Question

a 58 - year - old female presents with chronic, moderate neck pain that is worse upon waking and better with movement and a hot shower. radiographs of the cervical spine reveal moderate intervertebral disc height loss at c5/c6 with endplate sclerosis and osteophyte formation. what is the diagnosis?
a) osteoarthrosis
b) rheumatoid arthritis
c) ankylosing spondylitis
d) degenerative disc disease

Explanation:

• Osteoarthrosis: It is a degenerative joint disease. In the cervical spine, it can present with neck pain. Radiographic findings like intervertebral disc height loss, endplate sclerosis, and osteophyte formation (bone spurs) are characteristic. The pain pattern (worse on waking, better with movement) also aligns as in osteoarthrosis, joint stiffness is common after rest (like waking up) and improves with movement.
• Rheumatoid arthritis: Is an autoimmune - inflammatory disease. It typically affects smaller joints symmetrically. Radiographic features include marginal erosions, not the disc height loss and osteophyte formation seen here.
• Ankylosing spondylitis: Usually affects the sacroiliac joints first. Radiographic features include syndesmophytes (bony bridges) and bamboo - spine appearance. The pain is often worse at night and in the morning but has a different clinical and radiographic presentation than described.
• Degenerative disc disease: While disc height loss is a feature, degenerative disc disease alone does not typically include endplate sclerosis and osteophyte formation to the same extent as osteoarthrosis. Osteoarthrosis encompasses both disc and joint (facet joint in the spine) degenerative changes which better fit the radiographic and clinical picture.

Answer:

A. osteoarthrosis