Pathology Flashcards
radiological features of OA (LOSS)
Loss of joint space (cartilage loss) Osteophytes (disorganised bone remodelling) Subchondral sclerosis (eburnation) Subchondral cysts (synovial fluid accumulation)
what can osteophytes irritate?
nerves
pathology of RA
cytokine production with pannus formation (granulation tissue) and destroyed cartilage leading to fibrosis and deformity
what do seronegative spondyloarthritides affect?
ligamentous attachments
examples of seronegative spondyloarthritides
ankylosing spondylitis
reactive arthritis
enteritis arthritis
psoriatic arthritis
causes of gout
hyperuricaemia by increased production (enzyme defect)
or reduced excretion by kidney (chronic renal disease or thiazide diuretics side effect)
three ways to detect genetic abnormalities
- karotyping
- FISH
immunohistochemitry
what is karotyping?
overview of chromosome number and structure
what is FISH?
looks for specific abnormalities using immunofluorescence
what is immunohistochemistry?
pigmented antibody is used to detect protein being produced
benign bone tumours
osteochondroma enchondroma simple bone cyst aneurysmal bone cyst giant cell tumour fibrous dysplasia
describe aneurysmal bone cyst
lots of chambers filled with blood or serum due to AV malformations
giant cell tumour appearance
XR shows soap bubble appearance
can giant cell tumour metastasize?
yes to the lung to change benign pulmonary CGT
describe fibrous dysplasia
genetic mutation results in lesions of fibrous tissue forming a shepherd’s crook deformity
examples of malignant bone tumours
osteosarcoma
chondrosarcoma
fibrosarcoma
Ewing’s sarcoma
describe osteosarcoma associations
young
Codman’s triangle
sunray spiculation
XR of chondrosarcoma
popcorn calcification
describe presentation of Ewing’s sarcoma
small, round, blue tumours with “onion-peel” sign
10-20
fever and swelling
genetic abnormality in Ewing’s sarcoma
t(11;22)
management of Ewing’s sarcoma
radio and chemo sensitive
what is nodular fasciitis?
benign soft tissue lesion that presents rapidly with history of preceding trauma
what is myositis ossificans?
bone formation in muscle with history of preceding trauma
when do you intervene in myositis ossificans?
must wait until maturity of ossification or risks reoccurrence
soft tissue tumour examples
ganglion cyst bursitis sebaceous cyst abscess superficial and deep fibromatoses
what is a ganglion cyst?
peripheral lump near joint capsule or tendon sheath e.g. Baker’s cyst in the knee
what is bursitis
inflamed bursa due to repeated pressure resulting in swelling
can become abscess
what can an abscess form from?
cellulitis
bursitis
penetrating wound
infection
example of superficial fibromatoses
Dupuytrens
example of deep fibromatoses
desmoid tumours (Gardner’s syndrome FAP)
examples of tumours of unknown origin
Ewing's sarcoma synovial sarcoma pleomorphic undifferentiated sarcoma giant cell tumour aneurysmal bone cyst
which is more common- primary or secondary bone tumours?
secondary (metastasis)
