Deforming arthrosis (osteoarthritis) is a progressive pathology leading to dystrophy and degeneration of articular surfaces and damage to cartilage, up to its complete destruction in the joint area.
Usually, deforming arthrosis is detected in old and old age, in the presence of concomitant factors and diseases, it is often detected during examinations, but does not manifest itself clinically.
Deforming arthrosis is the most frequent and widespread joint pathology. It occurs in 70% of all joint diseases.
Causes
The exact cause of deforming arthrosis has not yet been clarified, but some factors have been identified that reliably increase the likelihood of its development. First of all, these are general aging of the body and dystrophic phenomena in tissues, changes in cartilage and joint capsules.
Factors affecting the development of osteoarthritis can be divided into:
- external - these include overloading of the joints (for example, due to lifting weights), permanent injuries, occupational influences, hypothermia of the joints,
- internal - this is the influence of heredity with overstretching of the ligaments and laxity of the joints, ovarian dysfunction and climacteric changes in women, vascular accidents, impaired blood circulation in the cartilage tissues, obesity.
Deforming arthrosis, as one of the symptoms, can be with alcoholism or myxedema, acromegaly or with hormone treatment, with congenital dislocation of the hip, Marfan syndrome (a hereditary disease characterized by excessive joint mobility and elongation of the tubular bones). joint stiffness)
Stages of development
In the development of deforming arthrosis, there are a number of regular successive stages that replace each other:
- reducing the wateriness of the cartilage, which leads to its thinning and drying,
- formation of defects and cracks in the cartilage,
- destruction of cartilage with a simultaneous sharp narrowing of the articular space,
- the disappearance of cartilage from the bone margins,
- compensatory compaction of the ends of the bones, which were left without a cartilaginous surface,
- disruption of the joints with dislocations, fractures and dysfunction of the limbs.
Symptoms of deforming arthrosis
First of all, the main manifestation of deforming arthrosis 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 changes in analyzes.
The process often occurs in the ankle, knee, hip or interphalangeal joint.
If the disease progresses to the degree of destruction of the cartilage, painful blockage of the joint occurs, when walking, severe pain appears, which does not allow the legs to move and makes it stop. This is due to pieces of cartilage or small fragments of bones (articular "mice") getting into the joint cavity.
In the area of the joints on the phalanges, nodular, very hard formations appear, while the joints are not very deformed, the muscles do not undergo atrophy, and there is no ankylosis (joint immobility).
Inside the joints, when moving, a crunch is heard due to the friction of uneven surfaces against each other.
Pain and limited mobility can cause contractures (muscle contractions), which 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 arthrosis; it can be outwardly recognized only 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 diagnostics is radiological data that arise 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 surfaces of the joint, instability in the joint area with dislocations and subluxations, marginal bone growths, osteosclerosis (excessive increase in bone density) are noticeable.
As the process progresses, bone spines and bumps are revealed, the joint space can become wedge-shaped.
The study is complemented by arthroscopy, a blood test with no signs of inflammation.
It is necessary to conduct a study of the periarticular fluid.
Treatment of deforming arthrosis
The treatment is carried out by traumatologists and orthopedists.
Methods for the treatment of deforming arthrosis depend on the degree of involvement of the joints in the process, as well as on the duration of the lesion and the presence of pain.
First of all, conservative therapy is used.
- reducing the stress on the joints,
- weight loss,
- 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 quinolone drugs,
- anti-inflammatory therapy.
If there is inflammation in the joint, a course of hormones inside the joint is indicated.
A complex of massages, physiotherapeutic effects, mud therapy, thermal effects are also used. Spa treatment is useful.
In advanced cases, surgical treatment helps - arthroplasty. In the future, unloading of the joint, weight loss, walking with support on a cane or crutches, physiotherapy exercises are shown.
Forecast
Deforming arthrosis without the necessary treatment has a slow but steadily progressive course. Leads to disability and significant dysfunction of the joints, movement disorders. Therefore, when the first signs of osteoarthritis appear, active therapy is indicated, lasting in courses of 1-2 months.