The Hip book

Abductor Digiti Minimi

Anatomy origin: pisiform bone and from the tendon of the FCU ; insertion two slips; into ulnar side of the base of proximal phalanx of little finger; into ulnar border of aponeurosis of extensor digiti minimi expansion of finger extensor tendons; action abducts little finger & helps flex its proximal phalanx at MP joint; synergists … Read more

Multiple Myeloma

(see also: Bone Tumor Menu) Discussion myeloma is malignant tumor of plasma cells arising from a single clone; multiple myeloma accounts for > 40% of primary malignant tumors of bone. it is most common malignant primary tumor of bone may arise as single intraosseous tumor but more often it develops as multiple painful lesions throughout … Read more

Diff DX: Gout

(see also: Hyperuricemia) Differential Rheumatoid Arthritis: Infection: w/ rapid destruction of gouty joint (by intraarticular infection), crystalline deposits may be released into synovial fluid, leading to confusion; note that indomethacin can quell the clinical symptoms of early septic arthritis (just as it will w/ gout), and therefore, NSAIDs should not be used to differentiate between … Read more

Pathophysiology of Gout

Discussion: humans lack the enzyme uricase which is involved in elimination of excess nucleic acid purines & nitrogenous waste products through production and excretion of allantoic acid; hence in humans, uric acid is end product of purines degradation; gouty arthritis begins w/ deposition of MSU crystals in synovial & periarticular tissue; factors related to microtophus … Read more

Hemophilia

Discussion classic disease results from deficiency of factor VIII clotting activity; hemophilia A is not caused by an absolute deficiency of factor VIII, but from an abnormal molecule making up part of the VIII clotting factor; hemophilic arthropathy: pathologic changes (coag pathway / coag labs); inheritance pattern: sex-linked recessive; affected male will have normal sons … Read more

Gout

(see also: Therapeutic Principles & Anti-Gout Meds Discussion gout refers to articular dz of MSU deposits (tophi) in soft tissues. it is caused by deposition of monosodium urate crystals in poorly perfused tissues, as well as bursae, ligaments, articular cartilage, and synovial membranes; on average, a family history of gout can be obtained in less … Read more

Proteoglycans in Cartilage

(see also: cartilage topics) Discussion proteoglycan is a macromolecule constructed of a protein core to which many glycosaminoglycan chains are attached – protein with bound side chains (glycosaminoglycans); to this proteoglycan aggregate, hyaluronic acid is non covalently bound; in osteoarthritis, there is a characteristic reduction in a aggregrating proteoglycans; about 10% of wt of proteoglycan … Read more

Cartilage: Nourishment

(see also: Healing) Discussion mechanism of nutrition occurs by diffusion of materials through several millimeters of matrix; synovial fluid that bathes cartilage provides adequate nutrition; withdrawal of synovial fluid often leads to rapid deterioration of cartilage References The deleterious effects of drying on articular cartilage.

Hyaluronic Acid

(see also: osteoarthritis of the knee) Discussion hyaluronic acid is a glycosaminoglycan found in synovial fluid & cartilage; complex sugar (not a protein) ancient molecule, highly conserved- identical function acts as lubricant and shock absorber; acts as barrier permitting metabolites to pass thru it by diffusion but resists penetration by bacteria and other infectious agents; … Read more

Hyaline Cartilage

Discussion hyaline cartilage is the most common variety of cartilage; it is found in costal cartilages, articular cartilages, epiphyseal plates, & majority of fetal skeleton that is later replaced by bone; chondrocytes, occupy lacunae generously distributed through the matrix; each peripheral lacuna typically houses a single chondrocyte; deeper lacunae may contain two or more chondrocytes; … Read more