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Radiological Evidence of Degenerative Joint Disease (DJD)

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)

Classification

  • Primary osteoarthritis - most common in the older age group as the result of wear and tear on articular cartilage over time.
  • Secondary osteoarthritis - results from a previous process that damaged cartilage such as trauma, or inflammatory arthritis.

The most commonly involved joints in primary osteoarthritis are:

  • 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 Xray of OA of the Hip
4. OA of the Fingers Xray of OA of the Fingers
5. OA of the Knee Xray of Knee DJD
6. OA of the Spine Xray of OA of the Spine

Inflammatory Arthritis

An inflammatory process with the target organ being the synovial membrane leading to pannus formation (inflammatory exudate in the lining of the synovial cells).

Rheumatoid Arthritis

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 whole bones.
  • Uniform joint space narrowing - a feature which helps differentiate RA from OA.
  • Marginal erosions at bare areas where synovium lies on bone
  • Subluxation due to ligamentous or capsular laxity
  • RA of the Hands RA of the Hands Xray RA of the Hands Xray
  • RA of the Hips RA of the Hip Xray

2. MRI is technique of choice when cord compression is suspected (C1-C2)
MRI  Cord Compression

Ankylosing Spondylitis

1. Ankylosing Spondylitis Ankylosing Spondylitis Xray

2. Progression of Sacroiliitis in Ankylosing Spondylitis Ankylosing Spondylitis XrayAnkylosing Spondylitis XrayAnkylosing Spondylitis Xray

3. Ankylosing Spondylitis of the Spine Ankylosing Spondylitis of the Spine XrayAnkylosing Spondylitis of the Spine Xray

Crystal Arthritis

1. Calcium Pyrophosphate Deposition Disease Calcium Pyrophosphate Deposition Disease XrayCalcium Pyrophosphate Deposition Disease XrayCalcium Pyrophosphate Deposition Disease Xray

2. Gout Xray of Gout

Neuropathic Arthropathy

Charcot Arthropathy Xray of Charcot Arthropathy icon gif

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