Tibial Osteophytes as Indicator of Osteoarthritis: Morphometry and Clinical Importance

Background: An osteophyte is a bony outgrowth, covered with fibrocartilage,that is one of the hallmarks of osteoarthritisespecially in the knee joint. Risk factors for development of osteophytes include age, physical activity, body mass index, and othergenetic and environmental factors. Aim: To analyze the frequency and morphological features of osteophytes at the upper end ofdry tibia bones and to define any relationship between the size of osteophytes and that of the intercondylar tibial spines.Methods: We evaluated 75 dry tibia bones for the degree of osteoarthritis at the upper end. Each plateau at the superior surface ofthe upper end was divided into four quadrants and the presence and size of bone outgrowths were recorded in each quadrant. The“medial/lateral tibial intercondylar spine index” for each specimen was calculated and relation with the osteophytes was observed.The measurements were meticulously recorded and the data were subjected to statistical analysis. Results: In the present study,osteophytes were found more frequently in the anterior quadrants of both the tibial plateaus than in the posterior quadrants. Grade1 osteophytes were the most common type of osteophytes with predominance in anterior quadrants of both medial and lateraltibial plateaus. There was positive correlation between grades of osteophytes and spine index. Conclusion: This study would helpclinicians to understand the morphological changes in the upper end of tibia in osteoarthritis which would help them in planningthe management.

Age estimation equations using vertebral osteophyte formation in a Thai population: comparison and modified osteophyte scoring method / 대한해부학회지

Age estimation from skeletal remains is an important step in forensic biological identification. The main objective of this study is to develop an age estimation equation for the Thai population from vertebral osteophytes. Each vertebra in the cervical, thoracic and lumbar segments was scored for degree of osteophyte formation. Classification was carried out in accordance with the criteria established by Snodgrass and Watanabe, and used a new modified score of the length of vertebral osteophyte for age estimation. The sample included 400 individuals (262 males, 138 females) ranging in age from 22 to 97 years. A sample of Thai vertebral columns was used, the columns being divided into the following groups of vertebrae: cervical (C2–C7), thoracic (T1–T12), and lumbar (L1–L5). Each vertebra was scored for the degree of osteophyte formation and the accumulated data was analyzed statistically. Correlation coefficients and R-squared from mean in lumbar vertebrae for females of criteria established by the method of Snodgrass and Watanabe, the new modified score by length of vertebral osteophytes were 0.801 and 0.642 (P<0.01); 0.755 and 0.57 (P<0.01); 0.786 and 0.618 (P<0.01), respectively. This study presents all 23 subcategories (C2–L5) of the vertebrae to apply in real situations, showing all age estimation equations for males, females and combined sexes of unknown sex. One application of this study is age estimation when dealing with forensic cases in the Thai population.

Variations in radiographic appearance of articular cartilage of knee joints in persons of 35 to 65 years of age.

Background: Osteoarthritis is a slowly progressive degenerative disease characterized by gradual loss of articular cartilage. Osteoarthritis is not a normal process of ageing processes. Age related changes are distinct from osteoarthritic changes but when coupled with certain precipitating factors like obesity, muscle weakness and neurological dysfunction may play an important role in the causation of osteoarthritis. Osteoarthritis occurrence appears to increase with patient’s age in a non-linear fashion. The prevalence of disease increases dramatically after the age of 50 years, likely because of age related alterations in collagen and proteoglycan synthesis coupled with diminished nutrient supply to the cartilage. Methods: In this paper presenting the naked eye assessment of radiographic appearance of articular cartilage of knee joints of 100 persons (both men and women) of 35 to 65 years of age with symptoms like pain and stiffness of the joint. Results: Parameters like changes in the joint space width, the presence or absence of osteophytes and subchondral sclerosis and cysts were noted. The correlation between the patient’s age, sex, symptoms and radiological appearance were observed. Conclusion: Osteoarthritis has a higher prevalence and more often generalized in women than in men. Before the age of 50 years, the incidence of osteoarthritis is low and men have a slightly higher prevalence than women, but after the age of 50 years, the disease becomes more frequent and women have a much higher prevalence with a female to male ration of about 12:1. The reason for this is sex difference in cartilage volume.

Early Detection of Anterior Cervical Osteophytes Causing Dysphagia by Esophagogastroduodenoscopy

Anterior cervical osteophytes affecting the cervical spine are a rare cause of dysphagia. They may affect the patient's life by compressing the larynx. A 66-year-old male patient complained of dysphagia during swallowing that started five months earlier. During esophagogastroduodenoscopy, the endoscopist felt outside pressure and severe resistance, and a protruded lesion at the posterior wall of the hypopharynx was found. A cervical spine x-ray showed prominent anterior osteophytes at the C-spine 2-5 level. In addition, computed tomography showed esophageal luminal narrowing related to prominent anterior cervical osteophytes at the C-spine 3-4 level. Due to the absence of any effective medical therapy and rapid progression of dysphagia, surgery was recommended to relieve the symptoms. Clinical improvement occurred after surgical resection of the osteophytes through an anterior cervical approach. So we report here on a rare case of anterior cervical osteophytes with dysphagia with review of the relevant literature.

