Particle disease

Changed by Bruno Di Muzio, 5 Jun 2016

Updates to Article Attributes

Body was changed:

Aggressive granulomatosis post hip replacement is a potential complication of a hip joint replacement. Some authors use the same term for particle disease - if you are an expert on this we would love your help.

Pathology

Aggressive granulomas consist of well organizedorganised connective tissue containing histiocytic-monocytic and fibroblastic reactive zones. They can be highly vascularized, and villous structures can be observed. On immunohistological evaluation, most of the cells in the aggressive granulomatous tissue tends to be multinucleated giant cells and C3bi-receptor and nonspecific esterase-positive monocyte-macrophages.

Radiographic features

Plain radiograph

May show the development of progressive lytic focal regions around the replacement. There is usually smooth endosteal scalloping 7 and no sclerotic reaction.

MRI

The presence of a joint effusion due to reactive synovitis may be an early MR finding. This may occur before symptoms arise. There may also be capsular thickening and the presence of low signal intensity debris within the joint, though the normal fluid signal intensity of the effusion may also be seen.

Differential diagnosis

In certain occasions, it may be mistaken for primary or secondary tumours.

History and etymology

The process is thought to have been first recognizedrecognised by John Charney,British orthopaedic surgeon, in the 1960s 8.

  • -<p><strong>Aggressive granulomatosis post hip replacement </strong>is a potential <a href="/articles/complications-of-hip-joint-replacements">complication of a hip joint replacement</a>. Some authors use the same term for <strong>particle disease</strong> - if you are an expert on this we would love your help.</p><h4>Pathology</h4><p>Aggressive granulomas consist of well organized connective tissue containing histiocytic-monocytic and fibroblastic reactive zones. They can be highly vascularized, and villous structures can be observed. On immunohistological evaluation, most of the cells in the aggressive granulomatous tissue tends to be multinucleated giant cells and C3bi-receptor and nonspecific esterase-positive monocyte-macrophages.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>May show development of progressive lytic focal regions around the replacement. There is usually smooth endosteal scalloping<sup> 7 </sup>and no sclerotic reaction.</p><h5>MRI</h5><p>The presence of a joint effusion due to reactive synovitis may be an early MR finding. This may occur before symptoms arise. There may also be capsular thickening and the presence of low signal intensity debris within the joint, though normal fluid signal intensity of the effusion may also be seen.</p><h4>Differential diagnosis</h4><p>In certain occasions it may be mistaken for primary or secondary tumours.</p><h4>History and etymology</h4><p>The process is thought to have been first recognized by <strong>John Charney</strong>,<strong> </strong>British orthopaedic surgeon, in the 1960s <sup>8</sup>.</p>
  • +<p><strong>Aggressive granulomatosis post hip replacement </strong>is a potential <a href="/articles/complications-of-hip-joint-replacements">complication of a hip joint replacement</a>. Some authors use the same term for <strong>particle disease</strong> - if you are an expert on this we would love your help.</p><h4>Pathology</h4><p>Aggressive granulomas consist of well organised connective tissue containing histiocytic-monocytic and fibroblastic reactive zones. They can be highly vascularized, and villous structures can be observed. On immunohistological evaluation, most of the cells in the aggressive granulomatous tissue tends to be multinucleated giant cells and C3bi-receptor and nonspecific esterase-positive monocyte-macrophages.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>May show the development of progressive lytic focal regions around the replacement. There is usually smooth endosteal scalloping<sup> 7 </sup>and no sclerotic reaction.</p><h5>MRI</h5><p>The presence of a joint effusion due to reactive synovitis may be an early MR finding. This may occur before symptoms arise. There may also be capsular thickening and the presence of low signal intensity debris within the joint, though the normal fluid signal intensity of the effusion may also be seen.</p><h4>Differential diagnosis</h4><p>In certain occasions, it may be mistaken for primary or secondary tumours.</p><h4>History and etymology</h4><p>The process is thought to have been first recognised by <strong>John Charney</strong>,<strong> </strong>British orthopaedic surgeon, in the 1960s <sup>8</sup>.</p>

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