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Difference between revisions of "Degenerative disc disease"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Degenerative_disc_disease_-_high_mag.jpg | |||
| Width = | |||
| Caption = Degenerative disc disease. [[HPS stain]]. | |||
| Synonyms = | |||
| Micro = benign fibrous tissue, nests of chondrocytes | |||
| Subtypes = | |||
| LMDDx = [[chondrocalcinosis]], [[synovial cyst]], malignancy (primary or metastasis) | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = vertebral disc - see ''[[spine]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = back pain | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = disc herniation | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
| Tx = surgical (e.g. discectomy) | |||
}} | |||
'''Degenerative disc disease''', abbreviated '''[[DDD]]''', is a common [[ditzel]], typically generated in the course of a discectomy operation. | |||
''Sciatica'',<ref name=pmid26023617>{{Cite journal | last1 = Suthar | first1 = P. | last2 = Patel | first2 = R. | last3 = Mehta | first3 = C. | last4 = Patel | first4 = N. | title = MRI evaluation of lumbar disc degenerative disease. | journal = J Clin Diagn Res | volume = 9 | issue = 4 | pages = TC04-9 | month = Apr | year = 2015 | doi = 10.7860/JCDR/2015/11927.5761 | PMID = 26023617 }}</ref> ''vertebral disc'' and ''discectomy'' redirect here. | |||
==General== | |||
*Herniated disc - causes back pain. | |||
*May result in ''cauda equina syndrome''. | |||
*Composed of ''fibrous cartilage''.<ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm]. Accessed on: 2 January 2010.</ref> | |||
==Microscopic== | |||
Features: | |||
*Benign fibrous tissue. | |||
*Nests of chondrocytes (as in immature [[cartilage]]). | |||
*+/-Synovium with or without proliferation.<ref name=pmid16393686/> | |||
*+/-Neovascularization of disc material.<ref name=pmid16393686/> | |||
*Hemosiderin deposits (trauma or previous surgery). | |||
DDx: | |||
*[[Chondrocalcinosis]] (CPPD).<ref name=pmid16393686>{{Cite journal | last1 = Pytel | first1 = P. | last2 = Wollmann | first2 = RL. | last3 = Fessler | first3 = RG. | last4 = Krausz | first4 = TN. | last5 = Montag | first5 = AG. | title = Degenerative spine disease : pathologic findings in 985 surgical specimens. | journal = Am J Clin Pathol | volume = 125 | issue = 2 | pages = 193-202 | month = Feb | year = 2006 | doi = 10.1309/89FV-RT04-EGBV-EUD9 | PMID = 16393686 }}</ref> | |||
*[[Synovial cyst]]. | |||
*Malignancy - very rare if not suspected. | |||
**''Not'' reported in a series of 985 specimens.<ref name=pmid16393686/> | |||
** Unexpected malignancy in 2 of 2177 specimens.<ref name=pmid16506461>{{Cite journal | last1 = Hasselblatt | first1 = M. | last2 = Maintz | first2 = D. | last3 = Goll | first3 = T. | last4 = Wildförster | first4 = U. | last5 = Schul | first5 = C. | last6 = Paulus | first6 = W. | title = Frequency of unexpected and important histopathological findings in routine intervertebral disc surgery. | journal = J Neurosurg Spine | volume = 4 | issue = 1 | pages = 20-3 | month = Jan | year = 2006 | doi = 10.3171/spi.2006.4.1.20 | PMID = 16506461 }}</ref> | |||
===Images=== | |||
<gallery> | |||
Image:Degenerative_disc_disease_-_intermed_mag.jpg | Degenerative disc disease - intermed. mag. (WC) | |||
Image:Degenerative_disc_disease_-_high_mag.jpg | Degenerative disc disease - high mag. (WC) | |||
</gallery> | |||
<gallery> | |||
Image: Degenerative disc disease -- intermed mag.jpg | DDD - intermed. mag. (WC) | |||
Image: Degenerative disc disease -- high mag.jpg | DDD - high mag. (WC) | |||
Image: Degenerative disc disease -- very high mag.jpg | DDD - very high mag. (WC) | |||
</gallery> | |||
www: | |||
*[http://radiology.rsna.org/content/245/1/43/F3.expansion.html Degenerative disk disease (rsna.org)].<ref name=pmid17885180>{{Cite journal | last1 = Modic | first1 = MT. | last2 = Ross | first2 = JS. | title = Lumbar degenerative disk disease. | journal = Radiology | volume = 245 | issue = 1 | pages = 43-61 | month = Oct | year = 2007 | doi = 10.1148/radiol.2451051706 | PMID = 17885180 }}</ref> | |||
*[http://library.aua.edu.ag/webpath/webpath/histhtml/normal/norm004.htm Normal vertebral disc (edu.ag)]. | |||
==Sign out== | |||
<pre> | |||
Disc Material (L4-L5 Disc), Excision: | |||
- Consistent with disc material (gross only). | |||
</pre> | |||
<pre> | |||
Disc Material (Left L5-S1 Disc), Excision: | |||
- Consistent with disc material (gross only). | |||
</pre> | |||
Note: | |||
*May be [[gross only]] specimens; a minority of institutions handle these specimens this way.<ref name=pmid10050786>{{Cite journal | last1 = Zarbo | first1 = RJ. | last2 = Nakhleh | first2 = RE. | title = Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions. | journal = Arch Pathol Lab Med | volume = 123 | issue = 2 | pages = 133-9 | month = Feb | year = 1999 | doi = 10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2 | PMID = 10050786 }}</ref> | |||
**It is suggested that gross only specimens should have no history or suspicion of malignancy - based on the surgical note, available pathology and imaging. | |||
===Block letters=== | |||
<pre> | |||
CERVICAL DISC, DISCECTOMY: | |||
- DISC WITH DEGENERATIVE CHANGES. | |||
- NO EVIDENCE OF MALIGNANCY. | |||
</pre> | |||
<pre> | |||
LUMBAR DISC, DECOMPRESSION: | |||
- DEGENERATIVE DISC DISEASE. | |||
</pre> | |||
==See also== | |||
*[[Spine]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||