Deforming arthrosis (osteoarthritis) is a progressive pathology that leads to dystrophy and degeneration of joint surfaces and cartilage damage, until its complete destruction in the joint area.
Generally, deforming arthrosis is detected in old age and in old age, in the presence of concomitant factors and diseases, it is often detected during examinations, but does not manifest itself clinically.
Deforming arthrosis is the most frequent and common joint pathology. It occurs in 70% of all joint diseases.
Causes
The exact cause of arthrosis deformans remains unclear, but some factors have been identified that reliably increase the likelihood of its development. First, it is about general aging of the body and dystrophic phenomena in tissues, changes in cartilage and joint capsules.
The factors that affect the development of osteoarthritis can be divided into:
- external - include joint overload (eg due to lifting weights), permanent injury, occupational influences, joint hypothermia,
- internal - is the influence of heredity with excessive stretching of ligaments and joint laxity, ovarian dysfunction and climatic changes in women, stroke, impaired blood circulation in cartilage tissues, obesity.
One of the symptoms of deforming arthrosis can be alcoholism or myxedema, acromegaly or hormonal treatment, with congenital dislocation of the hip, Marfan syndrome (hereditary disease characterized by excessive joint mobility and elongation of tubular bones). joint stiffness)
stages of development
In the development of deforming arthrosis, there are a series of successive regular stages that replace each other:
- reducing the wateriness of the cartilage, which leads to its thinning and drying,
- formation of defects and cracks in the cartilage,
- cartilage destruction with simultaneous narrowing of the joint space,
- the disappearance of cartilage from the bone margins,
- compensatory compaction of the ends of the bones, which were left without a cartilaginous surface,
- rupture of joints with dislocations, fractures and limb dysfunction.
Symptoms of deforming arthrosis
First, the main manifestation of deforming arthrosis is
- pain inside the joint, worse after exercise or at night,
- individual joints are affected,
- the affected joints are not symmetrical,
- at the same time, there are no common manifestations of joint damage,
- no
- there is no strong redness in the joints,
- no changes in the analyses.
The process usually occurs at the ankle, knee, hip or interphalangeal joint.
If the disease progresses to the degree of cartilage destruction, there is a painful blockage of the joint, when walking there is severe pain, which does not allow the legs to move and makes it stop. This is due to the entry of pieces of cartilage or small bone fragments ("mice" joints) into the joint cavity.
In the region of the joints of the phalanges, nodular formations appear, very hard, while the joints are not very deformed, the muscles do not atrophy and there is no ankylosis (joint immobility).
Inside the joints, when moving, there is a clicking sound due to the friction of the irregular surfaces against each other.
Pain and difficulty in walking can cause contractures (muscle contractions), which shorten the legs or arms.
Arthrosis deforming in its manifestations is similar to several forms of arthritis, first of all it must be distinguished from rheumatoid arthritis.
Diagnosis
There are no typical criteria for the diagnosis of arthrosis deformans, it can only be recognized externally by the nodules in the phalanges of the fingers. Osteoarthritis is suspected when:
- typical common damage,
- long-term development of the disease over many years,
- elderly patient.
The diagnosis is based on radiographic data that appear even before the period of clinical manifestations and the painful syndrome.
There is a narrowing of the joint space, an alteration with flattening and deformation of the joint surfaces, instability in the joint area with dislocations and subluxations, marginal bone growth, osteosclerosis (excessive increase in bone density).
As the process progresses, pimples and bony bumps are revealed, the joint space can become wedge-shaped.
The study is complemented by arthroscopy, a blood test without signs of inflammation.
A study of the periarticular fluid is necessary.
Treatment of deforming arthrosis
Treatment is carried out by traumatologists and orthopedists.
The methods for treating arthrosis deformans depend on the degree of involvement of the joints in the process, as well as the duration of the injury and the presence of pain.
First, conservative therapy is used.
- reducing stress on joints,
- weight loss,
- the use of metabolites - a course of aloe or vitreous intramuscularly in courses,
- use cartilage restoration stimulants in intramuscular injections in courses.
Complements the treatment:
- the use of quinolone drugs,
- anti-inflammatory therapy.
If there is inflammation in the joint, a course of hormones within the joint is indicated.
A massage complex, physiotherapeutic effects, mud therapy, thermal effects are also used. The spa treatment is helpful.
In advanced cases, surgical treatment helps - joint arthroplasty. In the future, joint unloading, weight loss, walking with a cane or crutches, physical therapy exercises.
Forecast
Deforming arthrosis without the necessary treatment has a slow but continuously progressive course. It leads to significant impairment and dysfunction of the joints, movement disorders. Therefore, when the first signs of osteoarthritis appear, active therapy is indicated, lasting 1 to 2 months.