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The diagnosis of DDD is not a radiologic diagnosis, since the interpreting radiologist is not aware whether there are symptoms present or not. Typical radiographic findings include disc space narrowing, displacement of vertebral bodies, fusion of adjacent vertebral bodies, and development of bone in adjacent soft tissue (osteophyte formation).
Degenerative process of spondylosis such as disc bulging, osteophyte formation, and hypertrophy of the superior articular process all contributes to the narrowing of the spinal canal and intervertebral foramen, leading to compression of these spinal nerves that results in radiculopathy-related symptoms. [6]
Joint space narrowing, with or without subchondral sclerosis. Joint space narrowing is defined by this system as a joint space less than 3 mm, or less than half of the space in the other compartment, or less than half of the space of the homologous compartment of the other knee. II: Obliteration of the joint space III: Bone defect/loss < 5 mm IV
The condition is likely triggered by changes in the anulus fibrosus, the tough outer ring of the intervertebral disc. This disc degeneration causes osteophytes to grow in the area. The osteophytes develop bridges of connective tissue which become ossified, forming bone spurs. The pattern of osteophyte formation varies.
Osteophytes form because of the increase in a damaged joint's surface area. This is most common from the onset of arthritis. Osteophytes usually limit joint movement and typically cause pain. [6] Osteophytes form naturally on the back of the spine as a person ages and are a clinical sign of degeneration in the spine.
The typical changes seen on X-ray include: joint space narrowing, subchondral sclerosis (increased bone formation around the joint), subchondral cyst formation, and osteophytes. [54] Plain films may not correlate with the findings on physical examination or with the degree of pain. [55]
The natural evolution of disc disease and degeneration leads to stiffening of the intervertebral joint. This leads to osteophyte formation—a bony overgrowth about the joint. This process is called spondylosis, and is part of the normal aging of the spine. This has been seen in studies of normal and diseased spines.
Rarely, large anterior cervical spine osteophytes may affect the esophagus or the larynx and cause pain, difficulty swallowing [5] [6] or even dyspnea. [7] Similar calcification and ossification may be seen at peripheral entheseal sites, including the shoulder, iliac crest , ischial tuberosity , trochanters of the hip, tibial tuberosities ...
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