osteoarthritis of the spine
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Pathology
- most common in facet joints of C6-C7 & L3-S1
Clinical manifestations
- lumbosacral osteoarthritis
- pain localizes poorly
- pain aggravated by movement, relieved by rest
- may radiate to paraspinal areas or buttocks
- osteophyte encroachment on a nerve root may produce radicular symptoms, L4-L5 & L5-S1 most commonly involved
- acute symptoms may be superimposed on chronic mechanical low back pain
- cervical spine osteoarthritis
- stiffness & decreased range of motion
- lateral flexion & extension generally more limited than forward flexion
- osteoarthritis of the hands would be supporting evidence
Laboratory
Radiology
- X-ray of spine
- MRI of spine if diagnosis is uncertain
Differential diagnosis
Management
- identify & eliminate provocative activities[2]
- weight reduction, back posture, abdominal muscle strenthening
- acetaminophen or a short course of NSAIDs
- gabapentin or tricyclic antidepressant for neurogenic pain
- glucocorticoid injections may be useful
- consider opiates & other pain management stategies for refractory pain[2]
- see osteoarthritis
More general terms
Additional terms
- diffuse idiopathic skeletal hyperostosis (DISH, Forestier disease, ankylosing hyperostosis of the spine, spondylosis hyperostotica)
- facet/zygapophysial/interarticular joints
- low back pain (LBP)
- spinal stenosis
- vertebra