Existe edema ósseo na osteoartrose acromioclavicular?
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Data
2018-07-06
Autores
Negro, Marcus Vinicius Pinheiro Monte [UNIFESP]
Orientadores
Cohen, Moises [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
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Resumo
Objetivo: Investigar, por meio de avaliação histológica, a existência de edema ósseo na
extremidade acromial da clavícula em pacientes com osteoartrose acromioclavicular
submetidos à cirurgia artroscópica de ressecção lateral da clavícula. Métodos: Estudo
de série de casos prospectivo, que analisou os achados histológicos de oito pacientes
com diagnóstico de osteoartrose acromioclavicular (AC) submetidos à cirurgia
artroscópica de ressecção lateral da clavícula. As amostras de fragmentos ósseos da
extremidade acromial da clavícula retiradas durante o procedimento cirúrgico foram
colocadas em recipientes com formol a 40% e encaminhadas ao laboratório de anatomia
patológica, sendo submetido ao processamento histológico padrão, com afecção de
cortes histológicos, corados pelo método de rotina hematoxilina e eosina. As lâminas
foram analisadas em microscópio ótico eletrônico por um médico patologista especialista
em medula óssea. Resultados: Todos os pacientes avaliados são homens, brancos,
praticantes de atividade física que apresentavam uma média de idade de 39,75 (±6,22)
anos. Na execução do estudo foram examinadas oito biópsias, que levaram aos achados
de reação difusa de granulação, compatível com o diagnóstico de osteoartrite. Essa
reação foi caracterizada por ectasia importante nos vasos de pequeno calibre e, ainda,
pela presença de fibrose óssea, necrose, microfraturas e principalmente o
remodelamento do trabeculado ósseo em fases distintas, em cada paciente. No material
coletado para as biópsias dos pacientes ficou evidenciada a ocorrência de edema de
medula discreto focal, ocupando menos de 1% do volume dos espaços intertrabeculares.
Conclusão: O presente estudo revelou uma presença ínfima de edema ósseo ocupando
menos de 1% do volume dos espaços intertrabeculares na extremidade acromial da
clavícula.
Objective: To investigate, through histological evaluation, the existence of bone edema at the acromial extremity of the clavicle in patients with acromioclavicular osteoarthrosis who underwent arthroscopic surgery of lateral resection of the clavicle. Methods: Prospective case series study, which analyzed the histological findings of eight patients diagnosed with acromioclavicular (AC) osteoarthritis submitted to arthroscopic lateral resection surgery of the clavicle. The samples of bone fragments of the acromial end of the clavicle removed during the surgical procedure were placed in containers with formalin 40% and sent to the laboratory of pathological anatomy, being submitted to standard histological processing, with affection of histological sections, stained by the routine method hematoxylin and eosin. The slides were analyzed in an electronic optical microscope by a bone marrow specialist pathologist. Results: All the patients evaluated were white men, practicing physical activity, with a mean age of 39.75 (± 6.22) years. In the execution of the study eight biopsies were examined, which led to the findings of diffuse granulation reaction, compatible with the diagnosis of osteoarthritis. This reaction was characterized by significant ectasia in small vessels and also by the presence of bone fibrosis, necrosis, microfractures, and especially the remodeling of bone trabeculation at different stages in each patient. In the material collected for the biopsies of the patients it was evidenced the occurrence of focal discrete medulla edema, occupying less than 1% of the volume of the intertrabecular spaces. Conclusion: The present study revealed a small presence of bone edema occupying less than 1% of the volume of intertrabecular spaces at the acromial end of the clavicle.
Objective: To investigate, through histological evaluation, the existence of bone edema at the acromial extremity of the clavicle in patients with acromioclavicular osteoarthrosis who underwent arthroscopic surgery of lateral resection of the clavicle. Methods: Prospective case series study, which analyzed the histological findings of eight patients diagnosed with acromioclavicular (AC) osteoarthritis submitted to arthroscopic lateral resection surgery of the clavicle. The samples of bone fragments of the acromial end of the clavicle removed during the surgical procedure were placed in containers with formalin 40% and sent to the laboratory of pathological anatomy, being submitted to standard histological processing, with affection of histological sections, stained by the routine method hematoxylin and eosin. The slides were analyzed in an electronic optical microscope by a bone marrow specialist pathologist. Results: All the patients evaluated were white men, practicing physical activity, with a mean age of 39.75 (± 6.22) years. In the execution of the study eight biopsies were examined, which led to the findings of diffuse granulation reaction, compatible with the diagnosis of osteoarthritis. This reaction was characterized by significant ectasia in small vessels and also by the presence of bone fibrosis, necrosis, microfractures, and especially the remodeling of bone trabeculation at different stages in each patient. In the material collected for the biopsies of the patients it was evidenced the occurrence of focal discrete medulla edema, occupying less than 1% of the volume of the intertrabecular spaces. Conclusion: The present study revealed a small presence of bone edema occupying less than 1% of the volume of intertrabecular spaces at the acromial end of the clavicle.