Osteoarthritis, or deforming osteoarthritis (DOA), is a chronic progressive disease in which there is a violation of the structure of the cartilage covering the articular surfaces. This leads to a disruption of the joint function, its gradual deformation and the appearance of certain clinical symptoms.
Deforming osteoarthritis is 70% of the total number of joint lesions. In 95-97% of cases, people over 60 are ill.
Many mistakes, considering the appearance of arthrosis as an inevitable sign of aging of the body and joints in particular.
This process is subject to correction and can be significantly slowed down. But you need to know how and when
Deforming osteoarthritis: the mechanism of development and the main causes
Normally, the processes of formation and destruction of cartilage tissue in the joints are balanced, and in arthrosis the processes of destruction over the processes of cartilage restoration prevail.
The basis of the development of arthrosis is the violation of the synthesis of high-grade cartilage by specific cells-chondrocytes. This leads to a gradual dehydration and loss of elasticity of the articular cartilage, so the load on the adjacent parts of the bones increases.
The bone tissue in this place is sealed (osteosclerosis), the articular surfaces become more dense with the formation of small marginal bone growths (osteophytes). They take on excessive load, which contributes to their gradual growth.
At the same time, the strength of the articular cartilage itself decreases; therefore, under severe stresses, they can crack and fragmentation. This process is most common in the knee joints.
All this in general leads to a decrease in the amplitude of movements accompanied by consolidation and loss of elasticity of the articular structures, the relationship, the development of toughness.
Periodically, secondary inflammation in the joint occurs - arthrosoidal arthritis, which promotes not only changes in the joint cavity, but also in surrounding tissues adjacent to the muscles, where their atrophy begins to develop through hypodynamia.
The surfaces of the bones are approaching, and gradually their bridging is formed - bone ankylosis forms and it becomes impossible to carry out movements in the joint.
- Women are ill 10-12 times more often than men, which is due to the inheritance of this disease by the female line.
- Inherited genes of defective formation of collagen protein, which is involved in the formation of articular cartilage.
- Congenital diseases of the bone and joint system lead not only to change the shape of the joint but also to distort its work, deformation of the articular surfaces due to excessive loading on them, which causes premature wear of the cartilage, its microtraumatization and the rapid formation of arthrosis. It occurs in congenital abnormalities (dysplasia) of the skeleton, flattening, asymmetrical development of the pelvis and lower extremities, etc.
Lifetime factors acquired:
- With age (usually after 40 years) there is a decrease in the ability of cartilage cells to synthesize a complete tissue, the processes of its destruction predominate.
- Over the years, especially after a climax, osteoporosis begins to develop, which is associated with falling levels of estrogen production, so these processes are much more pronounced in women.
- Obesity, overweight, leads to excessive knee and ankle joints in which arthrosis is rapidly developing.
- Acquired diseases of the bone and articular system (especially arthritis) in the absence of treatment, leading to an unhealthy lifestyle sooner or later lead to the formation of arthrosis.
- Violations of blood circulation, innervations that develop with age, worsen metabolism in the joint, and the appearance of joint pain during movement causes patients to have a sedentary lifestyle leading to atrophy of the connective-muscular apparatus and osteoporosis of the bones.
- Joint operations promote the development of arthrosis, despite their healing effect.
- Excessive physical activity contributes to faster wear of the joint, causing its microtraumatization (in sports, weight gain, heavy physical labor, etc.).
- Traumatic damage to the musculoskeletal system of various nature - acute trauma and microtraumatization with occupational hazards (vibration, lead or other industrial intoxication, forced uncomfortable working conditions, etc.)
Basic manifestations of osteoarthritis
The most commonly deforming osteoarthrosis: it is a pain that occurs during physical activity, a rash in the joint, some rigidity in the morning, a decrease in the amplitude of movements, edema in the joint, and a feeling of instability.
Joint pain increases with the development of arthrosis - at first it is insignificant and appears only with physical activity, during short-term resting, but the longer the disease lasts, the more often and more painfully disturbed (often they increase at night and when the weather changes).
In some cases, patients may have very sharp pain relief when moving, this may be due to the appearance of cartilage fragments. They are formed in the destruction of articular cartilage, meniscus and can fall between the joint surfaces, broken. This is the cause of severe pain, limitation of movement, that is, there is a "blockage of the joint."
Sometimes the pain begins to disturb the patient constantly, while the joint swells, increases in volume, the skin temperature rises above it, in the cavity of the joint and around the articular bags, the fluid (bursitis) is accumulated.
But not always the severity of the pain corresponds to the severity and degree of changes in the joints, as well as the duration of the disease. In some cases, the weakness of the connective-muscular apparatus gradually increases, there is a sense of crunch even when the patient is sutured, and with this osteoarthrosis, this cross can be heard by others.
Localization of the process of osteoarthritis
Deforming osteoarthritis can develop in almost all joints. But less and less easily affected by the elbow and shoulder, as well as the fibrous articular joint.
The defeat of the hip joints (coxarthrosis) and knee joints (gonorrhea) is difficult, pain is often very painful, often with no treatment, ankylosis develops (joining of the joints), disability occurs. In these cases, the endoprosthetics (artificial joints) is sometimes the only acceptable method of treatment.
Knee joints are more often struck in women, especially when overweight. Often in these joints, when moving, there is a crunch, pain when descending from the stairs and after a long sitting. Possible formation of Baker's cyst (accumulation of fluid in the articular bags of the popliteal region) and the development of bursitis (accumulation of fluid in the articular bags). This complicates the movement of the joints, and the pain becomes permanent, the atrophy of the tibia muscles gradually develops.
In the development of arthrosis in women in the interphalangeal joints of the hands of hands often appear dense slightly painful subcutaneous small nodes, which usually do not disappear.
With arthrosis in the first pleusnephalangeal articulation of the feet there is a transverse flattening and distortion of the axes of the joints (valgus deformation). Protrude inside the joint (popularly called "humorous") become a significant problem in the selection and purchase of shoes.
The course of deforming osteoarthritis without appropriate treatment - progressive, with periodic exacerbations and remissions. Often, patients are forced to resort to surgery to replace the patient's joint to the artificial (endoprosthetics).
Diagnosis and degree of osteoarthritis
The doctor, as a rule, puts the diagnosis on the basis of clinical manifestations and data of X-ray examination (X-ray, computer tomography), in more difficult cases, ultrasound of the joints and surrounding tissues, as well as MRI (magnetic resonance imaging).
Radiologically allocate 4 stages of osteoarthrosis:
- 1 st Art. - Joint joints are not narrowed, but there is a slight reorganization of the bone structure of the bones that are articulated.
- 2nd Art. - A slight narrowing of the articular gap, the formation of marginal osteophytes, cysts and osteosclerosis.
- 3rd century - Significant narrowing of the articular slit, deformation of articular surfaces with severe sclerosis and large regional osteophytes, with cystic rearrangement against the background of osteoporosis.
- 4th century - Joint joints are absent in whole or in part, the bone substance of the articular cavity and the articular head are connected - this state is called bone ankylosis, and the joint itself ceases to exist.