Osteophyte

Osteophyte, commonly known as a bone spur, is a bony outgrowth that forms at the margins of a bone, usually within a joint. Osteophytes develop as part of the body's reparative response to joint injury or degeneration, most often in osteoarthritis or other conditions that involve mechanical stress. They can occur on vertebral bodies and facet joints in the spine, or on peripheral joints such as the knee, hip, or shoulder.

Pathophysiology: Osteophyte formation involves stimulation of the periosteum and subsequent bone growth in response to altered biomechanics and cartilage loss. While they may help stabilize a deteriorating joint, osteophytes can contribute to pain, stiffness, reduced range of motion, or nerve compression when large enough or located near neural or soft tissue structures.

Clinical features: Many osteophytes are asymptomatic. When symptoms occur, they depend on location and size and may include joint pain, reduced mobility, or neurologic symptoms from nerve compression in the spine.

Diagnosis: Diagnosis is typically made with imaging. X-rays can reveal bony projections at joint margins. CT or MRI provides detail about size and relation to adjacent structures.

Management: Asymptomatic osteophytes require no treatment. Symptomatic management includes analgesics (such as NSAIDs or acetaminophen), physical therapy, and activity modification. Corticosteroid injections can help some patients. Surgery to remove an osteophyte is considered when symptoms persist or when the spur causes nerve compression or other mechanical problems despite conservative care.

Prognosis and notes: Osteophytes are not malignant. They may recur if underlying joint degeneration progresses.