Osteoarthritis — chronic pathology, a stunning connective tissue structure, Nov-skeletal system. The gradual progressive destruction of cartilage typical for the disease. Osteoarthritis detected in the majority of patients after the age of 65, so one of the reasons his development, as is natural aging.
Why degenerative-results from previous trauma distroficeskoj pathology, endocrine, and inflammatory diseases, excessive exercise, or conversely, a sedentary lifestyle. In joints with osteoarthritis the symptoms leading pain, her pain, swelling, restriction of movement.
Edited instrumental diagnosis pathology research — radiography, arthroscopy, MRI, SA. Osteoarthritis 1. 2 severity and treated conservatively money online are drugs, physiotherapy and massage, exercise therapy. Irreversible destructive changes in the joints seen time to surgical intervention, arthrodesis, arthroplasty.
Pathogenetic mechanisms
Internal changes occurring osteoarthritis connective tissue structures. Is formed on the deformed cartilage erosion, causes, broken fibers, collagen and proteoglycans consist of a protein (5-10%) and glycosaminoglycan (90-95%). As a result, the lattice loses collagen, extracellular matrix metalloproteinase protein stability to any Start Free. Using collagenase and stromelysin biosynthesis by increasing the destruction accelerates. Cytokines, small peptide information molecules control enzyme is usually normal quantitative values. But the concentration of these proteins is reduced with the progression of osteoarthritis, which affects cartilage tissue that what provokes a large amount of the free enzyme.
Spilled begins to change the structure of proteoglycans with water molecules, it is possible to keep covered. Therefore, the excess fluid enters and collagen fibers. They "stretched", believe in tomorrow, tensile strength and elasticity. Qualitative and quantitative composition of the synovial fluid or negative changes. Its concentration is reduced in a osteoarthritis hyaluronic acid . Aisha is no longer sufficient cartilage regeneration, the amount of nutrients and oxygen for the future yellow. The softening of this cartilage lesions of the tissues, necrotic and then grow in the cracks special. Bonehead starts microtraumatic each other during the change to being naked.
Causes and precipitating factors
The causes, development, primary (idiopathic) is not loaded until arthrosis. When that is missing, any precipitating factors, therefore, a hereditary predisposition which causes early breakage of the cartilage theory about the candidate. Secondary osteoarthritis develops as a result of other pathologies, joint, or previous injuries. That can cause degenerative-degenerative diseases:
- injuries, joints, or connective tissue structures — fractures, dislocations, meniscal damage, partial rupture, Nov, ligament, tendon, bone or a complete separation of the base;
- congenital dysplastic developmental articulation disorder;
- the violation the functioning of the endocrine glands disorders of the metabolic process;
- rheumatic fever or rheumatic fever;
- rheumatoid jet, metabolic, psoriatic, or gouty arthritis, polyarthritis;
- purulent arthritis, provoking Streptococcus, Staphylococcus or Golden epidermal;
- any localization tuberculosis, Brucella, chlamydia, gonorrhea, syphilis;
- degenerative-degenerative disease, for example, osteochondritis dissecans.
This predisposition to the development of osteoarthritis, joint hypermobility, due to the production of collagen special. In such a situation to occur 10% of the planet's residents, and is not regarded as a pathology. But hypermobility is accompanied by weakness of tendon-fiber apparatus, resulting in injury often custom ankle sprains and ligament tears, sprains).
The reason why osteoarthritis happens sometimes, blood disorders, e.g. haemophilia. Hemarthrosis, or bleeding in the cavity when the distortion provokes tissue, cartilage, and destroy them.
These predisposing factors include advanced age, often, load, joints, exceeding the limits to their power, overweight, surgery, hypothermia.
This risk, menopausal women, people who live in a negative environment, or ecological toxic chemical compounds that are in contact. Deficiency, diet products, vitamins and trace elements the prerequisites for the gradual destruction of hyaline cartilage.
Clinical picture
Deficiency symptoms osteoarthritis danger in the first stage of the development. Pathology, Clinical as shows up slowly, the first signs emerged that this is an important background broken cartilage tissue. The first man feels weak pain, non-clear localization. After that, the visible exercise — weight lifting, sports training. Joint flexion or extension movements crunch is sometimes the first clinical symptom. Is not the person that are beginning to realize that some movement is difficult. However, thanks to joint stiffness in osteoarthritis in the first stage occurs in the morning hours, and soon disappears.
