Degenerative Joint Disease (DJD) General considerations: Non-inflammatory degeneration of joint cartilage with secondary effects on adjacent bone. The most common form of arthritis. Synonyms include osteoarthritis. Clinical Features: Pain, stiffness, crepitus, deformity and swelling, with normal laboratory studies. Three types identified: Primary, sec ondary and erosive. Primary: Unknown cause, 5"'-6"' decade, females 10-1, weight-bearing joints. Secondary: Known cause, 2lui-6lh decade, equal sex distribution, any joint. Erosive osteoarthritis (EOA): Inflammatory cause, 4lh-5lh decade, females 3-I. intcrphalangeal joints. Pathological Features: Begins focally and gradually increases in size. Hand: Involvement of the interpha- langeal joints to the hand is a distinctive feature of DJD. Clinically, this osteo-phytic enlargement of the degenerating joints has been termed "various ep-onyms" according to location— Heberden's nodes for DIP joints and Bouchard's nodes for proximal interpha-langealjoints. The radiographic changes consist of lateral osteophytes, sclerosis, loss of joint space and malalignment, especially in the distal interphalangeal joints.EH See references on pg. 61 Dr. Teny R, Yochum is a second generation Chiropractor and a Cum Laudc Graduate of the National College of Chiropractic, where he subsequently completed his radiology residency. He is currently Director of the Rocky Mountain Chiropractic Radiological Center in Denver, Colorado, and Adjunct Professor of Radiology at the Southern California University of Health Sciences, as well as an instructor of skeletal radiology at the Univer- sit}' oj Colorado School of Medicine. Denver, CO. Dr. Yachutn's 3"'edition textbook, Essentials of Skeletal Radiology, was released in the fall of 2004 and is now available for purchase. Dr. Yochum can be reached at 303-940-9400 or by e-mail at dcrad099(waol.com. Dr. Chad./. Maola is a 1990 Magna Cunt Laude Graduate of the National College of Chiropractic. Dr. Maola has co-authored five chapters in Dr. Yochum's 3"' edition textbook and is rendering post-graduate lectures with Or. Yochum and separately throughout the United States. Or. Maota is a Chiropractic Orthopedist and is available for post-graduate seminars. He may be reached at 303-690-S503 or e-tnail DC OKamsn.com. Observe the degenerative osteophytes affecting the distal and proximal interphalangeal articulation of all four digits of the hand. The radiographic findings of subchondral cyst and sclerosis are clearly demonstrated. The palpable nodular osteophyte formation creates the classic Heberden's and Bouchard's nodes.
