Femoral head - Revision history

Michael at 02:28, 23 October 2014

2014-10-23T02:28:44Z

← Older revision		Revision as of 02:28, 23 October 2014
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			[[Image:Head of femur.jpg\|thumb\|right\|300px\|Femoral head. (WC)]]
	The '''femoral head''' is a common [[ditzel]] in surgical pathology at centres which have orthopaedic surgeons.		The '''femoral head''' is a common [[ditzel]] in surgical pathology at centres which have orthopaedic surgeons.

Michael: /* Fracture of bone due to metastatic carcinoma */

2014-04-22T15:09:38Z

Fracture of bone due to metastatic carcinoma

← Older revision		Revision as of 15:09, 22 April 2014
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	==Fracture of bone due to metastatic carcinoma==		==Fracture of bone due to metastatic carcinoma==
	{{Main\|Fracture of bone}}		{{Main\|Fracture of bone}}
	*[[AKA]] ''~~pathologic~~ fracture''.		:''Pathologic fracture'' redirects here, as the underlying cause is usually a carcinoma.
	===General===		===General===
	*Uncommon ~ 10 of 90 suspected cases.<ref name=pmid15826621>{{Cite journal \| last1 = Ramisetty \| first1 = NM. \| last2 = Pynsent \| first2 = PB. \| last3 = Abudu \| first3 = A. \| title = Fracture of the femoral neck, the risk of serious underlying pathology. \| journal = Injury \| volume = 36 \| issue = 5 \| pages = 622-6 \| month = May \| year = 2005 \| doi = 10.1016/j.injury.2004.08.034 \| PMID = 15826621 }}</ref>		*Uncommon ~ 10 of 90 suspected cases.<ref name=pmid15826621>{{Cite journal \| last1 = Ramisetty \| first1 = NM. \| last2 = Pynsent \| first2 = PB. \| last3 = Abudu \| first3 = A. \| title = Fracture of the femoral neck, the risk of serious underlying pathology. \| journal = Injury \| volume = 36 \| issue = 5 \| pages = 622-6 \| month = May \| year = 2005 \| doi = 10.1016/j.injury.2004.08.034 \| PMID = 15826621 }}</ref>

Michael: /* Gross */

2014-02-26T21:06:07Z

Gross

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	===Gross===		===Gross===
	*Irregular/jagged femoral neck margin.		*Irregular/jagged femoral neck margin - '''important'''.
	*Hemorrhage.		*Hemorrhage.

Michael: /* Non-pathologic fracture of the femoral neck */

2013-12-23T12:48:47Z

Non-pathologic fracture of the femoral neck

← Older revision		Revision as of 12:48, 23 December 2013
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	*[[Osteoporosis]] - thinner cortex, decreased trabecular thickness and number.<ref name=pmid18708176>{{Cite journal \| last1 = Blain \| first1 = H. \| last2 = Chavassieux \| first2 = P. \| last3 = Portero-Muzy \| first3 = N. \| last4 = Bonnel \| first4 = F. \| last5 = Canovas \| first5 = F. \| last6 = Chammas \| first6 = M. \| last7 = Maury \| first7 = P. \| last8 = Delmas \| first8 = PD. \| title = Cortical and trabecular bone distribution in the femoral neck in osteoporosis and osteoarthritis. \| journal = Bone \| volume = 43 \| issue = 5 \| pages = 862-8 \| month = Nov \| year = 2008 \| doi = 10.1016/j.bone.2008.07.236 \| PMID = 18708176 }}</ref>		*[[Osteoporosis]] - thinner cortex, decreased trabecular thickness and number.<ref name=pmid18708176>{{Cite journal \| last1 = Blain \| first1 = H. \| last2 = Chavassieux \| first2 = P. \| last3 = Portero-Muzy \| first3 = N. \| last4 = Bonnel \| first4 = F. \| last5 = Canovas \| first5 = F. \| last6 = Chammas \| first6 = M. \| last7 = Maury \| first7 = P. \| last8 = Delmas \| first8 = PD. \| title = Cortical and trabecular bone distribution in the femoral neck in osteoporosis and osteoarthritis. \| journal = Bone \| volume = 43 \| issue = 5 \| pages = 862-8 \| month = Nov \| year = 2008 \| doi = 10.1016/j.bone.2008.07.236 \| PMID = 18708176 }}</ref>
	*[[Osteoarthritis]].		*[[Osteoarthritis]].

