Difference between revisions of "Degenerative disc disease"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
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'''Degenerative disc disease''', abbreviated '''[[DDD]]''', is a common [[ditzel]], typically generated in the course of a discectomy operation. | '''Degenerative disc disease''', abbreviated '''[[DDD]]''', is a common [[ditzel]], typically generated in the course of a discectomy operation. | ||
'' | ''Sciatica'',<ref name=pmid26023617>{{Cite journal | last1 = Suthar | first1 = P. | last2 = Patel | first2 = R. | last3 = Mehta | first3 = C. | last4 = Patel | first4 = N. | title = MRI evaluation of lumbar disc degenerative disease. | journal = J Clin Diagn Res | volume = 9 | issue = 4 | pages = TC04-9 | month = Apr | year = 2015 | doi = 10.7860/JCDR/2015/11927.5761 | PMID = 26023617 }}</ref> ''vertebral disc'' and ''discectomy'' redirect here. | ||
==General== | ==General== | ||
*Herniated disc | *Herniated disc - causes back pain. | ||
*May result in ''cauda equina syndrome''. | *May result in ''cauda equina syndrome''. | ||
*Composed of ''fibrous cartilage''.<ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm]. Accessed on: 2 January 2010.</ref> | *Composed of ''fibrous cartilage''.<ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm]. Accessed on: 2 January 2010.</ref> | ||
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*+/-Synovium with or without proliferation.<ref name=pmid16393686/> | *+/-Synovium with or without proliferation.<ref name=pmid16393686/> | ||
*+/-Neovascularization of disc material.<ref name=pmid16393686/> | *+/-Neovascularization of disc material.<ref name=pmid16393686/> | ||
*Hemosiderin deposits (trauma or previous surgery). | |||
DDx: | DDx: | ||
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*Malignancy - very rare if not suspected. | *Malignancy - very rare if not suspected. | ||
**''Not'' reported in a series of 985 specimens.<ref name=pmid16393686/> | **''Not'' reported in a series of 985 specimens.<ref name=pmid16393686/> | ||
** Unexpected malignancy in 2 of 2177 specimens.<ref name=pmid16506461>{{Cite journal | last1 = Hasselblatt | first1 = M. | last2 = Maintz | first2 = D. | last3 = Goll | first3 = T. | last4 = Wildförster | first4 = U. | last5 = Schul | first5 = C. | last6 = Paulus | first6 = W. | title = Frequency of unexpected and important histopathological findings in routine intervertebral disc surgery. | journal = J Neurosurg Spine | volume = 4 | issue = 1 | pages = 20-3 | month = Jan | year = 2006 | doi = 10.3171/spi.2006.4.1.20 | PMID = 16506461 }}</ref> | |||
===Images=== | ===Images=== | ||
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==Sign out== | ==Sign out== | ||
<pre> | |||
Disc Material (L4-L5 Disc), Excision: | |||
- Consistent with disc material (gross only). | |||
</pre> | |||
<pre> | |||
Disc Material (Left L5-S1 Disc), Excision: | |||
- Consistent with disc material (gross only). | |||
</pre> | |||
Note: | |||
*May be [[gross only]] specimens; a minority of institutions handle these specimens this way.<ref name=pmid10050786>{{Cite journal | last1 = Zarbo | first1 = RJ. | last2 = Nakhleh | first2 = RE. | title = Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions. | journal = Arch Pathol Lab Med | volume = 123 | issue = 2 | pages = 133-9 | month = Feb | year = 1999 | doi = 10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2 | PMID = 10050786 }}</ref> | |||
**It is suggested that gross only specimens should have no history or suspicion of malignancy - based on the surgical note, available pathology and imaging. | |||
===Block letters=== | |||
<pre> | <pre> | ||
CERVICAL DISC, DISCECTOMY: | CERVICAL DISC, DISCECTOMY: | ||
Latest revision as of 18:30, 8 April 2016
| Degenerative disc disease | |
|---|---|
| Diagnosis in short | |
|
Template:Px Degenerative disc disease. HPS stain. | |
|
| |
| LM | benign fibrous tissue, nests of chondrocytes |
| LM DDx | chondrocalcinosis, synovial cyst, malignancy (primary or metastasis) |
| Site | vertebral disc - see spine |
|
| |
| Symptoms | back pain |
| Prevalence | common |
| Radiology | disc herniation |
| Prognosis | benign |
| Treatment | surgical (e.g. discectomy) |
Degenerative disc disease, abbreviated DDD, is a common ditzel, typically generated in the course of a discectomy operation.
