Arthritis

Arthropathy (osteoarthritis, deforming arthropathy) is a process of slow degeneration and destruction of the cartilage in the joint. The articular ends of the bones become deformed and enlarged and the peri-articular tissues become inflamed. The general diagnosis of "arthropathy" means a group of diseases that have similar symptoms, but differ in origin. The joint - the affected area - consists of articular surfaces covered by cartilage tissue, a cavity with synovial fluid, a synovial membrane and a joint capsule. With advanced disease, mobility is lost and the patient feels pain due to inflammatory processes.

Reasons

Arthritis of the joints develops due to the discrepancy between the amount of stress and the capabilities of the body. Lack of nutrients, excess body weight, heavy physical work and even sports can cause it.

Factors affecting the development of the disease:

• genetic, hereditary predisposition.
• age over 40;
• obesity, overweight;
• sedentary work, passive lifestyle.
• hard work, work that involves constant physical activity.
• inflammatory diseases;
• congenital pathologies of the joints (dysplasia).
• injuries, wounds;
• body dysfunction (poor blood circulation, hormone imbalance, micronutrients).

The disease can be primary or secondary. The causes of primary arthropathy are still not well understood. Doctors believe that it develops in the presence of genetic factors (predisposition) and external adverse conditions.

Secondary arthropathy occurs in the context of inflammatory diseases, dysplasia and as a result of injuries, including professional ones.

Workers' representatives and athletes have an increased chance of developing the disease. Representatives of the arts are also at risk: dancers (especially ballerinas), pianists. Arthritis of the wrist and finger joints most often affects people whose work involves fine motor skills: engineers, mechanics and pianists. "Occupational" loader arthropathy is found in the knees, clavicles and elbows. Drivers, painters and miners suffer from elbow and shoulder joints. The weak point of ballerinas is the ankle. Athletes are also more likely to have injuries to the ankle and other joints of the hands and feet, depending on the type of athletic activity. For example, a tennis player will be at high risk for shoulder and elbow joint disease.

Pathogenesis

Structural changes in cartilage occur due to an imbalance between tissue breakdown and repair. Collagen and proteoglycans are gradually "washed out" from the body, no new nutrients are provided. Cartilage tissue loses its elasticity, becomes soft and cannot withstand stress.

Regardless of location and root cause, the disease develops in the same way. Gradually, the cartilage is completely destroyed, the ends of the bones "grind" against each other. The patient experiences pain, the intensity of which increases depending on the stage. Joint mobility gradually decreases, the patient is limited in movements.

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Classification

Orthopedists use the classification formulated by the professor in 1961:

• Stage I. The bone becomes denser, the joint space narrows slightly. Discomfort during physical activity, which subsides after rest.
• Stage II. The joint space narrows noticeably, the edges of the bones grow and the connective tissue becomes denser. The pain becomes constant, the muscles hypertrophy, the joint is much less mobile, site-specific symptoms appear.
• Stage III. The joint space is practically absent, bony growths are extensive, and destruction of the bone beneath the cartilage is likely. The joint is completely deformed and immobile. Acute or continuous pain is possible depending on the type and location of the disease.

Depending on the location and form of the disease, symptoms, speed of development and treatment methods vary.

Printed matter

The disease is characterized by a chronic form, but it can also appear in an acute form.

When the disease spreads to several joints (for example, fingers), it is called generalized.

Anatomical shapes:

• deforming (osteoarthritis). It leads to bone growths.
• uncovered. It destroys the discs and intervertebral tissue in the cervical region.
• post-traumatic. It develops as a result of trauma, injury.
• rheumatoid. Autoimmune diseases, inflammation of the connective tissue. It can be a consequence of previous arthritis.
• psoriasisIt develops against the background of psoriatic arthritis.

Localizations

Osteoarthritis is a disease that affects joints throughout the body.

SPINE. The causes can be autoimmune diseases, back ailments, increased stress, injuries, lack of trace elements, hormonal imbalance.

