Joints - Revision history

Michael: /* Morawietz criteria */

2018-10-11T14:03:20Z

Morawietz criteria

← Older revision		Revision as of 14:03, 11 October 2018
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	====Morawietz criteria====		====Morawietz criteria====
	*23 neutrophils/10 HPF, where the field diameter = 0.625 mm.<ref name=pmid19635104>{{Cite journal \| last1 = Morawietz \| first1 = L. \| last2 = Tiddens \| first2 = O. \| last3 = Mueller \| first3 = M. \| last4 = Tohtz \| first4 = S. \| last5 = Gansukh \| first5 = T. \| last6 = Schroeder \| first6 = JH. \| last7 = Perka \| first7 = C. \| last8 = Krenn \| first8 = V. \| title = Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening. \| journal = Histopathology \| volume = 54 \| issue = 7 \| pages = 847-53 \| month = Jun \| year = 2009 \| doi = 10.1111/j.1365-2559.2009.03313.x \| PMID = 19635104 }}</ref>		*23 neutrophils / 10 HPF, where the field diameter = 0.625 mm.<ref name=pmid19635104>{{Cite journal \| last1 = Morawietz \| first1 = L. \| last2 = Tiddens \| first2 = O. \| last3 = Mueller \| first3 = M. \| last4 = Tohtz \| first4 = S. \| last5 = Gansukh \| first5 = T. \| last6 = Schroeder \| first6 = JH. \| last7 = Perka \| first7 = C. \| last8 = Krenn \| first8 = V. \| title = Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening. \| journal = Histopathology \| volume = 54 \| issue = 7 \| pages = 847-53 \| month = Jun \| year = 2009 \| doi = 10.1111/j.1365-2559.2009.03313.x \| PMID = 19635104 }}</ref>

	Notes:		Notes:

Michael: /* Microscopic */

2018-10-11T13:59:28Z

Microscopic

← Older revision		Revision as of 13:59, 11 October 2018
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	Notes:		Notes:
	*Various criteria for the number of neutrophils exist (see below).<ref name=pmid17545426>{{Cite journal \| last1 = Bori \| first1 = G. \| last2 = Soriano \| first2 = A. \| last3 = García \| first3 = S. \| last4 = Mallofré \| first4 = C. \| last5 = Riba \| first5 = J. \| last6 = Mensa \| first6 = J. \| title = Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection. \| journal = J Bone Joint Surg Am \| volume = 89 \| issue = 6 \| pages = 1232-7 \| month = Jun \| year = 2007 \| doi = 10.2106/JBJS.F.00741 \| PMID = 17545426 }}</ref>		*Various criteria for the number of neutrophils exist (see below).<ref name=pmid17545426>{{Cite journal \| last1 = Bori \| first1 = G. \| last2 = Soriano \| first2 = A. \| last3 = García \| first3 = S. \| last4 = Mallofré \| first4 = C. \| last5 = Riba \| first5 = J. \| last6 = Mensa \| first6 = J. \| title = Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection. \| journal = J Bone Joint Surg Am \| volume = 89 \| issue = 6 \| pages = 1232-7 \| month = Jun \| year = 2007 \| doi = 10.2106/JBJS.F.00741 \| PMID = 17545426 }}</ref>
	**The definitions suffer from [[HPFitis]].		**The definitions (with the exception of Morawietz ''et al.''<ref name=pmid19635104>{{Cite journal \| last1 = Morawietz \| first1 = L. \| last2 = Tiddens \| first2 = O. \| last3 = Mueller \| first3 = M. \| last4 = Tohtz \| first4 = S. \| last5 = Gansukh \| first5 = T. \| last6 = Schroeder \| first6 = JH. \| last7 = Perka \| first7 = C. \| last8 = Krenn \| first8 = V. \| title = Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening. \| journal = Histopathology \| volume = 54 \| issue = 7 \| pages = 847-53 \| month = Jun \| year = 2009 \| doi = 10.1111/j.1365-2559.2009.03313.x \| PMID = 19635104 }}</ref>) suffer from [[HPFitis]].
	*Finding of [[plasma cell]]s and lymphocytes is '''not''' contributory for the diagnosis of infection.<ref name=pmid17545426/>		*Finding of [[plasma cell]]s and lymphocytes is '''not''' contributory for the diagnosis of infection.<ref name=pmid17545426/>
	*[[Granuloma\|Granulomatous]] inflammation that isn't of a foreign-body type should get the usual work-up.<ref>URL: [http://path.upmc.edu/cases/case174.html http://path.upmc.edu/cases/case174.html]. Accessed on: 8 January 2012.</ref>		*[[Granuloma\|Granulomatous]] inflammation that isn't of a foreign-body type should get the usual work-up.<ref>URL: [http://path.upmc.edu/cases/case174.html http://path.upmc.edu/cases/case174.html]. Accessed on: 8 January 2012.</ref>

