What is arthrosis of the joints

Osteoarthritis can affect any joint, while degenerative-dystrophic changes can be isolated or occur in several joints at the same time.

This pathology is not life threatening, but significantly reduces its quality. Severe pain, limited mobility increases over time, provoking disability.

In the early stages, conservative therapy is prescribed, which helps stop the development of the disease.

It is difficult to completely cure osteoarthritis deformans (DOA), but it is possible to preserve bone function. In later stages, only surgical treatment will help.

Development mechanism

Many people have heard of a disease such as osteoarthritis, but not everyone understands what it is. To do this, you need to understand how the node works.

The bone surfaces that form the joints are covered with smooth, slippery, elastic cartilage that protects them from damage. With osteoarthritis, the blood supply to this area is disrupted and the hyaline cartilage begins to deteriorate. Further, degenerative-dystrophic changes occur with the capsule, ligaments, periarticular muscles, and other segments of the joint.

Usually the disease develops slowly, but the pathological process can be accelerated under the influence of external factors. Much depends on the characteristics of the patient's body, concomitant diseases, lifestyle.

Osteoarthritis develops as follows:

• Blood circulation is impaired in a certain area of the cartilaginous lining of the ankle, then it begins to suffer from lack of nutrients. Under the influence of traumatic factors, the area of destruction increases.
• The body replaces defects in the lining of the articular cartilage with mineralized tissue, which does not have a clear structure.
• Gradually, pathological growths (osteophytes) appear in the hyaline coating.
• Against the background of the pathological process, healthy areas of cartilage are exposed to excessive stress. As a result, the work of the node breaks down and its surfaces are gradually destroyed.

Carefully!Osteoarthritis provokes destruction of the bony surfaces of the joint, inflammation of the synovial membrane, compression of the joint capsule. There is a narrowing of the joint space, the joint is deformed, destroyed, then the patient may become incapacitated. Therefore, it is very important to diagnose and start treating the pathology in time.

As a rule, osteoarthritis is detected in patients over 60 years of age. However, the disease is diagnosed at a young age - from 20 to 45 years.

Reference. Arthritis and osteoarthritis are similar, so many patients are interested in the question of how the first disease differs from the second. With DOA, only the joints are damaged, and arthritis is characterized by inflammatory damage not only to the junction of the bones, but also to the internal organs (liver, kidney, heart). This is the main difference between these pathologies.

Distribution

People who are far from medicine, when they hear names such as gonarthrosis, coxarthrosis, osteoarthritis, do not understand the difference. The fact is that there are many types of this pathology, which differ in localization, course specificity, reasons, origin. Therefore, doctors have created several classifications of osteoarthritis to make their differentiation easier.

Types of osteoarthritis by localization:

• Gonarthrosis is a pathological process in the knees.
• Coxarthrosis is a lesion of the thigh joint.
• Uncovertebral - deformity of the cervical spine.
• Dystrophic changes in the shoulder joint.
• Interphalangeal - deformity of the interphalangeal joints of the bones.
• Spondyloarthritis is a degenerative change in the joints of the spine.
• Ankle - Wear on the ankle.
• Polyosteoarthritis is a multiple lesion of the finger joints.

In addition, there is also osteoarthritis of the jaw, temporal, cost-vertebral, clavicular-acromial.

Depending on the characteristics of the course, the following types of pathology are distinguished:

• Deforming osteoarthritis is a disease that has progressed to stage 3. It is a progressive disease that requires immediate surgery.
• Osteoarthritis - destruction of cartilage lining, inflammation.
• An acute illness in which characteristic symptoms become more pronounced.
• Chronic osteoarthritis is a slow destruction, thinning of the cartilaginous lining with an erased flow.

Depending on the reason, a distinction is made between:

• Dystrophic osteoarthritis - occurs as a result of metabolic disorders.
• Fracture arthrosis - develops as a result of a fracture.
• Post-traumatic - the disease appeared after a joint injury.

DOA varieties by origin:

• Primary (idiopathic) - occurs for no apparent reason, often due to age-related changes in the bone joints.
• Secondary - Degenerative-dystrophic disorders provoke many factors (metabolic disorders, hormonal imbalance, trauma).

Doctors distinguish monoarthrosis and polyarthrosis. In the first case, 1 node is affected, and in the second, all nodes are destroyed at the same time. The last type of disease is called generalized osteoarthritis, in which 3 or more bone joints are deformed.

