What is osteoarthritis of the ankle?

The ankle joint is often injured due to the heavy load to which it is subjected. A diagnosis like osteoarthritis of the ankle is not uncommon. It is placed regardless of the age and sex of the patient. What is osteoarthritis of the ankle and how to treat it?

What it is?

There is a huge load on the ankle. Its function is to keep the body upright. Thanks to him, a person walks and runs. With a violation of the ankle system, it is extremely difficult to lead a familiar way of life. What disrupts the work of the ankle?

What is ankle osteoarthritis? It is a chronic joint disease, characterized by a degenerative course. In the cartilage of the joint, irreversible processes are triggered, which lead to formidable complications.

Osteoarthritis of the ankle develops gradually. Healthy joint surfaces are elastic and smooth. They provide cushioning under heavy loads and a smooth glide while riding. With pathology, tissue trophism and metabolism are disturbed. The surface of the joint becomes inelastic and rough. During movement, the cartilages come into contact with each other, resulting in inflammation. When lifting weights, the main load falls on the bone, which threatens degenerative disorders.

Lack of treatment leads to more serious disorders. At 3-4 stages, damage to cartilage and tissue is observed. The synovium becomes inflamed. The joint becomes unstable. Support function is violated. All these violations as a whole lead to the fact that the movement becomes impossible.

Osteoarthritis (osteoarthritis) is one of the most common joint diseases that affects quite a number of people.

Causes and risk factors

What is Osteoarthritis of the Ankle Joint, we have sorted it out. Now let's see what is its root cause. Osteoarthritis of the ankle is considered a pathology of old age. This is due to age-related changes in the body. The cartilage thins, the bones become unstable and fragile. However, over the past decade, the diagnosis of osteoarthritis of the ankle has become much younger. Such statistics are disappointing, as many patients ignore the first signs of the disease. Late diagnosis always threatens the development of serious complications.

The provoking factors include:

• dislocations;
• bruises;
• inflammatory diseases;
• injury;
• overweight;
• impaired metabolism;
• unbearable physical activity;
• wearing uncomfortable shoes;
• autoimmune and endocrine diseases;
• osteochondrosis.

Clinical symptoms

Osteoarthritis of the ankle is recognized by the following features:

1. Pain. It is mild at first and appears after walking or exercising. Sometimes when a person is in an awkward position. With the progression of the pathological process, the pain syndrome intensifies and worries already at rest.
2. Swelling and inflammation. These signs appear against the background of injuries and dislocations. The body temperature in the affected area rises.
3. Click on. When the ankle is touched, the click is "dry" and causes an attack of pain.
4. Dislocation or subluxation. Due to the thinning and breakdown of cartilage tissue, the joint becomes unstable. Bones can move and fall out of the joint capsule. These changes cause attacks of acute pain.
5. Joint stiffness. When cartilage tissue is replaced, the bone joint stops functioning normally, which negatively affects its mobility.
6. Joint deformity. The symptom appears in 3-4 stages of osteoarthritis. Osteophytes also cause ankle curvature.

If any of the symptoms appear, it is recommended to seek immediate medical attention. Timely treatment is a step towards recovery.

Osteoarthritis of the foot and ankle joints is characterized by a slow course with a gradual development of clinical manifestations over several years.

Ranking and stages

The disease develops in different ways. In some patients, several years pass from the first signs to the final stage, in others, the rapid development of the disease is observed. The speed depends on the age and state of health of the patient and the time of initiation of treatment. Symptoms of osteoarthritis of the ankle joint clear up as the disease progresses.

There are four stages of osteoarthritis:

1. The first step often goes unnoticed. Sometimes morning stiffness and ankle pain appear after intense exertion. When the foot moves, a characteristic crunch is heard. Pathological changes are not yet visible on x-rays, but the destructive process of cartilage has already started.
2. Morning stiffness continues. It takes 20-30 minutes to develop a leg. Sometimes lameness occurs. Osteoarthritis of the 2nd degree of the ankle joint is recognized on the roentgenogram by the growth of bone tissue, displacement of bones.
3. Symptoms at 3 stages are pronounced. Pain no longer worries only after a heavy load, but also at rest. Pain relievers are difficult for a patient. Lameness increases. Crutches may be needed. The affected joint is swollen and deformed. The ankle muscles atrophy. The x-ray shows a narrowing of the joint space, the formation of osteophytes, a subluxation.
4. Step 4 is the most difficult. It develops from lack of treatment. Cartilage is destroyed, the surfaces of the joints are fused. Walking is no longer possible.

