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DEGENERATIVE JOINT DISEASE (Radiographic Signs p961 (HIP (Waldenstrom'…
DEGENERATIVE JOINT DISEASE
Clinical Features
Progressive, non-inflammatory
Changes in cartilage / joint components
Common in small joints of hand DIPs, PIPs, knees, spines, larger weight bearing hip & knee joints
M > F up to 45yo, after 45yo F > M
Aching, swelling, stiffness - go away with activity
Aggravated by cold temp, humidity
Type: primary, secondary
Pathophysiology
physical forces -> chondroitin sulfate lost ->
Cartilage degradation
Synovium thickens
Cartilage metaplasia -> increase stress at capsular insertion ->
Osteophytes formation
Increased
Subchondral bone
cartilage cracks -> bone bruise ->
Synovial fluid within bone
Radiographic Signs
p961
asymmetric distribution
non-uniform loss of joint space
osteophystes: traction, claw, collar
subchondral sclerosis (eburnation)
subchondral cysts
intra-articular loose bodies
articular deformity, subluxation
HIP
Waldenstrom's sign
superior
migration p979, widened
medial
joint space,
axial
migration rare
collar type
osteophytes around acetabulum, outer supra-acetabular margin, lateral & infero-medial surface of femur
large
subchondral cysts, near reduced joint space, superior femoral head
subchondral sclerosis at area of
greatest stress
buttressing
cortical thickening, medial femur
joint deformity with flattening of superior femoral head "
tilt deformity"