ABSTRACT
While synovial sarcoma most commonly presents as a painless mass, occasionally the cancer emerges in a misleading manner resulting in an unfavorable delay or error in diagnosis. A review of the litrature reveals 4 such occult patterns: pretumor phase characterized only by pain or tenderness; the acute inflammatory lesion presenting as a "hot" arthritis or bursitis; the chronic contracture; the post traumatic tumor. These conditions, especially when otherwise unaccounted for, are indications for biopsy. Four avoidable pitfalls in biopsy management also emerged from the review.
Subject(s)
Joint Diseases/diagnosis , Sarcoma, Synovial/diagnosis , Adult , Arthritis/diagnosis , Biopsy , Child , Child, Preschool , Contracture/etiology , Diagnosis, Differential , Female , Humans , Joint Diseases/complications , Joint Diseases/pathology , Joints/injuries , Male , Sarcoma, Synovial/complications , Sarcoma, Synovial/pathologyABSTRACT
Of the 115 elbow dislocations treated at two New Orleans hospitals between 1959 and 1969, 78% were posterior. Sixty-one percent of the patients were 21 years of age or younger, and the male-female ratio was 1.7:1.0. The most common associated injuries were fractures of the medial condyle or epicondyle. All uncomplicated dislocations were treated by closed reduction and plaster immobilization. Of the 35 cases complicated by medial condylar or epicondylar fractures, 29 required open reduction and internal fixation. Results were excellent or good in 91% of the cases. The three patients (2.6%) with poor results all had mental impairment. This study suggests a generally favorable prognosis for these injuries.
