Arthrosis (arthrosis deformans of a national title - a salt) is a chronic disease of the joints degenerative-dystrophic of god, in which there is destruction of the articular cartilage, the capsule of the joint, deformity of the bone.
It should be noted that there is a group of arthritis diseases of the joints, a variety of sources into the mechanisms by which close to. Most of the knee arthritis of the large joints:
- the knee joint deforming arthrosis (gonarthrosis),
- the hip joint deforming arthrosis (coxarthrosis)
- as well as arthrosis of the shoulder joint.
It is the most severe type of arthritis.
Arthrosis of the small joints, which is less common. More and more often, deforming arthrosis of the joints of hands, from the interphalangeal metacarpophalangeal joints in the fingers. The patients report of pain in the interphalangeal joints in order to reduce their mobility, and the emergence of the joints in the vicinity of the ring (in the nodules of Heberden, Bouchard). This is a form of arthritis that are common with more and more older people. They often can be found in the arthritis of the joints of the foot.
The polyarthrosis, or generalized osteoarthritis, a number of the characteristic lesions of the joints.
Arthrosis of the joints of the spine - spondylosis - fall into the group of diseases of the spine, although it is similar to any other arthritis-the mechanism of evolution.
The main clinical symptom of the osteoarthritis pain in a joint, reducing its mobility. The specific symptoms that are determined by the stage of osteoarthritis in a way dependent on the degree of destructive changes in the joint.
The causes of osteoarthritis
Osteoarthritis is divided into primary, in the secondary. Primary (idiopathic) osteoarthritis is a result of the disturbance of regenerative processes in a degeneration of the cartilage in the joint, without any of the abnormalities in the entire body. Secondary osteoarthritis occurs as a result of other pathologic processes in the body are damaged, or in any of the external impact to the joint, with partial destruction of the articular surface of the.
It is Often a traumatic arthrosis commonly diagnosed in young patients. In patients over the age it is not always possible to draw a clear line between the primary into the secondary osteoarthritis.
Although the exact cause of arthritis is not possible to determine the factors that contribute to the emergence of the developing countries, it is well-known.
Select one of the following types of reasons that contribute to the primary of the secondary deforming arthrosis.
The causes of the primary osteoarthritis hereditary factors
Show inherited disorder of the following, which could cause the development of primary osteoarthritis:
- a genetic disorder of the cartilage tissue in the joint leads to its rapid destruction;
- congenital defects of the musculoskeletal system (joint hypermobility, dysplasia, flat feet, etc.), the ban that caused the injury to the individual sections of the cartilage tissue, the consequence of the onset of osteoarthritis.
It was also noted that the deforming arthrosis of the interphalangeal joints of the upper limbs is found predominantly in women, is a feminine being through the line.
The causes of secondary osteoarthritis
Secondary osteoarthritis is caused by damage to the joint. Of these injuries, so that may be due to a variety of factors.
- Mechanical damage to the joints. The factors of This group, which includes a variety of joint injuries, intraarticular fractures, which has an impact on the structure of the joint. The result is the Same, we obtain the constant micro-trauma to the joints due to the excessive loads, the static to the dynamic (e.g., in athletes). Also, the overload of the damage to the joints caused you.
The drug is a factor that has a negative impact on the joints (especially the hip), it is incorrect posture.
The structure of the joint may also disrupt the operation. - A disease of the joints. Arthrosis can be the result of inflammation common to the disease (an acute into a chronic arthritis-synovitis, the primary aseptic necrosis of bone, etc.)
- Metabolic diseases, endocrine diseases, lack of minerals in the body. A variety of disorders of metabolism, deficiency of calcium, phosphorus, other minerals, vitamins in trace elements causes changes in the structure of the bones in the cartilage, synovial fluid, leading to the disruption of the recovery process, is the progressive destruction of the body as a whole.
- Auto-immune diseases (gout, chondrocalcinosis, hemochromatosis, psoriasis, rheumatoid arthritis), hormonal disturbances, lack of estrogen in postmenopausal women leads to make a change in the tissues of the joints, with their gradual destruction.
