What is osteoarthritis of the joints

Osteoarthritis can affect any joint, while degenerative-dystrophic changes can be isolated or occur in several joints simultaneously.

This pathology is not life-threatening, but significantly reduces its quality. Severe pain, restriction of mobility increases with time, which provokes injury.

In the early stages, conservative therapy is prescribed to help stop the development of the disease.

It is difficult to cure completely deforming osteoarthritis (DOA), but it is possible to preserve the functionality of the bone connection. In the later stages, only surgical treatment will help.

Development mechanism

Many people have heard of such a disease as osteoarthritis, but not everyone understands what it is. To do this, you need to understand how the joint works.

The surfaces of the bones that form the joints are covered with smooth, slippery elastic cartilage, which softens them and protects them from damage. In osteoarthritis, the blood supply to this area is disrupted and the hyaline cartilage begins to deteriorate. In addition, degenerative-dystrophic changes occur in the capsule, ligaments, periarticular muscles and other segments of the articulation.

The disease usually develops slowly, but the pathological process can be accelerated under the influence of external factors. Much depends on the characteristics of the patient's body, comorbidities, lifestyle.

Osteoarthritis develops as follows:

• The blood circulation is disturbed in a certain area of the cartilaginous lining of the joint, after which it begins to suffer from a lack of nutrients. Under the influence of traumatic factors, the area of destruction increases.
• The body replaces defects in the cartilage lining of the joints with mineralized tissue that has no clear structure.
• Gradually, pathological growths (osteophytes) appear on the hyaline coating.
• Against the background of the pathological process, healthy areas of cartilage are exposed to excessive stress. As a result, the work of the joint is disrupted and its surfaces are gradually destroyed.

Careful!Osteoarthritis provokes destruction of the bone surfaces of the joint, inflammation of the synovial membrane, thickening of the joint capsule. There is a narrowing of the joint space, the joint is deformed, destroyed, then the patient may become disabled. That is why it is very important to diagnose and start treatment of the pathology in time.

Osteoarthritis is usually found in patients over 60 years of age. However, the disease is also diagnosed at a young age - from 20 to 45 years.

Help. Arthritis and osteoarthritis are similar, so many patients are interested in how the first disease differs from the second. In DOA, only the joints are damaged, and arthritis is characterized by inflammatory damage not only to the bone ligament, but also to the internal organs (liver, kidneys, heart). This is the main difference between these pathologies.

Classification

People who are far from medicine, when they hear such names as gonarthrosis, coxarthrosis, osteoarthritis, do not understand the difference. The fact is that there are many types of this pathology, which differ in location, specificity of the course, causes, origin. Therefore, doctors have created several classifications of osteoarthritis to facilitate their differentiation.

Types of arthrosis by location:

• Gonarthrosis is a pathological process in the knees.
• Coxarthrosis is a lesion of the hip joint.
• Uncovertebral - deformity of the cervical spine.
• Dystrophic changes in the shoulder joint.
• Interphalangeal - deformation of the interphalangeal joints of the bones.
• Spondyloarthritis is a degenerative change in the joints of the spine.
• Ankle - wear and tear of the ankle joint.
• Polyosteoarthritis is a multiple lesion of the finger joints.

There are also maxillary, temporal, bone-vertebral, clavicular-acromial arthrosis.

Depending on the characteristics of the course, the following types of pathology are distinguished:

• Osteoarthritis is a stage 3 disease. It is a progressive disease that requires immediate surgery.
• Osteoarthritis - destruction of the cartilage, inflammation.
• Acute disease in which the characteristic symptoms become more pronounced.
• Chronic osteoarthritis is a slow destruction, thinning of the cartilage lining with an erased stroke.

Depending on the reason, a distinction is made between:

• Dystrophic osteoarthritis - occurs as a result of metabolic disorders.
• Fracture arthrosis - develops as a result of a fracture.
• Post-traumatic - the disease appeared after an injury to the joints.

DOA varieties by origin:

• Primary (idiopathic) - occurs for no apparent reason, often due to age-related changes in bone joints.
• Secondary - degenerative-dystrophic disorders provoke many factors (metabolic disorders, hormonal imbalance, trauma).

Doctors distinguish between monoarthrosis and polyarthrosis. In the first case 1 joint is affected, and in the second all joints are destroyed simultaneously. The last type of disease is called generalized osteoarthritis, in which 3 or more bone joints are deformed.

