title: Silicone elastomer microshards in fluid from a painful metatarsophalangeal implant site. A case report.
abstract: Histopathologic studies have demonstrated microshards from silicone elastomer metatarsophalangeal joint implants in adjacent tissues in a setting of chronic inflammation and in inguinal lymph nodes. Cytologic smears of synovial fluid from symptomatic implanted joints should show these refractile, nonpolarizing microshards in the reactive inflammatory context. Nonspecific enzymatic inflammatory activity contributes to further destabilization of the implants, eventuating in symptoms and signs requiring prosthesis removal. Cytopathologic examination of aspirated fluid from the vicinity of a symptomatic implanted joint demonstrates foreign body reaction to silicone elastomer, predicting a need for intervention before the local damage is severe and disabling.
authors.affiliation: Foot Care Surgicenter, Sun City, Arizona, USA.
authors.forename: G N
authors.initials: GN
authors.lastname: Friedlander
authors.forename: G K
authors.initials: GK
authors.lastname: Potter
authors.forename: R S
authors.initials: RS
authors.lastname: Tucker
authors.forename: S J
authors.initials: SJ
authors.lastname: Berlin
mesh_terms: D005260:Female; D005549:Foreign-Body Reaction / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D012826:Silicone Elastomers / Q000009:adverse effects* / Q000302:isolation & purification; D013585:Synovitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology
chemical_list: D012826:Silicone Elastomers