With the development of osteoarthritis of the ankle, there is a gradual change in the cartilage and bone tissue of the joint surfaces.

Diagnostic

The diagnosis of osteoarthritis of the ankle is based on clinical symptoms and information obtained during examinations. Laboratory studies are considered ineffective, since there are no special tests that can detect pathology. During the period of remission, all indicators are within normal limits, with exacerbation of the disease, a clinical blood test will show a high level of C-reactive protein and ESR. These indicators indicate that the pathological process has already started.

To confirm the diagnosis, instrumental methods are used:

• radiography;
• Magnetic resonance imaging;
• Ultrasound;
• bone scan;
• diagnostic joint puncture.

Simple x-ray

Plain radiography is the most reliable and effective method for diagnosing diseases occurring in the musculoskeletal system. The principle of manipulation is a different absorption of X-rays by muscle tissue. Soft tissue allows x-rays to pass, but hard tissue absorbs them. An x-ray can diagnose both the disease itself and its consequences.

Conventional radiography is a method of examination in which a small amount of x-rays are transmitted through the body or part of the body of the person.

The snapshot lets you see:

1. The condition of the bone surfaces in the joint.
2. The shape, size and arrangement of the structures in the joint are relative to each other.
3. The condition of the fabric.
4. The size of the joint space.

These indicators help the doctor determine the type and extent of joint damage. If the data is not enough, doctors order more studies.

In the event of osteoarthritis of the ankle, an X-ray is performed in three projections:

• side;
• back;
• back with one foot moved inward.

The disease is characterized by the following changes:

• reduction of joint space;
• the presence of osteophytes;
• replacement of bone cartilage (subchondral sclerosis);
• minor voids in the periarticular part.

Nuclear magnetic resonance

Nuclear Magnetic Resonance (NMR) as a diagnostic method allows you to study the parts of the body where there is water. The image shows dark colored bones because they contain less water, but the muscle tissue, discs and nerves are lighter. MRI can detect even the smallest changes in the structure of bone tissue and joints. The study is also prescribed to patients before the fitting of joint prostheses. YMG has one drawback - a high price.

At nuclear magnetic resonance, a change in the properties of hydrogen molecules under the influence of a strong magnetic field is recorded.

Magnetic resonance imaging

Magnetic Resonance Imaging (MRI) is an alternative diagnostic method that allows you to carefully examine the ligament structure of joint, muscle, and cartilage tissue. Using an MRI, the doctor assesses the condition of the joints in the lower leg. Based on the data of the survey, the pathology is revealed at an early stage of development.

The principle of diagnosis is based on exposure to radio waves and strong magnetic radiation. The magnetic field used is not dangerous and does not present a danger to health.

MRI is contraindicated in mental disorders, during pregnancy and in the presence of metal objects in the human body.

When diagnosing osteoarthritis of the ankle, conventional MRI machines (closed type) are used, as they have better image quality. An MRI machine is a large cylindrical tube surrounded by a magnet. The patient lies down on a special table. The dowel is fixed with a special coil. The procedure takes 30-40 minutes. The study is absolutely painless. Patients may feel heat in the lower part of the leg.

Ultrasound

Ultrasound has been widely used in medicine since the 90s of the twentieth century. This technique has been proven to make precise diagnoses. An ultrasound is also done for osteoarthritis of the ankle joint.

Today, the ultrasound examination is not of particular importance in the diagnosis of osteoarthritis, because it does not allow a sufficiently good study of the injured joints.

The device with which the study is carried out produces ultra-frequency waves. The waves are reflected by the tissues and recorded on the monitor. Based on the resulting image, the doctor determines the type of pathology. To make the image on the monitor clear, a special gel is used. It eliminates air gaps and gives the sensor better glide.

Ultrasound examination does not harm the patient, so the procedure can be repeated several times. The advantages of ultrasound also include low cost and high precision.

The following indicators are a clear sign of osteoarthritis:

• thinning of cartilage;
• the presence of bone growths;
• accumulation of effusion in the joint cavity (synovitis);
• loss of cartilage space.

