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Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
The pathophysiology of Charcot’s joint is believed to involve an inflammatory response caused by a minor injury, resulting in osteolysis. With peripheral neuropathy, the initial injury and inflammatory response may not be fully realized, and continuing inflammation and further injury can occur. Usually, Charcot’s joint is unilateral, though it may occur bilaterally in about 20% of cases. The two patterns of pathophysiology are atrophic and hypertrophic. The atrophic form is most common and occurs earlier. Joint destruction occurs along with resorption of fragments. There is a lack of osteophytes or osteosclerosis. The atrophic form mainly occurs in nonweight bearing joints of the arms. In the hypertrophic form, only the sensory nerves are affected, and the condition progresses slowly. The joint space first widens, and then narrows. Osteophytes and osteosclerosis are present.
Intervertebral Disk
Published in Verna Wright, Eric L. Radin, Mechanics of Human Joints, 2020
The cause of osteophyte formation remains largely speculative. It has been suggested that disk degeneration leads to tilting of the vertebral bodies and anterior squeezing of the disk, which then bulges forward and elevates the adjoining periosteum to stimulate new bone formation (14). However, microscopic studies do not provide convincing evidence for this concept. Instead, these studies indicate that osteophytes form, at least initially, by endochondral ossification occurring in the outer attachment region of the annulus following chondrocytic change of the fibrocytes of this zone (11). The stimulus to this chondroid metaplasia and to the progressive growth of osteophytes remains speculative. Relative instability, however, may play a role in the development.
The wrist and hand
Published in David Silver, Silver's Joint and Soft Tissue Injection, 2018
The patient commonly complains of aching around the joint, and examination reveals pain on passive backward movement of the thumb in extension. Often osteophytes are present, noted on radiographic examination of the joint. These may render injection into the small joint space difficult.
The outcome of minimally invasive surgery for digital mucous cyst: a 2-year follow-up of percutaneous capsulotomy
Published in Journal of Dermatological Treatment, 2022
Wei Hsiung, Hui-Kuang Huang, Tung-Ming Chen, Ming-Chau Chang, Jung-Pan Wang
This study reported the long-term results of the use of percutaneous capsulotomy in treating DMCs. The results seemed not to be inferior to those reported for open surgery (Table 4) (4,10,12,20–25). There was only one recurrence (2.5%) at the final follow-up. The patient underwent an open excision combined with an osteophyte excision for treatment. In addition, one patient had a smaller-sized cyst that recurred within 2 months after the initial treatment then the patient received repeated percutaneous capsulotomy. The patient had no further recurrence till final follow-up. Another patient had no recurrence but complained of persistent pain after the surgery. Open excision combined with osteophyte excision was performed to this patient and the symptoms improved without any recurrence.
Comparing the postoperative results of single-level anterior cervical discectomy and fusion, cervical disc prosthesis and minimal invasive posterior cervical disc surgery
Published in British Journal of Neurosurgery, 2020
Two different surgical methods can be used to treat cervical degenerative disc disorders causing radicular cervicalgia and brachialgia due to cervical root suppression. These methods are anterior cervical discectomy (anterior approach) and posterior cervical foraminotomy (posterior approach).1,2 Anterior cervical discectomy and fusion (ACDF) does not allow movement at the affected level. Thus, it prevents the development of osteophytes with nerve decompression. These properties make fusion effective in treatment; hence it is often preferred – at the theoretical cost of possibly increasing the rate of degeneration at the adjacent levels, the so-called ‘adjacent segment disease’.3,4 Two different approaches have been developed to prevent this. Posterior foraminotomy is a minimally invasive approach but is generally not popular because it doesn’t abolish the formation of osteophytes which tend to recur.5 The second approach is anterior cervical disc replacement (CDR) in which movement at the relevant level is maintained but a significant minority of patients end up fused anyway, while there have also been problems with stability.6
Factors associated with osteophyte formation in patients with rheumatoid arthritis undergoing total knee arthroplasty
Published in Modern Rheumatology, 2020
Nobuyuki Asai, Shuji Asai, Nobunori Takahashi, Naoki Ishiguro, Toshihisa Kojima
We retrospectively examined a total of 266 knee joints in 208 patients with RA who underwent primary TKA at our institute between January 1, 2004 and December 31, 2017. This study was approved by the Ethics Committee of Nagoya University Graduate School of Medicine (2018-0260) and complied with the principles set forth in the Declaration of Helsinki. Informed consent was obtained by an opt-out procedure. Radiographic assessment was performed using preoperative plain radiographs in anteroposterior and mediolateral projections. Two observers evaluated osteophyte formation by comparison with normal joint radiographs. Osteophytes were defined as bony protrusions emerging from the juxta-articular cortical shell (Figure 1). In cases of disagreement, a consensus was reached by discussion between the two observers. All data were analyzed using the joint as the statistical unit of analysis. Patients were divided into two groups according to osteophyte formation: osteophyte (+) and (–) groups. Data at the time of surgery were compared between the two groups using the Mann–Whitney U test for continuous variables and the chi-square test for categorical variables. Factors associated with osteophyte formation were assessed using univariate and multivariate logistic regression models. Variables found to be significant (p < .05) in univariate analysis were included in the multivariate model. Statistical analyses were performed using SPSS version 24.0 software (IBM Corp., Armonk, NY, USA). p < .05 was considered statistically significant.