Musculoskeletal block Pathology practical

1. Musculoskeletal block Pathology practical

2. Normal anatomy and histology

4. The overall structure of a long bone

8. Gross pathology and histopathology

9. Case no. 1

10. A 22 years old male presented with localized pain above his right knee joint with recurrent fever. Later, he had a discharging sinuses from the skin overlying the right knee. What is the most likely diagnosis ?

14. Osteomyelitis

16. Case no. 2

17. A 35 years old debilitated man presented to the orthopedic clinic with back pain, low grade fever, marked elevation of sedimentation rate and recent kyphosis and scoliosis . • The patient has a history of coughing up blood, fever, chills, night sweats, weight loss, pallor, and often a tendency to fatigue very easily.

20. Section of bone shows granuloma formation with epithelioid like cells , langhans-type giant cells and rim of lymphocytes

21. 2- Spinal TB - Potts Disease (Tuberculousosteomyelitis)

23. Case no. 3

24. A 40 years old woman complains of low grade fever , malaise and stiffness in her joints each morning .

25. Rheumatoid arthritis affecting the head of femur. The synovium becomes edematous, thickened and hyperplastic and transforming its smooth contour to one covered by delicate and bulbous fronds .

26. Section shows marked synovial hypertrophy with formation of villi

27. Section of synovial tissue containing a dense lymphoid aggregates .

28. 3- Rheumatoid arthritis

30. Case no. 4

31. An obese 56 years old woman presented with bilateral localized pain to her knees, hands and difficulty in walking .

32. Progressive erosion of articular cartilage, eburnatedarticular surface , subchondral cyst and residual articular cartilage (Osteoarthritis)

33. Mushroom-shaped osteophytes (bony outgrowths ) develop at the margins of the articular surface and are capped by fibrocartilage and hyaline cartilage that gradually ossify . Note the absence of inflammation . (Osteoarthritis)

34. 4- Osteoarthritis

36. Case no. 5

37. A 16 years old male was found to have a small swelling protruding from upper part of his leg with local pain .

38. This is an osteochondroma of bone. This benign lesion appears as a bony projection (exostosis). Most are solitary, incidental lesions that may be excised if they cause local pain. There is a rare condition of multiple osteochondromatosis marked by bone deformity and by a greater propensity for development of chondrosarcoma.

40. The microscopic appearance of an osteochondroma displays the benign cartilagenous cap at the left upper and the bony cortex at the right lower. This bone growth, though benign, can sometimes cause problems of pain and irritation that leads to removal surgically.

42. 5- Osteochondroma(osteochondromaexostosis)

44. Case no. 6

45. An 18 years old female presented to the rheumatology clinic with 2 months history of pain and swelling in her upper thigh with weight loss .

50. 6-Osteosarcoma