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Ischial bursal chondromatosis
Afshin A Mashoof1, Jeffrey F Lipton, Vincent J Vigorita
1Department of Orthopedic Surgery, Kingsbrook Jewish Medical Center, Brooklyn, New York, USA.
American Journal of Orthopedics (Belle Mead, N.J.)
|February 6, 2002
Summary
Recurrent ischial ulcers can indicate underlying bursal osteochondromatosis, a condition involving bone and cartilage growth within the bursa. Surgical excision of this tissue may be necessary for treatment.
Area of Science:
- Orthopedic surgery
- Pathology
- Regenerative medicine
Background:
- Ischial ulcers are a common complication in patients with limited mobility.
- Recurrence of ischial ulcers can be associated with various underlying pathologies.
- A Girdlestone procedure and hip fracture increase risk factors for pressure ulcers.
Observation:
- A 79-year-old male patient presented with a recurrent right ischial ulcer 6 months post-Girdlestone procedure and hip fracture.
- Radiographic imaging revealed soft-tissue calcification adjacent to the ulcer site.
- The calcified mass was surgically excised and identified as hyperplastic bursal tissue with chondroid metaplasia.
Findings:
- The excised mass demonstrated bursal osteochondromatosis, characterized by abnormal bone and cartilage formation within the bursa.
- Chondroid metaplasia signifies a process where cartilage-like tissue develops from other cell types.
- Histopathological analysis confirmed the nature of the excised tissue.
Implications:
- Bursal osteochondromatosis should be considered in the differential diagnosis of recurrent ischial ulcers, especially with radiographic calcifications.
- Surgical management may be required to address symptomatic bursal osteochondromatosis.
- Understanding this condition can improve patient outcomes and prevent further ulcer recurrence.