Gross diagnosis: Advanced osteoarthritis with eburnation and loose bodies.

Degenerative Joint Disease: Definition: Group of degenerative pathologic changes of the joints related directly to age, trauma and occupation. Clinical features: Loss of cartilage thickness leads to: narrowing of joint space, loss of stability of chondro-osseous junction. Changes: centered in cartilage (notorious for its poor capacity for repair), more prominent on joint surface exposed to: friction, weight bearing, movement, also in areas of joint not subject to these mechanical forces. Pathogenesis: Degenerative, Not inflammatory. Osteophytes at margins of joints progress through discrete stages of cartilage differentiation, cartilage degradation believed to be mediated by cytokines, particularly IL-16. Loss of chondroitin sulfate matrix precedes mechanical attrition of cartilage. Gross Pathology: Earliest change is even degeneration of hyaline cartilage of articular surface: first detected as fibrillation of cartilaginous matrix at a right angle to surface eventually resulting in: papillary appearance sometimes in freeing of fragments of cartilage leads to: thinning of cartilage. compensatory overgrowth of apposite joint surface. Secondary features: sometimes cysts close to surface in joint bones surrounded by dense bone and containing fluid or loose connective.

Path Consult