Musculoskeletal & Skin Pathology for Medical II Students

Spring 2008 Lab Supplement
Arthritis Carousel

Arthritis 3

Case History Osteoarthritis Slide 7: That of the 63-year-old woman whose arthritic joint are seen in slides 5 and 6.

Case History Osteoarthritis Slide 8: A 53-year-old scrub-woman, who spent much of her time on hands and knees, fell forcefully on her right knee. She had immediate and persistent pain which interfered with walking. X-ray examination failed to reveal a fracture. She wore a plaster shell for ten weeks but pain on bearing weight continued. Eight months after the accident, the knee grated on motion (crepitus) and flexion was limited to 90°. The quadriceps was atrophic. X-ray examination showed hypertrophic changes of the articular bones and a small loose body. An excision of the patella was performed. At operation, there was a 2x2 cm eburnated area devoid of cartilage over the lower pole of the patella. An incidental lesion was present over the opposing surface of the femoral condyle. At the margin of the eburnated area on the patella, the cartilage was rough and "pile-like."

Case History Osteoarthritis Slide 9: A 33-year-old woman had a history of pain in the left hip while bearing weight for six years. During the two years preceding surgery, there was progressive intensification of pain and limitation of motion. There was no history of antecedent injury or localized disease. A mild adduction-flexion deformity, positive Trendelenburg sign and moderate limitation of motion was recorded. There was no shortening of the extremity. Resection of the head of the femur with cup arthroplasty was performed.

Slides 7& 8 | Slide 9

Slide 7 This section, a higher power view of the joint seen in Slide 6, has been stained with Azure A-eosinate to illustrate early degeneration of articular cartilage. In the region of the transitional and radial zones of the articular cartilage, focal chondromucoid softening of the matrix is taking place. These areas are stained violet (metachromatic) rather than blue. There is some loss of solid substance in these foci. In several instances, they appear to be localized about cellular centers. A tangential crevice or flake is present in the surface. Chondrocytes disappeared in large part from the immediate vicinity of this fissure. The blue-stained band on the surface is a staining aftifact. Magnetic resonance imaging with gadolinium can reveal this early change preceding the advanced pathologic cartilaginous degeneration shown in slide 8.

Slide 8 This is a celloidin section from a roughened portion of the patella. There is splitting and fraying of the cartilage perpendicular to the joint surface. The more superficial chondrocytes are arranged in clusters rather than in perpendicular rows. The superficial matrix is fibrillar and pale.

Arthritis home | a.1 | a.2 | a.3 | a.4 | a.5 | a.6 | a.7 | a.8

MS Home

Medical II

Updated August 29, 2007