Degrees of pathology

According to the symptoms and progression, there are 4 stages of DOA:

• 1 degree.The shape and structure of the joint have not yet changed, so the disease has a latent course. From time to time the patient experiences slight discomfort in the affected area, especially after excessive exercise or sudden movements. The composition of the joint fluid changes, the blood supply to the joint is disrupted. The muscle fibers that surround the joint are weakened.
• 2nd degree.The bone joints begin to collapse, bone growths form on their surface. Moderate painful sensations appear, inflammation periodically appears. During movement, a characteristic crunch is heard in the affected joint. Muscle function decreases due to the fact that the trophism of the nervous tissue is disturbed.
• 3rd degree.There are pronounced degenerative disorders of hyaline cartilage and articulation, due to which the axis of the limb is bent. The ligaments and muscles shorten and the joint becomes pathologically mobile, but the movements are significantly limited. The patient often has incomplete dislocations.
• 4th degree.The bone connection is completely destroyed, complete immobility is observed, as well as a strong pain syndrome even during rest.

Important. In the last stage of osteoarthritis, only endoprosthesis will help (replacement of the affected joint with a prosthesis).

Causes of DOA

The question of why the disease occurs is quite relevant. Doctors distinguish between internal (certain diseases, bad habits, unhealthy eating) and external (injuries, peculiarities of professional activity) causes of osteoarthritis.

Often against the background of the inflammatory process develop secondary degenerative-dystrophic disorders:

• Infectious diseases that provoke various viruses and bacteria.
• Rheumatism.
• Autoimmune diseases.
• Purulent inflammation of the joint.
• Gout (deposition of uric acid salts on bone surfaces).
• Psoriasis of the joints.

DOA can occur due to abnormalities in the structure of cartilage and malnutrition. Pathological changes are caused by the following factors:

• Genetic disorders.
• Pathologies that occur during intrauterine development.
• Age-related changes in the body.
• Osteoporosis (increased bone fragility due to calcium deficiency).
• Hormonal imbalance.
• Disorders of metabolic processes.
• Lack of vitamins, minerals.
• Pathologies that are accompanied by muscle weakness.
• Prolonged intoxication.

Exacerbation of diseases of the musculoskeletal system also provokes degenerative changes in cartilage tissue.

External factors for the development of osteoarthritis include:

• Regular hypothermia.
• Dislocations.
• A blow of great force in the field of articulation.
• Fracture.
• Damage to the meniscus.
• Excessive physical activity related to professional sports or professional activities.
• Obesity.
• Surgery of joints or periarticular structures.

Regardless of the causes of DOA, it is important to first identify the cause of the pathological changes and then treat the consequences.

Help.Idiopathic osteoarthritis goes away on its own, for no apparent reason.

Symptoms

Osteoarthritis manifests itself with the following symptoms:

• pain syndrome;
• restriction of mobility;
• crunch when moving;
• swelling, change in the axis of the connection.

These are typical symptoms that occur in all patients.

The initial signs of the pathology are discomfort in the affected area, which appears after exercise. After the onset of discomfort you should consult a doctor, as the disease can be cured in the early stages.

Later, the patient complains of mild to moderate pain, which appears after loading the damaged joint and quickly disappears.

Decreased mobility of the bone joint indicates degenerative changes in its structure. At first, the patient feels numbness, especially in the morning. Later, it becomes increasingly difficult for the patient to perform active movements. With further development, restriction of movement appears even with additional help. If left untreated, a joint contracture occurs and over time its motor activity is blocked.

Many patients complain of crunching of the joints during movement, which is accompanied by painful sensations and reduced mobility. As the disease progresses, this manifestation becomes more pronounced.

In later stages, the axis of the limb bends and the joint membrane deforms. This shows that the bone connection has practically collapsed and healthy tissues have been replaced by osteophytes. At this stage, the neighboring joints are subjected to severe stress, after which the likelihood of damage to their cartilage increases.

Diagnosis

If you notice signs of osteoarthritis, seek medical attention immediately. The diagnosis of DOA is made after taking a medical history, conducting laboratory and instrumental tests.

First, a visual examination is performed, during which the doctor may notice swelling in the affected area. In addition, palpation is performed, which allows you to determine pain, nodules, changes in skin temperature and humidity.

Comprehensive diagnosis includes laboratory tests. Blood tests can reveal an inflammatory process, which is manifested by an increase in ESR (erythrocyte sedimentation rate), an increase in uric acid concentration. A urine test is done to determine the protein level.

Osteoarthritis is diagnosed with the help of the following instrumental tests:

• X-rays help to see the change in the shape of the joint.
• Contrast arthrography is a more accurate diagnostic method than X-rays.
• CT is used to assess the structure of the joint.
• Radionuclide diagnostics is performed using radiopharmaceuticals. This study allows you to assess the anatomical and functional state of the relationship.

Magnetic resonance imaging is a modern highly informative diagnostic method. During the examination you may see a deformity of the damaged joint, rupture of the menisci or ligaments.

