STUDY DESIGN: A clinicopathologic study of synovial cysts in the ligamentum flavum (LF) in patients with spinal stenosis. OBJECTIVE: To investigate the pathogenesis of lumbar juxtafacet cysts. SUMMARY OF BACKGROUND DATA: Contradictions in the terminology applied to lumbar juxtafacet cysts arise from the frequent sparsity of synovial lining cells, which ...

Ganglion cysts arising from the posterior cruciate ligament (PCL) of the knee are rare. We describe a 21-year-old Chinese woman who presented with right knee pain following a twisting injury six months prior. Her pain was exacerbated by squatting, although her range of knee motion was full. Magnetic resonance imaging ...

A synovial cyst of the fifth digit of the left forelimb in a 15-year-old cat was diagnosed. Radiographs showed severe osteoarthritis of the interphalangeal and metacarpophalangeal joints with soft tissue swelling. An ultrasound examination of the digit revealed a cystic structure. Following amputation of the digit, the cyst recurred 3 ...

Rheumatoid meningitis (RM) is one of the most severe complications of rheumatoid arthritis. The mortality rate of RM is relatively high and diagnosis can be difficult. We present an 80-year-old woman who was diagnosed with microscopic findings of RM after analysis of biopsy specimens taken from a brain lesion. MRI ...

From 2004 to 2008 we evaluated 431 SLAP lesions during 3,395 shoulder arthroscopies and compared two groups of patients, one with SLAP lesion as group I and one without SLAP lesions as group II. Exclusion of type I SLAP lesions, rotator cuff tears and history of dislocation of the shoulder ...

OBJECTIVE: We assessed levels of agreement between a diagnosis of rheumatoid arthritis (RA) at inclusion in a recent-onset arthritis cohort, then 2 and 10 years later. Performance of American College of Rheumatology (ACR) criteria alone or combined with rheumatologist diagnosis, and of recent new criteria adding antibodies to cyclic citrullinated ...

Characterizing osteochondral lesions of the talus has enabled the strategies of surgical management to be better specified. The main technical problem is one of access for arthroscopy instruments to posteromedial lesions. A range of techniques and approaches has been described in ankle arthroscopy in general, and a transmalleolar approach provides ...

This study's aim was to determine the patterns of osteoarthritis (OA) in both unicompartmental medial and lateral OA of the knee. Forty patients with medial and 20 with lateral unicompartmental knee osteoarthritis were studied to determine the location of full-thickness cartilage lesions. Intraoperatively, the distance between margins of the lesion ...

Loss of terminal knee extension after anterior cruciate ligament (ACL) reconstruction is problematic. Formation of a fibrous nodule, known as a cyclops lesion, at the site of the ACL graft exiting from the tibial tunnel can impinge at the roof of the intercondylar notch and block terminal knee extension. This ...

Lesions in articular cartilage can result in significant musculoskeletal morbidity and display unique biomechanical characteristics that make repair difficult, at best. Several surgical procedures have been devised in an attempt to relieve pain, restore function, and delay or stop the progression of cartilaginous lesions. Advanced MRI and ultrasonography protocols are ...

We describe a patient with a large subarticular cystic lesion in the proximal tibia developed following traumatic avulsion of PCL. There was a demonstrable communication between the cyst and the joint cavity and ingrowth of the synovial tissue was the most probable pathogenetic mechanism for the development of the cyst. ...

OBJECTIVE: To develop evidence-based recommendations for the diagnosis of knee osteoarthritis (OA). METHODS: The multidisciplinary guideline development group, representing 12 European countries, generated 10 key propositions regarding diagnosis using a Delphi consensus approach. For each recommendation, research evidence was searched systematically. Whenever possible, the sensitivity, specificity and likelihood ratio were ...

We describe a case of a ganglion cyst of the temporomandibular joint (TMJ) and review the literature of this rare entity. Because of the rarity of such cysts in the TMJ, an accurate diagnosis is not usually made preoperatively. Treatment is surgical but, if a diagnosis can be made, a ...