Bone scan

Scintigraphy is a high-precision study that, using isotopes, is able to detect pathological changes in the bones. Doctors divide the pathogenic foci into "cold" and "hot". In the first case, we are talking about areas in which there are no isotopes. These areas are poorly supplied with blood and are not visible during scanning. "Cold" areas are places that are affected by malignant tumors. In "hot" areas, isotopes build up quickly and appear very bright when scanned. Such areas indicate the presence of inflammatory processes.

The role of scintigraphy in osteoarthritis is important. The study makes it possible to distinguish osteoarthritis from a number of other diseases when the clinical symptoms are extremely similar.

During the bone scan, a special preparation containing special labeled atoms is injected into the body.

Based on the results of the scintigraphy, the doctor makes a clinical prognosis and determines the treatment regimen. The only downside to the study is its high cost. Scintigraphy is performed using special equipment and, unfortunately, not all medical institutions can afford to buy it.

Although radioactive scanning is a safe procedure, it still has a number of contraindications:

• pregnancy;
• lactation period;
• take medicines containing barium.

When a radioactive substance is injected, some patients experience an allergic reaction in the form of itching and rash. These side effects are harmless and go away on their own in no time.

Joint puncture

Joint puncture is a diagnostic procedure in which a needle is inserted into the joint cavity to collect synovial fluid. This liquid is then sent for further research. Based on the data obtained, the doctor draws a conclusion about the nature of the disease and the stage of its development.

At first glance, a puncture is a simple procedure, but it is not. The removal of fluid from the joint capsule requires exceptional precision in the physician's movements. The synovium is very thin and awkward movement traumatizes her. As a result, an inflammatory process develops. Potential risks also include infection. It is not difficult to bring the infection into the joint capsule using poorly sterilized instruments.

The manipulation technique is different for each joint. When collecting joint exudate from the ankle, the puncture is performed in front, between the outer ankle and the tendon of the extensor digitorum longus.

Diagnostic sampling of intra-articular fluid allows for laboratory analysis and excludes inflammatory arthritis.

Basic principles of treatment

After confirming the diagnosis of osteoarthritis of the ankle, symptoms will not be long in coming. Treatment is started immediately. The further prognosis depends on a well-chosen treatment regimen and the speed of onset.

Osteoarthritis is an insidious disease. He cannot be completely healed. The goal of therapy is to stop degenerative processes and extend the period of remission. For this purpose, doctors prescribe drugs, physiotherapy, massage, corrective gymnastics and folk remedies. If all the conditions are right, it is possible to count on a positive dynamic, otherwise the disease progresses.

Drug treatment of osteoarthritis

Depending on the therapeutic effect, drugs are divided into several groups:

1. Anti-inflammatory or analgesics. This group of drugs is aimed at eliminating the focus of inflammation and relieving pain. The earlier anti-inflammatory treatment is started, the greater the chances of saving the joint. Drugs of this group can be produced in the form of tablets and ointments.
2. Glucocorticoids. These drugs are prescribed when the above funds are ineffective. They are produced as a solution for injection. The drug is injected directly into the joint.
3. Chondroprotectors. Designed to slow down the destruction of cartilage.

The treatment regimen and dosage are selected by the doctor depending on the severity of symptoms, the age of the patient, the presence of concomitant diseases and other factors. Self-medication is dangerous and often worsens the situation, since many drugs have a number of side effects and have their own contraindications.

Features of radical treatment

If conservative treatment has failed, doctors are forced to resort to a radical method of treatment (surgical intervention). The operation is also displayed when:

• secondary (post-traumatic) and primary osteoarthritis of 3-4 degrees;
• osteoarthritis with complications;
• constant and severe pain in the ankle, radiating to the knee;
• severe lameness;
• paresis and paralysis of the leg muscles;
• violation of the flexion-extensor function of the joint;
• violation of the supporting ability of the foot.

Surgery is contraindicated if:

• the patient is less than 12 years old;
• there are fistulas in the joint;
• the patient has a history of diabetes mellitus, heart failure;
• Infectious diseases have been found in the proposed intervention area.

Traditional treatment

Doctors believe that the treatment of osteoarthritis should be carried out exclusively under the supervision of a specialist, but they do not deny the positive effect of folk remedies. Alternative medicine acts as an effective prophylaxis that helps eliminate symptoms and maintain remission.

Rather, folk remedies are symptomatic treatment of osteoarthritis of the foot.

Home treatment should be coordinated with your doctor to avoid side effects and complications.