Michael: /* Athanasou criterion */

2018-10-11T13:58:25Z

Athanasou criterion

← Older revision		Revision as of 13:58, 11 October 2018
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	====Athanasou criterion====		====Athanasou criterion====
	*>= Ten neutrophils / ten [[HPF]] (x400).<ref name=pmid17545426/>		*>= Ten neutrophils / ten [[HPF]] (x400).<ref name=pmid17545426/>

			====Morawietz criteria====
			*23 neutrophils/10 HPF, where the field diameter = 0.625 mm.<ref name=pmid19635104>{{Cite journal \| last1 = Morawietz \| first1 = L. \| last2 = Tiddens \| first2 = O. \| last3 = Mueller \| first3 = M. \| last4 = Tohtz \| first4 = S. \| last5 = Gansukh \| first5 = T. \| last6 = Schroeder \| first6 = JH. \| last7 = Perka \| first7 = C. \| last8 = Krenn \| first8 = V. \| title = Twenty-three neutrophil granulocytes in 10 high-power fields is the best histopathological threshold to differentiate between aseptic and septic endoprosthesis loosening. \| journal = Histopathology \| volume = 54 \| issue = 7 \| pages = 847-53 \| month = Jun \| year = 2009 \| doi = 10.1111/j.1365-2559.2009.03313.x \| PMID = 19635104 }}</ref>

			Notes:
			*The 0.625 mm field diameter is uncommon; it corresponds to a 25 mm eye piece with a 40x objective (25 mm/40 = 0.625 mm).
			*The PMNs/area is: 23 PMNs / (pi/40.625^2) = 7.49 PMNs/mm*mm
			If one uses a 22 mm eye piece microscope and the 40x objective, the field diameter is 0.55 mm; thus, one would need to count PMNs in 12.91 HPFs ( 3.0680 mmmm / 0.2376 mm*mm = 12.91 ) to get the same sample area.

	====A comparison of the criteria====		====A comparison of the criteria====

Michael: /* Sign out */

2015-11-05T15:17:02Z

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← Older revision		Revision as of 15:17, 5 November 2015
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	Comment:		Comment:
	The findings ~~are suggestive~~ of a joint infection; correlation with		The findings raise the possibility of a joint infection; correlation with
	cultures is ~~suggested~~.		cultures is required.

	1 HPF = 0.2376 mm*mm.		1 HPF = 0.2376 mm*mm.

Michael: /* Sign out */

2015-11-05T15:13:31Z

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← Older revision		Revision as of 15:13, 5 November 2015
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	<pre>		<pre>
	Tissue from ~~Right Shoulder~~, Revision Arthroplasty:		Tissue from Left Hip, Revision Arthroplasty:
	- Connective tissue with focally increased neutrophils (at least		- Connective tissue with focally increased neutrophils (at least
	11 neutrophils/HPF).		11 neutrophils/HPF).

Michael: /* Sign out */

2015-11-05T15:13:07Z

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← Older revision		Revision as of 15:13, 5 November 2015
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			<pre>
			Tissue from Right Shoulder, Revision Arthroplasty:
			- Connective tissue with focally increased neutrophils (at least
			11 neutrophils/HPF).
			- Negative for microorganisms with routine stains.
			- NEGATIVE for malignancy.

			Comment:
			The findings are suggestive of a joint infection; correlation with
			cultures is suggested.

			1 HPF = 0.2376 mm*mm.
			</pre>

			====Block letters====
	<pre>		<pre>
	HEMATOMA, RIGHT HIP, IRRIGATION AFTER HIP REPLACEMENT/TISSUE REMOVAL:		HEMATOMA, RIGHT HIP, IRRIGATION AFTER HIP REPLACEMENT/TISSUE REMOVAL:

Michael: +image

2015-10-08T13:15:12Z

+image

← Older revision		Revision as of 13:15, 8 October 2015
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			[[Image:907 Synovial Joints.jpg\|thumb\|right\|Schematic of a synovial joint. (WC/OpenStax College)]]
	'''Joints''' are important for locomotion. This article collects tidbits about their [[pathology]].		'''Joints''' are important for locomotion. This article collects tidbits about their [[pathology]].

