What is osteoarthritis of the joints?

Osteoarthritis can affect any joint, while degenerative-dystrophic changes occur in isolation or in several joints at the same time.

This pathology is not life-threatening, but it significantly reduces its quality. Severe pain, restricted mobility increase over time and provoke a disability.

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

Complete cure for osteoarthritis deformans (DOA) is difficult, but it is possible to keep the bone joint in good working order. In later stages, only surgical treatment will help.

Development mechanism

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

The joint-forming surfaces of the bones are covered with smooth, gliding, elastic cartilage, which cushions them and protects them from damage. With osteoarthritis, the blood supply to this area is cut and the hyaline cartilage begins to deteriorate. In addition, degenerative-dystrophic changes occur in the capsule, ligaments, periarticular muscles and other joint segments.

Usually the disease develops slowly, but the pathological process can accelerate under the influence of external factors. Much depends on the characteristics of the patient's body, comorbidities and lifestyle.

Osteoarthritis develops in this way:

• Blood circulation is impaired in a certain area of the cartilaginous lining of the joint, then it begins to suffer from nutritional deficiencies. 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 does not have a clear structure.
• Gradually, pathological growths (osteophytes) appear on the hyaline coating.
• Against the background of the pathological process, healthy areas of the cartilage are exposed to excessive loads. As a result, the work of the joint is disrupted, and its surfaces are gradually destroyed.

Carefully!Osteoarthritis provokes the destruction of the bone surfaces of the joint, inflammation of the synovial membrane, compaction of the joint capsule. There is a narrowing of the joint space, the joint is deformed, destroyed, then the patient can be handicapped. Therefore, it is very important to diagnose and treat the pathology in a timely manner.

Usually, osteoarthritis is diagnosed in patients over the age of 60. However, the disease is diagnosed even at a young age - from 20 to 45 years.

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

classification

People who are far from medicine when they hear names like osteoarthritis of the knee, osteoarthritis of the osteoarthritis, do not understand the difference. The fact is that there are many types of this pathology, which differ in localization, specificity of the course, reasons and origin. Therefore, doctors have created several classifications of osteoarthritis to make it easier to differentiate between them.

Types of osteoarthritis by localization:

• Osteoarthritis of the knee 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.
• Spondyloarthrosis is a degenerative change in the joints of the spine.
• Ankle - wear and tear on the ankle joint.
• Polyosteoarthritis is a multiple lesion of the finger joints.

In addition there is also jaw, temples, cost vertebrae, clavicle acromial osteoarthritis.

Depending on the features of the course, the following types of pathologies are distinguished:

• Deforming osteoarthritis is a disease that has passed into stage 3. This is a progressive disease that requires immediate surgery.
• Osteoarthritis arthritis - destruction of the cartilage lining, inflammation.
• An acute illness in which the characteristic symptoms become more pronounced.
• Chronic osteoarthritis is a slow destruction, thinning of the cartilage lining with an obliterated course.

Depending on the reason, a distinction is made between:

• Dystrophic osteoarthritis - occurs as a result of metabolic disorders.
• Fracture osteoarthritis - develops as a result of a fracture.
• Post-traumatic - the disease occurred after a joint injury.

DOA varieties by origin:

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

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

Pathology Degrees

Depending on the symptoms and course, there are 4 stages of DOA:

• 1 degree.The shape and structure of the joint has not yet changed, so the disease has a latent course. From time to time the patient may experience slight discomfort in the affected area, especially after excessive physical exertion or sudden movements. The composition of the synovial fluid changes, the blood supply to the joint is disturbed. The muscle fibers that surround the joint are weakened.
• 2 degrees.Bone joints begin to collapse, and bone growths form on their surface. Moderate painful sensations appear, inflammation occurs regularly. A characteristic crunch can be heard in the affected joint during movement. The functionality of the muscles decreases because the trophism of the nerve tissue is disturbed.
• 3 degrees.There are pronounced degenerative disorders of the hyaline cartilage and articulation, as a result of which the axis of the limb is bent. Ligaments and muscles are shortened and the joint becomes pathologically mobile, but the movements are clearly restricted. The patient often has incomplete dislocations.
• 4 degrees.The bone connection is completely destroyed, complete immobility, as well as severe pain syndrome, is observed even at rest.

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

Causes of DOA

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

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

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

DOA can occur due to abnormalities in the structure of the 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 fragility of bones due to lack of calcium).
• Hormonal imbalance.
• Disorders of metabolic processes.
• Lack of vitamins, minerals.
• Pathologies that are accompanied by muscle weakness.
• Prolonged high.

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

External factors for the development of osteoarthritis are:

• Regular hypothermia.
• Dislocations.
• Applying great force to the joint area.
• Fracture.
• Damage to the meniscus.
• Excessive physical activity related to professional sports or professional activities.
• Obesity.
• Surgery on joints or periarticular structures.

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

Reference.Idiopathic osteoarthritis occurs by itself for no apparent reason.