Sciatica,[1] vertebral disc and discectomy redirect here.
General
- Herniated disc - causes back pain.
- May result in cauda equina syndrome.
- Composed of fibrous cartilage.[2]
Microscopic
Features:
- Benign fibrous tissue.
- Nests of chondrocytes (as in immature cartilage).
- +/-Synovium with or without proliferation.[3]
- +/-Neovascularization of disc material.[3]
- Hemosiderin deposits (trauma or previous surgery).
DDx:
- Chondrocalcinosis (CPPD).[3]
- Synovial cyst.
- Malignancy - very rare if not suspected.
Images
- Degenerative disc disease - intermed mag.jpg
Degenerative disc disease - intermed. mag. (WC)
- Degenerative disc disease - high mag.jpg
Degenerative disc disease - high mag. (WC)
- Degenerative disc disease -- intermed mag.jpg
DDD - intermed. mag. (WC)
- Degenerative disc disease -- high mag.jpg
DDD - high mag. (WC)
- Degenerative disc disease -- very high mag.jpg
DDD - very high mag. (WC)
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Disc Material (L4-L5 Disc), Excision: - Consistent with disc material (gross only).
Disc Material (Left L5-S1 Disc), Excision: - Consistent with disc material (gross only).
Note:
- May be gross only specimens; a minority of institutions handle these specimens this way.[6]
- It is suggested that gross only specimens should have no history or suspicion of malignancy - based on the surgical note, available pathology and imaging.
Block letters
CERVICAL DISC, DISCECTOMY: - DISC WITH DEGENERATIVE CHANGES. - NO EVIDENCE OF MALIGNANCY.
LUMBAR DISC, DECOMPRESSION: - DEGENERATIVE DISC DISEASE.
See also
References
- ↑ Suthar, P.; Patel, R.; Mehta, C.; Patel, N. (Apr 2015). "MRI evaluation of lumbar disc degenerative disease.". J Clin Diagn Res 9 (4): TC04-9. doi:10.7860/JCDR/2015/11927.5761. PMID 26023617.
- ↑ URL: http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm. Accessed on: 2 January 2010.
- ↑ 3.0 3.1 3.2 3.3 Pytel, P.; Wollmann, RL.; Fessler, RG.; Krausz, TN.; Montag, AG. (Feb 2006). "Degenerative spine disease : pathologic findings in 985 surgical specimens.". Am J Clin Pathol 125 (2): 193-202. doi:10.1309/89FV-RT04-EGBV-EUD9. PMID 16393686.
- ↑ Hasselblatt, M.; Maintz, D.; Goll, T.; Wildförster, U.; Schul, C.; Paulus, W. (Jan 2006). "Frequency of unexpected and important histopathological findings in routine intervertebral disc surgery.". J Neurosurg Spine 4 (1): 20-3. doi:10.3171/spi.2006.4.1.20. PMID 16506461.
- ↑ Modic, MT.; Ross, JS. (Oct 2007). "Lumbar degenerative disk disease.". Radiology 245 (1): 43-61. doi:10.1148/radiol.2451051706. PMID 17885180.
- ↑ Zarbo, RJ.; Nakhleh, RE. (Feb 1999). "Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions.". Arch Pathol Lab Med 123 (2): 133-9. doi:10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2. PMID 10050786.