Degree of pathology

According to the symptoms and progression, there are 4 stages of DOA:

• 1 degree.The shape and structure of the joint has not changed yet, so the disease has a latent course. Occasionally, the patient feels slight discomfort in the affected area, especially after excessive physical exertion or sudden movements. The composition of the joint fluid changes, the blood supply to the joint is interrupted. The muscle fibers surrounding the wrist are weakened.
• 2nd degree.Bone joints begin to collapse, bone growths form on their surface. Moderately painful sensations appear, inflammation occurs periodically. During movement, a characteristic crack is heard in the affected node. Muscle functionality decreases due to the fact that nerve tissue trophism is disturbed.
• 3 degrees.There are pronounced degenerative disorders of the hyaline cartilage and articulation, because of this, the axis of the limbs is bent. Ligaments, muscles shorten and the joint becomes pathologically mobile, but movements are markedly limited. The patient often has incomplete dislocations.
• 4 degrees.The bony ligament is completely destroyed, complete immobility is observed, as well as severe pain syndrome even at rest.

Important. In the final stage of osteoarthritis, only endoprosthetics will help (replace the affected joint with a prosthesis).

Causes of DOA

The question of why the disease occurs is quite important. Doctors distinguish between internal causes (certain diseases, bad habits, unhealthy diet) and external (injuries, features of professional activity) of osteoarthritis.

Often secondary degenerative-dystrophic disorders develop against the background of the inflammatory process:

• Infectious diseases that provoke various viruses and bacteria.
• Rheumatism.
• Autoimmune diseases.
• Purulent inflammation of the joint.
• Gout (deposition of uric acid salts on bone surfaces).
• Psoriasis of the joints.

DOA can occur due to abnormalities in cartilage structure and malnutrition. Pathological changes are caused by the following factors:

• Genetic disorders.
• Pathologies that appear during intrauterine development.
• Age-related changes in the body.
• Osteoporosis (increased bone fragility due to lack of calcium).
• Hormonal imbalance.
• Disorders of metabolic processes.
• Lack of vitamins, minerals.
• Pathologies associated with muscle weakness.
• Prolonged intoxication.

Exacerbation of diseases of the musculoskeletal system also provokes degenerative changes in cartilage tissue.

External factors for the development of osteoarthritis include:

• Regular hypothermia.
• Dislocations.
• Impact of large force on the joint area.
• Fractures.
• Meniscus damage.
• Excessive physical activity related to professional sports or professional activities.
• Obesity.
• Surgery on joints or periarticular structures.

Regardless of the causes of DOA, it is important to first identify the cause of the pathological changes and then address the consequences.

Reference.Idiopathic osteoarthritis manifests itself spontaneously, for no apparent reason.

Symptoms

Osteoarthritis is manifested by the following symptoms:

• pain syndrome;
• mobility restriction;
• crackling when moving;
• edema, change in the axis of connection.

These are characteristic symptoms that appear in all patients.

The initial signs of pathology are discomfort in the affected area, which occurs after physical exercise. After the onset of anxiety, you should consult a doctor, as the disease can be cured in the early stages.

Later, the patient complains of mild to moderate pain that appears after loading the damaged joint and disappears quickly.

A decrease in bone junction mobility indicates degenerative changes in its structure. At first, the patient feels stiffness, especially in the morning. Later, the patient becomes increasingly difficult to perform active movements. With further development, movement restriction also occurs with additional assistance. If left untreated, ankle contracture occurs and over time, its motor activity is blocked.

Many patients complain of cracked joints during movement, which is accompanied by painful sensations and decreased mobility. As the disease progresses, this manifestation becomes more pronounced.

In later stages, the limb shaft is bent and the articular membrane is deformed. This indicates that the bone bond has practically collapsed and healthy tissue has been replaced by osteophytes. At this stage, the adjacent joints are subjected to strong stress, then the likelihood of damage to their cartilaginous lining increases.

Establishing a diagnosis

If you notice signs of osteoarthritis, then seek immediate medical attention. The diagnosis of DOA is made after taking the anamnesis, performing laboratory and instrumental studies.

First a visual examination is done, during which the doctor may notice swelling in the affected area. Next, palpation is performed, which allows you to determine pain, joints, changes in skin temperature and humidity.

Comprehensive diagnosis involves laboratory research. Blood tests can detect an inflammatory process, which is indicated by an increase in ESR (erythrocyte sedimentation rate), an increase in uric acid concentration. A urine test is done to determine the level of protein.

Osteoarthritis is diagnosed using the following instrumental studies:

• X-rays help to see the change in the shape of the wrist.
• Arthrography using a contrast agent is a more accurate diagnostic method than x-rays.
• CT is used to assess the structure of the wrist.
• Radionuclide diagnosis is performed using radiopharmaceuticals. This study allows you to assess the anatomical and functional condition of the joint.

Magnetic resonance imaging is a modern highly informative diagnostic method. Examination reveals deformity of the damaged joint, rupture of the meniscus or ligaments.

