Joint joint (deforming arthrosis, folk name - deposit of salts) The degenerative -dynamic chronic disease of the joints, in which the destruction of joint cartilage, joint capsules and deformation of the bone itself occurs.
It should be noted that arthrosis is a whole group of joint diseases that are of different origin and close development mechanisms.Most often they are in arthrosis of large joints:
- Deforming the deforming artrosis of the knee joint (gonarthrosis),
- Deformation of deforming arthrosis of the hip joint (coksartrosis),
- and the shoulder joint joint joint.
These are the most serious types of arthrosis.
Arthrosis of small joints is less common.Most often, the intermeting joints of the hands and the deformary arthrosis of the thumb metakolangeal joints.Patients note the pain of the interalting joints, the reduction of their mobility, and the appearance near the joints of the seals (Geberden and Bushar knots).This type of arthrosis is more common in old age.Arthrosis of the leg joints often occurs.
Polirrosis or generalized arthrosis are characterized by several joint damage.
Joint joint The joints of the spine - spondylarthrosis - belong to the group of spinal diseases, although it has a similar mechanism of development with other arthrosis.
The main clinical symptom of arthrosis is the reduction of joint pain and mobility.Specific symptoms are determined by the stage of arthrosis and depends on the degree of destructive changes in the joint.
The joint reasons
Joint joint It is customary to divide into primary and secondary.Primary (idiopathic) arthrosis is the result of violation of healing processes and increased degeneration of joint cartilage tissue without a difference in the work of the entire body.Secondary arthrosis is other pathological processes of the body or in the joint, which is already damaged by any external effect, by partial destruction of the joint surfaces.
Most often, traumatic arthrosis is diagnosed in young patients.And for older patients, it is not always possible to draw a clear border between primary and secondary arthrosis.
Although the exact cause of arthrosis cannot be determined, the factors that contribute to occurrence and development are well known.
The following types of causes that contribute to primary and secondary deforming arthrosis can be distinguished.
Causes of primary arthrosis hereditary factors
The following hereditary disorders have been identified that can cause primary arthrosis:
- Genetic disorders in the composition of the cartilage tissue, which leads to accelerated destruction;
- Congenital errors in the muscle system (joints hypermobile, dysplasia, flat legs and others), which are the cause of the trauma of certain sections of the artificial cartilage and, as a result, the appearance of arthrosis.
It has also been noted that the deforming arthrosis of the Inter -Falax joints of the upper limbs is mainly found in women and is inherited by the female line.
Causes of secondary arthrosis
Secondary arthrosis is a consequence of joint damage.These damage can be caused by various factors.
- Mechanical damage to the joints.This group of factors includes various joint injuries, intraarticular bone fractures, which result in the joint structure disturbing.The same result is caused by constant microtraumatization of the joints as a result of static and dynamic excessive constant loads (such as athletes).Obesity also leads to overload and trauma.
Another factor that has a negative effect on the joints (primarily on the hips) is improper posture.
The structure of the joint can also interfere with surgical intervention. - Joint diseases.Arthrosis may be the result of inflammatory diseases of the joints (acute and chronic arthritis, synovitis, primary aseptic necrosis of the bone tissue, etc.)
- Violation of metabolism, diseases of the endocrine system, lack of minerals in the body.Different disorders of metabolism, calcium deficiency, changes in phosphorus and other minerals, vitamins and trace elements in the composition of the bone and cartilage, which leads to violation of healing processes and gradual destruction of the composition.
- Autoimmune diseases(gout, chondrocalcinosis, hemochromatosis, psoriasis, rheumatoid arthritis), hormonal disorders, lack of estrogen After postmenopause, women lead to changes in the tissues of the joints and their gradual destruction.
- Vascular disease (The lower limbs of blood vessels atherosclerosis, endarteritis, the destruction of varicose veins) and Hypodynamics They cause circulatory disorders in periarticular tissues, poor blood supply to joint tissues and, as a result, dystrophic changes.
The mechanism of joint development
Development joint joint Begins with the destruction of the cartilage.It is believed that the beginning of blood circulation is a violation of the periosteum cornea layer.Because cartilage nutrition stems from intraarticular fluid and the intake of the adjacent bone tissue, the circulatory disorder results in the fact that the cartilage gradually loses elasticity, becomes thinner, cracks appear, smooth the smoothness of the joint surfaces and reduce the amount of synovial fluid.As a result Pain and crunches during movements- the width of the joint gap gradually decreases, the bone is formed along the edge of the joint surfaces Osteophyta spikesOr
Finally, the joint is deformed and the amplitude of the movement decreases.This is how the body's aging develops invitation arthrosis.The formation of this form of arthrosis is generally gradually occurring over the years.
Other forms of large joints, such as post -trauma, post -infesting, metabolic, intoxication have many other development mechanisms, but as a result, similar changes in the joint are obtained.
Joint symptoms of joints.The joint sections and degrees
"Classic" is the classification of arthrosis based on clinical and radiological characteristics.Accordingly, the three stages of the disease can be distinguished.This corresponds to classifying a disability, which distinguishes 3 degrees of joint degree:
- I am of arthrosis - the disease does not hinder work, although complicated,
- II.Degree of arthrosis - the disease prevents work performance,
- III.Degree of arthrosis - loss of working capacity.
