Articles: cartilage-pathology.
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Cartilage-forming tumors as a group are the most common primary bone tumors; this is largely due to the common occurrence of asymptomatic benign lesions such as osteochondroma and enchondroma. The common feature of these tumors is the presence of chondrocytic cells and the formation of cartilaginous tumor matrix. ⋯ The morphologic heterogeneity of these tumors may be explained by a common multipotent mesenchymal cell differentiating along the lines of fetal-adult cartilage maturation. Recently mutations in IDH1 and IDH2 have been detected in a variety of benign and malignant cartilaginous tumors.(1-4.)
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Ned Tijdschr Geneeskd · Jan 2013
Review[Treatment of cartilaginous defects in the knee: recommendations from the Dutch Orthopaedic Association].
Cartilaginous defects in the knee occur frequently and can cause the patient considerable limitations. They are diagnosed and classified by means of MRI and arthroscopy. The surgical options available to treat deep chondral lesions include bone marrow stimulation techniques (microfracture treatment), chondrocyte therapies (autologous chondrocyte implantation) and tissue replacement therapies (osteochondral autologous transplantation). ⋯ Autologous chondrocyte implantation is a suitable method for treating single symptomatic chondral lesions larger than 2 cm2 in adults up to 50 years of age. There are no significant differences regarding the effectiveness of microfracture treatment, autologous chondrocyte implantation and osteochondral autologous transplantation for small defects: all show good clinical and functional short- and medium-term results. New second- and third-generation autologous chondrocyte implantation techniques seem to yield more sustainable tissue repair and better clinical long-term results for lesions larger than 4 cm2 in comparison to microfracture treatment.
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Osteoarthritis (OA) is a major cause of pain and disability in the aging population, but its pathogenesis remains incompletely understood. Alterations beneath the articular cartilage at the osteochondral junction are attracting interest as possible mediators of pain and structural progression in OA. Osteochondral changes occur early during the development of OA and may aggravate pathology elsewhere in the joint. ⋯ Bone turnover, angiogenesis and nerve growth are also features of other diseases such as osteoporosis and cancers, for which therapeutic interventions are already advanced in their development. Here we review pathological changes at the osteochondral junction and explore their potential therapeutic implications for OA. This article is part of a Special Issue entitled "Osteoarthritis".
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Originally defined as "tenderness to palpation over the greater trochanter with the patient in the side-lying position," greater trochanteric pain syndrome (GTPS) as a clinical entity, has expanded to include a number of disorders of the lateral, peritrochanteric space of the hip, including trochanteric bursitis, tears of the gluteus medius and minimus and external coxa saltans (snapping hip). Typically presenting with pain and reproducible tenderness in the region of the greater trochanter, buttock, or lateral thigh, GTPS is relatively common, reported to affect between 10% and 25% of the general population. Secondary to the relative paucity of information available on the diagnosis and management of components of GTPS, the presence of these pathologic entities may be underrecognized, leading to extensive workups and delays in appropriate treatment. This article aims to review the present understanding of the lesions that comprise GTPS, discussing the relevant anatomy, diagnostic workup and recommended treatment for trochanteric bursitis, gluteus medius and minimus tears, and external coxa saltans.
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Radiol. Clin. North Am. · Jul 2009
ReviewMeasures of molecular composition and structure in osteoarthritis.
Osteoarthritis involves ongoing degradative and healing processes that occur at the molecular level in multiple tissues in the joint in response to a number of biochemical and mechanical factors. Understanding these dynamic processes before they affect the structural aspects of the joint motivates the need for metrics to better visualize the compositional and structural molecular aspects of the tissues in vivo. As reviewed here, most of the work to date in this regard has been focused on magnetic resonance imaging approaches for interrogating molecular features of cartilage, including T2 mapping, T1rho mapping, delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), and sodium imaging. Specific examples illustrate new opportunities and insights emerging from these methods.