Degenerative diseases of the metacarpophalangeal joints

Degenerative arthritis of the finger metacarpophalangeal joints is uncommon and, when seen, a specific etiology should be sought. MP joint arthritis in the absence of a history of trauma may signal an underlying systemic disease. The clinical and radiographic findings may be subtle. Once degenerative changes occur, the usual treatment is arthroplasty using a flexible silicone rubber (Swanson) finger joint implant that should provide a relatively stable and painless joint with a functional range of motion. Degenerative arthritis of the thumb MP joint is more common following injuries that damage the ligaments on the ulnar or radial side of the MP joint and which result in lateral instability of the joint. Arthritis of the MP joint also may occur following infection or direct joint injury. Secondary MP arthritis may result from thumb CMC joint disease and must be attended to at the time CMC joint reconstruction is performed. Degenerative disease of the thumb sesamoid bones must be considered in patients with persistent MP joint pain after either trauma or MP joint fusion.     

Degenerative and post-traumatic arthritis affecting the carpometacarpal joints of the fingers

Symptomatic post-traumatic arthritis affecting the finger CMC joints is less common than might otherwise be expected based on the frequency of injury, especially to the fifth CMC joint. For the fifth CMC joint, the shallow concavoconvex articulation combined with the typical fracture location may provide a protective effect. Non-operative measures are typically successful, except in cases of missed fracture/dislocations and symptomatic joint instability. In these instances, re-construction emphasizes stability first, with an eye toward mobility for the ulnar column.It is common to detect a bony prominence in the region of the dorsal second and third CMC joints during examination of the hand. In most instances, the projection is asymptomatic and likely represents an os styloideum [18]. When painful and unresponsive to nonoperative treatments, this carpometacarpal boss can be excised surgically.     

Degenerative lesions of the accessory plantar ligaments

Summary Degeneration and disintegration of the accessory plantar ligaments occur in the absence of local inflammatory disease. The gross and histological changes are described. These lesions are associated with metatarsalgia, deformities of the metatarsophalangeal joints and the development of the convex anterior metatarsal arch. The connection between these three is explained.

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Résumé La dégénérescence et la destruction du ligament accessoire plantaire peuvent survenir en l'absence de toute affection inflammatoire locale. Les auteurs décrivent les modifications histologiques. Ces lésions sont associées à une métatarsalgie, à des déformations articulaires métatarso-phalangiennes et à un pied rond antérieur. Une explication de l'association de ces trois éléments est proposée.

     

Value of electroroentgenography in the diagnosis of skeletal degenerative and dystrophic changes and lesions

The authors have carried out an electroroentgenographic study of degenerative and dystrophic changes of various portions of the skeleton in 635 patients, 30 of whom had had surgical interventions on the hip joints. The findings concerning the frequency of the occurrence and the peculiarities of the representation of some manifestations of the degenerative and dystrophic changes of the skeleton using electroroentgenography and film roentgenography have been compared. It has been established that electroroentgenography is characterized by a high degree of informativity in the diagnosis of this kind of pathology and the evaluation of the results of its treatment, with its efficacy being, on the whole, not lower than that of film reontgenography.     

Degenerative osteoarthrosis of tarsometatarsal joints in hallux valgus: a radiographic study

To clarify the pathogenesis of degenerative osteoarthrosis of the tarsometatarsal joints in hallux valgus, we evaluated dorsoplantar and lateral radiographs during weight-bearing in 16 patients (25 feet) with hallux valgus accompanied by degenerative osteoarthrosis of the tarsometatarsal joints and 25 controls (25 feet) with hallux valgus alone. The proximal second metatarsal articular angle (a parameter we devised), the hallux valgus angle, intermetatarsal angle, metatarsal length, sesamoid displacement, calcaneal pitch, and foot length were measured and then evaluation using a mapping system was performed. There were no significant differences in the hallux valgus angle, intermetatarsal angle, sesamoid displacement, calcaneal pitch, or foot length. In the presence of degenerative osteoarthrosis of the tarsometatarsal joints, the second, third, and fourth metatarsals were long, and a large inclination of the proximal articular surface of the second metatarsal and adduction of the first to fourth metatarsals were observed. These findings appeared to be involved in the development of this disorder.     