	~~Note:~~
	*There isn't a number for "thin" trabeculae. Anecdotally, I suspect "thin" is 0.15-0.2 mm.
	**Crude guess at normal thickness is ~ 0.4 mm.<Ref name=pmid24271010>{{Cite journal \| last1 = Klintström \| first1 = E. \| last2 = Smedby \| first2 = O. \| last3 = Moreno \| first3 = R. \| last4 = Brismar \| first4 = TB. \| title = Trabecular bone structure parameters from 3D image processing of clinical multi-slice and cone-beam computed tomography data. \| journal = Skeletal Radiol \| volume = \| issue = \| pages = \| month = Nov \| year = 2013 \| doi = 10.1007/s00256-013-1766-5 \| PMID = 24271010 }}</ref>

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Michael: /* Non-pathologic fracture of the femoral neck */

2013-12-23T12:44:59Z

Non-pathologic fracture of the femoral neck

← Older revision		Revision as of 12:44, 23 December 2013
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	Note:		Note:
	*There isn't a number for "thin" trabeculae. Anecdotally, I suspect "thin" is 0.15-0.2 mm.		*There isn't a number for "thin" trabeculae. Anecdotally, I suspect "thin" is 0.15-0.2 mm.
			**Crude guess at normal thickness is ~ 0.4 mm.<Ref name=pmid24271010>{{Cite journal \| last1 = Klintström \| first1 = E. \| last2 = Smedby \| first2 = O. \| last3 = Moreno \| first3 = R. \| last4 = Brismar \| first4 = TB. \| title = Trabecular bone structure parameters from 3D image processing of clinical multi-slice and cone-beam computed tomography data. \| journal = Skeletal Radiol \| volume = \| issue = \| pages = \| month = Nov \| year = 2013 \| doi = 10.1007/s00256-013-1766-5 \| PMID = 24271010 }}</ref>

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Michael: /* Microscopic */

2013-12-23T12:41:07Z

Microscopic

← Older revision		Revision as of 12:41, 23 December 2013
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	*[[Osteoporosis]] - thinner cortex, decreased trabecular thickness and number.<ref name=pmid18708176>{{Cite journal \| last1 = Blain \| first1 = H. \| last2 = Chavassieux \| first2 = P. \| last3 = Portero-Muzy \| first3 = N. \| last4 = Bonnel \| first4 = F. \| last5 = Canovas \| first5 = F. \| last6 = Chammas \| first6 = M. \| last7 = Maury \| first7 = P. \| last8 = Delmas \| first8 = PD. \| title = Cortical and trabecular bone distribution in the femoral neck in osteoporosis and osteoarthritis. \| journal = Bone \| volume = 43 \| issue = 5 \| pages = 862-8 \| month = Nov \| year = 2008 \| doi = 10.1016/j.bone.2008.07.236 \| PMID = 18708176 }}</ref>		*[[Osteoporosis]] - thinner cortex, decreased trabecular thickness and number.<ref name=pmid18708176>{{Cite journal \| last1 = Blain \| first1 = H. \| last2 = Chavassieux \| first2 = P. \| last3 = Portero-Muzy \| first3 = N. \| last4 = Bonnel \| first4 = F. \| last5 = Canovas \| first5 = F. \| last6 = Chammas \| first6 = M. \| last7 = Maury \| first7 = P. \| last8 = Delmas \| first8 = PD. \| title = Cortical and trabecular bone distribution in the femoral neck in osteoporosis and osteoarthritis. \| journal = Bone \| volume = 43 \| issue = 5 \| pages = 862-8 \| month = Nov \| year = 2008 \| doi = 10.1016/j.bone.2008.07.236 \| PMID = 18708176 }}</ref>
	*[[Osteoarthritis]].		*[[Osteoarthritis]].