Distribution and length of osteophytes in the lumbar vertebrae and risk of rupture of abdominal aortic aneurysms: a study of dry bones from Chiang Mai, Thailand / 대한해부학회지

Vertebral osteophytes are a characteristic feature of intervertebral disc degeneration. In the lumbar spinal region, the two major structures in close proximity anterior to the spine are the inferior vena cava and the abdominal aorta, both of which have been reported to be affected by osteophytes. The purpose of this study was to determine the distribution, classification and lengths of osteophytes in the lumbar vertebrae. One hundred and eighty lumbar columns of 90 males and 90 females from Chiang Mai, Thailand, in the age range 15 to 96 years (mean age, 63 years) were collected. The measuring length of osteophytes was assessed on vertebral body and articular facet. Statistical analysis was performed by descriptive analysis, chi-square and Pearson Correlation. Lumbar osteophytes were presented in 175 specimens (97.2%), 88 males and 87 females. The highest frequency was at L4, most were on the superior, inferior surface of body and articular facet (39.7%, 38.4%, and 22%), respectively. The greatest mean length was 3.47+/-2.21 mm at L5, and the longest length of anterior superior surface of body was 28.56 mm. The osteophyte length was significantly correlated directly with age (P<0.01), and males were significantly greater than females (P<0.05). The highest prevalence of osteophytes was on the anterior side of superior surface of body (30.4%), and the classification was traction. It can be proposed that the abdominal aorta could be damaged, especially a risk of rupture of abdominal aortic aneurysm.

Utilidad del ultrasonido en osteoartritis: un enfoque de su rol diagnóstico y de monitoreo / Ultrasound in osteoarthritis: its role in the diagnosis and the disease monitoring

Ultrasonography (US) has been steadily and progressively gaining ground in the diagnostic approach to different areas of Rheumatology due to a combination of factors ranging from its low cost and portability, advantages related to the characteristics of the method, as the absence of ionizing radiation, the possibility of multiplanar imaging, high resolution real time and dynamic maneuvers to assess musculoskeletal structures with maximum functionality. Its specific role in osteoarthritis (OA) has allowed a detailed evaluation of the degenerative process, quantification of early or pre-radiological OA stages. The superb resolution of high power ultrasound probes can identify minimum alterations in the articular cartilage, bone tissue and other anatomical elements that contribute to OA. The aim of this review is to describe the major ultrasound findings in OA, and its usefulness as a diagnostic and monitoring disease progression in this rheumatic disease.

La ultrasonografía (US) viene ganando espacios, de manera continua y progresiva, en el abordaje diagnóstico de distintas áreas de la Medicina debido a una suma de factores que van desde su bajo costo y su portabilidad hasta ventajas relacionadas con las características propias del método, como la ausencia de radiación ionizante, la posibilidad de obtención de imágenes multiplanares de alta resolución en tiempo real, y de realizar maniobras dinámicas que permiten evaluar las estructuras en su máxima funcionalidad. Su específico rol en la evaluación de la osteoartritis se va afirmando a medida que se van generando métodos de evaluación que permiten una detallada cuantificación del proceso degenerativo, inclusive en las fases precoces o prerradiológicas. El magnífico poder de resolución de las sondas de última generación permite individualizar alteraciones mínimas de los elementos anatómicos frecuentemente comprometidos en la osteoartritis, como el cartílago articular y el tejido óseo. El objetivo de esta revisión es el de describir los hallazgos ultrasonográficos en osteoartritis, y su utilidad como herramienta diagnóstica y de seguimiento.

Degenerative Osteoarthritis of the Hip Misconceived as a Failed Back Surgery Syndrome: A case report / 대한마취과학회지

We report the treatment experience of a patient who developed pain in the right anterior thigh and buttock 3 months later after lumbar disc surgery. He was treated as failed back surgery syndrome and had no symptom improvement. On physical examination, groin pain was elicited by Patrick's test and internal rotation of the hip. Plain radiographs of the pelvis showed calcification or osteophytes near the superior lip of the acetabulum. On magnetic resonance imaging, the lesion was identified as osteophytes and joint effusion was also noted. Under C-arm guidance, we injected corticosteroids and local anesthetics, and the patient obtained dramatic pain relief and no recurrence of symptoms.