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Arthrosis (osteoarthrosis, arthrosis deformans) is a process of slow degeneration and destruction of the cartilage in the joint. The articular ends of the bones become deformed and enlarged and the periarticular tissues become inflamed. The general diagnosis of "arthrosis" means diseasesA group of conditions that are similar in symptoms but different in origin. The joint – the affected area – consists of articular surfaces covered with cartilage tissue, a cavity with synovial fluid, a synovial membrane, and an articular capsule. Advanced diseaseWith, he loses mobility, and the patient experiences pain due to inflammatory processes.

Joint pain due to arthrosis

Reason

Arthrosis of the joints develops due to the discrepancy between the amount of stress and the body's capabilities. Lack of nutrients, excess body weight, heavy physical work and even sports can also cause it.

Factors affecting the development of the disease:

  • genetics, hereditary predisposition;
  • over 40 years of age;
  • Obesity, overweight;
  • Sedentary work, inactive lifestyle;
  • hard work, work that involves sustained physical activity;
  • Inflammatory diseases;
  • Congenital joint deformity (dysplasia);
  • Injuries, wounds;
  • Malfunctions of the body (poor blood circulation, imbalance of hormones, microelements).

The disease can be primary or secondary. The causes of primary arthrosis are still not well understood. Doctors believe that it develops in the presence of genetic factors (predisposition) and external adverse conditions.

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

The likelihood of developing this disease increases in representatives of working professions and athletes. Representatives of the arts are also at risk: dancers (especially ballerinas), pianists. Arthrosis of the wrist joints and fingers often affects people whose workFine motor skills are involved in: mechanics, mechanics and pianists. "Professional" arthrosis of loaders is localized in the knees, collarbones and elbows. Drivers, painters and miners suffer from elbow and shoulder joints. The weak point of the ballerina is the ankle. Depending on the type of sporting activity, athletes are also more likely to suffer injuries to the ankle and other joints in the arms and legs. For example, a tennis player will be more at risk for shoulder and elbow joint disease.

Pathogenesis

Structural changes in cartilage are caused by an imbalance between the breakdown and repair of the tissue. Collagen and proteoglycans are gradually "flushed out" of the body, with no supply of new nutrients. Cartilage tissue loses elasticity, becoming soft. And is unable to cope with stress.

Regardless of the location and the root cause, the disease develops in the same way. Gradually, the cartilage is completely destroyed, the bones "grind" against each other. The patient experiences pain, the intensity of whichIncreases depending on the condition. Mobility of the joint gradually decreases, the patient's activities become limited.

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classification

Orthopedics use a classification devised by Professor in 1961:

  • Stage IThe bone becomes denser, the joint space becomes slightly narrowed. Discomfort during physical activity, which goes away after rest;
  • Step II. The joint space becomes markedly narrowed, the bone edges grow, and the connective tissue becomes denser. The pain becomes constant, the muscles become overextended, the joint becomes much less mobile, specific symptoms appear at the locationAre there;
  • Step III. The joint space is practically absent, bone growth is extensive, and the bone beneath the cartilage is likely to be destroyed. The joint is completely deformed and immobile. Depending on the type and location of the disease, intense or constant pain is possible;

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 multiple joints (for example, fingers), it is said to be generalized.

Body Size:

  • Deformation (osteoarthrosis). Leads to bone growth;
  • uncovertebral. Destroys discs and intervertebral tissue in the cervical region;
  • Post-traumatic. Develops as a result of trauma, injury;
  • Arthritis. Autoimmune diseases, connective tissue inflammation. May be the result of previous arthritis;
  • Psoriatic. Develops on the background of psoriatic arthritis.

Localizations

Osteoarthritis is a disease that affects joints throughout the body.

Spinal cord. The reasons for this can be autoimmune diseases, back diseases, increased stress, injuries, deficiency of micro elements, hormonal imbalance.

