Arthrosis (Deformation of arthrosis, National name - Salt deposition is a chronic joint disease of degenerative-irresistophic, in which the destruction of articulated cartilage, articulated capsules and deformation and deformation occurs.
It should be noted that the arthrosis is the entire group of common diseases that have different origins and close development mechanisms.There are most often arthritis of large joints:
- Deforming the arthrosis of the knee joint (gonartost),
- Deformation Arthrosis hip joint (coxartrosis),
- as well as shoulder arthritis.
These are the most difficult types of arthrosis.
The arthrosis of small joints is less common.Most often, there is deforming arthrosis of interfalance joints of hands, as well as metacarpophalanguive thumb joints.Patients record pain in interfaln couplings, reducing their mobility, appearance near the seal joints (nodes of Geberden and Bushar).This type of arthrosis is more common in age.The arthrosis of the feet joint occurs often.
Polyrosis or generalized arthrosis, characterizes damage to several joints at once.
Arthrosis Spondylarphrose compounds - belongs to the Group of Spine Disease, although it has a similar development mechanism with another arthrosis.
The main clinical symptom of arthrosis is the pain in the compound, reduction of its mobility.Specific symptoms are determined by the arthrosis phase and depend on the degree of destructive changes in the common.
Causes of arthrosis
Arthrosis It is common to divide the primary and secondary.The primary (idiopathic) arthrosis is a consequence of a violation of the recovery process and increased degeneration in the crispy joints without any deviations in the work of the entire organism.The secondary arthrosis is created as a result of other pathological processes in the body or in a common already damaged any external effect, with partial destruction of articulated surfaces.
The most commonly traumatic arthrosis is diagnosed in young patients.And in older patients, it is far from always possible to extract a clear border between primary and secondary arthrosis.
Although the exact cause of arthrosis cannot be determined, the factors that contribute to phenomena and development are well known.
The following types of causes that contribute to the development of primary and secondary deformation of arthrosis may differ.
Causes of primary arthrosis are hereditary factors
The following hereditary disorders identified that can cause the development of the primary arthrosis:
- Genetic disorders in the crunchy tissue composition on the wrist, leading to his accelerated destruction;
- Congenital shortcomings of the muscle-bone system (hipmobili joints, dysplasia, straight feet and others), which are the cause of trauma of certain parts of the cartilage tissue, and, as a result, arthrosis appearance.
It was also observed that the deformation of the arthrosis of the inter-refueling joints of the upper extremities is located mainly in women and legacy to a woman's line.
Causes of secondary arthrosis
Secondary arthrosis is a consequence of the damage to the community.This damage can cause various factors.
- Mechanical joint damage.This group of factors includes various common injuries, intra -articular bone fractures, as a result that is a joint structure disrupted.The same result is caused by constant microtraims of compounds as a result of excessive permanent load, both static and dynamic (for example, in athletes).Also, obesity leads to overload and trauma.
Another factor that has a negative impact on the joints (primarily on HIP) is an incorrect posture.
The structure of the joint can also disrupt the surgical intervention. - Joint diseases.Arthrosis can be the result of inflammatory joint diseases (acute and chronic arthritis, synonitis, primary aseptic necrosis of bone tissue, etc.)
- Breaches of metabolism, endocrine system diseases, lack of minerals in the body.Different metabolic disorders, lack of calcium, phosphorus and other minerals, vitamins and trace elements cause bone and cartilage composition, sinovial fluid, which leads to a violation of the recovery process and gradual destruction of the composition.
- Autoimune diseases(gout, chondrocalcinosis, hemochromatosis, psoriasis, rheumatoid arthritis), Hormonal disorders, lack of estrogen In postmenopausal, women lead to changes in the joint tissues and their gradual destruction.
- Vascular diseases (atherosclerosis of the vessels of the lower extremities, the nearby endartitis, varicose veins), as well as Hypodynamy They cause circulation disorders in periarticular tissues, poor blood supply into common tissues and as a result, dystrophical change.
Arthrosis development mechanism
Development arthrosis It starts by destroying cartilage.It is believed that in the beginning, there is a violation of blood circulation in the capillaries of the Corneal layer of peristeum.Since the nutritional crispies occurs due to the input of nutrients and neighboring bonies, the disorder leads to the fact that it is gradually losing elasticity, it becomes a thinner, the amount of joint surfaces, the amount of sinny fluid has been reduced.As a result, it appears Pain and crumb during movement.The width of the common spacing is gradually declining, the bone is formed along the edges of the hinged surfaces Osteophyta spikes.
Finally, the wrist is deformed, the amplitude of the movement in it decreases.Thus develops an invisible arthrosis associated with the aging of the body.The development of this form of arthrosis usually occurs gradually, over the years.
Other forms of large joint arthroses, for example, post -traumatic, post -infectic, metabolic, intoxication have several other development mechanisms, but as a result we receive similar changes in the wrist.
Symptoms of arthrosis joints.Phase and degree of arthrosis
"Classic" is the classification of arthrosis based on clinical and radiological characteristics.In accordance with her, three phases of disease development are different.This corresponds to the classification by the degree of maintaining disability, which distinguishes 3 degrees of arthrosis:
- And the degree of arthrosis - the disease does not prevent work, although it complicates,
- II degree of arthrosis - disease prevents work of work,
- III degree of arthrosis - loss of working ability.
