Deforming arthrosis (osteoarthritis) is a progressive pathology leading to dystrophy and degeneration of the joint surfaces and damage to the cartilage, to its complete destruction in the area of the joint.
Usually deforming arthrosis is detected in old age and in old age, in the presence of concomitant factors and diseases, is often detected during examinations, but does not manifest itself clinically.
Deforming arthrosis is the most common and widespread pathology of the joints. It occurs in 70% of all joint diseases.
Reasons
The exact cause of osteoarthritis is still unclear, but some factors have been identified that reliably increase the likelihood of its development. First of all, these are general aging of the body and dystrophic phenomena in the tissues, changes in cartilage and joint capsules.
Factors influencing the development of osteoarthritis can be divided into:
- external - they include overload of the joints (for example due to lifting weights), permanent injuries, occupational influences, hypothermia of the joints,
- internal - this is the influence of heredity with overstretched ligaments and sagging joints, ovarian dysfunction and menopausal changes in women, vascular accidents, impaired blood circulation in cartilage, obesity.
Deforming arthrosis, as one of the symptoms, can be with alcoholism or myxedema, acromegaly or hormonal treatment, with congenital dislocation of the hip joint, Marfan's syndrome (an inherited disease characterized by excessive joint mobility and elongation of the tubular bones). joint stiffness)
Stages of development
There are a number of regular successive stages in the development of deforming arthrosis:
- reducing the water content of cartilage, which leads to its thinning and drying,
- formation of defects and cracks in cartilage,
- destruction of cartilage with a sharp narrowing of the joint space,
- the disappearance of cartilage from the bone margins,
- compensatory compaction of the ends of the bones left without a cartilaginous surface,
- joint disorders with dislocations, fractures and dysfunction of the limbs.
Symptoms of deforming osteoarthritis
First of all, the main manifestation of deforming arthrosis is
- joint pain worsened after exercise or at night,
- individual joints are affected,
- the affected joints are not symmetrical,
- at the same time there are no general manifestations of joint damage,
- no temperature
- no severe redness of the joints,
- there are no changes in the analyzes.
The process often takes place in the ankle, knee, hip or interphalangeal joint.
If the disease progresses to the point of cartilage destruction, painful joint obstruction occurs, severe pain occurs when walking, which prevents the legs from moving and causes it to stop. This is due to pieces of cartilage or small fragments of bone (joint "mice") falling into the joint cavity.
Nodular, very hard formations appear in the area of the phalangeal joints, while the joints are not very deformed, the muscles do not undergo atrophy and there is no ankylosis (joint immobility).
Inside the joints, a crunch is heard when moving due to the friction of uneven surfaces into each other.
Pain and limited mobility can cause contractures (muscle contractions) that shorten the legs or arms.
Deforming arthrosis in its manifestations is similar to various forms of arthritis, in the first place it must be distinguished from rheumatoid arthritis.
Diagnosis
There are no typical criteria for diagnosing deforming osteoarthritis; it can only be recognized outward on the nodes of the phalanges of the fingers. Osteoarthritis is suspected when:
- typical joint damage,
- long-term development of the disease for many years,
- adult patient.
The diagnosis is based on X-ray data, which appear before the period of clinical manifestations and pain syndrome.
There is a narrowing of the joint space, a change with alignment and deformation of the joint surfaces, instability in the joint area with dislocations and subluxations, marginal bone growths, osteosclerosis (excessive increase in bone density).
As the process progresses, bone spines and bumps are revealed, and the joint space may become wedge-shaped.
The examination is supplemented by arthroscopy, a blood test without signs of inflammation.
A periarticular fluid examination is required.
Treatment of deforming arthrosis
The treatment is performed by traumatologists and orthopedists.
Methods of treating osteoarthritis depend on the degree of involvement of the joints in the process, as well as the duration of the lesion and the presence of pain.
Conservative therapy is used in the first place.
- reducing stress on the joints,
- weight loss
- the use of metabolites - a course of aloe or vitreous intramuscularly in courses,
- use cartilage repair stimulants for 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 inside the joint is indicated.
A complex of massages, physiotherapeutic effects, mud therapy, thermal effects are also used. Spa treatment is useful.
In advanced cases, surgical treatment helps - arthroplasty. In the future, unloading of the joint, weight loss, walking with a cane or crutches, physiotherapy exercises are shown.
Forecast
Deforming osteoarthritis without the necessary treatment has a slow but steadily progressive course. Leads to damage and significant joint dysfunction, movement disorders. Therefore, when the first signs of osteoarthritis appear, active therapy is indicated, lasting in courses of 1-2 months.