0:00

<v ->I wanted to throw in xanthomatosis

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even though we don't think of it as a joint process.

0:08

This is a group of tumor-like proliferations

0:12

that are characterized by infiltration with foam cells.

0:16

It's associated with elevated blood levels of cholesterol

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and clearly associated with diabetes.

0:23

And these xanthomatosis material may deposit within tendons.

0:30

And I've seen this most commonly about the ankle and foot

0:34

but it's described elsewhere, including the fingers,

0:38

the elbow, even large joints, such as the knee.

0:43

This is what xanthomatosis looks like

0:46

with massive enlargement of the Achilles tendon.

0:49

You see that there's enlargement here

0:51

of the peroneal tendons

0:54

and even the extensor tendons in this particular case.

0:58

And if you don't know the history,

0:59

or that there's elevated cholesterol,

1:02

you're gonna look at this and call this severe tendinosis,

1:05

or worse you're just gonna say,

1:07

gee maybe this is tendinosis with early tendon tearing

1:11

but you have to consider

1:13

in the differential diagnosis xanthomatosis.

1:17

Here's another one,

1:18

with involvement of the Achilles tendon.

1:21

I think the involvement was bilateral.

1:23

It's worse on one side than the other.

1:27

In fact, here it is bilateral, I'm sorry.

1:29

It just looks worse on one side than the other.

1:33

Marked enlargement of the Achilles tendon.