Symptoms

Osteoarthritis manifests itself through the following symptoms:

• Pain syndrome;
• Restriction of mobility;
• Crunching when moving;
• Edema, change in the axis of connection.

These are characteristic symptoms that occur in all patients.

The first signs of pathology are discomfort in the affected area that appears after physical exertion. After the onset of symptoms, you should consult a doctor, as the disease can be cured in the early stages.

Later, the patient complains of slight moderate pain, which occurs after loading the damaged joint and which quickly disappears.

A decrease in the mobility of the bone junction indicates degenerative changes in its structure. Initially, the patient feels stiffness, especially in the morning. Later it becomes more and more difficult for the patient to perform active movements. In the case of further development, there will also be restricted mobility with additional help. If left untreated, the joint will contract and over time its motor activity will be blocked.

Many patients complain of joint grinding 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 extremity is bent and the joint membrane is deformed. This suggests that the bone connection has practically broken down and healthy tissue has been replaced by osteophytes. At this stage, the adjacent joints are heavily stressed, then the likelihood of damage to their cartilage lining increases.

to make a diagnosis

If you notice any signs of osteoarthritis, see a doctor right away. The diagnosis of DOA is made after taking a medical history, conducting laboratory and instrumental studies.

First, a visual exam will be done, which will allow the doctor to find any swelling in the affected area. In addition, a palpation will be done, which will allow you to identify pain, nodules, changes in temperature, and moisture in the skin.

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

Osteoarthritis is diagnosed using the following instrumental studies:

• X-rays help identify changes in the shape of the joint.
• Arthrography with contrast media is a more accurate diagnostic method than X-rays.
• CT is used to assess the structure of the joint.
• Radionuclide diagnostics are carried out using radiopharmaceuticals. With this study you can assess the anatomical and functional condition of the connection.

Magnetic resonance tomography is a modern, highly informative diagnostic procedure. During the examination, you can see the deformation of the damaged joint, breakage 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 regimen.

Healing methods

Medical assistance is required for osteoarthritis at any stage. Complex therapy in the early stages will help stop pathological changes and restore the functioning of the joint. If the patient see a doctor late in the DOA, the prognosis is poor.

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

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

DOA treatment is carried out using physiotherapy methods:

• Magnetic Therapy.
• Ultra high frequency therapy.
• Electrophoresis.
• Shock wave therapy.
• Paraffin therapy.
• Sludge treatment.

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

During and after the treatment, it is recommended to ensure rest and to relieve the affected joint with the help of bandages, crutches and sticks.

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

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

With osteoarthritis, intra-articular injections are used:

• Glucocorticosteroids help normalize the blood supply to the affected area, stop the inflammatory process and increase the elasticity of bone tissue.
• Synovial fluid analogs with chondroprotective properties. These drugs relieve pain, improve joint mobility, and speed up collagen and spandex production.

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

• Endoprosthetics.
• Arthrodesis.
• Arthroscopy.

In more advanced cases, doctors replace the broken connection 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, the patient is prescribed arthrodesis. During the operation, the bone surfaces are immobilized with a special plate. Arthrodesis helps relieve severe pain, but does not restore motor activity to the joint.

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

DOA is dangerous, so it is important to identify and treat it in a timely manner.

reviews

According to patients with osteoarthritis, the easiest way to cure the disease is at an early stage. In advanced cases, only an operation will help. In both cases, however, treatment should be comprehensive.

• The first assessment: "I was diagnosed with 2nd degree knee osteoarthritis 1 year ago. I took special medication, underwent physiotherapy, went on a diet. At first the pain disappeared and mobility was restored, but after 3-4 months the symptoms returned. Sometimes the pain was accompanied by an increase in temperature. The doctor advised me to take capsules with hondoprotectors. With them, my condition has improved, and I haven't had any pain for six months.
• Second evaluation: "A few years ago I was diagnosed with 3rd degree coxoarthrosis. I was in constant pain, even at night I couldn't move my leg normally. The doctor advised me to have an operation, but at first I refused and decided to try intra-articular injections. However, after the procedures, my condition hasn't changed much. Then I decided on a radical method. After the endoprosthesis, she recovered for 1 year and 3 months. During this time, she took medication, performed specific exercises, went to massage, physical therapy, and followed a diet. Now I live a full life. I advise everyone not to hesitate with treatment. "
• Third review: "I was diagnosed with a rupture of the medial meniscus of the knee and grade 1 gonoarthrosis after an MRI. Doctors prescribed chondroprotectors. I also used the ointment twice a day. To protect the knee, I used an orthosis that I only took off when I was at home. After the course of the injections with the electrophoresis had started, the paraffin therapy, also bought a magnet therapy device, had already carried out 10 sessions. After another diagnosis, doctors said the joint had recovered by 70%. I am continuing treatment and I hope to have a full recovery of my leg. "

As you can see, there are different types of osteoarthritis. To avoid surgery and restore joint function, you need to see a doctor at the first suspicious signs. Only a doctor can determine the nature and degree of complexity of the disease and draw up a competent treatment regimen. DOA is easier to treat early on.