- Vascular diseases (atherosclerosis of vessels of lower extremities, obliterating endarteritis, varicose disease), and in physical inactivity causes poor blood circulation in periarticular tissues, poor blood supply to the tissues of the joint resulting in degenerative changes.
The mechanism of the development of osteoarthritis of the
The development of osteoarthritis begins with a loss of cartilage. It is believed that in the beginning there is an infringement of blood circulation in the capillaries, Podhradie layer of the periosteum. The cartilage the strength of the Angle is due to the receipt of the nutrient liquid on the iz, on the final day of the adjacent bone tissue to the blood circulation, causes the cartilage loses gradually its elasticity, it becomes thinner, the cracks, the smoothness of the drawing of the surface is disturbed, it reduces the amount of synovial fluid, which provides slip into the joint. Due to the pain, the crunching, when you are moving. The total Width of the space is gradually reduced, the edges of the articular surface forms a bone - spikes-osteophytes.
In the final phase of the joint becomes deformed, the amplitude of the motion decreases. Thus, the development of involutive osteoarthritis is associated with aging. Following the Development of the forms of osteoarthritis usually happens gradually over several years.
Other forms of arthritis, the large joints, for example, post-traumatic, post-infectious, metabolic, poisoning have slightly different mechanisms of evolution, but rather it is the result of the same changes in the joint.
The symptoms of osteoarthritis of the joints. The stages of the stages of osteoarthritis
The "Classic" is the classification of osteoarthritis based on the clinical v radiographic features. According to him, there are three stages of the development of the disease. To coincide with the classification according to the degree of maintaining the jobs ability to differentiate 3 degrees of osteoarthritis:
- I, the degree of osteoarthritis - a disease, does not preclude the performance of the work, even if completed,that the
- II, the degree of osteoarthritis - a disease that prevents the execution of the work
- III, the Class of osteoarthritis - related disability.
Let us look at the clinical symptoms in the sign of arthrosis at each of these levels
Osteoarthritis of 1 degree (the initial stage of arthrosis)
In the early stages of the disease in the morning, after a rest, marked rigidity of movement in the joints, a problem that takes place gradually over some period of time after the start of the movement. There may also be some limitations in common. Occasionally, both the "start-up" pain (a pain when you start moving after a long stay in a rest). The sharp changes of the tingling sensation, but I could not. The pain at this stage of the osteoarthritis to be displayed only when there is a significant or prolonged, the stress in the mine after the fire. The suspension in the light-load is a pain. At this stage of the disease, the patients rarely go to the doctor.
The x-ray, the degree of osteoarthritis of the 1, and no significant changes in the joint are not visible, can sometimes be seen with small osteophytes on the edges of the joint, the joint space was slightly narrowed.
2 ° Arthrosis (arthrosis of the second stage)
With the further evolution of osteoarthritis pain becomes meaningful, it becomes obvious. The Distinct crunching the total will appear in the [spirits of the craft] of the movements is to limit the age of the joints in the (contracture), a functional shortening of the limb, disorders of the biomechanics of the movement, but it still keeps on the move. The phase is characterized by the marked increase in the initial pain to become acute in several foods. Under the influence of daily physical activity appears to be continuing tiredness, a feeling of pressure the affected joints, there is therefore a so-called "mechanical pain", due to a reduction in depreciation of the capacity of the cartilage tissue.
The destruction of the joint, therefore, rather important joints, or both have become partially distorted.
An X-ray, visible, visible osteophytes, joint-space reduction from 2 to 3 times compared to the norm, sclerosis subchondral is of the bones in the formation of a cystic cavity in the area of the epiphyseal.
Osteoarthritis of degree 2 is characterized by a decrease in working capacity, the inability of a particular type of service.
