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Arthrosis

Arthrosis (osteoarthrosis, arthrosis deformans) is a process of slow degeneration and destruction of cartilage in the joints. The articular ends of the bones become deformed and enlarged, and the periarticular tissue becomes inflamed. The general diagnosis "arthrosis" means a group of diseases that are similar in symptoms, but different in origin. The joint - the affected area - consists of an articular surface covered by cartilage tissue, a cavity with synovial fluid, a synovial membrane and an articular capsule. With advanced disease, he loses mobility, and the patient experiences pain due to the inflammatory process.

joint pain due to arthrosis

Cause

Arthritis of the joint develops due to the discrepancy between the amount of pressure and the ability of the body. Lack of nutrients, excess weight, heavy physical work and even sports can cause this.

Factors that affect the development of the disease:

  • genetics, hereditary predisposition;
  • age over 40 years;
  • obesity, overweight;
  • sedentary work, passive lifestyle;
  • hard work, work that involves constant physical activity;
  • inflammatory diseases;
  • congenital joint pathology (dysplasia);
  • injury, wound;
  • body damage (poor blood circulation, hormonal imbalance, microelements).

This disease can be primary or secondary. The cause of primary arthrosis is still not well understood. Doctors believe that it develops in the presence of genetic factors (tendencies) and unfavorable external conditions.

Secondary arthrosis occurs against the background of inflammatory diseases, dysplasia, and as a result of injuries, including professional ones.

Representatives of working professions and athletes have a higher chance of developing this disease. Representatives of the arts are also at risk: dancers (especially ballerinas), pianists. Arthrosis of the wrist and finger joints most often affects people whose work involves fine motor skills: mechanics, mechanics and pianists. "Professional" loader arthrosis is localized in the knees, collarbones and elbows. Drivers, painters, and miners suffer from elbow and shoulder joints. The weak point of ballerinas is the ankle. Athletes are also more likely to experience injuries to the ankles and other joints of the arms and legs, depending on the type of sports activity. For example, tennis players will be at high risk for shoulder and elbow joint disease.

Pathogenesis

Structural changes in cartilage occur due to an imbalance between tissue damage and repair. Collagen and proteoglycan are gradually "washed out" from the body, new nutrients are not supplied. Cartilage tissue loses elasticity, becomes soft and cannot withstand pressure.

Regardless of the location and cause of the cause, the disease develops in the same way. Gradually, the cartilage is completely destroyed, the bones end up "grinding" on each other. The patient experiences pain, the intensity of which increases depending on the stage. Joint mobility gradually decreases, the patient is limited in movement.

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Classification

Orthopedists use the classification formulated by the professor in 1961:

  • Stage I. The bones become denser, the joint space narrows a little. Discomfort during physical activity, which disappears after rest;
  • Stage II. The joint space is noticeably narrowed, the edges of the bones grow, and the connective tissue becomes denser. Pain becomes constant, muscles become hypertrophied, joints are more or less mobile, specific symptoms appear in the location;
  • Stage III. Joint space is almost non-existent, bone growth is extensive, and bone destruction under the cartilage is possible. The joint is completely deformed and immobile. Acute or persistent pain is possible depending on the type and location of the disease;

Depending on the location and form of the disease, symptoms, speed of development, and treatment methods will vary.

Form

The disease is characterized by a chronic form, but it can also occur in an acute form.

When the disease spreads to several joints (for example, fingers), it is called generalized.

Anatomical form:

  • deformation (osteoarthrosis). Leads to bone growth;
  • not covertebral. Destroys discs and intervertebral tissue in the cervical region;
  • after trauma. Develop due to trauma, injury;
  • rheumatoid. Autoimmune disease, inflammation of connective tissue. May be due to previous arthritis;
  • psoriatic. Develop against the background of psoriatic arthritis.

Localization

Osteoarthritis is a disease that affects joints throughout the body.

Backbone. The cause may be autoimmune disease, back disease, increased stress, injury, lack of microelements, hormonal imbalance.

Localization:

  • coccyx;
  • lumbar region;
  • thoracic spine;
  • cervical region

legs. Knees and ankles are more prone to arthrosis. The reason is injury, overweight, incorrect, overload. Localization type:

  • gonarthrosis - knee;
  • patellofemoral - femur and patella;
  • ankle;
  • talonavicular joint;
  • feet and toes.

hand. Lesions on the hands and fingers are more common, and in most cases they are associated with professional activities, injuries, age-related changes and hormones. In addition, this disease is localized in the shoulder joints, wrists and elbows.

