Abstract
We present the case of a 40-year-old male patient who had been suffering from Wilson disease for over 20 years, whose knee was diagnosed as osteoarthritis combined with subchondral cyst of the tibia. Preoperative examinations (X-ray, CT and MRI) confirmed the diagnosis. The microscopic examination detected thickening of the synovial membrane, and histopathological findings revealed that lymphoid cells and plasma cells were infiltrated at the synovial membrane. On copper-specific staining, no copper pigmentation was identified. However, the energy-dispersive X-ray (EDX) microanalysis revealed copper pigmentation in high concentration. These findings may contribute to our better comprehension of the development process of the arthropathy in patients with Wilson disease. The combination of subchondral cyst with Wilson disease is extremely rare, as only about 16 such cases have been reported in the English literature.
Similar content being viewed by others
Abbreviations
- EDX:
-
Energy-dispersive X-ray
References
Golding DN, Walsh JM (1977) Arthropathy of Wilson’s disease: study of clinical and radiological features in 32 patients. Ann Rheum Dis 36:99–111
Aksoy M, Camli N, DiIlsen G (1975) Osteoarticular pains and changes in Wilson’s disease: a radiological study in fourteen patients in nine Turkish families. Acta Hepato-Gastroenterol 22:164–170
Pan Henry YM, Huang CY, Lai CL (1985) Wilson’s disease in a patient presenting with skeletal abnormalities. Orthopedics 8:742–744
Aksoy M, Camli N, Dincol K (1972) Osseous changes in Wilson’s disease: a radiologic study of nine patients. Diagn Radiol 102:505–509
Mindelzum R, Elkin M, Scheinberg LH, Sternlieb J (1970) Skeletal changes in Wilson’s disease: a radiologic study. Radiology 94:127–132
Finby N, Bearn AG (1985) Roentgenographic abnormalities of the skeletal system in Wilson disease (hepatolenticular degeneration). Am J Roentgenol 79:603–611
Rosenoer VM, Michell RC (1959) Skeletal changes in Wilson’s disease (hepatolenticular degeneration). Br J Radiol 32:805–809
Dastur DK, Manghani DK, Waida NH (1968) Wilson’s disease in India. Neurology 18:21–31
Feller ER, Schumacher HR (1972) Osteoarticular changes in Wilson’s disease. Arthritis Rheum 15:259–266
Yu-zhang Wie, Xue-zhe Zhang, Xian-hao Xu (1985) Radiologic study of 42 cases of Wilson disease. Skel Radiol 13:114–119
Menerey KA, Eider W, Brewer GJ et al. (1988) The arthropathy of Wilson’s disease: clinical and pathologic features. J Rheumatol 15: 331–337
Strickland GT, Leu ML (1975) Wilson’s disease. Clinical and laboratory manifestations in 40 patients. Medicine (Baltimore) 54:113–137
Glass TA, Dyer R, Fisher L, Fechner RE (1982) Expansile subchondral bone cyst. Am J Roentgenol 139:1210–1211
Kramer U, Weinberger A, Yarom R (1993) Synovial copper deposition as a possible explanation of arthroplasty in Wilson’s disease. Bull Hosp Joint Dis 52:46–49
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kataoka, M., Tsumura, H., Itonaga, I. et al. Subchondral cyst of the tibia secondary to Wilson disease. Clin Rheumatol 23, 460–463 (2004). https://doi.org/10.1007/s10067-004-0913-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-004-0913-8