Osteoarthritis (deforming arthrosis of the origin of the popular name - is the deposit of salt) - it is a chronic disease of the joints degenerative diseases-degenerative in nature, in which there is destruction of the articular cartilage, the capsule of the joint, with the deformity of the bone.
It should be noted that arthritis is actually a group of diseases of the joints, with different backgrounds, and the friends of the mechanisms of its development. The most commonly seen for arthritis of the major joints:
- the deformation of the osteoarthritis of the knee (gonarthrosis),
- deforming osteoarthritis of the hip (coxarthrosis),
- and arthrosis of the shoulder joint.
It is the most heavy-duty types of arthritis.
Arthritis of the small joints is common. They are the most common deforming arthritis of interphalangeal joints of the brushes, and also the metacarpal-phalangeal major joints of the fingers of the painter. The patient observed the pain in interphalangeal joints and, by reducing their mobility, and the emergence of the joint seal (nodes Heberdena, and Bouchard). This is the view of the arthritis, is more common in older people. It often occurs in osteoarthritis of the joints of the foot.
The polyarthrosis, or arthritis, generalized, characterized by lesions of various joints.
Osteoarthritis of the facet joints of the vertebral column - spondiloarthrosis) - refers to a group of diseases of the spinal cord, although it looks like any other arthritis, the mechanism of the development.
The main clinical symptom of osteoarthritis is pain in the joint, reducing your mobility. The specific symptoms are determined at the stage of arthrosis, and on the degree to which the changes are destructive to the joint.
The causes of osteoarthritis
The win is accepted to divide the primary and the secondary. Primary (idiopathic) osteoarthritis is the result of a disturbance in the recovery process and increase the deterioration of the fabric of the articular cartilage of the joint, without any deviation in the functioning of the entire body. Secondary osteoarthritis-occurs as a result of other pathological processes in the body, whether you are already damaged, from any cause whatsoever of the outside of the joint, when the partial destruction of the joint surface.
More often than not, traumatic osteoarthritis is diagnosed in young patients. In older patients, it is not always possible to draw a boundary between the primary and the secondary osteoarthritis.
Although the exact cause of the osteoarthritis can be defined, the factors that contribute to the growth and development is well known.
A distinction can be made for the following reasons, it is conducive to the development of the primary and the secondary deformed from the arthritis.
The primary cause of arthritis - genetics
As identified in the following provinces of violations, which may be the cause of the development of primary osteoarthritis:
- genetic disorders in the composition of the tissue of the articular cartilage, leading to its rapid destruction, and
- congenital defects of the musculoskeletal system (hypermobility, joint, dysplasia, flat feet, etc.) that are the root cause of the trauma, the individual sections of the tissues of the articular cartilage of the joint, and, as a result of the onset of osteoarthritis.
He noted, too, that the deformity osteoarthritis of interphalangeal joints of the upper limbs is mostly found in women and is passed on by inheritance through the female line.
The cause of osteoarthritis in the secondary
Secondary osteoarthritis is the result of damage to the joint. This damage can be caused by a variety of factors.
- Mechanical damage to the joints. This group of factors relate to a different injury to joints, intra-articular bone, as a result of that, it is broken down the structure of the joint. To the same result leads to a permanent microfracture joints resulting in an excess of the permanent load, such as static and dynamic (for example, in athletes). Also, the stress and trauma to joint it leads to obesity.
The other factor is that when you press a negative impact on the joints (mainly the hip), this is a bad attitude.
The structure of the hinge can stop the prompt for the intervention. - Diseases of the joints. Osteoarthritis can be a result of inflammatory diseases of the joints (acute and chronic arthritis, synovitis, primary necrosis, aseptic, of bone, and Dr)
- Metabolic disorders, diseases of the endocrine system, the lack of minerals in the body. A wide variety of disorders, disorders of metabolism, deficiency of calcium, phosphorus and other minerals, vitamins and trace elements causes changes in the composition of the bone tissue and the cartilage, and the oxygen in the synovial fluid, which leads to a disruption of the recovery process step-by-step destruction of make-up.
- Auto-immune diseases (gout, honDrcalzinoz, disease, psoriasis, rheumatoid arthritis), hormonal disorders, estrogen deficiency in post-menopausal women, leading to changes in the tissues of the joints and gradual destruction.