Consider more detailed clinical symptoms and signs of arthrosis on each of these phases
First-degree arthrosis (starting phase of arthrosis)
In the initial phase of the disease in the morning, after vacation, stiffness, difficulties in joints, which gradually passes a time after the start of movement.Maybe a restrict of mobility in the wrist."Initial" pain appears periodically (pain at the beginning of the movement after a long stay at rest).With sharp movements, common crumbs, but there is no pain during movement.The pain at this phase of arthrosis appears only with significant and extended load and saves after vacation.There is no pain alone and at a small load.At this stage of disease, patients rarely see a doctor.
In the X -RAY image with the first degree of special changes in the joint, there are sometimes small osteophytes can be visible along the edges of the joints, and the articulated gap is slightly narrowed.
Arthrosis 2 degrees (second phase of arthrosis)
In addition to the further development of arthrosis, the pain is becoming significant, acute character acquires.Different crumbs appear in the joint, has a visible mobility limit in common (contraction), functional shortening of limbs, weakened biomechanics movements, but is still preserved.This phase is characterized by a noticeable strengthening of initial pain, they become acute and longer.Under the influence of daily physical activity, a constant fatigue appears, a feeling of pressure in affected joints, thus-were calculated "mechanical pain" caused by reducing the scorch -Aabsorption capacity of the wrist.
The destruction in the wrist is already quite significant, the joints are already partially deformed.
Visible osteophytes are visible to radiographs, narrowing a joint gap is 2-3 times in relation to the norm, sclerosis subchingral bone and the formation of cystic cavities in the epiphysic zone.
The agreat of the second degree is characterized by a decrease in the working ability, inability to perform certain types of work.
3-degree arthrosis (third phase of arthrosis)
Arthrosis 3 degrees are severe, neglected phase of the disease.At this stage there are:
- significant deformation of common (due to the growth of bones and liquid accumulation in the joint cavity);
- sharp restriction of movement, to preserve only rocking movements;
- Sharp pain not only when moving, but also in a state of full vacation - constant pain associated with the reflective spasms of nearby muscles, as well as the development of reactive sinovitis;
- Inflammation of joints,
- The sensitivity of the joints to change time.
- The muscles around the knees are nasty and atrophied;
The axis of limb is deformed, noticeably varus or valgus the curvature of the leg (it is in the shape of the letter "o" or "x").
On the radiographs with Arthrosis 3. The degree, a completely disappearance of the common spacing was observed, serious deformation of articulated surfaces, huge more regional osteophytes.Articulated mice and calcification of parairticular tissues can be determined.
In 3 degrees, the disease has passed very far, it is often the cause of permanent disability.It manifests in the following way:
- Pain becomes constant and painful: walking, and especially origin and climbing stairs - a difficult test for the patient;
- Loud crumbs in any movements, keeps well with others;
- Joint deformation strongly expressed, movements are limited only by a small amplitude or even impossible;
Images show the destruction of intra -Articular structures (ligaments and meniscus), as well as complete abrasion of cartilage and sclerosis signs (replacement of functional bodies and binding tissue structures).
Fourth degree arthrosis
The state of complete wrist destruction arthrosis, when together completely stops functioning is often different in separate - 4 degree arthrosis.There is such a - corded "articulated blockade" - an acute pain syndrome in which even a limited movement is impossible in ill.The fourth degree of arthrosis was accompanied by unbearable joint pain, which do not even remove powerful medications and intense physiotherapy.Complete ankylosis (common fusion) or neorin (formation of false compound between displaced ends of bones) is possible.Independent movement in both cases is almost impossible.
In the pictures, rough sclerosis of fatal surfaces with pronounced cystical enlightenment, fusion of coupling bones in a shared jail.Disease development at this stage almost always means disability, which can only be prevented by implantation of artificial joint ventures.
Treatment of arthrosis
Treatment of arthrosis in the initial phase of the disease
It is better to start treating arthrosis as soon as possible, with the appearance of the first signs - crumbs in the joints, difficulty moving.At this stage, medications are the useful -contro propeters that improve the cartilage structure, as well as vitamin complexes.
Medical physical education is important, proper nutrition, as well as preventive measures.It should be noted that the prevention of arthrosis is also of great importance to prevent disease deterioration.
Treatment of arthrosis 2 - 3 degrees
Although it is already impossible to completely cure an arthrosis of 2-3 degrees, however, the process of its development can be noticeably inhibited.The treatment of arthrosis at this stage includes the following phases:
- Removing or reducing pain syndrome
- Remove inflammation in the joint.
- Improve the rebuild of cartilage and slow down degenerative processes in it.
In an acute period, the treatment of arthrosis begins with the elimination of pain.For this, inhomonic anti -infalmator drugs (NSAID) are used by analgesics.Intra -Articular injections of corticosteroids are possible.It is necessary to reduce the load on the compound, you cannot walk or stand for long, raise heavy objects.
After removing the acute pain, the main task is to ensure, as much as possible, the activation of the recovery process in common and periarticular tissues: improving blood circulation, increased metabolism, inflammatory process elimination.Constructed concrusters are prescribed, vasodilation remedies are prescribed, as well as therapeutic exercises and physiotherapy.
Treatment of arthritis 4 degrees
At this stage of the disease, the wrist was almost completely destroyed.In this case, one output remains - operation and replacement of a diseased endoprosthesis.Endoprotez significantly improves the mobility of the common, allows the patient to continue active life, at least solve pain.