Osteoid osteoma is uncommonly located at the ankle joint level. Arthroscopic resection is an unusual treatment modality in this tumour situation. We report the case of a young man presenting with an osteoid osteoma of his talus neck. Diagnosis was made by MRI. Since the tumour was intraarticular and subperiosteal, ...

Osteochondritis dissecans (OCD) is an acquired, potentially reversible idiopathic disease of subchondral bone resulting in delamination and sequestration. Although juvenile-type OCD lesions typically appear stable on superficial examination, conservative treatment results in cure in approximate 50% of patients. We hypothesized that juvenile-type OCD lesions exhibit an underlying instability despite stability ...

PURPOSE: The purpose of this study was to determine inter- and intraobserver variability of MR arthrography of the shoulder in the detection and classification of superior labral anterior posterior (SLAP) lesions. METHODS: MR arthrograms of 78 patients who underwent MR arthrography before arthroscopy were retrospectively analysed by three blinded readers ...

Despite increasing knowledge of etiopathogenesis, therapy, and recurrence rate of popliteal cysts, they nevertheless occasionally represent clinical problems. We report the case of a 58-year-old rheumatoid arthritis patient in whom a giant recurrent cyst developed very shortly after primary excision. Reports of such large popliteal cysts are rare and very ...

A 4-year-old, spayed female, mixed-breed dog was presented for evaluation of chronic left hind-limb lameness. Lytic lesions were observed in the left patella on radiographs of the stifle. A biopsy of the patella led to a histopathological diagnosis of blastomycosis. Surgical debridement followed by a 90-day course of itraconazole and ...

Lesions of the superior labrum can be a source of significant shoulder pain and disability. SLAP (superior labrum anterior-posterior) tears have been classified into many different types. A type IV SLAP tear is a bucket-handle tear of the superior labrum with extension into the biceps tendon. This relatively uncommon SLAP ...

The atypical presentation of intra-articular osteoid osteoma in the hip joint frequently results in delayed diagnosis compared with the diagnosis of extra-articular osteoid osteoma. We present 2 cases of hip joint osteoid osteoma in children treated by hip arthroscopy. Intra-articular osteoid osteoma was suspected when computed tomography (CT) findings were ...

Primary cutaneous marginal zone B-cell lymphoma (PCMZL) is an indolent low grade B cell lymphoma of the skin, with lack of extracutaneous involvement at the time of diagnosis. Herein we report the case of a patient with rheumatoid arthritis (RA) who developed symmetrical PCMZL lesions on both ear lobes. Lesions ...

Rheumatoid nodulosis is considered a benign variant of rheumatoid arthritis. Several therapies have been used with variable results. We report a 63-year-old man who presented with nodular lesions on the metacarpophalangeal joints and knees which were diagnosed of rheumatoid nodulosis. Topical tacrolimus was started with good response on the following ...

Bone deficiencies of either the humeral head or glenoid fossa may cause recurrent shoulder instability following soft tissue stabilization procedures. The engaging Hill-Sachs lesion, a major risk factor for instability, has been identified in a majority of patients with recurrent anterior instability. Guidance for surgical management of large humeral head ...

An osteochondral lesion of the entire articular surface of the humeral head has not previously been reported. We report the case of a 73-year-old woman with a huge osteochrondal lesion which affected virtually the whole articular surface of the humeral head, caused by an unusal mechanism of injury. Clinical examination ...

Synovial chondromatosis of Hoffa's body is uncommon. Recurrences usually result from incomplete removal of the loose bodies or diseased synovium at the initial surgery. We report a patient with synovial chondromatosis localized into the Hoffa's body who presented with anterior knee pain and mechanical symptoms. At the first arthroscopy, all ...