			Note:
			*There isn't a number for "thin" trabeculae. Anecdotally, I suspect "thin" is 0.15-0.2 mm.

	===Sign out===		===Sign out===

Michael: /* Avascular necrosis of the femoral head */ split -out

2013-12-20T02:14:31Z

Avascular necrosis of the femoral head: split -out

← Older revision		Revision as of 02:14, 20 December 2013
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	==Avascular necrosis of the femoral head==		==Avascular necrosis of the femoral head==
	*[[AKA]] ''avascular necrosis'', abbreviated ''AVN''.		*[[AKA]] ''avascular necrosis'', abbreviated ''AVN''.
	~~===General===~~		{{Main\|Avascular necrosis of the femoral head}}
	~~Risk factors:~~
	*Oral steroids, e.g. prednisone.<ref>URL: [http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/osteonecrosis/osteonecrosis.html]. Accessed on: 30 April 2012.</ref>
	*[[Cushing disease]].
	*[[Cushing syndrome]].
	*Radiation.

	~~===Gross===~~
	~~Features:<ref name=Ref_Lester224>~~{{~~Ref Lester~~\|~~224}}</ref>~~
	*Wedge-shaped pale yellow abnormality below cartilage.
	*+/-Cartilage separates from the bone.
	*+/-Deformation of femoral head.

	~~Image:~~
	*[http://www.flickr.com/photos/11462589@N05/1126710488/in/photostream AVN (flickr.com)].

	~~===Microscopic===~~
	~~Features:<ref name=pmid20513874>{{Cite journal \| last1 = Steffen \| first1 = RT. \| last2 = Athanasou \| first2 = NA. \| last3 = Gill \| first3 = HS. \| last4 = Murray \| first4 = DW. \| title =~~ Avascular necrosis ~~associated with fracture~~ of the femoral neck after hip resurfacing: histological assessment of femoral bone from retrieval specimens. \| journal = J Bone Joint Surg Br \| volume = 92 \| issue = 6 \| pages = 787-93 \| month = Jun \| year = 2010 \| doi = 10.1302/0301-620X.92B6.23377 \| PMID = 20513874 }}
	~~</ref>~~
	*Empty lacunae (indicative of necrotic bone).

	~~===Sign out===~~
	~~<pre>~~
	~~FEMORAL HEAD, RIGHT, HIP ARTHROPLASTY:~~
	~~- AVASCULAR NECROSIS OF THE FEMORAL HEAD.~~
	~~</pre>~~

	~~====AVN and degenerative joint disease====~~
	~~<pre>~~
	~~FEMORAL HEAD AND JOINT CAPSULE, LEFT, HIP ARTHROPLASTY:~~
	~~- AVASCULAR NECROSIS OF THE FEMORAL HEAD.~~
	~~- DEGENERATIVE JOINT DISEASE WITH MILD SYNOVITIS AND VILLOUS HYPERPLASIA.~~
	~~- NEGATIVE FOR MALIGNANCY.~~
	~~</pre>~~

	~~<pre>~~
	~~FEMORAL HEAD AND JOINT CAPSULE, RIGHT, HIP ARTHROPLASTY:~~
	~~- AVASCULAR NECROSIS OF THE FEMORAL HEAD.~~
	~~- DEGENERATIVE JOINT DISEASE.~~
	~~- BENIGN JOINT CAPSULE TISSUE.~~
	~~- NEGATIVE FOR MALIGNANCY.~~
	~~</pre>~~

