Eric A. Brandser, M.D.
Peer Review Status: Internally Peer Reviewed
Copyright protected material used with permission of the author
and the University of Iowa's Virtual Hospital, www.vh.org
Degenerative Joint Disease (DJD or Osteoarthritis)
- Primary osteoarthritis - most common in the older age
group as the result of wear and tear on articular cartilage
- Secondary osteoarthritis - results from a previous process
that damaged cartilage such as trauma, or inflammatory arthritis.
The most commonly involved joints in primary osteoarthritis
- Distal interphalangeal joints
- First carpometacarpal joint
- Weight bearing joints: spine, hips, knees
Imaging of degenerative joint disease
1. Diagnosis by plain films includes identification of:
- Asymmetric joint space narrowing
- Osteophytes-bony spurs
- Degenerative cysts
- Sclerosis of subchondral bone
2. CT or MRI are also useful on certain occasions
3. OA of the Hip
4. OA of the Fingers
5. OA of the Knee
6. OA of the Spine
An inflammatory process with the target organ being the synovial
membrane leading to pannus formation (inflammatory exudate
in the lining of the synovial cells).
Imaging in RA
1. Diagnosis usually made by plain film confirmation of:
- Osteopenia - a demineralization of the bone - is the result
of increased blood flow, due to inflammation, which washes
out the calcium.
- Early on in the inflammatory process,only the periarticular
portion of the bones are affected.
- Over time, the inflammatory pain causes disuse of
affected joints leading to generalized osteopenia of
- Uniform joint space narrowing - a feature which helps
differentiate RA from OA.
- Marginal erosions at bare areas where synovium lies on
- Subluxation due to ligamentous or capsular laxity
- RA of the Hands
- RA of the Hips
2. MRI is technique of choice when cord compression is suspected
1. Ankylosing Spondylitis
2. Progression of Sacroiliitis in Ankylosing Spondylitis
3. Ankylosing Spondylitis of the Spine
1. Calcium Pyrophosphate Deposition Disease
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