Let's look at the clinical symptoms and signs of arthrosis in this stage in more detail
Arthrosis of Arthrosis 1 (initial stage of arthrosis)
At the initial stage of the disease, in the morning, after relaxation, stiffness, difficulty movement in the joints, which gradually disappears after movement begins.Perhaps a restriction of mobility in the joint.Occasionally, "beginner" pains occur (pain at the beginning of movement, after a long rest).With sharp movements, the joint is cracking, but there is no pain during movement.At this stage of arthrosis, the pain appears only with significant and longer loads and decreases after rest.There is no and low load on its own.At this stage of the disease, patients rarely seek medical attention.
In the X image, whose arthrosis is not visible in arthrosis of the joint changes in the joint, sometimes small osteophytes are visible along the edges of the joint, and the joint gap is slightly narrow.
2 degrees of arthrosis (second stage of arthrosis)
With further development of arthrosis, pain becomes more significant and acquires an acute character.There is a separate crisis in the joint with any movement, mobility is noticeable in the joint (contracture), functional abbreviation of the limb, impaired biomechanics of movements, but joint mobility is still preserved.This stage is characterized by a noticeable reinforcement of starting pain, acute and longer.Day physical activity causes constant fatigue, feeling of pressure in the affected joints, and the so -called "mechanical pain" caused by a reduction in the shock of the articular cartilage tissues.
The destruction of the joint is quite significant, and the joints are partially deformed.
The X-rays, the noticeable osteophytes, are visible, the joint gap is 2-3 times, such as the norm, the sclerosis of the subchondral bone, and the formation of cystic cavities in the epifational zone.
Degree arthrosis is a decrease in working capacity and inability to perform certain types of work.
3 degrees of joint (third stage of arthrosis)
Joint joint 3 degrees The serious, neglected stage of the disease.They are at this stage:
- Significant deformation of the joint (due to growth of bones and fluid accumulation in the joint cavity);
- sharp restrictions on movements only until the rocking movements are preserved;
- Sharp pain not only when mobility, but also in a state of rest - is a constant pain associated with reflex cramps of nearby muscles and the formation of reactive synovitis;
- arthritis,
- The sensitivity of the joints to weather changes.
- The muscles around the knee are ugly and atrophy;
The axis of the limbs is deformed, noticeably varus or the valgus curvature of the legs (ie in the form of "O" or "X").
X -rays with 3 arthrosis, almost complete disappearance of joint gap, severe deformation of joint surfaces, and huge more regional osteophytes.The calcification of joint mice and paraarticular tissues can be determined.
At 3 degrees, the disease went very far, often the cause of lasting disability.Manifests as follows:
- The pain becomes constant and painful: walking, especially descending and climbing stairs - a difficult test for the patient;
- Loud crunch in any gesture, for others.
- The deformation of the joints is highly expressed, the movements are limited by only a small amplitude;
The images show the destruction of intraarticular structures (ligaments and meniscus), as well as signs of complete wear and sclerosis (replacement of functional organs and construction of connective tissue).
Grade 4 is a joint
The state of complete destruction of the joint joint joint, when the joint stops operation completely, it often differs separately -with 4 degrees Arthrosis.There is a so -called "joint blockade" - an acute pain syndrome in which even limited movement in the patient joint is impossible.The fourth degree of arthrosis is accompanied by unbearable joint pain, which is not removed even by strong drugs and intense physiotherapy.Complete ankylosis (joint fusion) or neoartrosis (formation of a false joint between the displaced ends of the bones) is possible.Independent movement is almost impossible in both cases.
The coarse sclerosis of the Sattim surfaces with pronounced cystic enlightenment in the images shows the merger of the connecting bones in the joint gap.The development of the disease into this stage is almost always a disability, which can only be prevented by implanting an artificial joint prosthesis.
Treatment of joint treatment
Treatment of arthrosis at the initial stage of the disease
It is better to start treating arthrosis as soon as possible, with the appearance of the first signs - crunching in the joints and difficulties of movement.At this stage, drugs are useful -Klondroprotectors that improve the structure of the cartilage and the vitamin Prime Minister.
Medical physical education, proper nutrition and preventive measures are important.It should be noted that prevention of arthrosis is also of great importance to worsen the disease.
Treatment of arthrosis is 2 - 3 degrees
Although it is impossible to fully cure the arthrosis of the 2-3 degrees, the process of development can be noticeably inhibited.Treatment of arthrosis at this stage includes the following sections:
- To remove or reduce the pain syndrome
- Remove inflammation in the joint.
- Improve cartilage recovery and slow down the degenerative processes in it.
During the acute period, the treatment of arthrosis begins with the elimination of pain.For this, non -hormonal anti -inflammatory drugs (NSAIDS) are used by analgesics.Intraarticular injections of corticosteroids are possible.The joint load should be reduced, may not be or stand for a long time, and raise heavy objects.
After removing the acute pain syndrome, the main task is to ensure healing processes in joint and periarticular tissues: improvement of blood circulation, increased metabolism, and elimination of inflammatory processes.Condroprotectors, vasodilators, therapeutic exercises and physiotherapy are prescribed.
Treatment of arthrosis is 4 degrees
At this stage of the disease, the joint is almost completely destroyed.In this case, one exit remains - replacing surgery and sick joint with endoprothesis.Endoprosthesis significantly improves joint mobility, allows the patient to continue active life, at least get rid of pain.