The aim of the present review is to systematically analyse the current literature about gender differences in hip or knee cartilage composition and degeneration, to help explaining how and why osteoarthritis affects women more often and more severely than men. A systematic review of the literature in English was performed. Eleven studies on 1962 patients (905 females and 787 males) that reported differences on cartilage composition between males and females were included. Nine evaluated the knee, one the hip, and one both. They were heterogeneous in their methods: one conducted histological analyses, and all the others evaluated cartilage characteristics (volume, width, and composition) through magnetic resonance imaging. All authors reported gender differences in both volume and morphology of the cartilage, from infancy to menopause. In fact, a study on 92 healthy children statistically showed significant gender differences in cartilage thickness at all sites, even after adjustment for age, body, and bone size. Gender differences become more evident after menopause, when women have a lower cartilage volume and a higher cartilage loss. Men show significantly higher knee and hip cartilage volumes than women, and women carry a significantly greater risk to develop osteoarthritis. This is in part due to body and bone size, but also depends on qualitative and quantitative differences in the composition of cartilage and its degeneration rate after menopause. Structural changes in cartilage that occur between genders during ageing have significance in the development of osteoarthritis.

15% of all soft tissue tumors are located on the hand and wrist. Only 2% of lesions are malignant. Considering that most masses are benign, if clinical evaluation and ul-trasound show frankly benign features for lesions smaller than 3 cm, a primary exci-sional biopsy is justified. If the history and clinical evaluation or imaging show fea-tures suggestive of malignancy, a second-level imaging method is indicated. Treatment in a non-oncology center including unplanned excision does not influence the progno-sis. The primary objective of the study is to evaluate the effectiveness of our treatment method for wrist and hand tumors smaller than 3 cm in size, with primary excisional biopsy performed as an outpatient surgery procedure, following a clinical and anam-nestic assessment and ultrasound imaging, in terms of functional and aesthetic benefit and reduction of any painful symptoms. The secondary objectives are to demonstrate the advantages of treating these tu-mors with our procedure in limiting the overload of specialist oncology centers and to evaluate the outcomes of the excisional biopsy in terms of prognosis in patients who tested positive for malignant disease at histological examination. In the present study, we retrospectively analyzed 209 specimens from surgical ex-cision of masses with a diameter of less than 3 cm involving the wrist and hand from 01/01/2015 to 01/06/2024, from a patient aged over 18 years. In our clinic, during the first outpatient visit, the patient's medical history is collected, a clinical evaluation is performed, first-level tests such as X-rays are performed, and any ultrasound exami-nations are acquired. If no risk factors or red flags for malignant pathologies emerge, the patient is offered excision under outpatient surgery. On the day of surgery, ultrasound examinations are acquired, local anesthesia is performed with the WALANT technique, and the mass is excised. At the end of the procedure, the specimen is sent to pathology for histological examination. The most frequent histological diagnosis was ganglion cyst (44,98%) the second diagnosis in frequence was giant-cell tumor of the synovial sheath (15,32%). Only one case (0,48%) had a diagnosis of malignant disease. According to our method, in accordance with the literature, tumors < 3 cm in size can be treated with excisional biopsy, without necessarily overloading specialized on-cology centers for such tumors.