Deforming osteoarthritis (osteoarthritis) is a progressive pathology that leads to dystrophy and degeneration of the joint surfaces and cartilage damage, until its complete destruction in the joint area.
Usually deforming arthrosis is detected in old age and old age, in the presence of concomitant factors and diseases, it is often detected during examinations, but does not manifest itself clinically.
Deforming osteoarthritis is the most common and widespread joint pathology. It occurs in 70% of all joint diseases.
Causes
The exact cause of deforming osteoarthritis has not yet been clarified, but some factors have been identified that reliably increase the likelihood of its development. First of all, these are the general aging of the body and dystrophic phenomena in tissues, changes in cartilage and joint capsules.
The factors that affect the development of osteoarthritis can be divided into:
- external - these include joint overload (for example, due to weight lifting), permanent injuries, occupational influences, hypothermia of the joints,
- internal - this is the influence of heredity with excessive stretching of the ligaments and laxity of the joints, ovarian dysfunction and climacteric changes in women, vascular accidents, impaired blood circulation in cartilage tissues, obesity.
Deforming osteoarthritis, as one of the symptoms, can be with alcoholism or myxedema, acromegaly or with hormonal treatment, with congenital hip dislocation, Marfan syndrome (a hereditary disease characterized by excessive joint mobility and elongation of the tubular bones). joint stiffness)
Development phases
In the development of deforming arthrosis, there are a number of regular successive stages that replace each other:
- Reduce the moisture of the cartilage, which leads to its thinning and drying.
- formation of defects and cracks in the cartilage,
- destruction of cartilage with simultaneous acute narrowing of the joint space,
- the disappearance of cartilage from the bone margins,
- compensatory compaction of the ends of the bones, which were left without a cartilaginous surface,
- joint breakage with dislocations, fractures, and limb dysfunction.
Symptoms of deforming osteoarthritis.
First of all, the main manifestation of deforming osteoarthritis is
- pain inside the joint, worse after exercise or at night
- individual joints are affected,
- the affected joints are not symmetrical,
- at the same time, there are no common manifestations of joint damage,
- no fever
- there is no strong redness of the joints,
- no change in analysis.
The process often occurs in the ankle, knee, hip, or interphalangeal joint.
If the disease progresses to the degree of cartilage destruction, a painful blockage of the joint occurs, when walking, severe pain appears that does not allow the legs to move and makes it stop. This is due to pieces of cartilage or small bone fragments (joint "mice") entering the joint cavity.
In the area of the joints in the phalanges, nodular and very hard formations appear, while the joints are not very deformed, the muscles do not suffer from atrophy and there is no ankylosis (joint immobility).
Inside the joints, when moving, a cracking noise is heard due to the friction of uneven surfaces against 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, first of all it must be distinguished from rheumatoid arthritis.
Diagnostics
There are no typical criteria for the diagnosis of deforming osteoarthritis; it can only be recognized externally by the nodules on the phalanges of the fingers. Osteoarthritis is suspected when:
- typical joint damage,
- long-term development of the disease over many years,
- elderly patient.
The basis of the diagnosis is the X-ray data arising even before the period of clinical manifestations and pain syndrome.
There is a narrowing of the joint space, a change with flattening and deformation of the joint surfaces, instability in the joint area with dislocations and subluxations, marginal bone growths, osteosclerosis (excessive increase in bone density) are noticeable.
As the process progresses, bony spines and protrusions are revealed, the joint space may become wedge-shaped.
The study is complemented with an arthroscopy, a blood test without signs of inflammation.
A study of the periarticular fluid is necessary.
Treatment of deforming osteoarthritis
Treatment is carried out by traumatologists and orthopedists.
Methods for the treatment of deforming osteoarthritis depend on the degree of involvement of the joints in the process, as well as the duration of the injury and the presence of pain.
First, conservative therapy is used.
- reduce stress on the joints,
- weightloss,
- the use of metabolites: a course of aloe or vitreous body intramuscularly in courses,
- use stimulants of cartilage restoration in intramuscular injections in courses.
Complements the treatment:
- the use of quinolones,
- anti-inflammatory therapy.
If there is inflammation in the joint, a course of hormones within the joint is indicated.
A complex of massages, physiotherapeutic effects, mud therapy, thermal effects are also used. The spa treatment is helpful.
In advanced cases, surgical treatment helps: joint arthroplasty. In the future, joint unloading, weight loss, walking with support on a cane or crutches, physical therapy exercises are shown.
Forecast
Deforming osteoarthritis without the necessary treatment has a slow but progressive course. It leads to disability and significant dysfunction of the joints, movement disorders. Therefore, when the first signs of osteoarthritis appear, active therapy is indicated, with a duration of 1-2 months.