Virtual Microscopy	Choose another topic Cardiovascular Respiratory Renal and Urinary Tract Musculoskeletal Neuro(CNS and PNS) Gastrointestinal Reproductive Endocrine Hematopoiesis and Lymphoid Skin

Case 1:

A 12 year old boy with a recent “cold” complains of left leg pain. The skin in the region of the pain is red and warm to the touch. The child has an elevated white cell count and an elevated erythrocyte sedimentation rate. Radiographic analysis revealed a sclerotic lesion involving the bony cortex.

Slide: [schematic of normal bone]

Photomicrograph: [acute osteomyelitis]

1. Is this process characterized by bone growth or bony destruction?
2. What is the predominant cell type within the medullary cavity?
3. Can you suggest an etiology and treatment?

Case 2:

A 57-year old ex-NFL quarterback has had progressive pain and loss of movement in his hips bilaterally. Radiographic analysis revealed asymmetric joint space narrowing, subchondral sclerosis, and osteophyte formation.

Gross Photo: [gross picture of hip bones]

Photomicrograph: [normal articular surface]

Photomicrograph: [hip with loss of articular cartilage/eburnation]

Photomicrograph: [rheumatoid arthritis 1 and rheumatoid arthritis 2]

1. Where is the histologic section taken from?
2. Describe the gross abnormalities.
3. Describe the histologic abnormalities.
4. How can you relate the pathologic findings to the patient's career?
5. What is the main histological difference between the second photomicrograph from above and the two last photomicrographs?

Case 3:

A 70 year old man with long standing chronic pain involving the right hip that has not been relieved by anti-pain medications, presents to the ER with a fracture of his right femur after stepping off a curb.

Slide: [radiograph of right femur]

Photomicrograph: [active Paget's disease]

1. Describe the pathologic findings in the second photomicrograph (compare and contrast with the first photomicrograph).
2. The patient later develops heart failure – describe the relationship of heart failure to the primary process in the patient's hip.

The patient is in for a routine checkup for management of his disease several years later and complains of severe pain in the right hip. After a workup, a major surery is performed to resect the femur.

Gross Photo: [Paget's sarcoma]

Photomicrograph: [Paget's sarcoma]

1. What happened? What is the pathologic process?