To examine the synovial fluid, doctors prescribe a puncture of the affected limb.

After diagnostic measures, the doctor designs a treatment regimen.

Methods of healing

With osteoarthritis of any stage, medical attention is needed. Complex therapy in the early stages helps to stop pathological changes and restore joint functionality. If the patient seeks a physician in a late stage of DOA, then the prognosis is poor.

With grade 1 osteoarthritis, drug treatment is performed. Chondroprotectors are used to restore the structure of the cartilage lining. The patient is prescribed drugs in the form of tablets and capsules. They should be taken in courses of 3-4 months twice a year. The drug contains the structural elements of cartilage lining.

Non-steroidal anti-inflammatory drugs (pills, injections) help relieve pain.

DOA treatment is performed using physiotherapeutic methods:

• Magnetic therapy.
• Ultra high frequency therapy.
• Electrophoresis.
• Shock wave therapy.
• Paraffin therapy.
• Mud treatment.

Physiotherapy and physiotherapy exercises are performed after the pain disappears. The doctor designs a set of exercises that the patient should perform systematically. Exercise therapy increases muscle tone, strengthens ligaments, normalizes blood circulation, and helps restore articulation.

During and after treatment, it is recommended to provide rest, reduce the load on the diseased joint with the help of bandages, crutches and canes.

Sometimes the patient is prescribed massage. After a course of procedures, the blood supply to the affected area improves and the pain decreases.

During therapy, the patient should eat properly. You should give up sugar, flour, fatty, spicy foods, potatoes, tomatoes, eggplants. And it is recommended to get rid of bad habits (alcohol, smoking) forever.

For osteoarthritis, intra-articular injections are used:

• Glucocorticosteroids help normalize blood supply to the affected area, stop the inflammatory process and increase the elasticity of bone tissue.
• Synovial fluid analogues with chondroprotective properties. These drugs reduce pain, improve joint mobility, and accelerate the production of collagen and elastin.

In the final stages of DOA, surgical methods of treatment are used:

• Endoprosthetics.
• Arthrodesis.
• Arthroscopy.

In advanced cases, doctors replace the destroyed composition with a metal prosthesis. Most often, this method is used to treat large joints. After surgery, the patient's quality of life improves.

If arthrodesis cannot be performed, then the patient is prescribed arthrodesis. During the operation, the bone surfaces are immobilized with a special plate. Arthrodesis helps relieve severe pain but does not restore motor activity to the joint.

During arthroscopy, a miniature and manipulative camera is inserted into the joint cavity, with the help of which the bone growths are removed and the cartilage structure is restored. The camcorder allows you to monitor all manipulations on the screen. As a rule, surgery is performed for gonoarthritis, but its effect is short-lived.

DOA is dangerous, so it is important to identify and treat it in a timely manner.

evaluations

According to patients who have encountered osteoarthritis, it is easier to cure the disease at an early stage. In advanced cases, only surgery will help. But in both cases, the treatment must be comprehensive.

• The first review: "I was diagnosed with second-degree knee osteoarthritis 1 year ago. I took special medication, did physiotherapy, went on a diet. At first the pain went away, mobility was restored, but after 3-4 months the symptoms returned again. "Sometimes the pain was accompanied by a rise in temperature. The doctor advised me to take capsules with chondroprotectors. With them my condition improved, for six months now I do not feel any pain. "
• Second review: "A few years ago I was diagnosed with grade 3 coxarthrosis. I suffered from pain all the time, even at night, I could not move my leg normally. The doctor advised me to have an operation, but at first I refused and decidedto try intra-articular injections. However, after the procedures, my condition did not change much. As a result, I decided on a radical method. After endoprosthetics she was cured for 1 year and 3 months. During this period, she was taking medication, doing exercises"special, went to massage, physiotherapy, followed a diet. Now I am living a full life. I advise everyone not to hesitate with treatment. "
• Third review: "I was diagnosed with an internal meniscus rupture of the knee and grade 1 gonoarthritis after MRI. Doctors prescribe chondroprotectors. I used the ointment twice a day. To protect the knee I used an orthosis, I haveremoved only at home during rest. After the course of injections began electrophoresis, paraffin therapy, also bought a magnetotherapy device, had already performed 10 sessions. After another diagnosis, doctors said that the joint was recovered by 70 %. I continue treatment and hope toI fully recover my leg. "

As you can see, there are different types of osteoarthritis. To avoid surgery and restore joint function, you should seek medical help at the first suspicious signs. Only a doctor will be able to determine the type, degree of complexity of the disease and design a competent treatment regimen. DOA is easier to treat early.