Spondylosis or degenerative arthritis is the most common cause of spinal stenosis, resulting from compression of the spinal cord by disc de...
Helps distinguish spinal stenosis from other causes of back pain and peripheral vascular disease
Insidious onset and slow progression are typical; discomfort with standing, paresthesia...
In general, nonoperative interventions are preferred in the absence of progressive or debilitating neurologic symptoms:
Physical therapy, exercise, weight management, medications, followed by...
Follow up based on progression of symptoms.
No limitations to activity; patients may be as active as tolerated. Exercise should be encouraged.
M48.00 Spinal stenosis, site unspecified
M48.06 Spinal stenosis, lumbar region
M48.04 Spinal stenosis, thoracic region
M48.05 Spinal stenosis, thoracolumbar region
M48.08 Spinal stenosis, sacra...
Spinal stenosis typically presents as neurogenic claudication (pain, tightness, numbness, and subjective weakness of lower extremities), which can mimic vascular claudication.
Flexion o...
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<bold>FIG. 108.1.</bold> Degenerative joint disease of the knee. Large areas of erosion of articular cartilage are present on the patellar facet and on the condyles of the femur. These erosions occupy principally the central portions of the joint surfaces and spare the marginal regions. The cartilage at the eroded edges is fi illated. The irregular elevations at the periphery of the surfaces are osteophytes.
<bold>FIG. 108.1.</bold> Degenerative joint disease of the knee. Large areas of erosion of articular cartilage are present on ...
<bold>FIG. 108.8.</bold> Heberden node. The articular cartilage has completely disappeared from the surfaces of the distal interphalangeal joint. Bony osteophytes, directed toward the base of the finger, are present on the dorsal and palmar aspects of both articulating surfaces. Advanced osteoarthritic changes also are present in the proximal interphalangeal joint and form a so-called Bouchard node. (Hematoxylin and eosin stain, original magnification 320.)
<bold>FIG. 108.8.</bold> Heberden node. The articular cartilage has completely disappeared from the surfaces of the distal int...
<bold><italic>FIGURE 9-44.</bold></bold> Lumbar spondylolysis. Imaging of the lumbar spine in four separate patients with low back pain, two with L4 spondylolysis <bold>(A,B,C,D,E)</bold> and two with L5 spondylolysis <bold>(F,G,H,I,J,K)</bold> demonstrates the multimodality approach to imaging when assessing for spondylolysis/spondylolisthesis. Conventional lumbar radiographs, including lateral and bilateral obliques (A,B,C) nicely demonstrate the bony break (<italic>arrows in A</bold>) within the region of the bilateral L...
<bold><italic>FIGURE 9-44.</bold></bold> Lumbar spondylolysis. Imaging of the lumbar spine in four separate patien...
Causes of Low Back Pain Sagittal View Labeled
Osteoarthritis
Figure 10-5 <bold>INFLAMMATORY VERSUS DEGENERATIVE ARTHRITIS.A. Inflammatory Arthritis (Rheumatoid Arthritis).</bold> The most prominent feature is the uniform bicompartmental loss of joint space.<bold> B. Degenerative Arthritis (Degenerative Joint Disease).</bold> In contrast, selective loss of a single compartment joint space in a non-uniform manner is apparent.<bold><italic>COMMENT:</bold></bold> This is an important differential feature between inflammatory and degenerative joint changes.
Figure 10-5 <bold>INFLAMMATORY VERSUS DEGENERATIVE ARTHRITIS.A. Inflammatory Arthritis (Rheumatoid Arthritis).</bold> The most...
Figure 10-46 <bold>DEGENERATIVE JOINT DISEASE: KNEE. A. Recumbent. B. Erect.</bold> Observe the loss of lateral joint space not seen on the recumbent film (<italic>arrow</bold>).
Figure 10-46 <bold>DEGENERATIVE JOINT DISEASE: KNEE. A. Recumbent. B. Erect.</bold> Observe the loss of lateral joint space no...
<bold><italic>Figure 10.27.</bold></bold> Degenerative joint disease of fingers: Bouchard's nodes on proximal interphalangeal (PIP) joint, Heberden's nodes on distal interphalangeal (DIP) joint. Look for the company of other finger or of thumb osteoarthritis.
<bold><italic>Figure 10.27.</bold></bold> Degenerative joint disease of fingers: Bouchard's nodes on proximal inte...
FIG. 9 <bold>A:</bold> Low back pain with small contained prolapse, L-5 to S-1, and high signal-intensity zone at L4-5. <bold>B,C:</bold> Major concordant pain responses by clinical distention at each level.
FIG. 9 <bold>A:</bold> Low back pain with small contained prolapse, L-5 to S-1, and high signal-intensity zone at L4-5. <bo...
<bold>FIG. 65.9.</bold> "Whittling" of the middle phalanx and expansion of the base of the distal phalanx—the "pencil-in-cup" deformity.
<bold>FIG. 65.9.</bold> "Whittling" of the middle phalanx and expansion of the base of the distal phalanx—the "pencil-in-cup" ...
Left Hand and Wrist with Osteoarthritis Unlabeled