PMC4722564_01
Front and dorsal view of the forearm on presentation showing the bite wounds.
JOCR-4-3-g001.jpg
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F1
Both swellings gradually increased to present size of a golf ball (Fig 1a & b).
Intraoperative photograph showing the bursal mass with discrete yellow crystals.
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F3
The bursa was excised in toto;(Fig 3) a careful examination during surgery did not show any pedicle or communication with the elbow joint and specimen sent for histopathological examination (Fig 4a & b).
Gross specimen showing the bursal sac with yellow crystals
JOCR-4-3-g004.jpg
PMC4722564_01_JOCR-4-3-g004.jpg
F4
The bursa was excised in toto;(Fig 3) a careful examination during surgery did not show any pedicle or communication with the elbow joint and specimen sent for histopathological examination (Fig 4a & b).
Hematoxylin-eosin-stained sections, under ordinary light, original magnification X50.
JOCR-4-3-g005.jpg
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F5
On histological examination, showed fibrocollagenous tissue with focal collections of chronic foam cells, congested vessels and haemorrhage, multiple irregular deposits of positive birefringent calcium pyrophosphate crystals with surrounding granulomatous lesion (Fig 5, 6).
Wall of bursa. CPPD crystal deposits on the inner surface. Crystals in layers with underlying birefringent fibrous bundles (unstained sections under polarized light).
JOCR-4-3-g006.jpg
PMC4722564_01_JOCR-4-3-g006.jpg
F6
On histological examination, showed fibrocollagenous tissue with focal collections of chronic foam cells, congested vessels and haemorrhage, multiple irregular deposits of positive birefringent calcium pyrophosphate crystals with surrounding granulomatous lesion (Fig 5, 6).
Postoperative photograph showing healed operative scar with full flexion
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PMC4722564_01_JOCR-4-3-g007.jpg
F7
On post operative follow up patient has painless full range of movements and wound healed without complications and patient satisfied (Fig 7a & b).