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Articulation osteoarthritis

Osteoarthritis is a disease characterized by the progressive destruction of the joint due to the development of dystrophic changes in the tissues.According to the WHO, each tenth resident of the planet faces this problem.After 50 years, the risk of the disease is around 30% and 70 years reached 80 to 90%.

Healthy articulation affected by osteoarthritis

general information

Osteoarthritis is a long -term chronic process that not only affects joints.As it progresses, the dystrophic and degenerative changes are also incredible the auxiliary apparatus.In the process, the patient is faced with inflammation of the cartilage and bone tissue, the capsule of the joint and the perioseminal bag, as well as muscles, ligaments and subcutaneous tissues in contact with them.

Whatever the location, the pathological process passes according to a single scheme.First, in the thickness of the fabric, the balance between the growth and destruction processes of cartilage is disturbed and balance is offset in favor of dystrophy and reverse development (degeneration).Currently, changes invisible to the eye in the cartilage microstructure occurs, which leads to its slimming and cracking.

As the disease progresses, the joint loses its elasticity and becomes denser.This reduces its ability to depreciate, the rate of tissue lesions increases constantly due to vibrations and microtraums during movements.The slimming of the cartilaginous layer causes the active growth of bone structures, as a result of which the tips and edges appear on the smooth surface of the joint - osteoarthrosis is developing.The movements become more and more limited and painful.The spasms of the muscles surrounding the affected area develop, which worsens the pain and distorts the member.

Steps of the disease

The arthritis of the joints develops gradually and, in the process, three sequential stages which determine the seriousness of the disease:

  • Step 1: The pathology is not detected on an X -ray or an ultrasound, but the destruction processes have already been launched;The composition of the changes of joint fluid, as a result of which the tissues are obtained less than nutritious creatures and become more sensitive;The increase in load in the damage area causes inflammation (arthritis) and pain;
  • The 2nd step is characterized by the active destruction of the cartilage fabric, and the spikes and bone growth appear along the edges of the joint platform (surface contact area);Currently, pain becomes familiar and inflammatory processes become stronger or lower;The spasms associated with the articulation of the muscles are periodically noted;
  • Step 3: The destruction areas affect almost the entire surface of the cartilage, the joint platform is distorted, the injured member deviates from its axis;The volume of movements is reduced and the ligaments weaken and become short.

Some experts also distinguish the stage IV in osteoarthritis development.It is characterized by the almost complete immobility of the articulation.

Guys

Depending on the cause of the disease, primary and secondary osteoarthritis is distinguished.In the first case, pathology occurs independently in the context of a complete effect of predisposing factors.The secondary form is the result of other diseases and is divided into following groups:

  • damage to the joints that have occurred due to metabolic disorders or endocrine diseases (drop, diabetes mellitus, acromegaly, hyperparathyroidism);
  • Destruction associated with congenital pathologies (freezing disease, dislocation of congenital lips, scoliosis, hemophilia, etc.);
  • Post-traumatic osteoarthritis, which appeared in the context of fractures, cracks, necrotic processes or surgical operations, as well as on the continuation of the characteristics of the profession.

The most in demand is the classification of osteoarthritis, according to the location of the pathological process:

  • Gonartrose: The lesion of the knee, one of the varieties of which is the pemoral osteoarthritis on the palette - the destruction of the joint between the femoral bone and the ball joint;
  • Osteoarthritis of the ankle joint: occurs in the bottom of a large load and frequent injuries;
  • Osteoarthritis of the foot joints: the thumb most often suffers at the junction with the foot;Defeat develops on the context of gout or valgus deformation;
  • Shoulder osteoarthritis is characterized by shoulder damage and is often at a young age in a context of increased physical activity (movers, athletes, manufacturers);
  • Coksartrose: damage to the hip joint;Perhaps both an act and bilateral and is one of the frequent causes of disability in people over 50;
  • Vertebral arthritis: the destruction of the cartilaginous discs between the vertebrae, most often affects the cervical and lumbar column;
  • Arthritis of the brush joints: finger joints are most often affected, pathologies are particularly sensitive to menopause women;
  • Osteoarthritis of the temporo-mandibular articulation: it is quite rare, most often in the context of chronic inflammation due to bite disorders or incorrect prostheses;
  • Arthritis of the elbow joint: a rare form of the disease, most often associated with the injuries of this area.

Development reasons

The main factor in the development of osteoarthritis is the lag between the test and the joint capacity of the joint to resist this load.Acute or chronic, this process inevitably leads to the destruction of the tissues.