Localization:

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

Feet. Knees and ankles are more susceptible to arthrosis. The causes are injuries, overweight, incorrect, excessive loads. Types of localization:

  • Gonarthrosis - knee;
  • Patellofemoral – femur and patella;
  • ankle;
  • talonavicular joint;
  • Feet and toes.

Hand. Lesions in the hands and fingers are more common, and in most cases they are associated with professional activities, injuries, age-related and hormonal changes. In addition, the disease is localized in the shoulder, wrist and elbow joints.

Torso. Localization in the trunk is less common than arthrosis of the extremities. Lesions are associated with professional activity, sedentary lifestyle (stagnation).

Types of localization:

  • Collarbone. When moving, "clicks" and pain are felt. Athletes and military personnel involved in weightlifting are at risk due to possible injuries;
  • Hip joint (coxarthrosis). This disease manifests itself as pain in the groin area.

head>, Sometimes dental problems, autonomic disorders and even hearing loss occur due to damage to the temporomandibular joint. Inflammation disrupts facial symmetry, 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. In the early stages - during movement, during work, in the later stages - during rest;
  • Swelling, swelling. Periarticular tissues swell, the skin turns red;
  • "Click", crunching. When moving, characteristic sounds are heard;
  • Difficulty in walking. As the disease progresses, mobility of the affected area becomes impaired;
  • Reaction to cold. Many types of arthrosis are characterized by exacerbation in the rainy and cold seasons.

The exacerbation of the disease is associated with a general weakening of health. Due to viral diseases and increased stress, it becomes severe and develops several times faster. During the exacerbation, the symptoms, especially pain, become more pronounced. It becomes difficult for the patient to move, to the extent of completely losing mobility and performing normal functions.

Possible complications

The main danger is the loss of joint mobility, its deformity beyond the possibility of recovery. Due to the displacement of the axis, posture is disrupted and the figure loses symmetry. Possible increased pressure on internal organs, their displacement, compression. Concomitant diseases andFailures of body systems appear. For example, with arthrosis of the coccyx in women, gynecological complications are possible, and arthrosis of the temporomandibular joint or the cervical spine causes disturbances in the autonomic system: dizziness, sleep disturbances. A patient suffering from arthrosis may become disabled.

diagnosis

To make a diagnosis, a comprehensive examination is performed:

  • history taking;
  • Radiography in multiple projections;
  • MRI and CT to exclude tumors and obtain a three-dimensional image;
  • Blood and urine tests to exclude concomitant diseases and assess general health.

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

Treatment

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

Conservative (non-surgical) treatment:

  • Physiotherapy, use of orthoses, canes, crutches to reduce load. Elimination of concomitant and provoking factors (for example, weight loss, stress, change in activity);
  • Taking non-steroidal anti-inflammatory drugs. Selective COX-2 inhibitors are most effective. Chondroprotectors and atypical antidepressants are prescribed as adjunctive agents;
  • Intra-articular injections of glucocorticoid hormones to reduce severe pain and inflammation.

Surgical Methods:

  • Arthroscopy – internal examination of the joint and removal of cartilage fragments;
  • Arthroplasty – implantation of artificial cartilage;
  • Osteotomy – removal or dissection of bone tissue;
  • Chondroplasty – restoration of cartilage;
  • Arthrodesis – artificial stabilization of the joint (usually ankle);
  • Endoprosthetics – removal and replacement of damaged joints with artificial joints.

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

Prediction and prevention

After starting treatment for stage I and II arthrosis, a lasting improvement occurs: pain and swelling go away. In this case, complete relief of the disease or its long-term preservation is possible.

When treating stage III arthrosis, improvement does not occur immediately. In some cases, the disappearance of pain is possible only after surgery. Often the joint remains immobile or deformed. Patients with severe types of arthrosis of the hip and knee jointsReceives 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 to reduce the risk of developing the disease. Examination at the first symptoms of arthrosis (especially after injuries and infectious diseases)After) and paying careful attention to health will allow you to identify the disease at an early stage.