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ABSTRACT: Core biopsies obtained from the articular cartilage of the femoral head of a 16-year-old girl with idiopathic chondrolysis of the hip were subjected to an ultrastructural study. Zone I was missing and zone II was the most superficial layer present in the articular cartilage of our patient. Collagen fibrils were thinner than normal and more uniform in diameter, and proteoglycans were normally distributed among them. Degenerating chondrocytes were found, as well as debris of dead cells, but many chondrocytes were still vital and engaged in active synthesis. Most of the chronic degenerative changes observed in ultrastructural studies on osteoarthritis were not observed in this case of idiopathic chondrolysis which seems to be, on the basis of our findings, a pathological process which develops and runs its course very quickly.
Introduction
Idiopathic chondrolysis of the hip is a rare disease, the etiology and pathogenesis are still unknown. The disease is characterized by an extensive loss of the articular cartilage of both the femoral head and the acetabulum, that starts and develops acutely.1-5
The histopathology of the disease has not been well investigated, the few published studies report on its light microscopic aspects.2'3 To the best of our knowledge, no extensive ultrastructural study has been reported.
In this article we describe the results of an ultrastructurai study performed on core biopsies of the femoral head articular cartilage obtained at surgery from a 16-year-old girl suffering from the disease.
Materials and Methods
Core biopsies of the femoral head articular cartilage were obtained from a 16-year-old white female who had been complaining of groin pain on the left and had been limping for 6 months. Initially, pain subsided with rest and administration of anti-inflammatory drugs, but later became resistant to any kind of medical treatment. At that time, the patient also noticed limitation of the range of motion of her left hip. At physical examination the patient had flexion contraction of 20° and atrophy of the glutei and thigh muscles. All blood tests done during the last 6 months had been negative; these included inflammation tests, such as sedimentation rate, white blood cell count, test for rheumatoid factor, and cultures for tuberculosis organisms and bacteria. AlJ these tests were repeated on admission to our hospital, as...