Dr. Alex Jimenez, El Paso's Chiropractor
I hope you have enjoyed our blog posts on various health, nutritional and injury related topics. Please don't hesitate in calling us or myself if you have questions when the need to seek care arises. Call the office or myself. Office 915-850-0900 - Cell 915-540-8444 Great Regards. Dr. J

Spinal Arthritis Diagnostic Imaging Approach Part I

Degenerative Arthritis

  • Spinal Arthritis:
  • Spondylosis aka Degenerative disease of the spine represents an evolution of changes affecting most mobile spinal segments beginning with:
  • Intervertebral disc (IVD) dehydration (desiccation) and degeneration aka Degenerative Disc Disease (DDD) with an abnormal increase in mechanical stress and degeneration of posterior elements affecting 4-mobile synovial articulations ( true osteoarthritis)
  • 2-Facets in the L/S & 2-Facets & 2-Uncovertebral joints in the C/S
  • Imaging plays a significant role in the diagnosis, grading, and evaluation of neurological complications (e.g., spondylotic myelopathy/radiculopathy)
  • X-radiography with AP, Lateral & Oblique spinal views provides Dx and classification of Spondylosis
  • MR imaging may help to evaluate the degree of neurological changes associated with degenerative spinal canal and neural foraminal stenosis
spinal arthritis el paso tx.
  • Spinal motion segment:
  • 2-adjacent vertebrae
  • IVD (fibrocartilage)
  • 2-facets (synovial)
  • Pathology: loss of disc height increases mechanical stress on mobile elements
  • Ligamentous laxity/local instability
  • Spinal osteophytes aka spondylophytes & bony facet/uncinate proliferation
  • Disc herniation and often disc-osteophyte complex
  • Ligamentum flavum “hypertrophy” or thickening due to buckling
  • Loss of normal lordosis with or w/o reversal or kyphosis
  • Vertebral canal & neural foraminal stenosis

Neutral lateral cervical radiograph: note mild to moderate disc narrowing and spondylophyte formation at C5-6 & C6-C7 (most common levels affected by cervical spondylosis). Straightening or flattening with mild reversal of cervical lordosis. Some mild facet proliferation is noted at the above levels

spinal arthritis el paso tx.
  • On radiographs: evaluate for disc height (mild, moderate or severe) loss
  • End-plate sclerosis & spondylophytes; mild, moderate or severe
  • Facet and uncinate irregularity, hypertrophy/degeneration; mild, moderate or severe
  • Note degenerative instability aka degenerative spondylolisthesis/retrolisthesis
  • Normal or lost lordosis vs. degenerative kyphosis
  • Key Dx: correlate with a clinical presentation: neck/back pain with or w/o neurological disturbance ( myelopathy vs. radiculopathy or both)
spinal arthritis el paso tx.
  • Uncinate processes undergo degeneration/proliferation resulting in uncovertebral arthrosis
  • Early findings present with mild bone proliferation along the cortical margin (white and black arrows) if compared to normal uncinate (orange arrow)
  • Later, more extensive bone proliferation extending into and narrowing vertebral canal and neural osseous foramina (IVF’s) may be noted. The latter may contribute to spinal/IVF stenosis and potential neurological changes
  • Posterior oblique views may help further
spinal arthritis el paso tx.
  • AP lower cervical (a) and posterior oblique (b) views
  • Note mild uncinated process proliferation with neural foraminal narrowing (arrows)
  • Typically if less than a third of IVF becomes narrowed, patients may present w/o significant neurological signs
spinal arthritis el paso tx.
  • Lumbar spondylosis is evaluated with AP and lateral views with additional AP L5-S1 spot view to examine lumbosacral junction
  • Typical features include disc height loss/degeneration
  • Intra-discal gas (vacuum) phenomenon (blue arrow) along with spondylophytes
  • Degenerative spondylolisthesis and/or retrolisthesis (green arrow) may follow disc and facet degeneration and can be graded by the Meyerding classification
  • In most cases, degenerative spondylolisthesis rarely progresses beyond Grade 2
  • Lumbar facet degeneration seen as bone proliferation/sclerosis and IVF narrowing
spinal arthritis el paso tx.
spinal arthritis el paso tx.
  • MR imaging w/o gad C is an effective modality to evaluate clinical signs of spondylosis & associated neurological complications with pre-surgical evaluation
  • Case: 50-y.o Fe with neck pain. Case b-45-y.o.M (top a b images). MRI reveals: loss of disc hydration or desiccation, spondylophytes and disc herniation w/o neurological changes
  • (Bottom images) Left: preoperative and right postoperative MRI slices of the patient presented with clinical signs of cervical spondylotic myelopathy. Note disc herniation, ligam flavum hypertrophy and canal stenosis (left)
spinal arthritis el paso tx.
  • Sagittal MRI slice of lumbar DDD manifested with disc desiccation and posterior herniation effacing thecal sac
  • Correlating sagittal and axial slices will be more informative to evaluate canal stenosis and potential degree of neurological involvement (above-bottom images)
spinal arthritis el paso tx.
spinal arthritis el paso tx.

