Arthritis (osteoarthrosis, arthrosis deformans) is a slow degenerative process and destruction of cartilage in joints. The joint ends of the bones become deformed and grow, and the tissues around the joints become inflamed. The general diagnosis of "arthritis" refers to a group of diseases with similar symptoms but different origins. The joint - the affected area - consists of articular surfaces covered by cartilage tissue, synovial fluid compartments, synovial membranes and joint capsules. With progression of the disease, he loses mobility, and the patient experiences pain due to the inflammatory process.
reason
Arthritis develops due to the difference between stress levels and the body's capabilities. Lack of nutrients, being overweight, heavy work and even playing sports can cause this condition.
Factors affecting the development of the disease:
- heredity, genetic predisposition;
- age over 40 years;
- obesity, overweight;
- sedentary work, passive lifestyle;
- hard work, work that involves constant physical activity;
- inflammatory disease;
- congenital joint pathology (dysplasia);
- wound, wound;
- malfunctions of the body (poor blood circulation, hormonal imbalance, trace elements).
The disease can be primary or secondary. The cause of primary arthritis is not well understood. Doctors believe that it develops in the presence of genetic factors (predisposition) and adverse external conditions.
Secondary arthritis occurs due to inflammatory diseases, dysplasia and trauma, including professional trauma.
Representatives of working professions and athletes are at higher risk of getting the disease. Representatives of the arts are also at risk: dancers (especially ballerinas), pianists. Wrist and finger arthritis often affects people whose jobs involve fine motor skills: mechanics, mechanics, and pianists. The carrier's "professional" arthritis is concentrated in the knees, collarbones, and elbows. Drivers, painters and miners suffered from elbow and shoulder pain. The ballerina's weak point is her ankles. Athletes are also more likely to suffer injuries to the ankles and other joints of the arms and legs, depending on the type of athletic activity. For example, a tennis player will have a high risk of developing shoulder and elbow joint problems.
Pathogenesis
Structural changes in cartilage occur due to an imbalance between tissue breakdown and repair. Collagen and proteoglycans are gradually "washed away" from the body, new nutrients are not provided. Cartilage tissue loses elasticity, becomes soft and cannot withstand pressure.
Regardless of location and root cause, the disease develops in the same way. Gradually, the cartilage layer is completely destroyed, the bone ends "grind" together. Patients feel pain, the intensity gradually increases depending on the stage. Joint mobility gradually decreases, and the patient's movement is limited.
p>Classify
Orthopedists use the classification given by the professor in 1961:
- Stage I. Bones become denser, joint spaces narrow slightly. Discomfort during physical activity that disappears after rest;
- Phase II. The joint space is noticeably narrowed, the bone edges grow, and the connective tissue becomes denser. The pain becomes constant, the muscles hypertrophy, the joints move much less, specific symptoms appear locally;
- Phase III. Joint space is practically absent, the bone is extensively developed, and subchondral bone destruction is likely. The joint is completely deformed and immobile. Acute or constant pain may occur depending on the type and location of the disease;
Depending on the location and type of disease, symptoms, development speed and treatment methods will be different.
Forms
The disease is characterized by a chronic form, but it can also occur in an acute form.
When the disease spreads to certain joints (for example, fingers), it is called systemic disease.
Anatomical shape:
- deformity (osteoarthritis). Leads to bone growth;
- opentebral. Destruction of intervertebral discs and intervertebral tissue in the cervical region;
- after injury. Developed due to injury, trauma;
- rheumatism. Autoimmune disease, connective tissue inflammation. May be a result of previous arthritis;
- Psoriasis. Developed based on psoriatic arthritis.
Localization
Osteoarthritis is a disease that affects joints throughout the body.
Backbone. Causes can be autoimmune diseases, back diseases, increased stress, trauma, micronutrient deficiencies, and hormonal imbalance.
Localization:
- coccyx;
- lumbar region;
- thoracic spine;
- cervical area
Foot. Knees and ankles are more susceptible to arthritis. The cause is injury, being overweight, improper exercise, and excessive load. Types of localization:
- gonorrhea - knee;
- patella - femur and patella;
- fish's eyes;
- talonavicular joint;
- feet and fingers.
