Ischial bursal chondromatosis

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.