Osteophyte

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Osteophytes on a specimen of an arthritically altered elbow joint (pig). One recognizes the pathologically roughened and partially broken cartilage of the joint surface and the bone bulges that have formed on the edge of the joint surface (arrows).
In the upper x-ray of a human hip joint , one can see the clear changes caused by hip arthrosis in hip dysplasia . There are several osteophytes in the edge area of ​​the joint. In the image below, the X-ray image of a healthy hip joint is shown for comparison.
In the upper X-ray of a human knee joint with osteoarthritis of the knee , the narrowing of the joint space and the osteophytes on the outer joint edge of the shin can be seen. In the image below, the X-ray image of a healthy knee joint is shown for comparison.
Classification according to ICD-10
M25.7 Osteophyte
M47.9 Spondylosis
ICD-10 online (WHO version 2019)

Osteophytes (from the Greek ὀστέον "bone" and φυτόν "plant"), also called exophytes , are degenerative, structural changes in the form of bony extensions at the edge of the bone . These new bone formations, which can form as protruding bones on the edge of the joint surfaces , can appear in the form of braces, jagged edges, cusps or surface deposits. The formation of osteophytes is a failed attempt by the body to widen the contact surface of an arthritic joint and thus to reduce the contact pressure. They occur in stage 4 of arthritic joint changes. On the knee one speaks of the formation of consoles , on the spine of spondylophytes or syndesmophytes (see also osteochondrosis intervertebralis ). Osteophytes limit mobility when they are in the direction of movement . Pressure on nerves and other soft tissues can also cause pain and further damage. In terms of differential diagnosis, it must be differentiated from exostoses .

Pathophysiology

With arthritic joint changes, the cartilage destruction leads to incongruences in the area of ​​the joint surfaces. This leads to locally circumscribed increases in pressure from stage II of osteoarthritis, which are expressed in subchondral sclerosis . Local cartilage and bone necrosis develop, which appear radiologically as rubble cysts . It is assumed that osteophytes form from parts of these necroses as well as cartilage and bone abrasion, which accumulate at the edge of the joint surfaces and calcify secondarily. In horses, osteophytes can arise as a local reaction to enzymes released by the inflamed synovia .

Diagnosis

Osteophytes are detectable in the X-ray and sonographically . They are considered a sign of advanced osteoarthritis.

therapy

Osteophytes can cause pain and consequential damage through local pressure on nerves and other soft tissues, or they can mechanically hinder joint mobility. Broken osteophytes, as free joint bodies, can cause pinching in joints. Depending on their extent and location, they can be removed arthroscopically or openly surgically. Depending on the extent and location of the underlying joint osteoarthritis, endoprosthetic treatment or arthrodesis of the affected joint may be indicated.

Individual evidence

  1. ↑ Alphabetical index for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 665
  2. ^ Matthias Krams, Sven Olaf Frahm, Udo Kellner, Christian Mawrin: Kurzlehrbuch Pathologie. Thieme, Stuttgart et al. 2010, ISBN 978-3-13-143251-3 , (online) .
  3. ↑ Carlos Thomas: Special Pathology. Schattauer, Stuttgart et al. 1996, ISBN 3-7945-1713-X , (online) .
  4. ^ Hans Peter Bischoff, Jürgen Heisel, Hermann Locher (eds.): Practice of conservative orthopedics. Thieme, Stuttgart et al. 2007, ISBN 978-3-13-142461-7 , (online)
  5. ↑ Ted S. Stashak: Adams' lameness in horses. Unchanged reprint of the 4th edition. Schaper, Hannover 2008, ISBN 978-3-7944-0219-9 , (online) .
  6. ↑ Werner Konermann, Gerd Gruber: Ultrasound diagnosis of the locomotor organs . Course book according to the guidelines of DEGUM and DGOOC. 2nd, fundamentally revised and expanded edition. Thieme, Stuttgart et al. 2007, ISBN 978-3-13-114972-5 , (online)
  7. ^ Abdul-Kader Martini (Ed.): Orthopedics and orthopedic surgery. Elbow, forearm, hand. Thieme, Stuttgart et al. 2003, ISBN 3-13-126211-7 , (online)