Grade 3 Arthrosis (arthrosis of the third stage)
Osteoarthritis of the 3 the class is a serious, advanced stage of the disease. At this stage, so:
- a significant deformity of the joint (as a result of the growth of the bones in an accumulation of fluid in the articular cavity);
- the harsh restrictions on movement, including the preservation of only the fluctuations;
- a sharp pain not only when running but also a state of the complete rest - for persistent pain associated with reflex spasm of the nearby muscles, as well as the development of reactive synovitis;
- the inflammation of the joints,
- the sensitivity of the conclusions for the weather to change.
- the muscles around the knee spasmatic, in atrophied;
Axis of the limb is deformed, a noticeably varus valgus, or curvature of the foot (i.e., in the form of the letter "O" or "X").
On radiographs in osteoarthritis grade 3, there is an almost complete disappearance of joint space, severe deformity of the articular surfaces, a large multiple of the marginal osteophytes. No more of the figure, the joint mice calcification of the paraartikulyarnye tissues.
Class 3-advanced the disease is very far away, and often he is the cause of permanent disability. Share in the following ways:
- the pain does not become permanent, the painful walking, especially downhill, in climbing up a flight of stairs can be for the ordeal of the patient;
- high škrtanje the sound of the [spirits of the craft] of the movements, is very audible to others;
- the deformation of the joints strongly expressed, the motion is limited to a low amplitude or even not possible.
The images show the destruction of the articular structures (ligaments within the meniscus) within the full wear and tear of the cartilage in the signs of sclerosis (change the functioning of the organs within the structures of the connective tissue).
Arthrosis of 4 degrees
The condition of the total destruction of the joint with osteoarthritis, the joint to function when you stop completely, often pointed out the - 4, the degree of osteoarthritis. There is a so-called "lock-joint" - an acute pain, which is not possible with the limited movement of the patient in the joint. Fourth, the degree of osteoarthritis of the accompanied by unbearable pain in the joints, that is, it is not possible to remove, even with strong painkillers in a of intense physical therapy. The possible total ankylosis (fusion of joint), or newartriot (false joint formation between the displaced ends of the bone). The independent movement in both of these cases, it is almost impossible not to.
In the images shown to the coarse surface of the soslanovna sclerosis with severe, cystic enlightenment, accretion integration of the bone in the region of the joint space. The development of the disease, at this stage, it almost always means a disability which can be prevented only to the introduction of the artificial prosthetic joint.
The treatment of osteoarthritis of the
Arthrosis the Treatment of a disease in an early stage of the
Started the for the treatment of osteoarthritis of the better as soon as possible, at the first signs of the crisis in the joints, difficulty in movement. At this stage, the useful products chondroprotectors, which is to improve the structure of cartilage, in vitamin-mineral complexes.
It is important for the therapeutic exercise and correct diet in the prevention measures. It should be noted that the prevention of osteoarthritis of great importance to prevent worsening of the disease.
Treatment for arthritis is 2 to 3 degrees
Even in the fully cured arthrosis of 2-3 degrees, it is not possible, but the development process is significantly slow. Treatment of the arthrosis phase of this involves the following steps:
- the removal or reduction of pain
- for the relief of inflammatory conditions in the joint.
- to enhance the regeneration of cartilage, in the to slow down the degenerative processes in it.
The acute The phase of the the treatment of osteoarthritis starts with pain relief. For this purpose, the non-hormonal anti-inflammatory drugs (nsaids), analgesics. Can intra-articular injections of corticosteroids. If it is necessary, in order to reduce the load on the joint, you can't, or to walk, stand and lift heavy objects.
The acute pain of being taken, the main task is to ensure, in so far as it is possible for the activation of regenerative processes in the joint in the periarticular tissues are: improved circulation, increased metabolism, elimination of inflammatory processes. A dedicated chondroprotectors, vasodilator drugs, as well as a remedial gymnastics, in physiotherapy.
The treatment of osteoarthritis of the level 4
At this stage of the disease the joint is almost completely destroyed. In this case, it is left with one option - surgery to the replace the diseased joint with a prosthesis. The implant, which significantly improves the mobility of the joint, the patient ban that allows you to continue living an active life, at the very least, how to get rid of the pain.