Difference between revisions of "Femoral head"

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*[[AKA]] ''avascular necrosis'', abbreviated ''AVN''.
*[[AKA]] ''avascular necrosis'', abbreviated ''AVN''.
===General===
===General===
*May be due to steroids.<ref>URL: [http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html]. Accessed on: 30 April 2012.</ref>
Risk factors:
*Oral steroids, e.g. prednisone.<ref>URL: [http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html]. Accessed on: 30 April 2012.</ref>
*[[Cushing disease]].
*[[Cushing syndrome]].
*Radiation.


===Gross===
===Gross===

Revision as of 19:06, 30 April 2012

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

Diagnoses to consider

  • Avascular necrosis of the femoral head.
  • Osteoarthritis.
  • Rheumatologic disease - rheumatoid arthritis.
  • Pathologic fracture.
  • Infection (osteomyelitis).

Specific diagnoses

Avascular necrosis of the femoral head

  • AKA avascular necrosis, abbreviated AVN.

General

Risk factors:

Gross

Features:[4]

  • Wedge-shaped pale yellow below cartilage.
  • +/-Cartilage separates from the bone.
  • +/-Deformation of femoral head.

Image:

Microscopic

Features:[5]

  • Empty lacunae (indicative of necrotic bone).

Osteoarthritis

See Osteoarthritis.

Infection

See Osteomyelitis.

Rheumatoid arthritis

Main article: Rheumatoid arthritis

Gross

Features:

  • Pannus[6] - fibrovascular tissue or granulation tissue.

Image: RA (tumorlibrary.com).

See also

References

  1. ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 225. ISBN 978-0443066450.
  2. ↑ 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.
  3. ↑ URL: http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html. Accessed on: 30 April 2012.
  4. ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 224. ISBN 978-0443066450.
  5. ↑ 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.
  6. ↑ Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 223. ISBN 978-0443066450.
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