- Vascular disease (atherosclerosis of the vessels of the lower limbs, endarterite, varicose veins, and also the lack of exercise, causing disturbances in circulation in periarticular tissues, poor blood circulation in the tissues of the joint, and is the result of degenerative changes.
The mechanism of the development of osteoarthritis
The development of arthritis, begins with the destruction of the articular cartilage. It is believed that, in the beginning, it is a violation of the circulation of the blood in the capillaries Podhradie layer of the periosteum. As well as the nutrition of the articular cartilage occurs because of the addition of nutrients and the intra-articular liquid oxygen, and the adjacent bone tissue, impairment of the circulation of the blood, which causes the cartilage loses elasticity, becoming thinner, they do appear to crack, smooth surface of the joints is broken down, it decreases the amount of oxygen in the synovial fluid, which provides for a slip joint. As a result, you get the pain, and curling during movements. The width of the slit joint gradually decreases in the rim of the articular surfaces of bone are formed spikes-osteophytes.
Eventually, the link with the deformation of the amplitude of the motion, it slows down. So if you develop involutive osteoarthritis is associated with aging of the whole organism. The development of this type of osteoarthritis most commonly occurs gradually, over the course of many years.
Other forms of arthritis, the large joints, such as, for example, post-traumatic, post-infectious, metabolic, substance they have many other mechanisms in development, but the end result is a similar change in the enunciation.
The symptoms of the arthrosis of the joints. The stage and the grade of osteoarthritis
The "old school", which is considered in the classification of osteoarthritis based on clinical and x-ray signals. According to her, there are three stages in the development of the disease. It is a rating of the degree of preservation of the capacity for work, thus freeing up the 3-degree-of-arthritis:
- Degree of arthritis, disease does not work, although it is difficult to
- II (grade of osteoarthritis disease - it prevents you from performing work,
- III the extent of the arthritis, the loss of earning capacity.
Let's look at more details on the symptoms, clinical signs and symptoms of osteoarthritis in each of the phases
To win, grade 1 (the initial stage of arthrosis)
In the early stage of the disease, in the morning, after the rest of the notes of the stiffness and difficulty of motion in the joints, which gradually passes in a short time after the start of the movement. It may be a limitation of the mobility of the joint. Periodically, there are "points of departure" for the pain (the pain in the beginning of the movement, after a long period of time is found in a state of rest). When the force of sudden movements of the joint are tingling, but the pain of the movement, it does not have. The pain at this stage of the osteoarthritis is only present if it is a large and long-term loading, and goes away after rest. In peace and with a small load of pain to not have it. At this stage of the disease, the patient will rarely have recourse to the doctor.
In the x-ray when you win, to 1 level, for a given change in the joint can be viewed, at times, it can be seen, the small bone spurs on the edges of the joint to articulate in the slot is a little low.
With the win, the 2-level (second-stage of osteoarthritis)
When the future development of osteoarthritis-the pain and if it becomes substantial, it becomes a serious matter. Separate and squeeze the joint to appear when any of the entries, there is a pronounced limitation of the mobility of the joint (contracture), a functional shortening of the limbs, disturbances in the biomechanics of the movement, but the movement of the joint also occurs. At this stage, it is characteristic that it was designed before the dig, a gain of a match of the aches and pains of the head, become more acute, and more time-consuming. Under the influence of the days of the physical load is of a constant, appears in the onset of fatigue, a feeling of pressure in the affected joints, are the so-called "mechanical pain, which is caused by the reduction of the depreciation of the skills of the tissues of the articular cartilage of the joint.
The destruction of the joint is just as significant, the relationship is already starting to partially deform.
The x-ray, visible, and noticeable bone spurs, narrowing of the joint gap of 2-3 times compared to the norm, there may be sclerosis subchondral bone, and cyst cavities in the epiphyseal area.
With the win, the 2-level is characterized by a reduced ability to work, not being able to perform certain jobs.
