Arthrosis (arthrosis deformation national title - salts) is a chronic disease of the joints degenerative-dystrophic character, in which destruction of articular cartilage, a capsule, a joint deformity in a bone.
Noted should be that arthritis is a group of diseases of the joints, the different origins, and mechanisms to close. The most common arthritis in the knee a large joints:
- deforming arthrosis of the knee joint (gonarthrosis),
- deformation of the hip joint arthrosis (coxarthrosis)
- as well as the arthrosis of the shoulder joint.
This is the most severe rheumatoid arthritis.
Arthrosis is a small joints are less common. Often in deforming arthrosis a interphalangeal joints of the hands and metacarpophalangeal joints of the fingers. The patients with pain in last interphalangeal joints, reduces mobility, the emergence of near joints gaskets (knots heber on Bouchard as well). This is a form of arthritis are more common in the elderly. Often the arthritis of joints of a foot.
A polyarthrosis, osteoarthritis, or generalized, characterized by lesions of multiple joints.
Arthrosis of the joints of the spine - spondylosis - group, diseases of the spine, although similar to other arthritis mechanism development.
A main clinical symptom of osteoarthritis is pain in a joint, reducing your mobility. Specific symptoms determine the stage, while depends on the degree of destructive changes in a joint.
Causes of osteoarthritis
Osteoarthritis is divided into primary, not a secondary. Primary (idiopathic) osteoarthritis is the result of a disturbance to a regenerative process, and the increased degeneration of a cartilage, a common without any disorder, the entire body. Secondary osteoarthritis occurs as a result of other pathological processes in the body, a already or external damage to any effects joint partial destruction of the articular surfaces.
Often traumatic arthrosis is diagnosed in a young patient. And older patients with all is not possible to draw a clear line between primary, not a secondary osteoarthritis.
Although the exact cause of the arthritis cannot be determined, a factor is that the appearance and the development of well-known.
You can select the following types of look for contribution of the primary, a secondary deforming arthrosis.
Cause of primary arthritis, hereditary factors
It turns out that the following inherited abnormalities that can be because of the development of primary osteoarthritis:
- genetic disorders a cartilage tissue, a common and yet a quick destruction;
- congenital anomalies of musculoskeletal system (joint hypermobility, dysplasia, flat feet, etc.), that damage to individual sections of a cartilage tissue and, therefore, the onset of osteoarthritis.
Note that a deforming arthrosis interphalangeal joints of the upper limbs can be found mainly in women and is inherited through a female line.
The look for a secondary osteoarthritis
Secondary osteoarthritis is the result of damage to a community. Ezek a injuries caused by different factors.
- The mechanical damage of the joints. This group is a belong to different factors joint injuries, intraarticular fractures, which affects a structure, a community. The same result is obtained a permanent micro-injuries to joints due to the constant excessive load, not a static, or dynamic (e.g., athletes). The overloading and trauma to the obesity joints causing.
Another factor, which is the negative impact on joints (especially the hip), incorrect posture.
A structure, a joint is disturbed the surgery. - Diseases of the joints. Arthrosis can be the result of inflammatory joint diseases (acute or chronic arthritis, synovitis, necrosis of primary aseptic bones, etc.)
- The metabolic diseases, endocrine diseases, lack of minerals in the body. Various diseases of metabolism, deficiency of calcium, phosphorus and other mineral substances, vitamins, trace elements because of changes in the composition of a bone, cartilage, synovial fluid, what bothers me is a restorative process, and the gradual destruction of the whole.
- Autoimmune diseases (gout, chondrocalcinosis, hemochromatosis, psoriasis, rheumatoid arthritis), hormonal disorders, estrogen deficiency in postmenopausal women leads to the changes in the tissues of the joints and gradual destruction.
- Vascular diseases (atherosclerosis, the vessels of the lower limb, exterminate endarteritis, varicose disease), or physical inactivity , because poor circulation in periarticular tissues, poor blood supply to the tissues of the joint resulting in degenerative changes.
A mechanism for development of osteoarthritis
![Osteoarthritis in the x-ray](/images/article/23/Osteoarthritis%20in%20the%20x-ray.jpg)
A development of osteoarthritis begins with cartilage loss. It is believed that in the beginning of infringement of blood circulation, the capillaries Podhradie layer, a periosteum. Mint is a power, a cartilage due to a receipt for a nutrients in the synovial fluid, as well as an adjacent bone tissue, a blood flow causes the cartilage gradually loses its elasticity, becomes thinner, cracks, smoothness of the articular surfaces is disturbed, it reduces the synovial fluid, which is a sliding of a community. The result of the pain and crunching when you move. The width of a joint space is gradually reduced, the edges of the articular surfaces formed bone spikes-joint.
Finally, a joint becomes deformed, the amplitude of the motion decreases. So developing involutive osteoarthritis is associated with aging. The development of the forms of osteoarthritis that usually happens gradually, over several years.
Other forms of arthritis, the large joints, for example, a post-traumatic, post-infectious, metabolic, intoxication slightly different mechanisms of development, but the results were the same changes a community.
The symptoms of a osteoarthritis of the joints. The stage degree of osteoarthritis
"Classic" is a classification of women with osteoarthritis based on the clinical, not a radiological characteristics. In accordance with the three stages in the progress of the disease. This corresponds to classification according to the degree of preservation of work ability, distinguish 3 degrees of osteoarthritis:
- Degree of osteoarthritis I - a is not a disease to rule out that the execution of the work, although, makes,
- II degree of osteoarthritis - a disease prevents the execution of the work
- Grade III osteoarthritis - disability.