Predicting the development of degenerative and dystrophic lesions of the hip joint of dysplastic etiology

On the basis of the roentgenologic changes in 368 patients in 184 children with hip joint dysplasia and developing degenerative and dystrophic lesions in it the authors have proposed a prognostic table of roentgenologic values of the hip joint in various age groups of the patients who may develop degenerative and dystrophic lesions. Prognosis of the development of a degenerative and dystrophic lesion of the hip joint allows to considerably reduce the quantity of its appearance and progress.     

Degenerative changes of the cervical facet joints in the medial and lateral atlantoaxial joint - a paleopathological study

AIM: This article describes the prevalence of degenerative changes of the upper cervical spine (C1-C2) and cervical facet joints found during investigations of spinal column remains. MATERIALS AND METHODS: This study was conducted on a sample of 196 cervical spines from southwestern Germany which derive from the 6th to 8th centuries AD. The degenerative lesions were classified into grades 1 (marginal osteophytes), 2 (uneven joint surfaces), or 3 (osseous ankylosis). RESULTS: Of the skeletons examined, 19.4 % (n = 38) showed degenerative changes of the cervical facet joints and/or upper cervical spine (mean age at death was 44 years). The medial (6.1 %) and lateral (0.6 %) atlanto-axial joints were rarely involved in degenerative changes. The facet joints from C3-C4 to C6-C7 showed degenerative changes in 8.0-11.7 % of cases (usually grade 1 and 2). The C2-C3 facet joints were significantly involved in degenerative changes in 19.7 % of cases, one fourth of which were osseous ankylosis (grade 3). CONCLUSION: The C2-C3 facet joints showed a high rate of degenerative changes.     

Role of mechanical factors in the development of degenerative dystrophic lesions of the hip joint

The authors present the results of their studies of distribution of pressure on the articular surfaces of the hip joint with regard to the value of the angle between the femoral neck and the diaphysis and the state of the cartilaginous coat. The regularity of distribution of pressure was studied on a real model of the hip joint by means of tensometry and ichnography. It was established that the region of maximum pressure was most frequently affected by degenerative dystrophic process, and the epicenter of pressure on the femoral head surface was shifted due to an increased or decreased angle between the femoral neck and the diaphysis directed laterally or medially as compared with the normal state. These peculiarities should be taken into consideration when performing corrective osteotomies.     

Degenerative lesions in the articular cartilage after meniscectomy: preliminary experimental study in dogs

Articular cartilage degeneration was studied in an experimental model including 68 knees of adult dogs on which five different types of medial meniscectomy had been performed with a followup period of 10 to 450 days. The results were assessed by macroscopic, radiologic, and histologic methods. The degenerative lesions increased proportionally to the amount of meniscal tissue resected and the duration of observation. These lesions proved to be more intense at the tibial plateau compared to the femoral condyle. For both joint surfaces the predominant location was the central zone. Considering the degenerative process by the articular cartilage after total meniscectomy, maximum preservation of meniscal tissue is recommended.     

Lymphographic semeiotics of inflammatory and dystrophic lesions of the lymph nodes in the light of morphological data]

The authors report clinica, roentgeno-lymphographic and morphological findings in 164 patients whom lymph nodes showed various changes of non-tumor origin, 584 lymph nodes being studied by aimed lymphographic and morphological correlations. The changes observed were subdivided into 2 groups: diffuse and focal. Diffuse inflammatory and reactive changes, and multiple micrometastases as well, are manifested by an analogous lymphographic picture. In focal hyperplasia a lymph node is somewhat increased in size, it shows smooth and distinct contours, defects of filling and absorption.