The list of causes that increase the risk of osteoarthritis of any location includes:

  • heredity;
  • endocrine pathology (diabetes);
  • Wounds of the joint apparatus: bruising, dislocations, fractures or bone cracks inside the joint bag, full or partial ruptures of ligaments which penetrate into the wounds;
  • a regular regular increase in the joint charge associated with the profession;
  • obesity;
  • hypothermia;
  • Inflammatory junior diseases transferred: acute arthritis, tuberculosis, etc.;
  • Blood diseases in which hemorrhages often occur in joint (hemophilia);
  • Clear changes in the hormonal context (pregnancy, menopause);
  • Local circulatory disorders in relation to atherosclerosis, varicose veins, thrombophlebitis, etc.;
  • Autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.);
  • Dyyplasia of the connective tissue (congenital, accompanied pathology, including excessive mobility of the joints);
  • Congenital pathologies of the musculoskeletal system (flat feet, dysplasia or congenital dislocation of the hip joint, etc.);
  • Age of over 45 to 50 years (the increase in risk is associated with a decrease in the synthesis of collagen);
  • osteoporosis (bone empty);
  • Chronic body intoxication (including heavy metal salts, drugs, alcohol);
  • Surgical interventions on joints.

Symptoms

Symptoms of osteoarthritis practically independent of its cause and location, because changes in the joints go according to the same scenario.The disease is developing gradually and begins to manifest itself, already when cartilage is very seriously damaged.

One of the first signs of dysfunction is the tightening of the problematic zone during movement.Most often, this happens when the knee or shoulder is damaged.At the same time, a person may feel a slight decrease in mobility after prolonged inaction, for example, in the morning.

When asked what symptoms appeared with osteoarthritis, most patients first call pain.At the beginning, insignificant and weak, it gradually gained strength, preventing it from moving normally.Depending on the scene and the location of the pathology, a person may feel:

  • Starting pain: occur during the first movements after an extension of inaction of the joint and are associated with the formation on the surface of the cartilage of the thin film of the destroyed fabric;After the start of work, the film moves and the discomfort disappears;
  • Pain with prolonged physical effort (standing, walking, running, etc.): appear due to a decrease in the properties absorbing the shocks of the joint;
  • Meteorological pain: caused by low temperature, humidity, atmospheric pressure changes;
  • Nocturnal pain: associated with venous stagnation and an increase in blood pressure inside the bones;
  • Joint unhappy: acute and severe pain associated with the violation of a piece of cartilage or bone located in the joint cavity.

As osteoarthritis develops, the symptoms become more visible, the patient notes the following signs:

  • an increase in morning rigidity;
  • Strengthening and increased pain duration;
  • decrease in mobility;
  • joint deformation due to bone growth;
  • Deformation of surrounding bones and tissues: the process is well noticeable on the limbs and fingers of the hands, which become significantly curved.

When inflammation is attached, the affected area swells, blushes and becomes hot to the touch.Pressing causes a sharp increase in pain.

Joint pain in osteoarthritis

Analysis and diagnostics

The diagnosis of osteoarthritis is engaged in the orthopedic doctor.He conducts a detailed investigation with the patient to identify complaints and anamnesis.The doctor in detail at the time of the appearance of the first signs and the speed of their development, injuries and diseases, the presence of similar problems in parents.

A general blood test allows you to identify an inflammatory process, which often accompanies osteoarthritis.

The Main Method of Diagnosis is radiography.In the image, the following signs are clearly viewed:

  • narrowing of the joint difference;
  • Modify the contours of the contact bones;
  • Bone structure disturbed in the affected area;
  • Bone growth (osteophytes);
  • curvature of the axis of the limb or finger;
  • Subluxation of the joint.

For more detailed diagnoses, they can be prescribed:

  • Tomodensitometry (CT);
  • Magnetic resonance imaging (MRI);
  • Ultrasound of the joint;
  • Arthroscopy (internal examination of the joint cavity using a camera introduced by a small perforation);
  • Scintigraphy (assessment of the state of bones and metabolism in them by the introduction of radiopharmaceutical drugs).

In the event of suspicion of the secondary nature of the disease, appropriate tests and consultations with narrow specialists are prescribed.

Treatment of joint osteoarthritis

The choice of methodology for the treatment of arthritis of joints depends on the cause of the disease, its stages and its symptoms.In the arsenal of doctors, there is:

  • Drugs;
  • treatment not linked to drugs;
  • Surgical methods.

In addition, the patient must strictly observe a diet and adjust his lifestyle in order to minimize additional damage to the joints.

Drugs

The appointment of drugs for osteoarthritis pursues two main objectives:

  • elimination of pain and inflammation;
  • The restoration of the cartilage fabric or, at least, stops degeneration.

To facilitate the condition of the patient, various types of drugs are used:

  • Non-steroidal anti-inflammatory drugs in the form of tablets, injections, ointments or candles;They relieve pain and inflammation well;
  • Hormones (corticosteroids): shown in serious pain and, most often, are introduced directly into the joint cavity;
  • Other pain relievers, for example, antispasmodic action: help reduce the level of pain by relaxing muscles;

It is important to remember: all types of pain relievers are only used to facilitate the condition of the patient.They do not affect the state of cartilage, and with prolonged use, they accelerate its destruction and cause serious side effects.