Diffuse Idiopathic Skeletal Hyperostosis (DISH) aka Forestier disease

  • Flowing degenerative ossification of ALL
  • M/c Thoracic spine. 2nd m/c-cervical spine
  • Dx by imaging only. X-radiography is sufficient
  • CT w/o contrast helps with Dx of Fx
  • Men>women. Pts>60-y.o. Extensive DISH shows 49% association with type 2DM
  • Complications: Chalk (carrot) stick Fx. Unstable 3-column Fx requiring surgical fusion
  • Sagittal reconstructed CT scan slice in bone window
  • Chalk stick Fx at C5-C6 in the patient with DISH and OPLL

Spinal Arthritis

Post Disclaimer

Professional Scope of Practice *

The information herein on "Spinal Arthritis Diagnostic Imaging Approach Part I" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*

Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

We are here to help you and your family.

Blessings

Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

Licensed as a Registered Nurse (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
Compact Status: Multi-State License: Authorized to Practice in 40 States*

Presently Matriculated: ICHS: MSN* FNP (Family Nurse Practitioner Program)

Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
My Digital Business Card

Again  We Welcome You¸

Our Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive, cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, practical strength training, and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries.

We use Specialized Chiropractic Protocols, Wellness Programs, Functional & Integrative Nutrition, Agility & Mobility Fitness Training, and Rehabilitation Systems for all ages.

As an extension to effective rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high-performance exercises, and advanced agility treatment options. We have teamed up with the cities premier doctors, therapists, and trainers to provide high-level competitive athletes the possibilities to push themselves to their highest abilities within our facilities.

We’ve been blessed to use our methods with thousands of El Pasoans over the last three decades allowing us to restore our patients’ health and fitness while implementing researched non-surgical methods and functional wellness programs.

Our programs are natural and use the body’s ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, unwanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living.

With a bit of work, we can achieve optimal health together, no matter the age or disability.

Join us in improving your health for you and your family.

It’s all about: LIVING, LOVING & MATTERING!

Welcome & God Bless

EL PASO LOCATIONS

East Side: Main Clinic*
11860 Vista Del Sol, Ste 128
Phone: 915-412-6677

Central: Rehabilitation Center
6440 Gateway East, Ste B
Phone: 915-850-0900

North East Rehabilitation Center
7100 Airport Blvd, Ste. C
Phone: 915-412-6677

Dr. Alex Jimenez DC, MSACP, CIFM, IFMCP, ATN, CCST
My Digital Business Card

Clinic Location 1

Address: 11860 Vista Del Sol Dr Suite 128
El Paso, TX 79936
Phone
: (915) 850-0900
EmailSend Email
WebDrAlexJimenez.com

Clinic Location 2

Address: 6440 Gateway East, Building B
El Paso, TX 79905
Phone: (915) 850-0900
EmailSend Email
WebElPasoBackClinic.com

Clinic Location 3

Address: 1700 N Zaragoza Rd # 117
El Paso, TX 79936
Phone: (915) 850-0900
EmailSend Email
WebChiropracticScientist.com

Just Play Fitness & Rehab*

Address: 7100 Airport Blvd, Suite C
El Paso, TX 79906
Phone: (915) 850-0900
EmailSend Email
WebChiropracticScientist.com

Push As Rx & Rehab

Address: 6440 Gateway East, Building B
El Paso, TX 79905
Phone
: (915) 412-6677
EmailSend Email
WebPushAsRx.com

Push 24/7

Address: 1700 E Cliff Dr
El Paso, TX 79902
Phone
: (915) 412-6677
EmailSend Email
WebPushAsRx.com

EVENTS REGISTRATION: Live Events & Webinars*

(Come Join Us & Register Today)

Call (915) 850-0900 Today!

Rated Top El Paso Doctor & Specialist by RateMD* | Years 2014, 2015, 2016, 2017, 2018, 2019, 2020 & 2021

Best Chiropractor In El Paso

Scan QR Code Here - Connect Here With Dr. Jimenez Personally

Qrcode Chiropractor
Dr. Jimenez QR Code

Additional Online Links & Resources (Available 24/7)

  1. Online Appointments or Consultations:  bit.ly/Book-Online-Appointment
  2. Online Physical Injury / Accident Intake Form:  bit.ly/Fill-Out-Your-Online-History
  3. Online Functional Medicine Assessment:  bit.ly/functionmed

Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

phone: 915-850-0900

Licensed in Texas & New Mexico *

Dr. Alex Jimenez DC, MSACP, CIFM, IFMCP, ATN, CCST
My Digital Business Card

Post Disclaimer

Professional Scope of Practice *

The information herein on "Frailty and Locomotive Syndrome: Phase Angle Detection" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*

Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

We are here to help you and your family.

Blessings

Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

Licensed as a Registered Nurse (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
Compact Status: Multi-State License: Authorized to Practice in 40 States*

Presently Matriculated: ICHS: MSN* FNP (Family Nurse Practitioner Program)

Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
My Digital Business Card