Traditional healers suggest treating osteoarthritis of the ankle with:

1. Burdock. Wash the burdock leaves with soap and running water. Apply the leaves with the soft side to your skin. Secure the top with a bandage or cling film. It is best to keep the compress overnight.
2. Sea salt. Chop the salt in a pan. Pour it into a linen bag and tie it to your ankle. Hold the bag until the salt has cooled. Heat relieves pain. Sand, lentils, buckwheat are also used instead of salt.
3. Lilac. Pour the triple cologne over the lilac flowers. Let the tincture sit in a dark, cool place for 10-14 days. Rub the affected area in the morning and evening.
4. Egg shell. Grind the shells in a coffee grinder. Take the powder obtained for ½ tsp. before eating.

Remember that treatment with folk remedies should not be the only measure. The complex treatment includes medication, exercise therapy, massage, physiotherapy, spa treatments. In advanced cases, doctors resort to radical measures - surgical intervention.

Surgery

For osteoarthritis of the foot, the following types of operations are used in medicine:

• arthrodesis of the joint;
• arthroscopy of the joint;
• endoprostheses.

Arthrodesis is an operation to immobilize a joint. It is carried out in order to make the member of the lost support capacity. The only downside to surgery is that the bones (tibia and talus) grow together, which leads to immobility. Arthrodesis is rarely used in medical practice.

Arthroscopy is a minimally invasive procedure. During the operation, the doctor makes small incisions in the joint area and inserts an arthroscope (a special tube at the end of which a camera is installed) through them. With the help of this, the surgeon carefully examines and assesses the condition of the intra-articular structures. If necessary, pieces of the damaged joint or blood clots are removed from the synovial fluid. This manipulation is less traumatic. The only downside to arthroscopy is that the risk of recurrence is too high.

A stent is a treatment of last resort. It is performed with advanced osteoarthritis. The stent can partially or completely replace the affected joint. As a prosthetic product, innovative prostheses with modernized mechanics are used. An artificial joint lasts 10 to 20 years.

Power characteristics

In order to achieve a favorable result, drug therapy is supplemented with diet therapy. Nutritionists have developed a special diet to avoid exacerbation of the disease and at the same time provide the body with all the necessary vitamins and nutrients. The diet of overweight patients plays a special role. Obesity being one of the causes of the development of osteoarthritis, weight correction is an integral part of the treatment.

The patient needs to reconsider a number of his habits in daily life, which contribute to and cause the progression of osteoarthritis of the foot.

Nutritionists recommend respecting the following nutritional conditions:

1. Eat often and in small portions.
2. Drink at least 2 liters of fluid per day.
3. Give up sweets and salt.
4. The last meal is no later than 6: 00 p. m.
5. Dishes can be steamed, boiled or baked.

The main task of the diet for osteoarthritis is a balanced and fortified diet. Fasting is out of the question. Heavy diets and cleansing the body do more harm than good. Calcium is flushed out of the body, which is necessary for the restoration of cartilage. A nutritionist will help you compose a daily diet.

With osteoarthritis, it is allowed to eat cereals, pasta, dairy products, cheese, legumes, vegetables, fruits, rye bread, dried fruits, nuts, fish, meatPoultry. Heavy and fatty side dishes, foods containing colorings and flavors, as well as pickles, marinades, smoked meats, fatty broths, baked goods, spices, sauces, chocolate, ice cream, coffee and alcohol are prohibited.

Prevention of osteoarthritis

To prevent the development of osteoarthritis of the ankle joint, doctors recommend taking preventive measures:

• wear comfortable shoes without heels;
• stick to a diet and drink enough fluids;
• seasonally take vitamin and mineral complexes;
• to swim;
• walk more in the fresh air;
• eliminate excessive stress on the legs;
• avoid hypothermia;
• be examined by a doctor in a timely manner.

With existing osteoarthritis, it is recommended to correct the way of life:

1. Refuse bad habits. They have been shown to cause stagnation of blood in the tissues and accelerate the destruction of cartilage.
2. Perform a series of exercises to warm up the ankle.

Forecast

Osteoarthritis is a progressive disease. Without treatment, it leads to irreversible consequences and complete immobility of the joint. Early diagnosis of pathology allows you to do without radical measures. Medicines are able to suspend the pathological process and improve the patient's condition. The fight against the disease at an early stage is carried out without complications.