This article presents the case of a 63-year-old man who noted painless swelling within the suprapatellar pouch, which he attributed to an effusion. Small-magnet, lower-extremity magnetic resonance imaging (MRI) and subsequent arthroscopy missed the lesion. On MRI with gadolinium contrast, the lesion was defined but misdiagnosed as a suprapatellar pouch ...

Between 2002 and 2008, 130 consecutive ankles were replaced with an hydroxyapatite (HA) and titanium-HA-coated Ankle Evolutive System total ankle prosthesis. Plain radiographs were analysed by two independent observers. Osteolytic lesions were classified by their size and location, with cavities > 10 mm in diameter considered to be 'marked'. CT ...

Septic arthritis is a disabling and possibly life-threatening disease that requires early diagnosis for optimal management. It is important that clinical and imaging features of septic arthritis be promptly identified. In addition, because other disease entities may have characteristics similar to those of septic arthritis, analysis of a needle biopsy ...

BACKGROUND: Patellofemoral lesions represent a very troublesome condition to treat for orthopaedic surgeons; however, second-generation autologous chondrocyte implantation (ACI) seems to offer an interesting treatment option with satisfactory results at short-term follow-up. HYPOTHESIS: Hyaluronan-based scaffold seeded with autologous chondrocytes is a viable treatment for the damaged articular surface of the ...

We evaluated the histological changes before and after fixation in ten knees of ten patients with osteochondritis dissecans who had undergone fixation of the unstable lesions. There were seven males and three females with a mean age of 15 years (11 to 22). The procedure was performed either using bio-absorbable ...

Patients may present with a primary complaint of intra-articular knee masses causing mechanical symptoms of snapping or locking. If the history, physical examination, laboratory tests, and imaging studies point to a benign process, acceptable treatment consists of arthroscopic excision and postoperative pathology analysis. As reported in several case series, the ...

OBJECTIVE: To propose French recommendations for the clinical, biological and radiological diagnosis of peripheral psoriatic arthritis (PsA) in daily practice based on data from the literature and expert opinion. METHOD: The strategy was the following: the choice of four questions, concerning this topic by the scientific committee according to the ...

US guided procedures for diagnosis or treatment of different forms of arthritis are becoming more and more important. This review describes general considerations for fluid aspiration, articular or periarticular injections and biopsies by US guidance according to the recent literature. Guidelines regarding instrumentation, different techniques, pre- and postprocedural care as ...

As synovial fluid from the wrist may leak into the ulnar bursa and from there into the flexor synovial sheath in the little finger, the origin of a synovial cyst of the pulp of the little finger may be in the wrist. Here we present the surgical treatment of a ...

Rheumatoid leptomeningitis is a rare complication of rheumatoid arthritis (RA). We describe a woman with rheumatoid leptomeningitis presenting with acute-onset behavioral changes and consciousness disturbance in the early stage of RA. On fluid-attenuated inversion recovery images or diffusion-weighted images, high-signal-intensity lesions in the subarachnoid spaces of the right frontal lobe ...

OBJECTIVE: Our study describes sick leave during 3 years before and 3 years after diagnosis of rheumatoid arthritis (RA) in relation to referents and identifies predictors for sick leave during the third year after diagnosis of RA. METHODS: One hundred twenty patients (76% women) from the Swedish early RA study ...

Talar osteochondral defects (OCDs) are a challenge for treating physicians because they frequently are missed or diagnosed incorrectly, often resulting in severe degenerative arthritis of the ankle joint. Surgical intervention becomes a viable option in the presence of larger OCDs associated with loose bodies or osteochondral lesions that have failed ...

Joint aspiration/injection and synovial fluid (SF) analysis are both invaluable procedures for the diagnosis and treatment of joint disease. This chapter addresses: (1) the indications, the technical principles and the expected benefits and risks of aspiration and injection of intra-articular corticosteroid; and (2) practical aspects relating to SF analysis, especially ...

