Calcific tendinitis of popliteus tendon: a case report and review of literature

A 63-year-old woman presented with a 3-week history of worsening right knee pain. She was fully unable to bear weight and denied any history of trauma, locking or giving way. On examination, she was systemically well with posterolateral joint line tenderness and a reduced range of movement. Blood tests and a joint aspirate were normal. Radiographs reported no fracture, but suggested a loose body in the lateral gutter of the knee. She was discharged with analgesia and physiotherapy. Subsequent follow-up X-rays demonstrated the opacity in the later gutter to be appearing less dense until it eventually disappeared. This correlated to a progressive improvement in the patient’s pain and range of movement in the knee leading to the diagnosis of acute calcific tendinitis of the popliteus tendon. This case report suggests that calcifying tendinitis of popliteus tendon should be considered in the differential diagnosis of acutely painful knee. The case demonstrates that the natural history of calcifying tendinitis of popliteus is similar to that in supraspinatus and that conservative treatment will eventually resolve the symptoms.     

家族性Fahr病

本文报告一家系 Fahr 病,3代中有5人发病,临床检查除智力偏低外未见其它异常,CT 检查均有底节、小脑、白质区域的高密度灶。其中1例因脑内血肿住院手术。本病原因不明,有散发病例,多为家族性,表现为常染色体显性遗传或隐性遗传。     

Localization of type X collagen in canine growth plate and adult canine articular cartilage

Type X collagen was extracted from ends of canine growth plates by pepsin digestion after 4 M guanidine hydrochloride extraction, purified by stepwise salt precipitation (2.0 M NaCl in 0.5 M acetic acid), and chromatographed on a Bio-Gel A1.5 M column in 1.0 M CaCl2. Without reduction on sodium dodecyl sulfate (SDS) polyacrylamide gels, the preparation yielded a single, high-molecular-weight (mol wt) band; after reduction, a single band of relative mol wt 5.0 x 10(4) was found. Polyclonal sera were raised against the purified collagen and used in the immunolocalization of canine type X collagen. As expected, indirect immunoperoxidase (IP) or indirect immunofluorescent staining with the polyclonal sera demonstrated that most of the immunoreactivity was localized in the zone of provisional calcification of the growth plate and in cartilage remnants in the metaphyseal region of the physis. A progressive decrease in staining toward the diaphysis of the fetal canine long bone was apparent as the trabecular structures were remodeled to bone. Unexpectedly, type X collagen was also detected in the zone of calcified, mature articular cartilage. It was concentrated in the pericellular matrix of the chondrocytes, appeared at or just above the tidemark, and was expressed immediately before mineralization. Identification of type X collagen in both the canine growth plate and the zone of calcified articular cartilage suggests that cells in the deep layer of cartilage and in the zone of calcified cartilage in the adult animal retain some characteristics of a growth plate and may be involved in regulation of mineralization at this critical interface. The expression of growth plate-like properties would allow the deep chondrocytes of mature articular cartilage to play a role in remodeling of the joint with age and in the pathogenesis of osteoarthritis.     

Scanning electron microscopic analysis of different drug eluting stents after failed implantation: From nearly undamaged to major damaged polymers

Background : Implantation of drug eluting stents (DES) in tortuous and/or calcified vessels is much more demanding compared with implantation of bare metal stents (BMS) due to their larger diameters. It is unknown whether drug eluting stent coatings get damaged while crossing these lesions. Methods : In 42 patients (34 male, 68.1 ± 10 years) with 45 calcified lesions (15.9 mm ± 7.9 mm), DES could not be implanted, even after predilatation. Diabetes was present in 19 patients (45 %). Sixty‐one stents were used; 19 Cypher select?, 18 Taxus Liberté?, 10 CoStar?, 5 Endeavor RX?, 4 Xience V?. 3 Janus Carbostent?, 1 Yukon Choice S?, and 1 Axxion? DES. The entire accessible surface area of these stents, in either the unexpanded and expanded state, were examined with an environmental scanning electron microscope (XL30 ESEM, Philips) to evaluate polymer or surface damage. Results : The polymers of Taxus Liberte, Cypher Select, Xience V, CoStar, and Janus DES were only slightly damaged (less than 3% of surface area), whereas the Endeavor RX Stents showed up to 20% damaged surface area. In DES without a polymer (Yukon and Axxion), it could be shown that most of the stent surface (up to 40%) were without any layer of drug. Conclusion : Placement of drug eluting stents in tortuous vessels and/or calcified lesions could cause major surface damage by scratching and scraping of the polymer or drug by the arterial wall, even before implantation. There were remarkable differences among the stents examined, only minor damage with the Cypher, Taxus Costar, Janus, and Xience V, whereas the Endeavor, the Yukon, and the Janus DES showed large areas of surface injury. © 2009 Wiley‐Liss, Inc.