	~~====Remote AVN====~~
	~~<pre>~~
	~~FEMORAL HEAD AND JOINT CAPSULE, LEFT, HIP ARTHROPLASTY:~~
	~~- FEMORAL HEAD WITH DEGENERATIVE JOINT DISEASE AND MARKED DEFORMATION CONSISTENT WITH A HISTORY OF~~
	~~AVASCULAR NECROSIS.~~
	~~- JOINT CAPSULE WITH MINIMAL CHRONIC INFLAMMATION.~~
	~~</pre>~~

	~~=====Micro=====~~
	The sections show a femoral head with loss of cartilage and focal vertical cleft formation in the remaining thinned cartilage. Subchondral sclerosis is present. The underlying bone is viable. Bone marrow is present. The red blood cells have a sickled morphology.

	~~Joint capsule tissue with focal lymphocytes and plasma cells is present.~~

	==Osteoarthritis==		==Osteoarthritis==

Michael: /* AVN and degenerative joint disease */

2013-12-04T18:05:58Z

AVN and degenerative joint disease

← Older revision		Revision as of 18:05, 4 December 2013
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	- AVASCULAR NECROSIS OF THE FEMORAL HEAD.		- AVASCULAR NECROSIS OF THE FEMORAL HEAD.
	- DEGENERATIVE JOINT DISEASE WITH MILD SYNOVITIS AND VILLOUS HYPERPLASIA.		- DEGENERATIVE JOINT DISEASE WITH MILD SYNOVITIS AND VILLOUS HYPERPLASIA.
			- NEGATIVE FOR MALIGNANCY.
			</pre>

			<pre>
			FEMORAL HEAD AND JOINT CAPSULE, RIGHT, HIP ARTHROPLASTY:
			- AVASCULAR NECROSIS OF THE FEMORAL HEAD.
			- DEGENERATIVE JOINT DISEASE.
			- BENIGN JOINT CAPSULE TISSUE.
	- NEGATIVE FOR MALIGNANCY.		- NEGATIVE FOR MALIGNANCY.
	</pre>		</pre>

Michael: /* Remote AVN */

2013-12-02T14:44:19Z

Remote AVN

← Older revision		Revision as of 14:44, 2 December 2013
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	<pre>		<pre>
	FEMORAL HEAD AND JOINT CAPSULE, LEFT, HIP ARTHROPLASTY:		FEMORAL HEAD AND JOINT CAPSULE, LEFT, HIP ARTHROPLASTY:
	- FEMORAL HEAD WITH ~~OSTEOARTHRITIS~~ AND MARKED DEFORMATION CONSISTENT WITH A HISTORY OF		- FEMORAL HEAD WITH DEGENERATIVE JOINT DISEASE AND MARKED DEFORMATION CONSISTENT WITH A HISTORY OF
	AVASCULAR NECROSIS.		AVASCULAR NECROSIS.
	- JOINT CAPSULE WITH MINIMAL CHRONIC INFLAMMATION.		- JOINT CAPSULE WITH MINIMAL CHRONIC INFLAMMATION.

Michael: /* Sign out */

2013-12-02T14:43:46Z

Sign out

← Older revision		Revision as of 14:43, 2 December 2013
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	====AVN and degenerative joint disease====		====AVN and degenerative joint disease====
	<pre>		<pre>
	FEMORAL HEAD, LEFT, HIP ARTHROPLASTY:		FEMORAL HEAD AND JOINT CAPSULE, LEFT, HIP ARTHROPLASTY:
	- AVASCULAR NECROSIS OF THE FEMORAL HEAD.		- AVASCULAR NECROSIS OF THE FEMORAL HEAD.
	- DEGENERATIVE JOINT DISEASE WITH MILD SYNOVITIS AND VILLOUS HYPERPLASIA.		- DEGENERATIVE JOINT DISEASE WITH MILD SYNOVITIS AND VILLOUS HYPERPLASIA.