HISTOPATHOLOGICAL INVESTIGATION ON RAPIDLY DESTRUCTIVE COXARTHROPATHY WHICH FOLLOWS AN ACUTE OR SUBACUTE COURSE

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  • 急性，亜急性経過をとる急速破壊型股関節症に関する病理組織学的検討
  • キュウセイ,アキュウセイ ケイカ オ トル キュウソク ハカイガタ コ カンセツショウ ニ カンスル ビョウリ ソシキガクテキ ケントウ

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Abstract

Following the report on rapidly destructive coxarthropathy (RDC) by Postel et al. in 1970, several other studies have reported on RDC; however, the pathology underlying this condition remains largely unknown. In this study, we classified patients requiring surgery for RDC into two groups on the basis of their clinical course and conducted a comparative study of the pathological features of RDC. The patients were divided into an acute model group, requiring surgery within 6 months of the initial medical examination, and a subacute model group, requiring surgery more than 6 months after the initial examination. Osteonecrosis was almost equally diagnosed histologically in both groups. However, detritic synovitis and loose fibrosis were more frequent in the subacute model group than in the acute model group. In RDC, regressive changes, including osteonecrosis, occur from the incipient stage, and trabecular bone repair (regeneration) accompanying tissue reactions including desmoplasia (fibrosis) is believed to occur in the surrounding area with progress. RDC patients either present an acute or subacute tissue status depending on the rate of progression of the disease. Furthermore, it is also considered that fibrous tissue reaction can possibly control the collapse of the capital femoral epiphysis; however, further comparative studies on acute and chronic RDC are necessary to confirm this hypothesis.

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