The main preparations for the restoration of joints today are chondroprotectors.They contribute to the saturation of cartilage with nutrients, stop the monument and start the cell growth processes.The means only have an effect in the early and means of the development of the disease and subject to regular long -term use.

Preparations that improve microcirculation in tissues and anti-measurements help improve the effect of chondroprotectors.The first provide good supply in the area affected in oxygen and nutrients, and the second slows down the processes of tissue destruction.

The selection of specific drugs, their dosage and the administration regime is engaged in the doctor.

Non -medicinal treatment

Non -linked drug treatment includes the following methods:

  • physiotherapy:
    • Shock therapy: Destroyed bone growth and stimulates blood circulation due to the effects of ultrasound;
    • Automated electromostimulation: exposure to electrical impulses to stimulate muscle contraction;
    • Ultrafonophoresis: the effect of combination ultrasound using drugs;
    • Ozonotherapy: the introduction of a special gas mixture in the joint capsule;
  • Physiotherapy physiotherapy;
  • Mechanot therapy: exercise therapy using simulators;
  • Joint traffic to reduce the load;
  • massage.

Surgical treatment

Most often, the help of a surgeon is necessary at the serious stages of the disease.Depending on the location of the pathological process and the degree of lesion, it can be prescribed:

  • Punction: a perforation of the joint with the elimination of part of the liquid and, according to the indications, the administration of drugs;
  • Corrective osteotomy: withdrawal from part of the bone, followed by a fixing of a different angle to eliminate the load of the joint;
  • Endoprosthetics: replace the damaged joint with a prosthesis;Used in extremely neglected cases.

Osteoarthritis in children

Osteoarthritis is considered an elderly disease, but it can also be found in children.The most common cause of pathology is:

  • Congenital pathology of connective tissue;
  • serious injuries;
  • heredity;
  • Metabolic disorders and the work of the glands of internal secretion;
  • orthopedic disorders (flat feet, scoliosis, etc.);
  • overweight.

Children's osteoarthritis is rarely accompanied by pronounced symptoms: the pain is painful, and there is practically no stiffness and limitation of the function.Monothetic changes are detected on an X -ray, MRI and ultrasound.In the processing process, the same products are used as in adults.Maximum attention is paid to therapy and physiotherapy of the exercise, because at a young age, they are particularly effective.Without treatment, the disease goes on sooner or later in the advanced stage with a complete loss of mobility.

Diet

Diet is one of the most important factors in the treatment of osteoarthritis.In the presence of an excess weight, it is necessary to reduce it to reduce the load on the joints.In this case, a balanced diet with a calorie deficiency is prescribed.Whatever the body mass index, doctors recommend that it completely abandon:

  • Quick carbohydrates (sugar, desserts, flour);
  • alcohol;
  • spices;
  • legumes;
  • Solid tea and coffee;
  • Excessively fatty and sharp dishes.

The can and the offal are not excluded, but considerably limited, as well as salt.The ideal nutrition for osteoarthritis includes:

  • Low meat varieties;
  • fish and seafood;
  • eggs;
  • dairy products;
  • vegetable oils with flax seeds and olive;
  • Vegetables and fruits, a large amount of green vegetables;
  • Moderate cereals, pasta of hard pasta -wrap;
  • Products with a large collagen content (jelly, casting, jelly).

Prevention

Osteoarthritis is easier to warn than treating.To maintain joint health for many years, it is recommended:

  • Lead an active lifestyle;
  • Get regularly and visit the swimming pool;
  • Eat properly, use enough omega-3 and collagen;
  • prevent the BMI overcoming;
  • Wear comfortable shoes.

If the disease is diagnosed at an early stage, it is recommended to regularly undergo treatment at the SPA, as well as to exclude professional risk factors: long -term stay on the legs, rising gravity, vibrations.

Consequences and complications

Osteoarthritis is progressing very slowly.When prescribing a doctor, his current slows down considerably, allowing you to maintain joint mobility much longer.Non -reversible consequences develop without treatment:

  • pronounced joint deformation;
  • decrease in mobility until its complete loss (ankylosis);
  • the shortening of the limb (with damage to the knee or femoral joint);
  • Bone deformation, curvature of limbs and fingers.

Forecast

The prognosis for osteoarthritis depends on the form of the disease, its degree and its quality of treatment.Pathology is one of the frequent causes of disability and, in advanced cases, the ability to move and self-service.In serious forms of damage to the knee and hip joints, the patient receives the first or second disability group (depending on the scene and the volume of damage).