Bone spur
Encyclopedia
Osteophytes, commonly referred to as bone spurs, are bony
projections that form along joint
margins. They should not be confused with enthesophyte
s, which are bony
projections which form at the attachment of a tendon or ligament.
. Osteophytes usually limit joint movement and typically cause pain.
Osteophytes form naturally on the back of the spine
as a person ages and are a sign of degeneration in the spine. In this case the spurs are not the source of back pains, but instead are the common symptom of a deeper problem. However, bone spurs on the spine can impinge on nerves that leave the spine for other parts of the body. This impingement can cause pain in both upper and lower limbs and a numbness or tingling sensations in the hands and feet because the nerves are supplying sensation to their dermatomes
.
Spurs can also appear on the feet, either along toes or the heel
, as well as on the hands. In extreme cases bone spurs have grown along a person's entire skeletal structure: along the knees, hips, shoulders, ribs, arms and ankles. Such cases are only exhibited with multiple exostoses
.
Osteophytes on the fingers or toes are known as Heberden's nodes (if on the DIP joint
) or Bouchard's nodes
(if on the PIP joints).
Osteophytes may also be the end result of certain disease processes. Osteomyelitis
, a bone infection, may leave the adjacent bone with a spur formation. Charcot foot
, the neuropathic breakdown of the feet seen primarily in diabetics, will also leave bone spurs which may then become symptomatic.
). Often osteophytes form in osteoarthritic joints as a result of damage and wear from inflammation. Calcification and new bone formation can also occur in response to mechanical damage in joints.
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
projections that form along joint
Joint
A joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally.-Classification:...
margins. They should not be confused with enthesophyte
Enthesophyte
Enthesophytes are abnormal bony projections at the attachment of a tendon or ligament. They are not to be confused with osteophytes, which are abnormal bony projections in joint spaces....
s, which are bony
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
projections which form at the attachment of a tendon or ligament.
Pathophysiology
Osteophytes form because of the increase in a damaged joint's surface area. This is most common from the onset of arthritisArthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
. Osteophytes usually limit joint movement and typically cause pain.
Osteophytes form naturally on the back of the spine
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...
as a person ages and are a sign of degeneration in the spine. In this case the spurs are not the source of back pains, but instead are the common symptom of a deeper problem. However, bone spurs on the spine can impinge on nerves that leave the spine for other parts of the body. This impingement can cause pain in both upper and lower limbs and a numbness or tingling sensations in the hands and feet because the nerves are supplying sensation to their dermatomes
Dermatomic area
A dermatome is an area of skin that is mainly supplied by a single spinal nerve.There are eight cervical nerves ,twelve thoracic nerves,five lumbar nerves and five sacral nerves....
.
Spurs can also appear on the feet, either along toes or the heel
Heel
In human anatomy, the heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower leg.- Human anatomy :...
, as well as on the hands. In extreme cases bone spurs have grown along a person's entire skeletal structure: along the knees, hips, shoulders, ribs, arms and ankles. Such cases are only exhibited with multiple exostoses
Exostosis
An exostosis is the formation of new bone on the surface of a bone. Exostoses can cause chronic pain ranging from mild to debilitatingly severe, depending on where they are located and what shape they are....
.
Osteophytes on the fingers or toes are known as Heberden's nodes (if on the DIP joint
Distal interphalangeal joint
Distal interphalangeal joint can refer to:* Interphalangeal articulations of hand* Interphalangeal articulations of foot...
) or Bouchard's nodes
Bouchard's nodes
Bouchard's nodes are hard, bony outgrowths or gelatinous cysts on the proximal interphalangeal joints They are a sign of osteoarthritis, and are caused by formation of calcific spurs of the articular cartilage....
(if on the PIP joints).
Osteophytes may also be the end result of certain disease processes. Osteomyelitis
Osteomyelitis
Osteomyelitis simply means an infection of the bone or bone marrow...
, a bone infection, may leave the adjacent bone with a spur formation. Charcot foot
Charcot arthropathy
Charcot arthropathy is a progressive musculoskeletal condition characterized by joint dislocation, fractures and deformities. It results in progressive destruction of bone and soft tissue of weight-bearing joints, most commonly in the foot and ankle...
, the neuropathic breakdown of the feet seen primarily in diabetics, will also leave bone spurs which may then become symptomatic.
Cause
Osteophyte formation has been classically related to any sequential and consequential changes in bone formation which is due to aging, degeneration, mechanical instability, and disease (such as Diffuse Idiopathic Skeletal HyperostosisDiffuse idiopathic skeletal hyperostosis
Diffuse idiopathic skeletal hyperostosis is a spondyloarthropathy also known as Forestier's disease and ankylosing Hyperostosis.It is a noninflammatory disease, with the principal manifestation being calcification and ossification of spinal ligaments and the regions where tendons and ligaments...
). Often osteophytes form in osteoarthritic joints as a result of damage and wear from inflammation. Calcification and new bone formation can also occur in response to mechanical damage in joints.
Treatments
Normally, asymptomatic cases are not treated. NSAIDs and surgeries are two typical options for the rest.Fossil record
Evidence for bone spurs found in the fossil record is studied by paleopathologists, specialists in ancient disease and injury. Bone spurs have been reported in dinosaur fossils from several species, including Allosaurus fragilis, Neovenator salerii, and Tyrannosaurus rex.External links
- Mayo Clinic website concise information on bone spurs