What is the Difference Between Osteophytes and Syndesmophytes

The key difference between osteophytes and syndesmophytes is that osteophytes are the degenerative osteoproliferative lesions in the spine, while syndesmophytes are the inflammatory osteoproliferative lesions in the spine.

Osteophytes and syndesmophytes are two types of osteoproliferative lesions formed in the spine. In imaging testing, they look similar and are hard to differentiate. However, they are different types of lesions. Moreover, the formation of osteophytes in the spine is associated with medical conditions such as osteoarthritis. On the other hand, the formation of syndesmophytes in the spine is associated with medical conditions such as ankylosing spondylitis, ochronosis, fluorosis, reactive arthritis, and psoriatic arthritis.

CONTENTS

1. Overview and Key Difference
2. What are Osteophytes
3. What are Syndesmophytes
4. Similarities – Osteophytes and Syndesmophytes
5. Osteophytes vs. Syndesmophytes in Tabular Form
6. Summary – Osteophytes vs. Syndesmophytes

What are Osteophytes?

Osteophytes are bone spurs. Clinically, osteophytes are described as thick, triangle-shaped osseous outgrowths that generate at the site of Sharpey fibers attachment between the annulus fibrosus and the margin of the vertebral body in the spine. Other than that, osteophytes can also be found near joints in the hands and feet. They are bone growths developed near joints in the spine. Osteophytes develop over time in patients that usually suffer from arthritis or joint damage.

Osteophytes are most common in people 60 years or older; however, they can also be observed in younger people. Joint damage from osteoarthritis is the main cause of osteophytes. The symptoms of these lesions may include knobby or bumpy areas in the spine, fingers, or toes, numbness and weakness, pain near the affected joint, reduced range of motion, stiffness, tendinitis, and tendon tears. Osteophytes can be diagnosed through physical examinations, tests for motion and strength, CT scans, and MRIs. Furthermore, osteophytes can be treated with ice to reduce swelling in the affected area, over-the-counter pain relievers such as acetaminophen and ibuprofen, resting, weight loss, decreased joint and bone stress, physical therapy, and surgeries like spinal surgery to remove osteophytes.

What are Syndesmophytes?

Syndesmophytes are thin, gracile ossifications of the annulus fibrosus attached right at the endplate margin. They are more vertically oriented than osteophytes in the spine. Their formation is a clinical feature of ankylosing spondylitis (AS) and other medical conditions such as ochronosis, fluorosis, reactive arthritis, and psoriatic arthritis.

Syndesmophytes formation can cause symptoms such as pain, rigidity in the spine, worsened spinal pain, numbness or tingling in arms and legs, and a loss of mobility. It has been hypothesized from recent research that inflammation leads to bone loss, which triggers an attempt to form new bones or syndesmophytes. Moreover, syndesmophytes can be diagnosed through physical examination and imaging tests such as X-rays, CT scans, and MRIs. Furthermore, treatment options for syndesmophytes may include physical therapy, individual or group exercise programs, massage to relieve the pain, hydrotherapy, nonsteroidal anti-inflammatory drugs (NSAIDs)  such as acetaminophen and ibuprofen to relieve pain, codeine, anti-tumor necrosis factor (TNF) medications, monoclonal antibody, corticosteroids, disease-modifying antirheumatic drugs, and spinal surgery.

What are the Similarities Between Osteophytes and Syndesmophytes?

• Osteophytes and syndesmophytes are two types of osteoproliferative lesions formed in the spine.
• They look similar in imaging scanning.
• Their formation can cause similar symptoms, such as spinal pain, mobility issues, etc.
• Both of these lesions can be diagnosed through physical examination and imaging tests.
• Both can be treated through physical therapy, medications, and surgeries.

What is the Difference Between Osteophytes and Syndesmophytes?

Osteophytes are degenerative osteoproliferative lesions in the spine, while syndesmophytes are inflammatory osteoproliferative lesions in the spine. Thus, this is the key difference between osteophytes and syndesmophytes. Furthermore, osteophytes are formed above or below the endplate margin, whereas syndesmophytes are formed vertically right at the endplate margin.

The infographic below presents the differences between osteophytes and syndesmophytes in tabular form for side-by-side comparison.

Summary – Osteophytes vs. Syndesmophytes

Osteophytes and syndesmophytes are two different types of osteoproliferative lesions in the spine. Osteophyte is a salient feature of osteoarthritis, while syndesmophyte is a salient feature of ankylosing spondylitis (AS). However, syndesmophytes can also be associated with other medical conditions such as ochronosis, fluorosis, reactive arthritis, and psoriatic arthritis. Moreover, osteophytes are osseous outgrowths that run horizontally, while syndesmophytes are osseous outgrowths that run vertically. So, this summarizes the difference between osteophytes and syndesmophytes.

Reference:

1. “Osteophyte.”NHS Choices.
2. “Are syndesmophytes most prevalent in the lumbar or in the cervical spine in patients with ankylosing spondylitis and do they develop in a specific direction?” Academic – Oup.Com.

Image Courtesy:

1. “Osteoarthritis on X-ray” By James Heilman, MD – File:Osteoarthritis_left_knee.jpg (CC BY-SA 4.0) via Commons Wikimedia
2. “Ankylosing process” By User:Senseiwa – (CC BY-SA 3.0) via Commons Wikimedia