As the disease progresses, pain at night, it's just sleep deprivation and I felt provoked, but occur at the same time, chronic fatigue. The change in weather increases the intensity of pain in the second stage, acute and chronic pathologies, SARS. Reduced volume in a manner that is movements. Why is hardness of cartilage thinning, both the conscious restriction of human gestures, attempts to avoid pain. This leads to an increase in joint provokes reverse the burden of what, hurt him more. Specific to osteoarthritis and other symptoms characterized by:
- skeletal development and provokes pain spasms Nov Nov contractures (restrictions of passive joint movement);
- tough, joint pain, clicks, crackle move would be permanent, and occurs in almost anywhere the bones from each other;
- Nov that frequently occur painful cramps;
- the joints that leads to deformed posture and gait disorders;
- the third stage osteoarthritis that express the deformation of a bright, ' s What them significantly reduced or completely destroyed, bent and volume movements;
- osteoarthritis, a third-degree knee, ankle, and hip joint when moving the patient uses a cane or crutches.
If left untreated, the condition progresses and his remission and relapse are changed during the incidence of relapse is constantly increasing. Movements stiffness in the morning is now lost, and for a long time is continuous.
Inspection of patients with osteoarthritis of 1 degree, Doctor's notes just a little joint swelling, and full safety volume movements. Palpation pathology and detects a distortion of 2 degrees is to be in pain. The formation of the joint thickening of the bone gap observed in the field.
A typical synovitis of osteoarthritis for the development of inflammatory processes in synovial shells, hip, knee, ankle, shoulder joint. Rounded education is a symptom of the sealing area when you're in their world, he pressed on, felt a carrying fluid (type). The acute period, synovitis may be accompanied by the rise of temperature of 37-38°C drops to, headache, indigestion.
Diagnosis
The results of instrumental diagnosis exposure on the basis of research, characteristics, clinical history, complaints patients. Complete blood count and urine does not give the information — if all values remained within normal limits that are not designed by osteoarthritis a metabolic disease. With the development of synovitis and increased erythrocyte sedimentation rate (30 mm/hr), the blood increases white blood cell count, fibrinogen. Acute or chronic, is an inflammatory process in the body that points to it. Biochemical and immunological indicators of change, which occurs due to the secondary forms of osteoarthritis.
The most informative diagnostic method for degenerative-distroficeskoj pathology — radiography direct and lateral projection.
| Kellgre osteoarthritis according to the classification of the stage-Lawrence (1957) | Radiologic pathology |
| First | No radiological signs |
| First | Vague, irregular joint space narrowing. Shaping the bone plates in the mouth of a little flattening osteophytes is the primary or the lack thereof |
| Second | That is, a contraction joint spacing, a larger value of 2-3 times normal, training, numerous osteophytes, subchondral osteosclerosis. Kistevidnyj enlightenment in texture view |
| Third | The appearance of subchondral osteosclerosis and osteophyte formation edge is great, a significant contraction joint spacing |
| Fourth | Coarse osteophyte formation large formation, full mixing is almost a joint, fracture, deformation and sealing short bones, forming joints |
If after reviewing the radiographic image for the diagnosis of the doctor's suspicions invoice is assigned within SA. A suitable place for assessing the status and about a joint, connective tissue structures, MRI held. When using contrast can assess the dynamics of blood flow, tissue, set phase process development of inflammatory synovitis.
Basic treatment methods
Osteoarthritis, since it is so far an incurable disease, pharmacological drugs re-cartilage tissue. The main task of therapy the progression of pathology, warning, protection, joint mobility. Treatment is long-term, comprehensive, etc .. using local and systemic drug such as. Serious joint loads should be avoided in patients if necessary, restrict movements burning devices orthopedic volume — Ayse orthosis, flexible bandage. Make the necessary adjustments to the patient with excessive weight, the diet gradually reduce body weight and diet.
After reaching to a sustainable recovery physical therapy plus exercise therapy to the patient which are shown daily resort for a female. Are tracked in the center of the first exercise, exercise physiologist under a doctor's supervision, then exercises at home sick. Can be supported LFC, swimming, yoga, bike riding.
Various pharmacological and clinical groups to reduce prescription pain syndrome:
- non-steroidal anti-inflammatory drugs, ointments, tablets, solutions with active ingredients to inject;
- glucocorticosteroids injections into the joints the grout in conjunction with anesthesia;
- relaxant for spasms and contractures to eliminate restrictive Nov Nov.
This treatment scheme, including B vitamins, sedatives, if necessary, anxiolytics, and antidepressants. Chondroprotectors is assigned for a long course necessarily accept. The ability of this single drug group partially cartilage tissue back .. etc.
Organize clinical activities to improve physiotherapy treatment — laser therapy, magnetic field, UHF-therapy.
Emergency treatment for any joint pain to be a signal for the doctor. Therapy, osteoarthritis is drawn at the first stage, permission to stop the destruction of cartilage prevent the loss of Health and disability.