Osteophyte: Difference between revisions

No edit summary
No edit summary
Line 13: Line 13:


== Presentation ==
== Presentation ==
Osteophytes are most commonly found in the following areas.  Neck, shoulder, knee, lower back, fingers or big toe, foot or heel. Osteophytes cause problems for example if they: cause friction if rubbing against footwear; impinge nerves such as an existing spinal root; restrict movement as may occur in hip and knee OA; limit space as in an impingement syndrome of the shoulder.<ref name=":0">NHS [https://www.nhs.uk/conditions/osteophyte/ Osteophyte] Available:https://www.nhs.uk/conditions/osteophyte/ (accessed 7.9.2022)</ref>
Osteophytes are most commonly found in the following areas.  Neck, shoulder, knee, lower back, fingers or big toe, foot or heel. Osteophytes cause problems for example if they: cause friction if rubbing against footwear; impinge nerves such as an existing spinal root; restrict movement as may occur in hip and knee OA.<ref name=":0">NHS [https://www.nhs.uk/conditions/osteophyte/ Osteophyte] Available:https://www.nhs.uk/conditions/osteophyte/ (accessed 7.9.2022)</ref> See these pages for conditions where osteophytes are an issue, a sample only:


See these pages for conditions where osteophytes are an issue, a sample only:
* [[Hallux Rigidus]]
 
* [[Anterior Ankle Impingement Syndrome]]
Hallux Rigidus
* [[Uncovertebral Joints]]
 
* [[Lumbar Spinal Stenosis]]
Anterior Ankle Impingement Syndrome  
* Vertebral osteophytes are a characteristic of [[Degenerative Disc Disease|disc degeneration]]. <ref>Czervionke LF, Fenton DS. Imaging Painful Spine Disorders E-Book. Elsevier Health Sciences; 2011 Apr 28.Available:https://www.sciencedirect.com/topics/medicine-and-dentistry/osteophyte (accessed 8.9.2022)</ref>
 
* [[Cervical Osteoarthritis]]
Uncovertebral Joints  
* [[Lumbar Spondylosis]]
 
* [[Hip Osteoarthritis]]
Lumbar Spinal Stenosis  
 
Cervical Osteoarthritis
 
Lumbar Spondylosis
 
Hip Osteoarthritis  


== Treatment ==
== Treatment ==
Line 38: Line 31:
== Differential Diagnosis ==
== Differential Diagnosis ==


# Syndesmophyte: paravertebral ossifications, run parallel with the spine cf. osteophytes which typically protrude perpendicular to the spine
# [[File:Dx osteophyte.png|right|frameless]]Syndesmophyte: Thin, vertically oriented ossification of annular ligament (Sharpey fibers) from [[Ankylosing Spondylitis (Axial Spondyloarthritis)|ankylosing spondylitis]]<ref>Blankenbaker DG, Davis KW. ExpertDDx: Musculoskeletal E-Book. Elsevier Health Sciences; 2017 Oct 13.Available: https://www.sciencedirect.com/topics/medicine-and-dentistry/osteophyte<nowiki/>(accessed 8.9.2022)</ref>
# Enthesophyte: located at an attachment of a ligament or tendon, not associated with a joint.<ref name=":1" />
# Enthesophyte: located at an attachment of a ligament, fascia or tendon, not associated with a joint.<ref name=":1" />
# It is difficult to tell the difference between an osteophyte and [[Disc Herniation|disc herniation]] solely by MRI. CT is a helpful adjunct; however, often central canal and foraminal narrowing are caused by a combination of a disc herniation and osteophyte.


== References  ==
== References  ==

Revision as of 02:39, 8 September 2022

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton, Nupur Smit Shah and Kim Jackson  

Introduction[edit | edit source]

Osteophytes are cartilage-capped bony proliferations (bony spurs) that most commonly develop at the margins of a synovial joint as a response to articular cartilage damage, as seen very commonly in osteoarthritis (OA).[1]

Three types of osteophytes related to the degenerative spine: (a) traction osteophytes (arrow), (b) claw osteophytes (arrow) and (c) wraparound bumper osteophytes (arrow)

Pathophysiology[edit | edit source]

Osteophytes are formed of fibrocartilage and bone, often forming at the peripheral margins of joints at the interface between cartilage and the periosteum. Osteophytes are thought to develop from chondrogenic differentiation of progenitor cells, commonly from within the periosteum. Osteophytes appear to be a cellular repair response to the altered growth factor environment following joint injury. In some cases osteophytes can contribute to the stability of the joints.[2]

a. Cartilage erosion (arrows) b: Cartilage ulceration (arrow) c: Cartilage repair (arrow) d: Marginal osteophytes (arrows)

Presentation[edit | edit source]

Osteophytes are most commonly found in the following areas. Neck, shoulder, knee, lower back, fingers or big toe, foot or heel. Osteophytes cause problems for example if they: cause friction if rubbing against footwear; impinge nerves such as an existing spinal root; restrict movement as may occur in hip and knee OA.[3] See these pages for conditions where osteophytes are an issue, a sample only:

Treatment[edit | edit source]

Osteophytes when causing issues, for example with OA, can be managed along side management of OA, See link here Osteoarthritis.

Removal of an osteophyte is not usual, unless it's irritating a nerve in the spine or restricting a joint's range of movement. If surgery is warranted, a surgeon will explain the procedure's risks and benefits.[3]

Differential Diagnosis[edit | edit source]

  1. Dx osteophyte.png
    Syndesmophyte: Thin, vertically oriented ossification of annular ligament (Sharpey fibers) from ankylosing spondylitis[5]
  2. Enthesophyte: located at an attachment of a ligament, fascia or tendon, not associated with a joint.[1]
  3. It is difficult to tell the difference between an osteophyte and disc herniation solely by MRI. CT is a helpful adjunct; however, often central canal and foraminal narrowing are caused by a combination of a disc herniation and osteophyte.

References[edit | edit source]

  1. 1.0 1.1 Radiopedia Osteophyte Available:https://radiopaedia.org/articles/osteophyte-2 (accessed 7.9.2022)
  2. Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR. Kelley's Textbook of Rheumatology E-Book. Elsevier Health Sciences; 2012 Aug 31. Available:https://www.sciencedirect.com/topics/medicine-and-dentistry/osteophyte (accessed 7.9.2022)
  3. 3.0 3.1 NHS Osteophyte Available:https://www.nhs.uk/conditions/osteophyte/ (accessed 7.9.2022)
  4. Czervionke LF, Fenton DS. Imaging Painful Spine Disorders E-Book. Elsevier Health Sciences; 2011 Apr 28.Available:https://www.sciencedirect.com/topics/medicine-and-dentistry/osteophyte (accessed 8.9.2022)
  5. Blankenbaker DG, Davis KW. ExpertDDx: Musculoskeletal E-Book. Elsevier Health Sciences; 2017 Oct 13.Available: https://www.sciencedirect.com/topics/medicine-and-dentistry/osteophyte(accessed 8.9.2022)