Deforming osteoarthritis (osteoarthritis) is a progressive pathology leading to dystrophy and degeneration of joint surfaces and cartilage damage, until its complete destruction in the joint area.
Usually, deforming osteoarthritis is detected in the elderly and elderly, in the presence of concomitant factors and diseases, it is often detected during examinations, but does not manifest itself clinically.
Osteoarthritis deformans is the most frequent and widespread joint pathology. It occurs in 70% of all joint diseases.
Causes
The exact cause of OA has not yet been clarified, but some factors have been identified that reliably increase the likelihood of its development. These are first of all the general aging of the organism and dystrophic phenomena of the tissues, modifications of the 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 weight lifting), permanent injuries, occupational influences, hypothermia of the joints,
- internal - this is the influence of heredity with excessive stretching of ligaments and laxity of the joints, ovarian dysfunction and climacteric changes in women, vascular accidents, impaired blood circulation in cartilage tissues, obesity.
Osteoarthritis deformans, as one of the symptoms, may be associated with alcoholism or myxedema, acromegaly or hormone therapy, with congenital dislocation of the hip, Marfan syndrome (an inherited disease characterizedby excessive joint mobility and lengthening of the tubular bones). joint stiffness)
Stages of development
In the development of deforming osteoarthritis, there are a number of regular successive stages that replace each other:
- reduce the hydration of the cartilage, which leads to its thinning and drying out,
- formation of defects and cracks in the cartilage,
- destruction of cartilage with a simultaneous sudden narrowing of the joint space,
- the disappearance of cartilage from the bone margins,
- compensatory compaction of the ends of the bones, which remained without a cartilage surface,
- disruption of the joints with dislocations, fractures and dysfunction of the limbs.
Symptoms of deforming osteoarthritis
First of all, the main manifestation of deforming osteoarthritis 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 change 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, a painful blockage of the joint occurs, when walking, severe pain appears, which does not allow the legs to move and causes it to stop. This is because pieces of cartilage or small pieces of bone (joint "mice") enter the joint cavity.
At the level of the joints of the phalanges, very hard nodular formations appear, while the joints are not very deformed, the muscles do not atrophy and there is no ankylosis (joint immobility).
Inside the joints, when moving, a cracking sound is heard due to the friction of uneven surfaces against each other.
Pain and reduced mobility can cause contractures (muscle contractions), which shorten the legs or arms.
Deforming osteoarthritis in its manifestations is similar to various forms of arthritis, first of all it should be distinguished from rheumatoid arthritis.
Diagnostic
There are no typical criteria for the diagnosis of osteoarthritis deformans; it can only be recognized externally 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 the diagnosis is x-ray data that occurs 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 joint surfaces, instability of the joint area with dislocations and subluxations, marginal bone growths, osteosclerosis (excessive increase in densitybone) are noticeable.
As the process progresses, the bony spines and bumps are revealed, the joint space may become wedge-shaped.
The study is completed by an arthroscopy, a blood test without signs of inflammation.
It is necessary to carry out a study of the periarticular fluid.
Treatment of deforming osteoarthritis
The treatment is carried out by traumatologists and orthopedists.
Methods of treating OA deformans depend on the degree of involvement of the joints in the process, as well as the duration of the injury and the presence of pain.
First of all, conservative therapy is used.
- reduce stress on the joints,
- weightloss,
- the use of metabolites - a course of aloe or vitreous intramuscularly in courses,
- use stimulants for the restoration of cartilage in intramuscular injections in courses.
Completes the treatment:
- the use of quinolones,
- 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. A spa treatment is useful.
In advanced cases, surgical treatment helps - joint arthroplasty. In the future, unloading the joint, losing weight, walking with support on a cane or crutches, physiotherapy exercises are presented.
Forecast
Deforming osteoarthritis without the necessary treatment has a slow but gradual course. Causes severe impairment and dysfunction of the joints, movement disorders. Therefore, when the first signs of osteoarthritis appear, active treatment is indicated, lasting 1 to 2 months.