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PATIENTS OF DIFFERENT AGES PATHOMORPHOLOGICAL
CHARACTERISTICS OF EXOSTOSIS
Kadirkulov J. Sh.
Samarkand State Medical University, Uzbekistan
Relevance.
Osteochondral exostosis is a benign bone growth defect, usually formed in
the epiphyseal growth plate. It is mainly located in the metaphyses of the long bones of the
limbs, but with skeletal growth it moves towards the diaphysis, but can also be located at the
articular ends of the pelvis, ribs, vertebrae, humerus and humerus. It is the most common
disease of the skeleton, accounting for approximately 20% of all major skeletal tumors. Most
often occurring in children and adolescents (most often in the second decade of life), the
growth of osteochondral exostosis stops during skeletal maturity, but sometimes continues
after the growth plate has closed. In 70% of cases, solitary osteochondromas are detected in
patients under 30 years of age. Osteochondral exostosis develops from the cortical plate of the
metaphysis and its axis is directed away from the nearest joint. Osteochondromatosis (multiple
exostotic chondrodysplasia) is a hereditary disease, inherited in an autosomal dominant
manner, most often occurring in patients under the age of 20. The tibia is the second most
common site for the development of exostosis. It accounts for 15-20% of all diagnosed cases
of exostoses.
Research objective:
Identification of pathomorphological changes in the structures of
exostosis of the greater tibia .
Materials and methods:
Republican Center of Specialized Traumatology and
Orthopedics, Samarkand A total of 18 patients of different ages who underwent surgical
procedures at the branch of the Department of Pathological Anatomy of the Multidisciplinary
Clinic of the Samarkand State Medical University underwent surgical materials from the
femur. Pathomorphological assessment of morphological and morphometric changes in the
structures of the femur exostosis was carried out using anamnestic,
macroscopic, microscopic,
morphometric and statistical research methods were carried out. Histological sections were
stained with hematoxylin-eosin dye.
Result and discussion:
From the anamnesis of patients with exostosis, most patients
associate the disease with injuries and microtraumas during their lives, inflammatory
processes, compression of the foot, including very tight plaster. A group of patients, especially
young children, cannot associate the disease with anything.
Pathomorphological examination
of surgically removed exostosis of the greater tibia revealed macroscopically a broad-based
spherical exostosis in 11 patients and a thin-stemmed mushroom-shaped exostosis in 9
patients, the thickness of the overlying cartilage was 4.5±0.4 mm in children (6 patients),
2.4±0.5 mm in adolescents (8 patients), and 1.8±0.3 mm in 5 patients. In the remaining 4
patients, the thickness of the cartilage layer in the femoral exostosis was 0.4±0.1 mm.
Microscopic examination revealed the accumulation of cells of the cartilage layer of the
exostosis in the form of interstitial cells. Dystrophic and necrobiotic changes were noted in
these chondrocytes. Also, the nucleus of most chondrocytes is not detectable. Cells are visible
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as cavities. A proliferative state of chondroblasts is noted at the border of spongy bone. A
small number of osteoblasts are present in the bone tissue of exostosis, and an active
proliferative process is detected in them. Between them, dystrophic and necrotic signs are
detected in osteocytes with oval shape, irregular contours and a wide surface, and calcification
foci are found in the areas where they are located. In some preparations, fragmented remains
of chondrocytes are detected between the osteocytes in the exostosis . Signs of swelling are
observed in the periosteum covering the exostosis . Hydropic dystrophy and pyknotic state of
the endotheliocytes of the swollen intima in the periosteum and intraosseous blood vessels of
the healthy bone area located close to it are noted. Karyopicrexis and karyolysis are observed
in some endotheliocytes. Swelling of collagen and elastic fibers in the walls of blood vessels
is noted.
Conclusion:
Thus, exostosis formed on the tibia can have a macroscopically wide base and
thin legs. The development is observed in the form of a ball or a cone. The dimensions of its
articular part are of different thickness, dystrophic changes and necrobiotic changes are noted
in chondrocytes. A proliferative state of chondroblasts is noted at the border of the cancellous
bone. Dystrophic and necrotic signs are detected in osteocytes, and foci of calcification are
found in their areas. Signs of swelling are detected in the epithelia covering the exostosis.
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