Arthritis is a chronic joint disease associated with degenerative-dystrophic changes in its structure with primary damage to cartilage tissue.This disease develops slowly and in the early stages does not show symptoms.The cartilage and bone tissue of the joint, capsule and periarticular bursa are gradually destroyed, and then the surrounding muscles, ligaments and subcutaneous tissue are involved in the pathological process.
According to the WHO, every tenth person suffers from this disease, and the risk of developing it increases significantly in people over the age of 50.Knee and hip joints are most commonly affected.The cause of arthrosis is the joint's inability to support the load on it.In response to traumatic effects, inflammation develops, which leads to pathological processes in the joint tissue.
Patients with joint arthrosis require complex treatment, without this disease leads to a decrease in the ability to work and quality of life, limitation of sports and professional activities and, finally, to disability.
Classification of arthrosis
Based on the cause of the event, the disease is divided into:
- primary arthrosis - occurs due to the fact that the cells of joint cartilage tissue are destroyed faster than new ones are formed.Often this is associated with age-related changes and is not the result of any specific pathological process in the body;
- Secondary arthrosis - appears on the background of certain diseases or as a result of joint injuries.
Based on the location, arthrosis is divided into localized (affecting less than 3 joints) and general (affecting more than 3 joints).The latter is also called polyarthrosis.
Causes of arthrosis
This disease ranks first in the world among the causes of pain and impairment of activity.Although age-related changes are considered the main cause, it is often diagnosed in young patients.Women are more prone to arthrosis than men, although almost 70 years this difference becomes almost invisible.
Arthrosis of the hip, knee, ankle and shoulder joints has the greatest negative impact on the patient's quality of life and ability to work.Less common is arthrosis of the elbows and temporomandibular joints, as well as hands, feet and spine.
Predisposing factors include:
- old age;
- genetic predisposition;
- intense physical activity related to sports or professional activities, or, on the contrary, a sedentary lifestyle, which interferes with the normal nutrition of tissues, especially in large joints;
- joint injuries (fracture, fracture, dislocation);
- wearing inappropriate shoes;
- systemic diseases (metabolic disorders, endocrine diseases, neuropathy, gastrointestinal diseases, bleeding disorders);
- poor nutrition;
- overweight.
Women are more prone to this disease because they are more prone to hormonal imbalance.
Symptoms and levels of arthrosis
The main clinical sign of arthrosis is pain.In the early stages it may be absent, mild or intermittent.As the disease progresses, the pain becomes more pronounced, it can occur during exercise, and in advanced stages it can interfere even at rest.
Secondary manifestations of the disease depend on the localization of the process.Often, this is limited mobility in the affected area (especially after sleeping or a long rest), deformation, swelling and redness in the joint area, crackling and crepitation in it when moving, sleep disturbances due to pain and inability to find a comfortable body position, changes in gait and coordination, muscle spasms.
Keep in mind that pathological processes in one joint can move to neighboring ones due to improper load distribution or restrictions in movement.
According to the severity of the lesions, they are distinguished:
- arthrosis stage 1 - is asymptomatic or the signs are not specified, the patient can still work, and the diagnosis is difficult;
- Arthrosis of the 2nd degree - accompanied by severe symptoms, the patient's quality of life decreases, diagnostics reveal a clear disorder;
- arthrosis of the 3rd degree - characterized by an increase in clinical signs, deformation of the joint is observed externally, and diagnostic methods reveal serious intra-articular disorders;
- arthrosis of the 4th degree - leads to partial or complete disability;disorders are found in all joint structures, surrounding muscles and ligaments.
Diagnosis of arthrosis
The orthopedic trauma specialist makes the main diagnosis based on the patient's data on his lifestyle and work activities, the nature and duration of complaints, the dynamics of symptoms, the presence of arthrosis in relatives, and also conducts examinations and prescribes tests or consultations with relevant specialists (endocrinologist, hematologist, nutritionist, gastroenterologist).
Laboratory tests include general blood tests with leukocyte count, hemoglobin level and ESR.This indicator indicates inflammation in the body, which is necessarily present with arthrosis.Biochemical parameters measure levels of rheumatoid factor and C-reactive protein.If a specific pathology is suspected, other laboratory blood parameters are checked.Also of diagnostic value is the analysis of synovial fluid, which reveals pathological cells and inclusions, allowing you to confirm the diagnosis or distinguish other diseases.
Instrumental and visual methods for diagnosing arthrosis help not only to detect pathology, but also to determine the stage of the disease and the degree of involvement of surrounding tissues.The most effective of them are:
- radiography - carried out mainly in two projections, it is used to detect the narrowing of the joint space and the formation of bone growths (osteophytes) at the site of damaged cartilage;
- magnetic resonance and computed tomography - prescribed at the initial stage, when small changes are not yet visible on x-rays;
- Ultrasound - is used in addition to this method and helps to identify excessive fluid accumulation in the joint cavity (for example, Baker's cyst in gonarthrosis), assess the condition of the surrounding tissue, and measure the thickness of articular cartilage;
- scintography - involves the intravenous administration of radioactive drugs that accumulate in tissues with an inflammatory process, and the areas of such accumulation are displayed on the image, thanks to this it is possible to identify arthrosis at an early stage and carry out a differential diagnosis;
- arthroscopy - makes it possible to examine the joint from the inside by introducing a microcamera into the articular cavity through a small incision, as a result, you can collect detailed data on the ongoing pathological process and injury, as well as take a biopsy from the affected area;
- histological examination of the synovial membrane - reveals the altered ratio of healthy cells and the presence of pathological inclusions in the joint, allowing differential diagnosis.
Differential diagnosis allows you to distinguish arthritis from other diseases with a similar clinical picture, which include:
- various arthritis (ankylosing, reactive, rheumatoid, psoriatic, infectious);
- gout and pseudogout;
- muscle and ligament diseases (fibromyalgia, polymyalgia rheumatica);
- arthropathy (diabetes, paraneoplastic);
- congenital disease (femoral head hypoplasia).
Treatment of arthrosis
Despite the widespread prevalence of the disease and well-studied methods, there is no cure for arthrosis.The therapeutic approach aims to eliminate pain, relieve inflammation, restore joint function and prevent complications.
The choice of therapy depends on the cause, location and degree of arthrosis:
- drug therapy in the form of taking tablets for arthrosis (painkillers and non-steroidal anti-inflammatory drugs, corticosteroids, chondroprotectors), intra-articular or periarticular injections of this group of drugs, in addition to using ointments and gels;
- physiotherapy during remission (medical electrophoresis, galvanization, acupuncture, electrical stimulation, shock wave therapy, massage, magnetic and laser therapy, cryotherapy);
- therapeutic exercises for arthrosis are prescribed individually, sessions are conducted under the supervision of specialists;
- in advanced cases, surgical intervention is performed (partial or complete joint replacement, stitching or removal of a torn meniscus, removal of bone tumors and Baker's cysts).
Prevention of arthrosis
It is recommended to control the load on the joints, maintain a healthy lifestyle, engage in therapeutic exercises, monitor body weight and adhere to proper nutrition.
Orthopedic trauma specialists will help choose knee pads, orthoses or bandages for arthrosis patients to repair the affected joint, reduce the load on it and prevent injury.
Preventive examinations and timely consultation with a doctor when joint discomfort occurs allow you to identify problems at an early stage and avoid severe complications and disability.