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Tumors of joints and structures associated with joints



Reactive tumor-like lesions, such as tendon sheath cysts, synovial cysts and loose osteochondral bodies (articular mice), usually develop in the joints and tendon sheaths. As a rule, they are the result of injury or any degenerative processes and are much more common than tumors. Primary tumors of the joints and periarticular structures are rare diseases. During their growth, these tumors reproduce those cell and tissue formations (synovial membranes, fat, blood vessels, connective tissue, cartilage) that are present in the joints and related structures. Benign neoplasms of these sites are much more common than their malignant counterparts.

Cyst tendon sheath and synovial cyst. The cyst of the tendon sheath is a small cavity with a diameter of 1-1.5 cm, which is almost always located near the joint capsule or tendon sheath. The most frequent localization of this cyst is the area around the joints of the wrist. Here it manifests itself in the form of a dense fluctuating translucent nodule the size of a pea. The cyst develops on the basis of cystic or myxoid (mucous) degeneration of the local connective tissue, so the cyst wall is devoid of any true lining. The lesion can be multifocal and increase in volume by merging neighboring cysts. The fluid filling the cyst is similar to synovial fluid, although there is no connection with the articular space of the cyst.

Hernial protrusion of the synovial membrane through the joint capsule or a significant increase in the synovial sac can lead to the development of a synovial cyst. An example would be a synovial cyst that forms in the popliteal space for rheumatoid arthritis (Baker cyst). Synovial lining in the cyst of the same name is hyperplastic and may contain cells of the inflammatory response and fibrin.

Villous-nodular (villonodular) synovitis. This name is used for several closely related benign tumors that develop in the synovial lining of the joints, tendon sheaths and synovial bags. Previously, they were regarded as reactive synovial proliferates (hence the name "synovitis"). However, using cytogenetic studies in the tissues of these proliferates, persistent chromosomal aberrations were identified, indicating the clonal nature of cell proliferation and, therefore, the tumor character of proliferates. The prototypes of these tumors are pigment villonodular synovitis and localized nodular tendosynovitis (giant cell tumor of tendon sheaths). If pigmented villonodular synovitis tends to diffuse damage to one or more joints, then localized nodular tendosynovitis usually appears as a separate nodule growing on the tendon sheath.

Both pigment villonodular synovitis and localized nodular tendosynovitis usually occur in the 3-5th decades of life and are equally common in people of both sexes.
Pigmented villonodular synovitis is usually monoarticular arthritis, affecting the knee joint in 80% of patients, and the hip, ankle, and heel-cuboid joints in the remaining 20%. Patients usually complain of pain, limited mobility and recurring swelling of the joint. During the tumor progression, the amount of movement of the joint is limited and its stiffness develops. Sometimes a tumor node is determined by palpation. Neoplasms with an aggressive type of flow spread to the adjacent bone and soft tissue. This makes X-ray and morphological diagnosis difficult. As for the localized nodular tendosynovitis, it is



Fig. 24.15.

Pigmented villous (villiodulyarny) synovitis of the knee joint

.

it manifests itself as a single slow-growing and painless tumor, often involving the tendons of the wrist and fingers in the process. This is the most common mesenchymal tumor of the hand; cortical erosion of an adjacent bone in this case comes to light approximately in 15% of supervision.

The color of lesions in the pigmented villonodular synovitis and localized nodular tendosynovitis varies from red-brown to spotty yellow-orange. In pigment vilonodular synovigus, the entire smooth synovium of the joint, usually the knee, or the largest part of it is transformed into a kind of koltun (tangle) of red-brown folds and finger-like villi. The localized nodular tendosynovit, on the contrary, is well limited and resembles a small walnut. In both cases, the tumor cells have a multifaceted shape, moderate in size and resemble synoviocytes. When the villonodular synovitis is pigmented, they spread along the surface and infiltrate the sub synovial zone (Fig. 24.15). But in the case of localized nodular tendosynovitis, the tumor cells form a solid nodular aggregate that can attach to the synovial membrane with the help of the stem. Among other histological findings in both tumors, hemosiderin deposits, accumulations of macrophages with foamy cytoplasm, the presence of multinucleated giant cells and sclerosis zones should be mentioned.

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Tumors of joints and structures associated with joints

