Degenerative Joint Disease (DJD)
• Non-inflammatory degeneration of joint cartilage with secondary effects on adjacent bone.
• The most common form of arthritis.
• Synonyms include osteoarthritis.
• Pain, stiffness, crepitus, deformity and swelling, with normal laboratory studies.
• Three types identified: Primary, secondary and erosive.
Primary: Unknown cause, 5th-6th decade, females 10-1, weight-bearing joints.
Secondary: Known cause, 2nd-6th decade, equal sex distribution, any joint.
Erosive osteoarthritis (EOA): Inflammatory cause, 4th-5th decade, females 3-1, interphalangeal joints.
Pathological Features: Begins focally and gradually increases in size.
Hand: Involvement of the interphalangeal joints to the hand is a distinctive feature of DJD. Clinically, this osteophytic enlargement of the degenerating joints has been termed “various eponyms” according to location—Heberden’s nodes for DIP joints and Bouchard’s nodes for proximal interphalangeal joints. The radiographic changes consist of lateral osteophytes, sclerosis, loss of joint space and malalignment, especially in the distal interphalangeal joints.
Dr. Terry R. Yochum is a second generation Chiropractor and a Cum Laude Graduate of the National College of Chiropractic, where he subsequently completed his radiology residency. He is currently Director of the Rocky Mountain Chiropractic Radiological Center in Denver, Colorado, and Adjunct Professor of Radiology at the Southern California University of Health Sciences, as well as an instructor of skeletal radiology at the University of Colorado School of Medicine, Denver, CO. Dr. Yochum’s 3rd edition textbook, Essentials of Skeletal Radiology, was released in the fall of 2004 and is now available for purchase. Dr. Yochum can be reached at 303-940-9400 or by e-mail at
Dr. Chad J. Maola is a 1990 Magna Cum Laude Graduate of the National College of Chiropractic. Dr. Maola has co-authored five chapters in Dr. Yochum’s 3rd edition textbook and is rendering post-graduate lectures with Dr. Yochum and separately throughout the United States. Dr. Maola is a Chiropractic Orthopedist and is available for post-graduate seminars. He may be reached at 303-690-8503 or e-mail