To examine the synovial fluid, doctors prescribe a puncture of the affected limb.

After diagnostic measures, the doctor draws up a treatment plan.

Healing methods

Osteoarthritis requires medical attention at every stage. Complex therapy in the early stages helps to stop the pathological changes and restore the functionality of the joint. If the patient seeks medical attention at a late stage of DOA, then the prognosis is poor.

In case of 1st degree arthrosis, medical treatment is carried out. Chondroprotectors are used to restore the structure of the cartilage. The patient is prescribed drugs in the form of tablets and capsules. They should be taken in courses of 3-4 months twice a year. The drug contains the structural elements of the cartilage shell.

Non-steroidal anti-inflammatory drugs (pills, injections) help relieve pain.

Treatment with DOA is performed using physiotherapy methods:

• Magnetic therapy.
• Ultrahigh frequency therapy.
• Electrophoresis.
• Shock wave therapy.
• Paraffin therapy.
• Treatment with mud.

Physiotherapy and physiotherapy exercises are performed after the pain disappears. The doctor composes a set of exercises that the patient must perform systematically. Healing therapy increases muscle tone, strengthens ligaments, normalizes blood circulation and helps restore articulation.

During and after treatment it is recommended to provide rest, to reduce the load on the diseased joint with the help of bandages, crutches and canes.

Sometimes the patient is prescribed a massage. After a course of procedures, the blood supply to the affected area improves and the pain decreases.

During therapy, the patient must eat properly. You need to give up sugar, flour, fatty, spicy foods, potatoes, tomatoes, eggplant. And it is recommended to get rid of bad habits forever (alcohol, smoking).

In osteoarthritis, intra-articular injections are used:

• Glucocorticosteroids help to normalize the blood supply to the affected area, stop the inflammatory process and increase the elasticity of bone tissue.
• Analogs of synovial fluid with chondroprotective properties. These drugs reduce pain, improve joint mobility and accelerate the production of collagen and elastane.

In the last stages of DOA, surgical methods of treatment are used:

• Endoprosthesis.
• Arthrodesis.
• Arthroscopy.

In advanced cases, doctors replace the destroyed joint with a metal prosthesis. Most often this method is used to treat large joints. After the operation, the patient's quality of life improves.

If arthrodesis cannot be performed, then the patient is prescribed arthrodesis. During the operation, the bone surfaces are immobilized with a special plate. Arthrodesis helps to relieve severe pain, but does not restore motor activity of the joint.

During arthroscopy, a miniature chamber and manipulators are inserted into the articulatory cavity, with the help of which bone growths are removed and the structure of the cartilage is restored. The camcorder allows you to monitor all manipulations on the screen. As a rule, the operation is performed for gonoarthritis, but its effect is short-lived.

DOA is dangerous, so it is important to identify and treat it in time.

Reviews

According to patients who have experienced osteoarthritis, it is easiest to cure the disease at an early stage. In advanced cases, only surgery will help. But in both cases the treatment must be comprehensive.

• The first examination: "1 year ago I was diagnosed with osteoarthritis of the knee joint 2nd degree. I took special medications, went through physiotherapy, went on a diet. Initially, the pain disappeared, mobility was restored, but after 3-4 months the symptoms returned. Sometimes the pain is accompanied by a rise in temperature. The doctor advised me to take capsules with chondroprotectors. With them my condition has improved, I have not felt any pain for six months now. "
• Second examination: "Several years ago I was diagnosed with grade 3 coxarthrosis. I suffered from pain all the time, even at night, I could not move my legs normally. The doctor advised me to have surgery, but at first I refused and decided to try intra-articular injections. However, after the procedures my condition did not change much. As a result, I opted for a radical method. After endoprosthesis he recovers 1 year and 3 months. During this period she takes medication, performs special exercises, goes to massage, physiotherapy, follows a diet. Now I live a full life. I advise everyone not to hesitate with the treatment. "
• Third examination: "I was diagnosed with rupture of the internal meniscus of the knee and gonoarthritis 1 degree after MRI. Doctors prescribed chondroprotectors. I also used the ointment twice a day. To protect my knee, I used an orthosis, I only took it off at home during breaks. After the course of the injections, electrophoresis, paraffin therapy, a magnetic therapy device were purchased, and 10 sessions have already been performed. After another diagnosis, doctors said the joint had recovered by 70%. I continue the treatment and hope to fully recover my leg. "

As you can see, there are different types of osteoarthritis. To avoid surgery and restore joint function, you should seek medical attention at the first suspicious signs. Only a doctor will be able to determine the type, severity of the disease and prepare a competent treatment regimen. DOA is easier to treat in the beginning.