Musculoskeletal & Skin Pathology for Medical II Students

Spring 2008 Lab Supplement
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Arthritis 2

Case History Osteoarthritis Slide 4: A 57-year-old woman died one year following onset of acute myelocytic leukemia. She had been treated with 6-mercaptopurine, Methotrexate and prednisone. The patient was not obese and offered no complaints referable to the joints. A hemorrhagic diathesis was present and numerous petechial hemorrhages were observed at necropsy.

Case History Osteoarthritis Slide 5: A 63-year-old woman developed intermittent claudication half a year prior to admission to the hospital. A small, indolent ulcer appeared on the right heel during this period. There were no complaints referable to joint disease. Radiographs revealed osteoarthritic changes in the metatarso-phalangeal joints, principally in the great toe. There were no osteomyelitic alterations secondary to the gangrene. Osteophytes were present on the thoracic vertebrae. Because of pain, a mid-thigh amputation was performed. 

A prominent bony knob was present on the dorsal aspect of the first metatarsophalangeal joint. Hallux valgus was not seen. The articular cartilage of the patella and intercondylar surface of the femur had a minute area of softening and fibrillation.

Case History Osteoarthritis Slide 6: Same as above.

Slides 4 & 5 | Slide 6

Slide 4 In this photograph of the left knee, the joint has been opened anteriorly; the patella and patellar ligament have been reflected downward. Large areas of erosion of articular cartilage are present on the intercondylar and condylar surfaces of the femur and the patella. The destruction of cartilage is more marked on the medial than the lateral condyle. Small cartilaginous excrescences are present on the medial margin of the lateral condyle. The synovial membrane is normal except for an isolated petechial hemorrhage in the infrapatellar pad.

Slide 5 This radiograph has been made on the isolated first metatarsophalangeal and interphalangeal joints. The metatarsophalangeal joint space is narrowed. A large osteophyte is present on the dorsal margin of the head of the metatarsal bone. There is degree of condensation of bone adjacent to the articular surfaces. A prominent bony knob was present on the dorsal aspect of the first metatarsophalangeal joint. Hallux valgus was not seen. The articular cartilage of the patella and intercondylar surface of the femur had a minute areas of softening and fibrillation.

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Updated September 15, 2008