Osteoarthritis is 3 the degree of the third stage of arthrosis)
To read the 3 level - this is a record, starting with the stage of the disease. At this stage, they are aware of
- the great deformity of the joint due to the proliferation of the bones and the build-up of oxygen in the liquid in the articular cavity (a);
- the sharp limitation of movement in order to preserve the just balance sheet entries;
- the pain is acute, not only for traffic, but it is in a state of complete peace, the pain is continuous, associated with a flare by tightening the underlying muscles, as well as the development of the jet, synovitis;
- the inflammation of the joints,
- the sensitivity to joint changes in the weather.
- the muscles around the knee, spasmatic, and stunted;
The axis of the member is deformed, in obvious varus or valgus curvature of the foot (that is, in the form of the letter "o" or "X").
The x-rays to read the 3 level, as evidenced in the almost total disappearance of the crack, joint, expressed in the deformation of the articular surfaces, a wide multi-border of the bone spurs. It can also be defined by movement of the mouse, and the build-up of the para-articular tissues.
In the 3 levels of the disease had gone too far, too many times, it's because of the receipt of a disability. It manifests itself in the following way:
- the pain becomes continuous, and it is painful to stay, and, in particular, you want to walk up and down the stairs - a difficult test for the patient.
- the high kills in all the movements, and signals to others;
- the deformation of the joints is highly expressed in movement, and just a very small amplitude, if not impossible;
The images can be seen in the destruction of the intra-articular structures (ligaments and meniscus), and to top it off, the abrasion of the cartilage and signs of multiple sclerosis (ms) (a substitution of the functioning of the organs and structures of the connective tissue).
With the win, the 4-degree-of -
The state of the complete destruction of the joint when osteoarthritis, when the joint is in the fully stops working, often isolated on separate a - 4 the degree of the arthritis. It is likely that the so-called "lock-joint", the pain that is caused, that is not possible, or even limited motion in the joint the patient. The fourth degree of the arthrosis is accompanied by excruciating pain in the joints, which are not taken out even with strong pain killers and drugs and intensive physiotherapy. Available in a complete ankylosis (fusion of joint), or newartriot the education of a false joint between the displaced ends of the bone). The independent movement in both of these cases, it is practically impossible.
In the picture, it is so resistant to many soslanovna surface with a sharp-ers of the enlightenment, the growth of the connecting bone in the area of the joint gap. In the course of the disease prior to this phase, it will almost always mean a disability which, in order to prevent that, you can only deploy the prosthesis is an artificial joint.
For the treatment of osteoarthritis
For the treatment of osteoarthritis at the very early stage of the disease
You start explaining and talking points with the win, the better, as soon as possible after the first sign is a loud popping sound in the joint, difficulty in movement. At this stage, the helpful drugs, chondroprotectors, to improve the structure of tissue and cartilage, and also, the supplementation of vitamins and minerals.
It is important to have a therapeutic exercise, proper diet, as well as prevention activities. It should be noted that the prevention of arthritis, it is of great importance in order to avoid the worsening of the disease.
In the treatment of arthritis, a 2 to 3 degree
While it's fully cure, osteoarthritis, 2-3 degree, it is not possible, however, that in the course of its development, it can significantly curb. In the treatment of arthritis, this stage involves the following steps:
- to remove or reduce the pain that is caused
- to relieve the inflammation in the joint.
- to improve the recovery of the tissue from the cartilage and slow down degenerative processes in it.
In the acute phase of treatment of osteoarthritis begins with the resolution of the pain. For this reason, they are used in nonsteroidal anti-inflammatory agents, non-steroidal drugs (NSAIDS), pain killers. There may be an intra-articular injection of corticosteroids. The need to reduce the load on the joint, it is not possible at the time of walking or standing, lifting heavy objects.
After the day of your retirement from the starting point of the pain is an acute syndrome, the main challenge is to ensure that, as far as is possible, the activation of the recovery process at the center of the joint and periarticular tissues: improvement in blood circulation, increased metabolism, elimination of inflammatory processes. They are assigned to chondroprotectors, vasodilators to drugs, and also treatment of fitness, and physical therapy.
In the treatment of arthritis, a 4-degree-of -
At this early stage of the disease in the joint has almost completely collapsed. In this case, it is the only output operation, and the replacement of articulation of the patient o, a Prosthesis greatly enhances the mobility of joints, allows the patient to resume an active life, at least, to get rid of the pain.