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OSTEOPOROSIS AND EPIPHYSIAL ARREST IN JOINT TUBERCULOSIS

An Account of the Histological Changes in Involved Tissues

H. A. Sissons 1

1 Department of Pathology, Institute of Orthopaedics, Royal National Orthopaedic Hospital

Amputation or post-mortem specimens from eight cases of joint tuberculosis, with immobilisation changes in bone, have been studied by fine-detail slab radiographs and subsequent histological examination. The findings in three of these cases are presented in detail.

The immobilisation changes take the form of a true osteoporosis, which is strikingly focal in nature. In the adult the sites of most marked involvement include the subcortical bone adjacent to articular surfaces and the bone in the neighbourhood of the obliterated epiphysial plates.

Areas of permanent change in bone structure may result, although commencing "repair" is seen in the form of newly developed bone trabeculae in the osteoporotic areas.

In one case, where immobilisation occurred at an early age, changes in the growing epiphysial plates were produced in addition to osteoporosis. This is correlated with the known susceptibility of growing epiphysial cartilage to a wide variety of damaging agents.

Radiologically, it is important to discriminate between these immobilisation changes and the bone destruction which might be produced by extension of the tuberculous lesion itself.
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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General