What Are Osteophytes (Bone Spurs)?

Commonly Found in Joints Showing Degeneration

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Osteophytes are bony growths or deposits, also referred to as bone spurs. They are also sometimes called osteochondral nodules, osteochondrophytes, and chondro-osteophytes. Technically-speaking, osteophytes are fibrocartilage-capped bony outgrowths originating from precursor cells of the periosteum and growth factors. They commonly develop in joints that show signs of degeneration. Osteophytes are associated with the most common type of arthritis, known as osteoarthritis.

Their presence serves to distinguish osteoarthritis from other types of arthritis.

Osteophytes typically develop as a reparative response by the remaining cartilage in a damaged joint, correlating with cartilage loss elsewhere in the joint. Osteophyte formation stabilizes the damaged joint. These changes tend to be compartmental, suggestive of a localized event. That said, the pathophysiology of osteophyte formation is not completely understood. While osteophyte formation is associated with cartilage damage, they can also develop in the absence of explicit cartilage damage.

Marginal osteophytes can develop at the periphery or margins of all joints. Central osteophytes are most prominent in the hip and knee. Osteophytes also may be found in the spine region. In the spine, an osteophyte or bone spur can cause nerve impingement (compression of the spinal cord or nerve roots) at the neuroforamen (the empty space to the left and right of each vertebra which allows nerves to pass from the spinal cord to other parts of the body).

Sensory symptoms in this situation include pain, numbness, burning and pins and needles in the extremity served by that spinal nerve root. Motor symptoms include muscle spasm, cramping, weakness, or loss of muscular control in an associated part of the body.

Diagnosing Osteophytes

Osteophytes can be diagnosed by a physical exam of the PIP (proximal interphalangeal joint), DIP (distal interphalangeal joint), and first CMC joints (carpometacarpal joint) of the hand.

In other words, in the hand, a bump or lump may be visible during a physical examination.

For other joints, osteophytes also can be diagnosed using imaging studies, such as x-rays or MRI. If x-rays were performed on everyone over 50 years of age, most would show some evidence of osteophyte development. Yet, most osteophytes are asymptomatic (i.e., they do not produce symptoms).

Treatment of Osteophytes

The presence of osteophytes alone is not clinically significant unless associated symptoms are experienced. Treatment of osteophytes may include:

Typically, conservative treatment is tried first and surgery is reserved for patients with severe symptoms.

Osteoarthritis is not simply characterized by the degradation of cartilage. Osteoarthritis also involves subchondral bone remodeling and osteophyte formation.

Depending on the severity of associated symptoms, osteophytes may or may not need to be treated.

Sources:

Osteoarthritis. Fourth edition. Roland W. Moskowitz et al. Chapter 2 and Chapter 4. Wolters Kluwer. Lippincott | Williams & Wilkins.

Osteophytes: relevance and biology. Osteoarthritis and Cartilage. van der Kraan PM et al. March 2007.
http://www.ncbi.nlm.nih.gov/pubmed/17204437

Neuroforamen. Laser Spine Institute. Accessed 01/08/16.
https://www.laserspineinstitute.com/back_problems/spinal_anatomy/vertebral_column/neuroforamen/

Is it necessary to resect osteophytes in degenerative spondylotic myelopathy? Atul Goel. Journal of Craniovertebral Junction and Spine. 2013 January-June;4(1):1-2.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872653/

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