Osteoarthritis (arthrosis deformans national title - salts) and a chronic disease of the joints degenerative-dystrophic character, in which there is destruction of articular cartilage, capsule of the joint, the deformation of the bone.
It should be noted that arthritis and a group of diseases of the joints, of different origins and working mechanisms of the fence. The more Marta of arthritis of the knee large joints:
- deforming arthrosis of the knee joint (gonarthrosis),
- deforming arthrosis of the hip joint (coxarthrosis)
- osteoarthritis as well as l of l of the joint shoulder.
However, if more serious and the type of arthritis.
Osteoarthritis in small joints are less common. More often deforming arthrosis of the interphalangeal joints of the hands and joints metacarpophalangeal of fingers of the hands. Patients with pain in the report of the interphalangeal joints, reducing mobility, the appearance near the joints seals (of nodes and Heberden, Bouchard). This form of arthritis are more common in the elderly. They are often found in arthritis of the joints of the foot.
The polyarthrosis, l or osteoarthritis generalized, is characterized by multiple lesions of the joints.
Osteoarthritis of the joints of the spine - spondylosis - it belongs to the group of diseases of the spine, although similar to arthritis mechanism of other development.
The clinic's main of the symptoms of osteoarthritis and pain in the joint, reducing your mobility. Specific symptoms are determined by the stage of osteoarthritis and depend on the degree of destructive changes in the joint.
Causes of osteoarthritis
Osteoarthritis and divided into primary and secondary. Primary (idiopathic) osteoarthritis, the consequence of the disturbance of regenerative processes and the increase of the degeneration of the cartilage of the joint to sense any abnormalities in the whole body. Secondary osteoarthritis occurs as a result of pathological processes in the organism, or in the damaged in any external impact joint, with the destruction partial of the surfaces articulate.
Often traumatic osteoarthritis and diagnosed in young patients. And in patients of any always age and possible to draw a clear line between primary and secondary osteoarthritis.
Although the exact cause of The arthritis cannot be determined, the factors that contribute to the emergence and development, and well-known.
You can select the following types of reasons contribute to the primary and secondary deforming arthrosis.
Causes of primary osteoarthritis hereditary factors
The manifesto inherited the following disorders that can cause the development of primary osteoarthritis:
- genetic disorders in the cartilage tissue of the joint leading to its rapid destruction;
- congenital defects of the of diseases locomotor system (joints hypermobility, dysplasia, flat feet, etc.), that causes the trauma to the sections of the cartilage individuals tissue and, therefore, the appearance of osteoarthritis.
It was also noted that deforming arthrosis of the interphalangeal of the joints upper limb are found mainly in women and is transmitted through the female line.
The cause of osteoarthritis secondary
Secondary osteoarthritis, and the result of damage to the joint. These injuries can be caused by various factors.
- Mechanical damage of the joints. This set of factors includes destinations joint injuries, intraarticular fractures, which affects the structure of the joint. The same result for the s obtains constant micro-injuries of the joints due to the permanent excess of the loads, both static and dynamic (for example, in athletes). Overloads trauma and Also in the joints of the causes of obesity.
Another factor to have an impact on the joints negative (especially hip) and correct posture.
The structure of the joint can also disrupt the development of the surgery. - Diseases of the joints. Osteoarthritis may be a consequence of inflammatory joint diseases (acute and chronic arthritis, synovitis, necrosis, aseptic primary os, etc.)
- Of metabolic diseases, endocrine diseases, lack of minerals in the body. Disorders Different metabolism, the deficiency of calcium, phosphorus and other minerals, vitamins and trace elements cause changes in the composition of the bone and cartilage, synovial fluid that leads to interrupting the restorative processes and the progressive destruction of the joint.
- Autoimmune diseases (gout, chondrocalcinosis, hemochromatosis, psoriasis, rheumatoid arthritis), hormonal disorders, estrogen deficiency in postmenopausal women lead to changes in the tissues of the joints and their progressive destruction.
- Vascular diseases (atherosclerosis of vessels of lower extremities, obliterating endarteritis, varicose disease), and physical inactivity of the cause of poor circulation in periarticular tissues, poor supply to the blood tissues in the union that results in degenerative changes.
The mechanism of development of osteoarthritis
The development of osteoarthritis begins with a loss of cartilage. It is believed that in the beginning there is an infringement of the circulation of the blood in the capillaries Podhradie layer of the periosteum. As the power of cartilage is due to the receipt of nutrients from the synovial fluid and adjacent bone tissue, the circulation of the blood causes the cartilage gradually loses its elasticity, becomes thinner, it breaks up the smoothness of motion of the surfaces s alters it reduces the amount of synovial fluid, facilitate the sliding in the joint. The result and the and pain crack when you move. The width of the joint space reduced progressively the edges of the articulating surfaces formed bone photos-osteophytes.
Ultimately, the joint becomes deformed, the amplitude of movement decreases. So that the development of the involutive osteoarthritis associated with aging. The development of this form of osteoarthritis usually happens gradually over many years.
Other forms of arthritis of the large joints, for example, post-traumatic, post-infectious, metabolic, poisoning have slightly different working mechanisms of development, but the and the same result changes in the joint.
The symptoms of the arthrosis of the joints. The phase and the degree of osteoarthritis
"Classic", to the classification of osteoarthritis based on the clinical and radiographic features. In accordance with this, there are three stages of disease development. Corresponds to classification according to the degree of preservation of working capacity, distinguish 3 degrees of osteoarthritis:
- I degree of osteoarthritis - a disease does not preclude the execution of the work, however, and it does,
- II the degree of osteoarthritis - a prevents the execution disease of the work
- Grade III osteoarthritis - disability.
