Prof. P.Vijayaraghavan’s unitDr. Karthikeyan.S

X-RAY FindingsMultiple osteophytes seen.Subchondral sclerosis.Intervertebral disc calcification.Gas noted in the intervertebral space.

(vacuum phenomena).Diffuse narrowing of disc space.

Vacuum sign of knuttsen.Early radiologic finding.Collection of N2 in nuclear and annular

fissures.Present as a area of linear lucency.Sign of disc aging /degeneration.

IMPRESSION:

Secondary Degenerative Joint Disease.

Differential Diagnosis:OchronosisGoutCalcium Pyro Phosphate DiseaseHyperparathyroidismAnkylosing SpondylitisDISHFluorosis

DIFFERENTIAL DIAGNOSIS OchronosisRadiological Finding-Universal disc calcification and subchondral

sclerosisUniversal disc thinning/degenerative changes.Increased kyphosis and lordosis.Small osteophytes.Calcification of interspinous ligamentVertebral fusion.

Gout75% of patients c/o back pain.Spine involvement - less common .Cervical

spine involvement more.End plate erosion/ osteophytes.Annular calcification/posterior apophyseal

degeneration.

CPPDHaemochromatosis / Wilsons disease.Spine involvement relatively infrequent.Calcification of annulus.Vertebral body sclerosis.Osteophytes.Loss of disc space/ vaccum phenomena.

Hyperparathyroidism.Nuclear pulposus, annular fibrous

calcification.Rugger jersy spine.Trabecular pattern accentuated.

Ankylosing spondylitis-Sacro iliac involvement is the hallmark.Thoroco lumbar spine is the earliest involved.Disc changes include annular ossification.Romanas lesion-Discrete radiolucent Vertebral

body corner erosion is earliest.Vertebral body contour lost square shaped

Bamboo spine.Ossification of interspinous/supraspinous

ligament-Dagger sign.

DISH- Diffuse Idiopathic Skeletal Hyperostosis

Calcification and later ossification of ALL of four or more vertebrae.

Flowing wax sign.Disc space is preserved

FluorosisSpine involvement common.Osteopenia followed by hyperostosis .

ligament calcification present.No disc calcification ,space is maintained.