Hand. Lesions of the hands and fingers are more common and in most cases they are associated with occupational activities, trauma, age-related and hormonal changes. In addition, the disease is also localized in the shoulder, wrist and elbow joints.
Close. Trunk location is less common than arthritis in the limbs. The injuries are related to occupational activities and a sedentary lifestyle (stagnation).
Types of localization:
- collarbone. When moving, there will be a feeling of "splitting" and pain. Athletes involved in weightlifting and military personnel are at risk due to possible injury;
- hip joint (coxarthrosis). The disease manifests itself as pain in the groin area.
top>. Sometimes dental problems, autonomic dysfunction and even hearing loss are caused by damage to the temporomandibular joint. Swelling causes loss of facial symmetry, can affect the ears and cause headaches.
Symptom
Symptoms of the disease depend on its location. The expressions common to all types are:
- pain in the affected area. In the early stages - when moving, working, in the later stages - when resting;
- inflammation, swelling. The tissues around the joint swell, the skin turns red;
- "clicking", crunching sound. When moving, you will hear characteristic sounds;
- difficult to move. As the disease progresses, mobility of the affected area is impaired;
- react to cold. Many types of joint diseases are characterized by being aggravated by cold and rainy weather.
Exacerbation of the disease is associated with general deterioration of health. Due to viral diseases and increased stress, the disease turns into an acute form and develops many times faster. During an exacerbation, symptoms, especially pain, become more pronounced. The patient has difficulty moving, to the point of completely losing the ability to move and perform normal tasks.
Complications may occur
The main danger is loss of joint mobility, deformation beyond the possibility of recovery. Due to the displacement of the axis, the posture is disrupted and the shape loses symmetry. Possible increased pressure on internal organs, their displacement, compression. Concomitant diseases and malfunctions of body systems appear. For example, with arthritis of the coccyx in women, gynecological complications may occur, and arthritis of the temporomandibular joint or cervical spine causes disorders of the autonomic nervous system: dizziness, confusion. sleep disorder. A patient with arthritis may become disabled.
Diagnose
For diagnosis, a comprehensive examination is performed:
- take a history;
- X-ray in some projections;
- MRI and CT to rule out tumors and obtain three-dimensional images;
- blood and urine tests to rule out comorbidities and evaluate general health.
Depending on the cause of the disease, the patient is referred to a rheumatologist, traumatologist, surgeon or orthopedist.
Treatment
Stage I of the disease is best treated. Stage II patients can expect long-term relief from bone destruction. Stage III often requires surgical intervention.
Conservative treatment (non-surgical):
- Physical therapy, using orthopedic devices, canes, and crutches to reduce the load. Eliminate accompanying and aggravating factors (eg, weight loss, stress, changes in activity);
- taking non-steroidal anti-inflammatory drugs. Selective COX-2 inhibitors are the most effective. Chondroprotectors and atypical antidepressants are prescribed as auxiliary agents;
- inject glucocorticoid hormones into the joint to reduce severe pain and inflammation.
Surgical method:
- arthroscopy - examination inside the joint and removal of pieces of cartilage;
- Joint surgery - implantation of artificial cartilage;
- osteotomy - removal or dissection of bone tissue;
- chondroplasty - restoration of cartilage;
- arthritis - artificial joint fixation (usually the ankle);
- arthroscopy - removal and replacement of damaged joints with artificial joints.
Cardinal treatment allows you to stop the disease even at a late stage. It is possible to restore mobility in individual cases (after artificial replacement). However, this method is effective in fighting pain. After surgery, recovery through physical therapy and medication is required.
Prognosis and prevention
After starting treatment for stage I and II arthritis, lasting improvement occurs: pain and inflammation disappear. In this case, complete remission or long-term preservation of the disease is possible.
When treating stage III arthritis, improvement does not occur immediately. In some cases, the pain may only go away after surgery. Often the joint remains immobile or deformed. Patients with severe arthritis in the hip and knee joints receive a group I or II disability.
It has been proven that there are no effective preventive measures against arthritis. Weight control, a balanced diet and moderate exercise will help reduce the risk of developing the disease. Checking for the first signs of arthritis (especially after injuries and infectious diseases) and paying careful attention to your health will help you identify the disease in its early stages.