Radiological Evidence of Degenerative Joint Disease (DJD)
Eric A. Brandser, M.D.
Peer Review Status: Internally Peer Reviewed
Copyright protected material used with permission of the author and the University of Iowa’s Virtual Hospital, www.vh.org
Degenerative Joint Disease (DJD or Osteoarthritis)
Classification
Primary osteoarthritis – most common in the older age group as the result of wear and tear on articular cartilage over time.
Secondary osteoarthritis – results from a previous process that damaged cartilage such as trauma, or inflammatory arthritis.
The most commonly involved joints in primary osteoarthritis are:
Distal interphalangeal joints
First carpometacarpal joint
Weight bearing joints: spine, hips, knees
Imaging of degenerative joint disease
1. Diagnosis by plain films includes identification of:
Asymmetric joint space narrowing
Osteophytes-bony spurs
Degenerative cysts
Sclerosis of subchondral bone
2. CT or MRI are also useful on certain occasions
3. OA of the Hip
4. OA of the Fingers
5. OA of the Knee
6. OA of the Spine
Inflammatory Arthritis
An inflammatory process with the target organ being the synovial membrane leading to pannus formation (inflammatory exudate in the lining of the synovial cells).
Rheumatoid Arthritis
Imaging in RA
1. Diagnosis usually made by plain film confirmation of:
Osteopenia – a demineralization of the bone – is the result of increased blood flow, due to inflammation, which washes out the calcium.
Early on in the inflammatory process,only the periarticular portion of the bones are affected.
Over time, the inflammatory pain causes disuse of affected joints leading to generalized osteopenia of whole bones.
Uniform joint space narrowing – a feature which helps differentiate RA from OA.
Marginal erosions at bare areas where synovium lies on bone
Subluxation due to ligamentous or capsular laxity
RA of the Hands
RA of the Hips
2. MRI is technique of choice when cord compression is suspected (C1-C2)
Ankylosing Spondylitis
1. Ankylosing Spondylitis
2. Progression of Sacroiliitis in Ankylosing Spondylitis
Be sure to visit the Glucosamine Product Guide for a review of commercially available glucosamine products.
Liquid Glucsosamine Reviews and Product Guide
We highly recommend liquid formulas but included a solid formula in our comparison for argument?s sake. The following products may have additional ingredients that aren’t listed here. We intentionally chose to focus on the critical nutrients, critical attributes and items to beware of before purchasing.
Fields BOLDED and highlighted in GREEN denotes category winner.
FlexicosePlus®
Joint Juice®
Wellesse®
Osteo Bi-FLex®
Suitable For People and Pets
YES!
No
No
Unknown
Critical Nutrients:
Glucosamine
1500 mg
1500 mg
2000 mg
1500 mg
Glucosamine Form
Sulfate and HCL
HCL only
HCL only
HCL only
Chondroitin
400 mg
200 mg
1200 mg
Unclear!
MSM
100 mg
0 mg
500 mg
Unclear!
Vitamin A
1250 IU
0 IU
0 IU
0 IU
Vitamin C
15 mg
20 mg
0 mg
60 mg
Vitamin E (natural)
7.5 IU
0 IU
0 IU
0 IU
Manganese
0.7 mg
0 mg
0 mg
2 mg
Hyaluronic Acid
5 mg
0 mg
0 mg
Yes, unclear
Aloe Vera Gel
Yes
No
No
No
Yucca Root
Yes
No
No
No
Bromelain
Yes
No
No
No
Boswellia Serrata
Yes
No
No
Yes
Proprietary Blends*
1600 mg
0 mg
0 mg
1350 mg
Critical Attributes:
Bioavailability**
Up to 95%
Up to 95%
Up to 95%
Up to 35%
Sweetened with Stevia
Yes
No
No
No
Gluten-free
Yes
Yes
Yes
Yes
Safe for Diabetics?
Yes
No
No
No
Safe for Hypoglycemics?
Yes
No
No
No
Moneyback Guarantee
Yes
No
No
No
Free US Shipping
Yes, no minimum!
Over $25
Over $25
Over $25
Sales/Promotions
Always
Occasionally
Occasionally
Occasionally
Price
$29.95 or under
$29.99
$37.99
$39.99
#Of Servings
32
30
16
60
Cost/day
.94 or under
$1.00
$2.37
.67
Bulk Order Discounts
Yes
No
No
No
Safe for Pets?
Yes
No
No
No
BEWARE!!!
Calories
5
25
30
0
Carbs
1 g
4 g
7 g
0 g
Sugars
0 g
2 g
0 g
0 g
Sugar Alcohol
Absent
Absent
Present
Absent
Artificial Sweeteners
No
No
Yes
No
Sodium
0 mg
30 mg
115 mg
40 mg
When researching a liquid glucosamine product, you want to make sure that the following requirements are met:
Made in the USA.
Manufactured in a GMP (Good Manufacturing Practices) facility. This ensures that the product is subjected to strict quality controls and contains all of the ingredients listed on the label in the exact dosages stated.
Product that is naturally sweetened, sugar-free and also contains Chondroitin, MSM, Vitamins A, C, E, and anti-inflammatory ingredients including Aloe Vera Gel, Boswellia, Bromelain and Yucca root.
Our Final Recommendation:
FlexicosePlus® Liquid JointCare – For People and Pets