Michael: /* Feldman criteria */

2015-10-07T14:08:45Z

Feldman criteria

← Older revision		Revision as of 14:08, 7 October 2015
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	====Feldman criteria====		====Feldman criteria====
	*>= Five neutrophils / [[HPF]] (x400) in '''at least five''' separate microscopic fields.<ref name=pmid17545426/><ref name=pmid21131917>{{Cite journal \| last1 = Bori \| first1 = G. \| last2 = Muñoz-Mahamud \| first2 = E. \| last3 = Garcia \| first3 = S. \| last4 = Mallofre \| first4 = C. \| last5 = Gallart \| first5 = X. \| last6 = Bosch \| first6 = J. \| last7 = Garcia \| first7 = E. \| last8 = Riba \| first8 = J. \| last9 = Mensa \| first9 = J. \| title = Interface membrane is the best sample for histological study to diagnose prosthetic joint infection. \| journal = Mod Pathol \| volume = 24 \| issue = 4 \| pages = 579-84 \| month = Apr \| year = 2011 \| doi = 10.1038/modpathol.2010.219 \| PMID = 21131917 \| URL = http://www.nature.com/modpathol/journal/v24/n4/full/modpathol2010219a.html }}</ref>		*>= Five neutrophils / [[HPF]] (x400) assessed in '''at least five''' separate microscopic fields.<ref name=pmid17545426/><ref name=pmid21131917>{{Cite journal \| last1 = Bori \| first1 = G. \| last2 = Muñoz-Mahamud \| first2 = E. \| last3 = Garcia \| first3 = S. \| last4 = Mallofre \| first4 = C. \| last5 = Gallart \| first5 = X. \| last6 = Bosch \| first6 = J. \| last7 = Garcia \| first7 = E. \| last8 = Riba \| first8 = J. \| last9 = Mensa \| first9 = J. \| title = Interface membrane is the best sample for histological study to diagnose prosthetic joint infection. \| journal = Mod Pathol \| volume = 24 \| issue = 4 \| pages = 579-84 \| month = Apr \| year = 2011 \| doi = 10.1038/modpathol.2010.219 \| PMID = 21131917 \| URL = http://www.nature.com/modpathol/journal/v24/n4/full/modpathol2010219a.html }}</ref>

	====Athanasou criterion====		====Athanasou criterion====

Michael: /* Microscopic */

2015-06-11T21:26:00Z

Microscopic

← Older revision		Revision as of 21:26, 11 June 2015
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	*Various criteria for the number of neutrophils exist (see below).<ref name=pmid17545426>{{Cite journal \| last1 = Bori \| first1 = G. \| last2 = Soriano \| first2 = A. \| last3 = García \| first3 = S. \| last4 = Mallofré \| first4 = C. \| last5 = Riba \| first5 = J. \| last6 = Mensa \| first6 = J. \| title = Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection. \| journal = J Bone Joint Surg Am \| volume = 89 \| issue = 6 \| pages = 1232-7 \| month = Jun \| year = 2007 \| doi = 10.2106/JBJS.F.00741 \| PMID = 17545426 }}</ref>		*Various criteria for the number of neutrophils exist (see below).<ref name=pmid17545426>{{Cite journal \| last1 = Bori \| first1 = G. \| last2 = Soriano \| first2 = A. \| last3 = García \| first3 = S. \| last4 = Mallofré \| first4 = C. \| last5 = Riba \| first5 = J. \| last6 = Mensa \| first6 = J. \| title = Usefulness of histological analysis for predicting the presence of microorganisms at the time of reimplantation after hip resection arthroplasty for the treatment of infection. \| journal = J Bone Joint Surg Am \| volume = 89 \| issue = 6 \| pages = 1232-7 \| month = Jun \| year = 2007 \| doi = 10.2106/JBJS.F.00741 \| PMID = 17545426 }}</ref>
	**The definitions suffer from [[HPFitis]].		**The definitions suffer from [[HPFitis]].
	*Finding of plasma ~~cells~~ and lymphocytes is '''not''' contributory for the diagnosis of infection.<ref name=pmid17545426/>		*Finding of [[plasma cell]]s and lymphocytes is '''not''' contributory for the diagnosis of infection.<ref name=pmid17545426/>
	*[[Granuloma\|Granulomatous]] inflammation that isn't of a foreign-body type should get the usual work-up.<ref>URL: [http://path.upmc.edu/cases/case174.html http://path.upmc.edu/cases/case174.html]. Accessed on: 8 January 2012.</ref>		*[[Granuloma\|Granulomatous]] inflammation that isn't of a foreign-body type should get the usual work-up.<ref>URL: [http://path.upmc.edu/cases/case174.html http://path.upmc.edu/cases/case174.html]. Accessed on: 8 January 2012.</ref>

Michael: /* Microscopic */

2015-06-11T21:25:18Z

Microscopic

← Older revision		Revision as of 21:25, 11 June 2015
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	Features:		Features:
	*Microorganisms - '''key feature'''.		*Microorganisms - '''key feature'''.
	*Inflammatory cells, esp. [[neutrophils]].		*Inflammatory cells, esp. [[neutrophils]]. ‡
	*+/-[[Osteomyelitis]].		*+/-[[Osteomyelitis]].

			Note:
			*‡ There are several criteria for the number of neurophils in the context of prosthetic joints - see ''[[prosthetic joint infection]]''.

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