburnation? separation from the cartilage). | *Cartilage (thinning/eburnation? separation from the cartilage). | ||
*Bone (subchondral cysts? subchondral sclerosis?). | *Bone (subchondral cysts? subchondral sclerosis?). | ||
*Presence of soft tissue. | |||
*Other (osteophytes? pannus?). | *Other (osteophytes? pannus?). | ||
Revision as of 01:39, 28 July 2011
The femoral head is a common ditzel in surgical pathology at centres which have orthopaedic surgeons.
Many of these can be "gross only".
Gross
Features to comment on:[1]
- Liberality (on requisition).
- Dimensions of head and neck.
- Shape of head (round? deformed?).
- Resection margin (irregular?).
- Cartilage (thinning/eburnation? separation from the cartilage).
- Bone (subchondral cysts? subchondral sclerosis?).
- Presence of soft tissue.
- Other (osteophytes? pannus?).
Notes:
- Some advocate the use of cardboard when cutting[2] -- weird.
Criteria for gross only
- Well developed features of osteoarthritis.
- No history of cancer.
Diagnoses to consider
- Avascular necrosis of the femoral head.
- Osteoarthritis.
- Rheumatologic disease - rheumatoid arthritis.
- Pathologic fracture.
- Infection (osteomyelitis).
Specific diagnoses
Avascular necrosis
General
- May be due to steroids.
Gross
Features:[3]
- Wedge-shaped pale yellow below cartilage.
- +/-Cartilage separates from the bone.
- +/-Deformation of femoral head.
Microscopic
Features:[4]
- Empty lacunae (indicative of necrotic bone).
Osteoarthritis
- See Osteoarthritis.
Infection
- See Osteomyelitis.
Rheumatoid arthritis
Gross
Features:
- Pannus[5] - fibrovascular tissue or granulation tissue.
Image: RA (tumorlibrary.com).
See also
References
- ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 225. ISBN 978-0443066450.
- ↑ Dimenstein, IB. (Jun 2008). "Bone grossing techniques: helpful hints and procedures.". Ann Diagn Pathol 12 (3): 191-8. doi:10.1016/j.anndiagpath.2007.06.004. PMID 18486895.
- ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 224. ISBN 978-0443066450.
- ↑ Steffen, RT.; Athanasou, NA.; Gill, HS.; Murray, DW. (Jun 2010). "Avascular necrosis associated with fracture of the femoral neck after hip resurfacing: histological assessment of femoral bone from retrieval specimens.". J Bone Joint Surg Br 92 (6): 787-93. doi:10.1302/0301-620X.92B6.23377. PMID 20513874.
- ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 223. ISBN 978-0443066450.