We consider the clinical, the signs and symptoms of osteoarthritis each in these stages d'
Osteoarthritis of 1 degree (the initial stage of arthrosis)
In the initial phase of the disease in the morning, original works of art of un-rest, marked by the rigidity, the difficulty of movement of the joints, that little a little a little pren place original work of art, time of the beginning of the movement. There may be some limitation in the set. Periodically there are "start-up" pain (pain when you start moving original works of art from a long stay in the rest). The strong-motion joint and tingling, but I would not. The pain in this stage of osteoarthritis appears only when significant and prolonged stress, and disappears original work of art the rest. And To the rest in the light of the charges there is no pain. In this phase of the disease, the patients rarely go to the doctor.
In two rays from x to osteoarthritis a l of 1 degree, significant changes in the joint are not visible, can sometimes be seen with small osteophytes at the edges of the joint, the articulation of the space is a bit narrow.
Osteoarthritis of 2 degrees (second stage of osteoarthritis)
With a greater development of osteoarthritis pain becomes significant, becomes acute. The un course crack articulation appears in the in all movements, there is an obvious limitation in the joints (contracture), shortening functional of the limb that is to say, alterations of the biomechanics of the movement, but mobility is still maintained. This stage is characterized marked by an increase in the game, the learning, acute they become and more prolonged. Under the influence of daily physical activity appears constant tiredness, feeling of pressure in the affected joints, there is the so-called "mechanical pain", caused by a decrease in the amortization of the capacity of cartilage tissue.
The destruction of the joint are quite significant, the joints are already starting to partially deform.
X-ray visible visible osteophytes, narrowing of the joint space 2-3 times in respect to the regulations, there is sclerosis subchondral bone and formacio of the cavities epiphyseal in the area.
Osteoarthritis of degree 2 is characterized by a decreased capacity for work, the impossibility of carrying out certain types of work.
Arthrosis of grade 3 (the third stage of osteoarthritis)
The osteoarthritis grade 3 and severe in the advanced stage of the disease. At this stage, there is
- important deformity of the joint (due to the growth of the bones and accumulation of fluid in the joint cavity);
- the strong restriction of movement, even keeping only ranges installation;
- a sharp pain not only when moving, but also in a state of complete rest - persistent pain associat a reflex spasm of the nearby muscles, as well as the development of reactive synovitis;
- inflammation of the joints
- the sensitivity of joints to weather changes.
- the muscles around the knee spasmatic and atrofiat hello;
The axis of the limb is deformed, noticeably varus or valgus curvature of the foot (and to say in the form of the letter "o" or "X").
In the x-rays of osteoarthritis of degree 3 there is almost total disappearance of the joint space, joint deformity severe surfaces extensive multiple marginal osteophytes. Can not determine joint mice calcification paraartikulyarnye tissue.
In note 3 of the disease is very far progressed has, already, a often a cause of permanent disability. It is manifested in the following ways:
- the pain becomes a constant and painful to walk, especially going down and up stairs can be un ordeal for the patient;
- the un loud crack so that in all movements, very audible to others.
- deformation of the joints expresses the strength of the movement is limited to only a small amplitude or even impossible;
The images show, the destruction of joint structures (ligaments and meniscus), and a complete of wear on the cartilage and the the signs of multiple sclerosis (substitute organs the functioning of the structures of connective tissue).
Arthrosis of 4 degrees
The un state of complete destruction of the joint with osteoarthritis, when the set of shows functioning completely often pointed out - 4 the degree of osteoarthritis. There is the united nations so-called "locking the joint" - acute pain, not and it is possible even with a patient's movement limited of the joint. Fourth, The degree of osteoarthritis and is accompanied by the pains unbearable in the joints, which can not be removed, even with strong painkillers, and intensive physical therapy. Possible Total ankylosis (fusion of joint) or newartriot (formacio d a false joint between the ends displaced from the bones). Movement in cases Separate the two, and almost impossible.
In the visible images rough surfaces soslanovna multiple sclerosis with severe illustration, the accretion of the bones of the connection in the region of the joint space. The development of the disease in this stage almost always means a disability, which can prevent the implementation only of a prosthesis artificial joint.
Treatment of osteoarthritis
Treatment of osteoarthritis in the initial phase of the disease
Start to treat osteoarthritis better, as soon as possible at the first signs of the crisis in the joints, the difficulty of movement. At this stage, useful products - chondroprotectors that improve the structure of cartilage, vitamins and minerals complex.
Important and therapeutic exercise, proper nutrition and preventative measures. It should be noted that the prevention of osteoarthritis, and of great importance to avoid examining the worsening of the disease.
The treatment of The arthritis 2 - 3 degrees
Although totally games arthrosis 2-3 degrees and impossible, but the process of the development of the pot significantly the time of lent. Treatment of osteoarthritis in this stage consists of the following steps:
- removal or to reduce the pain
- to relieve the inflammation of the joint.
- to improve the regeneration of cartilage and slow down degenerative processes in it.
In the acute phase treatment of osteoarthritis starts with pain relief. For this purpose, non-hormonal anti-inflammatory drugs (Aine), analgesics. Possible intra-joint injections of corticosteroid. And necessary to reduce the load of the joint, who can't walk or stand, lift heavy objects.
Original works of art of the withdrawal of acute pain main task and ensure, to the extent possible, the activation of regenerative processes in the periarticular joint and tissues: improves the blood circulation, increase metabolism and elimination of inflammatory processes. Assigned chondroprotectors, vasodilator drugs, as well as a remedial gymnastics and physiotherapy.
Treatment of osteoarthritis 4 degree
In this phase of the disease in the joint has almost completely destroyed. In this case, and on the left a choice with the surgery to replace the patient and a joint with a prosthesis. The implant significantly improves the mobility of the joint, allowing the patient to resume an active life, at least, get rid of the pain.