Pathological mineralizations: calcifications and Si-bearing particles in soft tissues and their eventual relationship to different prostheses.

Polarizing microscopy (PM), scanning electron microscopy (SEM), x-ray dispersive analysis (EDAX), x-ray diffraction (XRD), and infrared spectrometry (IR) were used to study the following pathological mineralizations: calcifications and silicon(Si)-bearing mineralizations in cerebral tissue from an epileptic child; traces of Si-bearing particles in periprosthesic mammarian tissue, and calcifications in capsular mammarian tissue from a patient with a silicone gel mammarian implant, and 2 calcium-bearing compounds, a typical apatitic calcification, and a nonphosphorous-bearing calcification in arterial tissues. In this tissue we also found Si-bearing particles due to an artifact from glassware.

Apatite deposition in polymyositis subluxing arthropathy.

We describe a 47-year-old woman who developed chronic subluxing arthropathy associated with polymyositis (PM) and positive anti-Jo1 antibodies. After a followup of 3 years, PM did not recur and polyarthritis dominated her clinical picture, leading to deformities and periarticular calcifications in her hands, shoulders, and feet. Patients with myositis, anti-Jo1 antibodies, and periarticular calcifications are at risk of developing deforming arthritis unresponsive to conventional therapy.

Lymphadenopathy secondary to silicone hand joint prostheses.

The occurrence of lymphadenopathies was investigated in 23 patients with diverse rheumatic conditions who had silastic prosthesis in joints of the hands, to determine whether these adenopathies were due to the presence of silicone particles. Five cases had clinically detectable lymph node enlargement and tissue samples were studied by light and scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDXA). In 3 out of the 5 cases foreign body granulomas were observed by light microscopy, SEM showing a highly irregular distribution of foreign body material with a peak for silicone by EDXA. Foreign body particle distribution closely correlated with silicone concentration. No granulomas were found in the two remaining patients with adenopathies who presented a non-specific reactive lymphadenitis. Our findings show that silicone lymphadenopathy is a more frequent complication (13%) of silastic arthroplasty than is usually recognized and therefore should be considered in the differential diagnosis of patients with lymph node enlargement who have previously received a silicone arthroplasty.

Idiopathic familial chondrocalcinosis due to apatite crystal deposition.

Idiopathic familial chondrocalcinosis was found in five members of a family. The clinical features of the disease were morning stiffness, pain and limitation of motion of the dorsolumbar spine in four of the five members, associated with arthritis of the small joints of the hands in three, shoulder periarthritis in two and costal cartilage pain in one. Radiologically, four of the five patients had multiple intervertebral disk calcifications, mainly located at the nucleus pulposus area. Three of them also had periarticular calcific deposits, associated with costal cartilage calcifications and degenerative changes in the small joints of the hands in two. None of these cases showed cartilage calcification in the knees, public symphysis or triangular ligament of carpus. In the propositus, optical microscopy of a specimen of the second proximal interphalangeal joint obtained by open biopsy showed the presence of multiple calcified areas in the intercellular matrix and chondroid metaplasia with calcification of the matrix in the synovial membrane and capsule. X-ray diffraction studies, energy dispersive analysis, and infrared spectrophotometry of a costal cartilage sample obtained by open biopsy demonstrated the presence of carbonate calcium hydroxyapatite. In this study, no relation was found between HLA antigens, loci A, B and C, and this syndrome due to calcium hydroxyapatite crystal deposition.