Loose bodies from a knee joint
GC.10088
Loose bodies from a knee joint.
From a male aged 62, a seaman, who suffered from gonococcal arthritis forty years previously. Seven years after this he suffered from suppurative arthritis of the knee which was treated by incision and drainage. A year later he noticed small loose bodies in the joint and during the following thirty years these increased in size and number. There had recently been some stiffness and difficulty in walking but very little pain. On examination the right knee was found to be greatly swollen and the joint was somewhat unstable. The swelling was due partly to fluid and partly to the presence of about forty loose bodies which were shown by radiography to be situated in all parts of the joint, the larger ones being in the suprapatellar pouch. The knee joint also showed extensive arthritic changes, and the synovial membrane presented a number of papilliform outgrowths which projected into the joint.
The specimen includes ten large and thirty small loose bodies. The larger ones are of somewhat polyhedral shape, the largest measuring approximately 45 mm. in its long axis. They are for the most part of smooth contour though in places they have a spongy texture. Several are faceted on one or more aspect owing to mutual contact. The smaller ones are of more or less uniform size, averaging about 15 mm. in length. They are of irregular or somewhat polyhedral shape and smooth surface. Radiographic examination of the loose bodies shows that they are highly calcified throughout with one exception. This last body was found at operation to be still attached to the synovial membrane and it is shown by radiography to be almost devoid of calcium.