  1. Joints (problems)
    Joints consist of several elements that prevent direct contact and splicing of bones. Joint disease may be accompanied by pain or loss of mobility. For more on metaphysical causes and manifestations, see the article ARTHRITIS Joint problems also indicate indecision or self-doubt, fatigue and unwillingness to act. The patient is blocking his
  2. Joint diseases
    Diseases of the joints are sometimes caused by defects in their development, they can be caused by infectious pathogens, and also be a link in the pathogenesis and manifestation of various metabolic and immune diseases, and tumors develop in the joints. Among the defects in the development of joints, dysplasia of the hip joint and congenital dislocation of the hip are most important. Pathogenetically, these are two blemishes.
  3. Wounds of joints
    Wounds of joints in animals compared with injuries of other areas of the body are less common, but are more severe and dangerous complications. Classification of wounds of joints. By the nature and extent of damage to the tissues of the joint in relation to its wound cavity can be: periarticular, not penetrating into the joint; penetrating into the joint cavity with soft tissue damage; penetrating the cavity of the joint with
  4. Syphilis joints
    Arthralgia, acute and subacute hydroarthrosis are characteristic of early syphilis. In the tertiary period, syphilis may develop hydroarthrosis and osteoarthritis. Arthralgia is an early symptom of syphilis, they appear 5–7 weeks after the appearance of a hard chancre. The clinical picture is characterized by pains in the joints, especially the knee and shoulder joints, aggravated at the beginning of movement.
  5. Joint diseases
    Lesions of joints of different nature are quite common in the clinic of internal diseases. Joint diseases can be an independent nosological form (rheumatoid arthritis, osteoarthritis, gout), a manifestation of the pathology of other systems (arthritis with SLE, SJS) or be a reaction to a different pathological process (reactive arthritis with any acute infection). All variety
  6. Diseases of the joints
    The most common in dogs are exudative, septic and purulent diseases of the joints. Aseptic serous synovitis. It is characterized by serous exudation, as a result of which the joint cavity overflows, which is accompanied by some enlargement of the joint space and protrusion of the front and rear folds. The pressure from the latter is transmitted to the front, and vice versa. When this occurs
  7. Knee surgery
    The most common operations on the knee joint are arthroscopy and total arthroplasty. Arthroscopy of the knee joint Preoperative period Arthroscopy revolutionized the surgery of many joints - knee, shoulder, ankle, wrist joints. Arthroscopy is usually performed on an outpatient basis. Most often, knee arthroscopy is performed in young
  8. Total hip arthroplasty
    Preoperative period In most cases, total hip joint arthroplasty is performed on patients suffering from osteoarthritis or rheumatoid arthritis. Osteoarthritis is a degenerative disease that affects the articular surfaces of one or more joints (most often hip and knee). Osteoarthritis is believed to be caused by multiple microtraumas of the joints.
  9. Polyarthritis (chronic rheumatism of the joints)
    Causes Disruption of the body’s immune system, chronic inflammation of the inner lining of the joints, resulting in deformation of the protective cartilage and the joint itself. Pristupoobrazny course of the disease can last for years, aggravated by changes in the joints and the surrounding supporting and connective tissue, until complete destruction. Inflammation can go to any other organ -
  10. Examination of the joints
    The study of joints begins with a description of the shape and measurement of their perimeter. Then surgical incisions are made for disarticulation and resection of the articular ends. The knee joint is opened, as when cutting the femoral epiphysis. To do this, produce an arcuate incision of the skin and underlying tissues in the lower thigh and knee joint. Cut to the bone begin at the border
  11. Aseptic joint inflammation
    By the nature of the exudate can be serous, serous-fibrinous, fibrinous, according to the clinical course - acute and chronic. Etiology. Bruises, sprains, sprains and other mechanical damages determine the subsequent development of aseptic arthritis. In light injuries, serous arthritis is more common. More severe damage to the joints leads to the development of sero-fibrinous and
  12. Joint stiffness
    Mobility of a joint is its inability to provide normal movement; may result in ankylosis, that is, complete loss of mobility. See the article JOINT (PROBLEMS), with the addition that a person is tense and not flexible enough, especially in relation to himself. In order to find out in which area of ​​his life these tensions manifest, it is necessary to find out the purpose of
  13. Diseases of the joints
    In addition to a certain predisposition of individual breeds and animals, diseases of the joints are manifested and aggravated as a result of a violation of mineral metabolism, lack, excess or imbalance, primarily calcium and phosphorus. Various digestive disorders (or inconsistency with changing needs) of vitamins and essential nutrients, first of all, high-grade protein, aggravate the picture.
  14. JOINTS AND LINKS OF THE HORSE'S AUTODODY
    The figures show the distal parts of the skeletons of the limbs and the arrangement of their ligaments. The joints in this area are simple hinges, moving in a single longitudinal plane, therefore, have characteristic collateral ligaments, limiting the movement of this plane. In addition to the usual collateral ligaments, there are ligaments associated with sesame bones on the fetters and
  15. Osteoarthritis of the knee (gonarthrosis)
    In many cases, it is secondary and is often caused by violations of the anatomical axis of the leg. Osteoarthritis is characterized by pain when walking up stairs and any other load on this joint: kneeling, squatting, etc. For osteoarthritis between the femur and the tibia is typical pain that occurs after a long walk and subsides at rest. When viewed on this
  16. Osteoarthritis, or degenerative joint disease
    Osteoarthritis is the most common joint disease, characterized by progressive thinning (erosion) of the articular cartilage. Currently, osteoarthritis is regarded as a lesion of cartilage, in which biochemical and metabolic changes lead to its disintegration. In most cases, osteoarthritis begins imperceptibly, gradually, without the obvious influence of age factors (idiopathic, or
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