PMID- 29399706
DCOM- 20180827
LR  - 20180827
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 37
IP  - 3
DP  - 2018 Mar
TI  - Differential diagnostic perspectives provided by en face microscopic examination 
      of articular surface defects.
PG  - 831-836
LID - 10.1007/s10067-018-4001-x [doi]
AB  - Surface defects have a central position in diagnosis of articular pathology.
      Recognizing the limitations of standard radiologic techniques and those imposed
      by positioning and averaging artifacts on CT evaluation, direct visualization of 
      surface defects was pursued to identify disease characteristics that would
      facilitate interpretation of radiologic findings. Epi-illumination surface
      microscopy was utilized to examine macroscopically recognized articular surface
      defects in individuals in the Hamann-Todd, Terry, and Huntington human skeletal
      collections with previously verified diagnoses of rheumatoid arthritis,
      spondyloarthropathy, juvenile inflammatory arthritis (JIA), calcium pyrophosphate
      deposition disease (CPPD), gout, metastatic cancer, multiple myeloma, septic
      arthritis, tuberculosis, fungal arthritis, histiocytosis and sickle cell anemia
      (Rothschild and Rothschild Clin Infect Dis 20(5):1402-1408, 1995; Rothschild et
      al. Amer J Phys Anthropol 82(4):441-449, 1990; Rothschild and Rothschild Amer J
      Phys Anthropol 96(4):357-563, 1995; Rothschild and Woods Clin Exp Rheumatol
      10(2):117-122, 1992; Barrett and Keat Radiographics 24(6):1679-1691, 2004;
      Rothschild and Heathcote Amer J Phys Anthropol 98(4):519-525, 1995; Rothschild
      and Woods Am J Phys Anthropol 85:25-34, 1991; Hershkovitz et al. Amer J Phys
      Anthropol 106(1):47-60, 1998; Winland et al. Amer J Phys Anthropol 24:S243, 1997;
      Rothschild et al. Clin Exp Rheumatol 10(6):557-564, 1992; Rothschild and Martin ,
      2006; Rothschild et al. Amer J Phys Anthropol 102(2):249-264, 1997). Observed
      alterations were compared with standard radiographs. Fronts of resorption
      distinguished inflammatory arthritis from those caused by the other disorders
      studied. Multiple myeloma, fungal disease, and gout are expansile character; the 
      latter accompanied by reactive new bone formation more prominent than that noted 
      with spondyloarthropathy and JIA. Those were clearly distinguished from the
      crumbling alterations found with CPPD. Histiocytosis had a unique crenulated
      appearance, while nodules were prominent with syphilis. Defects in sickle cell
      anemia had ivory fragments at their base. These findings provided explanation for
      radiologic observations. Direct surface microscopy revealed characteristics
      apparently pathognomonic for specific disorders and facilitated distinguishing
      among them. The technique provides visualization an order of magnitude greater
      than that available with clinical radiologic techniques and identifies new
      characteristics which should facilitate clinical diagnoses. This demonstrates
      that there would be value to the development of higher resolution, clinically
      applicable imaging techniques.
FAU - Rothschild, Bruce M
AU  - Rothschild BM
AD  - Department of Vertebrate Paleontology, Carnegie Museum, Pittsburgh, PA, 15213,
AD  - Department of Medicine, West Virginia University College of Medicine, Morgantown,
      WV, 26501, USA.
LA  - eng
PT  - Journal Article
DEP - 20180204
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
SB  - IM
MH  - Arthritis, Rheumatoid/*diagnostic imaging
MH  - Chondrocalcinosis/*diagnostic imaging
MH  - Diagnosis, Differential
MH  - Gout/*diagnostic imaging
MH  - Humans
MH  - Joints/*diagnostic imaging
MH  - Microscopy
OT  - Calcium pyrophosphate deposition disease
OT  - Erosion
OT  - Gout
OT  - Infection
OT  - Rheumatoid arthritis
OT  - Spondyloarthropathy
EDAT- 2018/02/06 06:00
MHDA- 2018/08/28 06:00
CRDT- 2018/02/06 06:00
PHST- 2017/11/09 00:00 [received]
PHST- 2018/01/23 00:00 [accepted]
PHST- 2018/01/12 00:00 [revised]
PHST- 2018/02/06 06:00 [pubmed]
PHST- 2018/08/28 06:00 [medline]
PHST- 2018/02/06 06:00 [entrez]
AID - 10.1007/s10067-018-4001-x [doi]
AID - 10.1007/s10067-018-4001-x [pii]
PST - ppublish
SO  - Clin Rheumatol. 2018 Mar;37(3):831-836. doi: 10.1007/s10067-018-4001-x. Epub 2018
      Feb 4.