II. DEGENERATIVE PROCESSES

Deterioration of the human body accompanies the process of living. Arthritis and osteoporosis are examples. They may follow trauma, or be the result of a metabolic process.

A. ARTHRITIS

(22) Arthritic cupping is on edges of vertebral body, and changes are present on articular processes, secondary to spondylolysis and separate neural arch. (refer to congenital and developmental processes).

II. Lipping and a spur are present on lumbar vertebrae. There is narrowing of the body of the vertebra, commensurate with osteoporosis due to aging. The neural arch system shows partial assimilation of last lumbar vertebra (refer to congenital and developmental problems).

XXVIII. Mild arthritic changes in a lumbar vertibra with spondylolysis. (refer to congenital disease)

XXXI. Severe degenerative disease in thoracic spine, and congenital fusion of two lower thoracic vertebra. Marked vertebral lipping, badly misshapen vertebral bodies, osteophytes on the articular processes. (refer to congenital disease)

XLIII. Spondylolysis accompanied by unusual motion between the vertebral bodies led to arthritic changes on vertebral bodies and articular processes. (refer to congenital diseases)

LXXXIV. Moderately severe vertebral lipping is present on the vertebral body's surface.

XC. Moderately severe degenerative changes are present on the articular rim with slight flattening of the vertebral body. Slight changes are on the articular processes. (refer to congenital diseases)

CV. Mild lipping and compression of the body of the fifth lumbar vertebra in a person having spondylolysis. (refer to congenital disease)

CL. There are severe arthritic changes in the fifth lumbar vertebra of a person with spondylolysis. (refer to congenital diseases)

CLXXI. Moderately severe degenerative changes in a person having assimilation of the fifth lumbar vertebra, neural arch defect in L4,L5 lumbar vertebrae. (refer to congenital diseases)

CCXXVI. Lumbar vertebrae showing severe degeneration manifested by vertebral collapse, osteophyte formation. Although they could be the result of trauma, the changes are most likely the result of osteoporosis.

CCLXXIV. Lumbar vertebra with separate neural arch showing degenerative changes on the vertebral body and on the articular pedicles. (refer to congenital disease)

CCLXXVII. Lumbar vertebra with separate neural arches and degenerative changes circumferentially. In addition there is fusion of two mid-thoracic vertebrae. (refer to congenital and developmental disease)

CCCLXXIII. Lumbar vertebra showing severe osteoporosis, lipping, and arthritic changes in the articular processes.

B. COMPRESSION FRACTURE SECONDARY TO OSTEOPOROSIS

XXII. The body of a lumbar vertbra is compressed posteriorly and to the left side. There is little evidence of arthritis. This probably resulted from traumatic compression fracture superimposed on osteoporosis. (refer to trauma)

XXXVII. A thoracic vertebra is compressed anterior-posteriorly so that the vertebral architecture is lost. This is the effect seen with osteoporotic vertebrae. (refer to trauma)

CXXIV. Anterior vertebral collapse, osteoporosis, and osteophyte formation are all visible in this specimen. This must be differentiated from traumatic collapse.

CCVIII. Anterior collapse of a mid-thoracic vertebra. The uppermost vertebra has purposely been turned around to show the knife cut on its surface. Although this probably represents osteoporotic disease as a factor, it could be the result of trauma. (refer to trauma)

C. DEGENERATIVE JOINT DISEASE

[3] Mild degenerative changes are in the glenoid cavity of the scapula, and on the articular border of the capsule. This happens when the articular cartilage wears thin.

XLVIII. Degenerative changes involve the entire knee joint. The eminence holding the cruciate ligaments is broad and prominent.

LXXXI. Arthritic changes are present at the periphery of the articular capsule laterally and medially. They indicate early joint degeneration, and often follow trauma to the knee. (refer to traumatic processes)

XCIX. Early degenerative change in the tibia is visible in the area of insertion of the articular capsule, circumferentially.

CX. Early joint changes are present on the distal femur, indicated with an arrow.

CXXII. Early hypertropic arthritic changes are on the distal femur.

CXXXI. The distal femur is shown. In one area, bone has sloughed from the surface, leaving a cup like defect with slightly raised edges. This is commensurate with osteochondritis dissecans.

CCXXA. Anterior view. Advanced hypertropic changes are present at the periphery of the knee joint and on the articular surface of the joint. In one place an area of bone is denuded, exposing the marrow space.

CCXXB. Lateral view.

CCXXV. Moderately advanced arthritic changes are on the medial and lateral surfaces of the femur. The joint surfaces appear not affected.

CCXXXIV. Distal femur fragment showing degenerative changes in the area of the lateral portion of the articular surface.

CCXLI. The proximal portion of a tibia with moderate degenerative changes in the area of the articular capsule insertion.

CCLA. Top view. A tibia with degenerative disease involving the entire joint. There is lipping at the point of attachment of the articular capsule, roughness of the joint surface, and new bone formation in the peri-articular soft tissue.

CCLA. View showing the lateral surface..

CCLXXXIII. The distal femur of an adult female as seen in the lateral and posterior views. On the posterior surface the cartilage is worn so the medulary space is exposed. On the lateral side the line for the attachment of the articular capsule is markedly accentuated.

[18] The left hip joint is worn such that the bone has been eroded and the underlying marrow is exposed.

[24] The vertebral body is slightly wedged on the left side with accentuated osteophytes on this side, suggesting that a degree of scoliosis had existed during life. Additionally there is lipping on the right iliac crest.

[51] On the distal humerus the cartilage has been eroded with exposure of the marrow space, suggesting osteochondritis dissecans.

[54] The right scapula has accentuated markings circumferentially on the articular border of the capsule. In the glenoid cavity there is a roughly round eroded area surrounded by a margin of osteoid material.

[62] There is an osteolytic defect in the left sacro-iliac synchondroses which may represent early degenerative disease in this area.

[71] Slight elevation of the articular border and an small area of erosion

of cartilage in the scapular glenoid space indicate early degenerative change.

[74] Marked lipping, severe osteoporosis, and anterior fusion of lumbar vertebrea indicates an advanced degree of osteoarthritis.

[76] A hand phalange demonstrates hypertrophic changes near the head.

[85] In the distal femur there is erosion of the articular cartilage so the underlying cortical bone is exposed.

[88] In the anterior view the distal articular surface of the femur shows thinness and roughening of the surface, osteoporosis, accentuation of the articular capsule line.

[94] The mandibular teeth are present, and from what is seen, are worn moderately, but are in good repair. On the mandibular heads there is evidence of wear, more on the left side as might be seen if the person were using the jaws as tools (processing leather - refer to dental problems).

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