Degenerative changes in peripheral joints as indicators of mechanical stress: Opportunities and limitations

Abstract

Abstract Although it commonly has been assumed that environmentally mediated stress is centrally important in initiating degenerative joint disease, it does not necessarily follow that we can make predictive statements concerning those specific stresses in the past that have led to the onset of degenerative change. Indeed, numerous examples from clinical studies of apparently clearly demarcated occupational stress have failed to show expected correlations with degenerative disease. Comparisons of laterality, age of onset, location, frequency and severity of involvement can be used to facilitate general comparisons concerning type and overall level of mechanical stress as, for example, between hunter‐gatherer and agricultural groups. As shown from statistical analysis of skeletons of American Whites, American Blacks, Alaskan Eskimos, Pueblo Indians and Californian Indians (total N > 950), the expression of degenerative lesions varies both within and between joints. The most behaviourally sensitive joint modifications are seen on articular surfaces (pitting, eburnation), but not around joint margins (osteophytes), where strong age‐related phenomena predominate.

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