Musculoskeletal disorders in the elderly

Abstract

Musculoskeletal disorders are among the most common problems affecting the elderly. The resulting loss of mobility and physical independence can be particularly devastating in this population. The aim of this article is to present some of the most frequent musculoskeletal disorders of the elderly, such as fractures, osteoporosis, osteoarthritis, microcrystal disorders, infections, and tumors.

Keywords: Aged; arthritis; fracture; musculoskeletal diseases; neoplasm.

Figure 1

Usual benign vertebral compression (a) multiple levels, diffuse radiolucency, and whole vertebral endplate involvement (arrows); usual malignant vertebral compression characteristics (b) single vertebral involvement, focal and bulging of the posterior wall (arrowheads).

Figure 2

Missed fracture of the odontoid process and vertebral body of C2 (arrows) in a patient with a history of fall one month before. Note the associated degenerative changes of the lower cervical spine (arrowheads).

Figure 3

Transverse fracture of thoracic vertebral body (arrow) and posterior arch (arrowhead) with posterior epidural hematoma (curved arrow) in an ankylosed spine depicted on (a) T1- and (b) T2-weighted sequences.

Figure 4

Insufficiency fractures (arrows) located in the sacrum with adjacent edema (arrowheads), better depicted on (a) T1- and (b) T2- weighted sequences, respectively. This bone edema should not be confused with sacroiliitis.

Figure 5

Multiple fractures (white arrows) in (a) the proximal femur and (b) pubic ramus on coronal T1-weighted images

Figure 6

Subchondral fracture of the femoral head: (a) conventional radiography and (b) fat saturated sagittal T2-weighted image (white arrow).

Figure 7

Typical osteoarthritis of (a) the distal and proximal interphalangeal joints and (b) hip joint: joint space narrowing (arrows), subchondral cysts (arrowheads), osteophytes (curved arrows), and subchondral sclerosis (thick arrow).

Figure 8

Ultrasound images in (a) the long and (b) short axis of the supraspinatus tendon demonstrating a complete tear (arrowheads).

Figure 9

Gout of the first MTP joint in conventional radiography: Excentric dense nodular soft tissue mass (arrows), large erosions (arrowhead), lack of periarticular osteoporosis, and exuberant bony proliferation (curved arrow).

Figure 10

Gout involvement of the MTP (a) shows the tophus (arrow) with hyperechogenic microcrystal deposits (arrowheads) and a thickened synovium (curved arrows). Another patient with tophus deposition in the dorsal midfoot (b) demonstrates microcrystal deposits (arrowhead) with acoustic shadows (thick arrows).

Figure 11

Calcium pyrophosphate dihydrate deposition disease demonstrated by deposits of microcrystals in the menisci (arrow), articular cartilage (arrowhead), and periarticular soft tissue (curved arrow).

Figure 12

Tuberculosis of the second metacarpophalangeal joint. (a) On conventional radiography there is mild osteoporosis, extensive soft tissue swelling, and large marginal erosion (arrowhead), (b) On Doppler ultrasound the synovitis (arrows) and bone erosion (arrowhead) are well-depicted.

Figure 13

Paget's disease affecting the iliac bone demonstrated with coarsening of the bone trabeculae and cortical thickening (arrows).

Figure 14

Chondrosarcoma of the pelvis in (a) conventional radiography appears as an isolated osteolytic lesion (arrows), (b) Coronal T2-weighted image demonstrates a lobulated hyperintense lesion (arrowheads).