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A comparison was made between the specific activity of cathepsin D and a histologic score for inflammation on synovial tissue obtained from 36 patients undergoing total hip replacement and an excellent correlation was found between these parameters (correlation coefficient 0.82). In addition it was found that 5 patients with the clinical diagnosis of rheumatoid arthritis had high cathepsin-specific activity (0.92±0.07) and high histologic scores (27.0±7.0). Patients with other diagnoses (failed prosthesis, idiopathic avascular necrosis, former resected hip) had low enzyme levels (0.44±0.23) as well as low histologic scores for inflammation (11.4±5.5). In cases with degenerative hip disease two groups could be definitively separated. Group 1 (20%) was characterized by high enzyme levels (0.89±0.19) and high histological scores (20.6±5.4). Group II (80%) was characterized by low enzyme levels (0.31±0.15) and low histologic scores (8.6±4.7) (Table 1).

Synovial sarcomas are rare soft tissue tumors which histopathologically can be divided into monophasic, biphasic and mixed variants. As part of a protocol for intra-arterial chemotherapy 12 patients with biopsy proven synovial sarcoma underwent angiography. The angiograms on these patients were reviewed to determine whether synovial sarcomas and their variants demonstrated a characteristic angiographic appearance. Synovial sarcomas appeared angiographically as soft tissue masses which showed a fine network of tumor vessels with an inhomogeneous capillary blush. Their degree of vascularity varied according to their histopathology. Monophasic synovial sarcomas demonstrated in general a higher degree of neovascularity than the biphasic form. This finding was also suggested by histopathologic analysis of the vessels in the tumor. Although angiography did not show a distinctive vascular pattern it may be useful to evaluate tumor size and vascularity.

Enchondroma protuberans has been defined as an exophytic enchondroma of a long bone. We contrast a case of enchondroma protuberans with two cases of coincident enchondroma and osteochondroma. Our cases and the previously published ones lead us to believe that enchondroma protuberans is probably an enchondroma variant and that its unusual growth pattern may be related to the oblique orientation of the proximal humeral epiphysis. Unlike osteochondroma, which may be treated surgically by removing the cartilage cap and, in some cases, the stalk, enchondroma protuberans requires intralesional curettage. Enchondroma protuberans must be distinguished radiographically from chondrosarcoma.

A peculiar branched cylindrical structure within the nuclei of human osteosarcoma cells is reported. Although the described structures may be postulated to represent either "vermicellar bodies" or a response to cellular injury by chemotherapeutic agents, their origin and function are unknown to us.

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