PREVALENCE OF DEGENERATIVE MORPHOLOGICAL-CHANGES IN THE JOINTS OF THELOWER-EXTREMITY

Information on the prevalence and extent of degenerative morphological changes (DMC) in the joints of the lower extremity, including foot jo ints is sparse. In the present study, the first and fifth metatarsalph alangeal (MTP), transverse tarsal, subtalar, talocrural, knee and hip joints of 50 cadavers were examined grossly and graded on a five-point scale for signs of DMC. Selected samples were examined histologically . Our results confirm clinical findings that severe DMC in foot joints are uncommon except in the first MTP joint where the plantar aspect i s most affected. The knee joint displayed the most numerous and severe signs of DMC followed by the first MTP joint. The hip, talocrural, su btalar and transverse tarsal joints displayed comparatively moderate l evels of DMC while the fifth MTP was rarely affected. The only joint t o display significantly greater levels of DMC on the distal side of th e joint as compared with the proximal side, when a difference was pres ent, was the hip. There were significantly greater levels of DMC on th e medial aspect of two or more joints within an extremity than on the lateral aspect. Radiographs often showed few or no signs of DMC even w hen erosion down to subchondral bone was observed upon gross examinati on. (C) 1996 Osteoarthritis Research Society.