What Is Subchondral Sclerosis?
Subchondral sclerosis (SCL) is a group of diseases characterized by inflammation of the soft tissues including the joints. These include:
Joint pain, stiffness, or swelling due to joint degeneration (arthritis). Joints may become inflamed and painful because they are damaged from overuse or trauma.
Joint deformity such as arthrosis, osteoarthritis, or bursitis.
Aching or tightness in the muscles of your legs and feet (gait abnormalities).
Painful swellings in the bones around your joints (osteomalacia).
What Causes Subchondral Sclerosis?
The exact cause of subchondral sclerosis is not known. However, it appears that there are several factors which contribute to its development. Some studies have shown that genetics play a role in determining whether someone will develop this disease. Other research suggests that environmental factors may play a role in causing this condition. Researchers believe that the risk increases with age, especially if you smoke cigarettes or drink alcohol regularly.
Joint trauma is one of the primary causes of subchondral sclerosis. Trauma to the body can cause a wear and tear to the cartilage of the joint. This eventually leads to inflammation which in turn causes pain and swelling. In addition, it has been found that obese people are more prone to SCL than those who have a healthy weight.
SCL is common in people who routinely perform heavy labor, such as those in manual labor jobs. However, people who do not perform manual labor are also at risk of developing it.
Genetics may also play a role in whether or not someone develops subchondral sclerosis. If a parent has or had SCL, you have a greater chance of developing it as well. In addition, it is more common among people with certain connective tissue diseases such as Down syndrome and Marfan’s syndrome.
Aging is a risk factor for developing subchondral sclerosis. As people grow older, the cartilage pads that separate the bones in the joints become thinner and wear away. This causes bones to rub against one another which leads to inflammation and pain.
Medical conditions such as gout, pseudogout, or osteomyelitis may also cause subchondral sclerosis due to infection or the presence of crystals in or around the joint.
What Are the Symptoms of Subchondral Sclerosis?
The symptoms of subchondral sclerosis can vary from mild to severe. The most common symptom is joint pain or swelling that occurs suddenly. In most cases, pain worsens with movement and goes away when you rest. Pain can also occur at night and wake you up from sleep. Other symptoms of subchondral sclerosis include:
Stiffness in the joints
Pain in your heel or the middle of foot (plantar fascia)
Swelling or pain in one joint in particular
Trouble walking or exercising due to pain
What Are the Complications of Subchondral Sclerosis?
If left untreated, complications may arise which can cause permanent joint deformities and damage to the bones. Complications may also increase your risk of developing bone and joint infections.
How Is Subchondral Sclerosis Diagnosed?
Your doctor will ask you to describe the symptoms you have been experiencing and will perform a complete physical examination. Your doctor may also ask you questions about any medical conditions you or your family have suffered from. Your doctor will also inquire about your medical history in general. He or she will then perform a neurological examination to check your senses and motor skills. Your doctor may also check your circulation by checking your pulse and the temperature of your hands and feet.
Your doctor will use an x-ray to confirm a diagnosis of subchondral sclerosis. In most cases, the results will show clear signs of bone remodeling in the affected joints. In some cases, a bone scan may be used to confirm the presence of bone degeneration.
How Is Subchondral Sclerosis Treated?
The treatment you receive for subchondral sclerosis will depend on the symptoms you are experiencing and the severity of the disease. Your doctor may suggest an exercise plan to strengthen your muscles and improve your movement. In some cases, surgery may be needed to regenerate the cartilage in the affected joints.
Sources & references used in this article:
Decreased bone tissue mineralization can partly explain subchondral sclerosis observed in osteoarthritis by LGE Cox, CC van Donkelaar, B van Rietbergen… – Bone, 2012 – Elsevier
Relationship between joint space width and subchondral sclerosis in the osteoarthritic hand: a quantitative microfocal radiographic study. by JC Buckland-Wright, DG Macfarlane… – The Journal of …, 1992 – europepmc.org
Ankle images digital analysis (AIDA): digital measurement of joint space width and subchondral sclerosis on standard radiographs by ACA Marijnissen, KL Vincken, MA Viergever… – Osteoarthritis and …, 2001 – Elsevier
Quantitative analysis of subchondral sclerosis of the tibia by bone texture parameters in knee radiographs: site-specific relationships with joint space width by AKO Wong, KA Beattie, PD Emond, D Inglis… – Osteoarthritis and …, 2009 – Elsevier
The relationship between subchondral sclerosis detected with MRI and cartilage loss in a cohort of subjects with knee pain: the knee osteoarthritis … by MD Crema, J Cibere, EC Sayre, FW Roemer… – Osteoarthritis and …, 2014 – Elsevier
Retrospective study of subchondral sclerosis and lucency in the third carpal bone of Standardbred trotters by H Uhlhorn, J Carlsten – Equine veterinary journal, 1999 – Wiley Online Library