Idiopathic calcium pyrophosphate deposition disease (pseudogout) has a variable presentation. Many joints are usually affected; single joint disease is uncommon. We present a case report of primary monoarticular pseudogout affecting the hip. The diagnosis was made on the appearance and analysis of specimens obtained at arthroscopy. Monoarticular pseudogout is rare, ...

A retrospective analysis of patients who underwent knee arthroscopy was undertaken to determine the accuracy of clinical diagnosis when compared with arthroscopic findings, and to see whether any specific pathologies were difficult to diagnose. The preoperative diagnosis was compared with the operative findings and the accuracy, sensitivity and specificity of ...

A 17-year-old female patient presented with chronic symmetrical oligoarthritis of both knees and ankles, xerostomia, xerophthalmia, multiple bilateral lymphadenopathies in the cervical region, and bilateral parotid enlargement with the histological finding of chronic sialoadenitis. She had been already given methotrexate, chloroquine, and corticosteroids with the diagnosis of rheumatoid arthritis (RA) ...

We present a case of a 13-year-old male patient with hip pain and limp. Inconclusive investigations and persistent symptoms resulted in the patient undergoing hip arthroscopy. At arthroscopy, a large focal cartilaginous defect of the femoral head with synovitis was seen and synovial biopsy confirmed the diagnosis. Arthroscopic debridement of ...

HYPOTHESIS: This study reassessed the sensitivity and the specificity of the external rotator lag sign (ERLS) for diagnosis of supraspinatus tears in a large cohort of patients. MATERIALS AND METHODS: The ERLS was used to assess 401 consecutive patients with 406 painful shoulder conditions. The clinical diagnosis was controlled either ...

We present a 16 year old student with right elbow pigmentary villonodular synovitis. Clinical diagnosis, radiological features, MRI findings, biopsy results, management and follow up are discussed. MRI is the diagnostic modality of choice and assists the surgeon for a proper incision. Correlation of all the clinical aspects and the ...

OBJECT: Intraneural ganglia are nonneoplastic mucinous cysts contained within the epineurium of peripheral nerves. Their pathogenesis has been controversial. Historically, the majority of authors have favored de novo formation (degenerative theory). Because of their rarity, intraneural ganglia affecting the upper limb have been misunderstood. This study was designed to critically ...

Septic arthritis due to Salmonella has been reported frequently, but multiple joint involvements have rarely been reported in children. A 3-year-old girl presented with Salmonella arthritis involving multiple joints. Laboratory investigations revealed pancytopenia inconsistent with diagnosis of juvenile rheumatoid arthritis or septic arthritis. Bone marrow examination 2 weeks later confirmed ...

A 59-year-old woman presented with recurrent synovial chondromatosis of the distal interphalangeal joint at the site of removal of what was thought to be a ganglion cyst in 2003 and the subsequent excision of a recurrent synovial chondromatosis in 2005. Although synovial chondromatosis is typically described as a benign, self-limiting ...

Superior labral tears (SLAP lesions) can pose a significant challenge to orthopaedic surgeons and rehabilitation specialists alike. Although advancement in arthroscopic techniques has enhanced arthroscopic repair of SLAP lesions, the clinical diagnosis of SLAP lesions can still be difficult. There is a variety of etiologic factors associated with SLAP lesions ...

This article describes modified physical examination maneuvers for diagnosing lateral meniscal cysts. The typical presentation of lateral meniscal cysts usually makes their clinical diagnosis simple, but a wide variation in size may sometimes lead to misdiagnosis. We evaluated the effect of leg rotations on the cystic swelling at 45 degrees ...

<p>Osteopoikilosis presents as round or ovoid sclerotic lesions with an appearance like enostosis on pathology. Synovial osteochondromatosis occurs due to cartilaginous metaplasia with synovial villous proliferation with calcified nodules in proximity to joints. A case of osteopoikilosis associated with synovial osteochondromatosis is described. Intraosseus and juxta osseus sclerotic bone lesions ...