Body trunk. Localization in the trunk is less common than in arthrosis of the legs. Lesions are associated with professional activity, an inactive lifestyle (stagnation).

Localization type:

  • clavicle. When moving, "click" and pain is felt. At risk are athletes involved in weightlifting and military personnel due to the possibility of injury;
  • hip joint (coxarthrosis). This disease manifests itself as pain in the groin area.

Head>. Sometimes dental problems, autonomic disorders and even hearing loss are caused by damage to the temporomandibular joint. Swelling disturbs the symmetry of the face, can affect the ears and cause headaches.

symptoms

Symptoms of the disease depend on its location. Common manifestations for all types are:

  • pain in the affected area. At the initial stage - during movement, work, at a later stage - rest;
  • inflammation, swelling. The periarticular tissue swells, the skin becomes red;
  • "click", clang. When moving, a characteristic sound is heard;
  • difficulty moving. As the disease progresses, the mobility of the affected area is impaired;
  • reaction to cold. Many types of arthrosis are characterized by aggravation in rainy and cold weather.

The severity of the disease is associated with general weakness of health. Due to viral diseases and increased stress, it takes an acute form and develops many times faster. During an exacerbation, symptoms, especially pain, become more pronounced. It is difficult for the patient to move, to the point of complete loss of mobility, and to do normal work.

Possible complications

The main danger is the loss of joint mobility, its deformation beyond the possibility of recovery. Due to the axial displacement, the posture is disturbed and the figure loses its symmetry. Possible increased pressure on internal organs, their displacement, compression. Concomitant diseases and body system failures appear. For example, with arthrosis of the coccyx in women, gynecological complications are possible, and arthrosis of the temporomandibular joint or cervical spine causes disorders in the autonomic system: dizziness, sleep disorders. Patients with arthrosis may become disabled.

Diagnostics

To make a diagnosis, a comprehensive examination is carried out:

  • taking anamnesis;
  • radiography in several projections;
  • MRI and CT to exclude tumors and obtain three-dimensional images;
  • blood and urine tests to rule out comorbidities and assess general health.

Depending on the cause of the disease, the patient is referred to a rheumatologist, traumatologist, surgeon or orthopedic specialist.

Treatment

Stage I of the disease is best treated. Patients with stage II can expect long-term relief from bone destruction. Stage III most often requires surgical intervention.

Conservative (non-surgical) treatment:

  • physiotherapy, the use of orthosis, crutches, crutches to reduce the load. Elimination of accompanying and aggravating factors (for example, weight loss, stress, changes in activity);
  • take non-steroidal anti-inflammatory drugs. Selective COX-2 inhibitors are the most effective. Chondroprotectors and atypical antidepressants are prescribed as additional agents;
  • intra-articular injection of glucocorticoid hormones to reduce severe pain and inflammation.

Surgical method:

  • arthroscopy - internal examination of the joint and removal of cartilage fragments;
  • arthroplasty - implantation of artificial cartilage;
  • osteotomy - removal or surgery of bone tissue;
  • chondroplasty - cartilage restoration;
  • arthrodesis - artificial immobilization of a joint (usually the ankle);
  • endoprosthetics - removal and replacement of damaged joints with artificial joints.

Cardinal treatment allows you to stop the disease even at a late stage. It is possible to restore mobility in isolated cases (after replacing it with an artificial one). However, this method is effective in combating pain. After surgery, rehabilitation is required using physiotherapeutic methods and drugs.

Prognosis and prevention

After starting treatment for stage I and II arthrosis, a lasting improvement occurs: pain and inflammation disappear. In this case, complete remission of the disease or long-term preservation is possible.

When treating stage III arthrosis, improvement does not occur immediately. In some cases, the loss of pain is possible only after surgery. Often the joint remains immobile or deformed. Patients with a severe form of arthrosis of the hip and knee joints receive disability group I or II.

It has been proven that there is no effective prevention against arthrosis. Weight control, a balanced diet and a moderate amount of exercise will help reduce the risk of getting this disease. Examination of the early signs of arthrosis (especially after injuries and infectious diseases) and careful attention to health will allow you to identify the disease at an early stage.