Local settings:

• coccyx;
• lumbar region;
• thoracic spine;
• cervical region

Legs. Knees and ankles are more prone to arthritis. The reasons are injuries, excess weight, incorrect, excessive loads. Types of detection:

• Gonarthrosis - knees;
• patellofemoral - femoral and patella;
• ankle;
• lightning joint;
• feet and toes.

Hands. Hand and finger injuries are more common and in most cases are related to occupational activities, injuries, age-related and hormonal changes. In addition, the disease is found in the shoulder, wrist and elbow joints.

Torso. Location on the trunk is less common compared to arthropathy of the extremities. Damages are associated with professional activity, sedentary lifestyle (stagnation).

Types of detection:

• clavicle. When moving, "clicks" and pain are felt. Weightlifters and military personnel are at risk due to potential injuries.
• hip joints (coxarthrosis). The disease manifests as pain in the groin.

Head>. Sometimes dental problems, autonomic disorders, and even hearing loss are caused by damage to the temporomandibular joint. The swelling disturbs the symmetry of the face, can affect the ear and cause headaches.

Symptoms

The symptoms of the disease depend on its location. Common events for all types are:

• pain in the affected area. In the first stages - during movement, work, in the last stages - at rest.
• inflammation, swelling. The periarticular tissues swell, the skin becomes red.
• "click", tingle. During movement, characteristic sounds are heard.
• difficulty moving. As the disease progresses, the mobility of the affected area decreases.
• reaction to cold. Many types of joints are characterized by exacerbations in rainy and cold weather.

Exacerbations of the disease are associated with general weakening of health. Due to viral diseases and increased stress, it takes an acute form and develops many times faster. During an exacerbation, symptoms, especially pain, become more intense. It is difficult for the patient to move, to the point of complete loss of mobility and to perform the usual work.

Possible complications

The main danger is the loss of mobility of the joint, its deformation beyond the possibility of recovery. Due to the displacement of the axis, the posture of the body is disturbed and the figure loses symmetry. Possible increased pressure on internal organs, their displacement, compression. Simultaneous diseases and damage to body systems appear. For example, with arthropathy of the coccyx in women, gynecological complications are possible, and arthropathy of the temporomandibular joint or cervical spine causes disturbances in the autonomic system: dizziness, sleep disorders. A patient with arthropathy can become disabled.

Diagnostics

To make a diagnosis, a comprehensive examination is carried out:

• receiving a souvenir;
• X-ray in multiple views.
• MRI and CT to rule out tumors and obtain a 3D image.
• blood and urine tests to rule out co-morbidities and assess 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. Patients with stage II can expect long-term relief from bone destruction. Stage III most often requires surgery.

Conservative (non-surgical) treatment:

• physiotherapy, use of braces, canes, crutches to reduce the load. Elimination of accompanying and aggravating factors (for example, weight loss, stress, change 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.
• intra-articular injections of glucocorticoid hormones to reduce severe pain and inflammation.

Surgical methods:

• arthroscopy - internal examination of the joint and removal of cartilage fragments.
• arthroplasty - implantation of artificial cartilage.
• osteotomy - removal or dissection of bone tissue.
• chondroplasty - restoration of cartilage.
• arthrodesis - artificial immobilization of a joint (usually the ankle).
• endoprosthetic - removal and replacement of damaged joints with artificial ones.

Basic treatment allows you to stop the disease even at a later stage. It is possible to restore mobility in individual cases (after replacing it with an artificial one). However, this method is effective in combating pain. After the operation, recovery using physiotherapeutic and pharmaceutical methods is required.

Prognosis and prevention

After starting treatment for stage I and II arthropathy, a permanent improvement occurs: pain and inflammation subside. In this case, it is possible to completely relieve the disease or to maintain it for a long time.

When treating stage III arthropathy, improvements do not appear immediately. In some cases, the disappearance of pain is possible only after surgery. Often the joint remains immobilized or deformed. Patients with severe forms of arthrosis of the hip and knee joints receive disability group I or II.

It has been proven that there is no effective prevention against arthrosis. Weight control, a balanced diet and moderate amounts of exercise will help reduce the risk of developing the disease. Examination at the first signs of arthropathy (especially after injuries and infectious diseases) and careful attention to health will allow you to recognize the disease at an early stage.