Difference between revisions of "Joints"

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Revision as of 11:57, 29 May 2014

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→‎Ganglion cyst: split out
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==Ganglion cyst==
==Ganglion cyst==
===General===
{{Main|Ganglion cyst}}
*Very common.
**Most common tumour of the hand.<ref name=emed_gc>URL: [http://emedicine.medscape.com/article/1253223-overview http://emedicine.medscape.com/article/1253223-overview]]. Accessed on: 8 February 2012.</ref>
*Classically on the wrist.<ref name=pmid17488856>{{Cite journal  | last1 = Hasham | first1 = S. | last2 = Burke | first2 = FD. | title = Diagnosis and treatment of swellings in the hand. | journal = Postgrad Med J | volume = 83 | issue = 979 | pages = 296-300 | month = May | year = 2007 | doi = 10.1136/pgmj.2005.043992 | PMID = 17488856 }}</ref>
*May be painful.<ref name=Ref_Derm322>{{Ref Derm|322}}</ref>
 
===Gross===
*Mass at a joint - classically in the hand.
 
DDx - clinical:
*Metacarpal boss - degenerative [[arthritis]].<ref name=pmid432327>{{Cite journal  | last1 = Cuono | first1 = CB. | last2 = Watson | first2 = HK. | title = The carpal boss: surgical treatment and etiological considerations. | journal = Plast Reconstr Surg | volume = 63 | issue = 1 | pages = 88-93 | month = Jan | year = 1979 | doi =  | PMID = 432327 }}</ref>
*[[Giant cell tumour of tendon sheath]].
===Microscopic===
Features:<ref name=emed_gc>URL: [http://emedicine.medscape.com/article/1243454-overview http://emedicine.medscape.com/article/1243454-overview]. Accessed on: 8 February 2012.</ref><ref name=Ref_Derm322>{{Ref Derm|322}}</ref>
*Empty space(s); usually multiple.
*Fibrotic wall.
*No epithelial lining.†
*+/-Myxoid change - very common.
**May have some spindled fibroblasts.
 
<br>
† The entity is really a pseudocyst.<ref name=emed_gc/>
 
DDx:
*[[Synovial cyst]] - true cyst (has an epithelial lining), villous projections into the cystic space.
*[[Juxta-articular myxoma]].
*Myxoma.
*[[Digital mucous cyst]] - has many spindled fibroblasts, usu. superficial.<ref name=Ref_Derm322>{{Ref Derm|322}}</ref>
 
====Images====
<gallery>
Image:Ganglion_Cyst,_Hand.jpg | Ganglion cyst of the hand. (WC/Uthman)
</gallery>
www:
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=2008080217190580 Ganglion cyst (surgicalpathologyatlas.com)].
 
===Sign out===
<pre>
SOFT TISSUE ("GANGLION CYST"), LEFT WRIST, EXCISION:
- GANGLION CYST.
</pre>
 
====Micro====
The sections show fibroadipose tissue with cyst-like spaces surrounded by fibrous tissue. There are no villous projections into the cyst-like spaces. Focal myxoid areas are present with rare bland spindle cells. There is no nuclear atypia and no mitotic activity is appreciated. Dense connective tissue consistent with tendon is present focally.
 
=====Alternate=====
The sections show cyst-like spaces surrounded by fibrous tissue. There are no villous
projections into the cyst-like spaces. Focal myxoid areas are present with rare bland
spindle cells. There is no nuclear atypia and no mitotic activity is appreciated. Dense
connective tissue consistent with tendon is present focally. Benign glands are present.


==Rheumatoid arthritis==
==Rheumatoid arthritis==
Michael
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