Let's look at the clinical symptoms of arthrosis of each section
Osteoarthritis of 1 degree (one-mode stage of arthrosis)
A mode stage of the disease in the morning, after the other candidates, stiffness, difficult movement, in the joints, which gradually takes place some time after the beginning of a movement. There may be some restrictions a community. Regularly there are is a "start-up" pain (pain when moving after a long stay in the other). The sharp movements joint tingling, but I don't. The pain in this stage of osteoarthritis appears only if a significant, lasting stress relief after the other. The other, and the light loads and no pain. At this stage of the disease, the patients rarely go to the doctor.
The x-ray of osteoarthritis of 1 degree, significant changes in a community is not visible, sometimes I saw a little joint with a edges of the joint, the joint space was slightly narrowed.
Arthrosis 2 degrees (second stage of arthrosis)
The further development of osteoarthritis, the pain will be significant, it becomes acute. A separate crunching a appears in every common movement, there is a noticeable restriction in the joints (contracture), functional shortening of a limb, diseases, biomechanics of movement, but the mobility is still there. This stage is characterized a significant increase in, a movie written for a song, the pain becomes acute or longer. A daily Effect is displayed below physical activity, constant fatigue, sense of pressure in the affected joints, there are the so-called "mechanical pain" caused to decrease of repayment ability of a cartilage tissue.
The destruction of a community significant enough, the joints are already partially deformed.
The x-ray visible visible joints, narrowing of the joint space 2-3 times, mint norma a, there is a MS subchondral bone, formation of cystic cavities in a epiphyseal area.
Osteoarthritis 2. grade is characterized by reduced ability to work, inability to perform certain types of work.
Arthrosis is a 3 -like stage (the third stage of an arthrosis)
Osteoarthritis, 3 -as grade severe, advanced disease. In this section:
- significant deformity of a joint (due to the increase in the bones and accumulation of fluid in the synovial cavity);
- the sharp restriction of movements of, including keeps only oscillation;
- sharp pain a, not only when moving, but the state of the complete rest - persistent pain associated with reflex spasm of nearby muscles, as well as the development of reactive synovitis;
- arthritis
- the sensitivity of joints to weather changes.
- the muscles around the knee of the brain is soft, and atrophied;
The shaft of a limb is deformed, noticeably or varus valgus curvature of a foot (i.e. in the form of the letter "O" or "X").
An x-ray osteoarthritis, 3 -like grade almost complete disappearance of a joint space, severe deformity of the articular surfaces, extensive, more marginal joints. Be fixed I don't know, that joint mice calcification, and paraartikulyarnye tissues.
3 than grade disease has progressed very far, often because of discrimination disability. It manifests itself in the following way:
- the pain will be constant, painful walking, especially downhill the stairs a patient can be an ordeal for you;
- a loud crunching hanging the movements of all, it's very audible to others;
- deformation of joints is strongly expressed, the motion is limited to only a small amplitude, or even impossible;
The images show that the destruction of articular structures (ligaments and meniscus), as well as a full wear a cartilage as well as a ms signal (replace a function of organs, and structures of connective tissue).
Arthrosis of 4 degrees
Complete A state of destruction of a joint with osteoarthritiswhen a joint stops completely often singled - 4 degrees of osteoarthritis. There is a so-called "blockade, a common" - acute pain, which is not yet possible for a limited amount of patient motion, a common. A fourth degree of osteoarthritis accompanied by unbearable pain in the joints, which cannot be removed by even the strong painkillers, and intensive physical therapy. Possible total ankylosis (fusion of a joint) or newartriot (formation of false among the common displaced end of the bone). Independent movement in both cases is almost impossible.
The pictures you can see rough surfaces soslanovna sclerosis severe cystic enlightenment, the accretion has a connecting bones in a region, a common space. The development of the disease in this stage almost always means disability, which prevents only an artificial implant, artificial joint.
Treatment of Osteoarthritis
Treatment of arthrosis in a mode stage of the disease
Begin to treat a osteoarthritis better as soon as possible, the first signs of the crunch in the joints, difficult to move. In this section, useful products, chondroprotectors, to improve the structure, a cartilage, vitamin-mineral complexes.
Important therapeutic exercise, a high nutrition, as well as the preventive measures. Noted should be that a big in the prevention of osteoarthritis importance to prevent worsening of the disease.
A treatment arthritis 2 - 3 degrees
Although fully cured arthrosis of 2-3 degrees is impossible, but a development process is significantly slow. Treatment of arthrosis in this section involves the following steps:
- remove or reduce the pain
- to relieve inflammation of a joint.
- it improves the regeneration of a cartilage and slow the degenerative processes.
In the acute phase treatment of osteoarthritis the pain starts. For this purpose, non-hormonal anti-inflammatory drugs (Nsaids), analgesics. Possible intra-articular injection of a corticosteroid. It is necessary to reduce the load on the joint, whether or not you can stand to walk, lift a heavy objects.
After the withdrawal of acute pain, the main is to ensure a task, to the greatest extent possible, the activation of a regeneration process in a common periarticular tissues: improved circulation, increased metabolism necessary for the inflammatory processes. Recipient chondroprotectors, vasodilator drugs, as well as the corrective gymnastics, physiotherapy.
Treatment of Osteoarthritis 4 degrees
At this stage of the disease in a community almost completely destroyed. In this case, the only option is surgery, and then replace a patient's joint, a prosthesis. The implant significantly improves the mobility of a joint, which allows you to continue a patient to an active life, at least, to get rid of the pain.