What is osteoarthritis of the joints?

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

This pathology is not life-threatening, but it significantly reduces its quality. Severe pain, limitation of mobility increases over time, causing disability.

In the early stages, conservative therapy is prescribed, which helps to stop the development of the disease.

It is difficult to completely cure deforming osteoarthritis (DOA), but it is possible to preserve the functionality of the bone connection. In the 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 surfaces of the bones that make up the joints are covered with elastic, smooth and gliding cartilage that cushions them and protects them from damage. With osteoarthritis, the blood supply to this area is interrupted and the hyaline cartilage begins to deteriorate. In addition, degenerative-dystrophic changes occur in the capsule, ligaments, periarticular muscles, and other segments of the joint.

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, lifestyle.

Osteoarthritis develops like this:

• Blood circulation is affected in a certain area of the cartilaginous lining of the joint, then it begins to suffer from a lack of nutrients. 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, which does not have a clear structure.
• Little by little, pathological growths (osteophytes) appear in the hyaline lining.
• Against the background of the pathological process, healthy areas of cartilage are exposed to excessive stress. 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 synovium, compaction of the joint capsule. There is a narrowing of the joint space, the joint is deformed, destroyed, and then the patient can be disabled. Therefore, it is very important to diagnose and start treating the pathology in time.

As a general rule, osteoarthritis is detected in patients older than 60 years. However, the disease is also diagnosed at an early age, 20 to 45 years old.

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

Classification

People who are far from medicine, when they hear names like gonarthrosis, coxoarthrosis, osteoarthritis, they don't understand the difference. The fact is that there are many types of this pathology, differing in localization, specificity of the course, reasons, origin. Therefore, doctors have created various classifications of osteoarthritis to facilitate their differentiation.

Types of osteoarthritis by location:

• Gonarthrosis is a pathological process in the knees.
• Coxarthrosis is an injury to 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 - Used at the ankle joint.
• Polyosteoarthritis is a multiple injury to the finger joints.

In addition, there is also mandibular, temporal, costal-vertebral, clavicular-acromial osteoarthritis.

Depending on the characteristics of the course, the following types of pathology are distinguished:

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

Depending on the reason, a distinction is made between:

• Dystrophic osteoarthritis - occurs as a result of metabolic disorders.
• Osteoarthritis from fracture - develops as a result of a fracture.
• Post-traumatic - the disease appeared after an injury to the joint.

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 cause many factors (metabolic disorders, hormonal imbalance, trauma).

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

Degrees of pathology

Based on symptoms and progression, 4 stages of DOA are distinguished:

• 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 feels mild discomfort in the affected area, especially after excessive physical exertion or sudden movements. The composition of the joint fluid changes, the blood supply to the joint is interrupted. The muscle fibers surrounding the joint weaken.
• 2nd grade.Bone joints begin to collapse, bony growths form on their surface. Moderate painful sensations appear, inflammation occurs periodically. During movement, a characteristic crunch is heard in the affected joint. The functionality of the muscles decreases due to the fact that the trophism of the nervous tissue is disturbed.
• 3 degrees.There are pronounced degenerative disorders of the hyaline cartilage and the joint, due to this, the axis of the limb is bent. Ligaments, muscles shorten, and the joint becomes pathologically mobile, but movements are significantly limited. The patient often has incomplete dislocations.
• 4 degrees.The bone connection is completely destroyed, complete immobility and severe pain syndrome is observed even during rest.

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

Causes of DOA

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

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

• Infectious diseases that cause various viruses and bacteria.
• Rheumatism.
• Autoimmune diseases.
• Purulent inflammation of the joint.
• Gout (deposit of uric acid salts on the surface of the bones).
• Joint psoriasis.

DOA can occur due to abnormalities in the structure of cartilage and malnutrition. Pathological changes are caused by the following factors:

• Genetic disorders
• Pathologies that appear during intrauterine development.
• Age-related changes in the body.
• Osteoporosis (increased brittleness of the bones due to calcium deficiency).
• Hormonal imbalance
• Disorders of metabolic processes.
• Lack of vitamins, minerals.
• Pathologies that are accompanied by muscle weakness.
• Prolonged intoxication.

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

External factors for the development of osteoarthritis include:

• Regular hypothermia.
• Dislocations.
• Impact of great force in the joint area.
• Fracture.
• Damage to the meniscus.
• Excessive physical activity associated with professional sports or professional activities.
• Obesity.
• Surgery of joints or periarticular structures.

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

Reference.Idiopathic osteoarthritis occurs on its own, for no apparent reason.

Symptoms

Osteoarthritis is manifested by the following symptoms:

• pain syndrome;
• limitation of mobility;
• creaking when moving;
• edema, change in the axis of the connection.

These are characteristic symptoms that occur in all patients.

The initial signs of pathology are discomfort in the affected area, which occurs after physical exertion. After the onset of discomfort, you should consult a doctor, since the disease can be cured in the early stages.

Subsequently, the patient complains of mild to moderate pain that appears after loading the damaged joint and disappears quickly.

A decrease in the mobility of the bone junction indicates degenerative changes in its structure. At first, the patient feels stiff, especially in the morning. Subsequently, it becomes increasingly difficult for the patient to perform active movements. With further development, the restriction of movement occurs even with additional assistance. If left untreated, a contracture of the joint occurs and, over time, its motor activity is blocked.

Many patients complain of joint creaking during movement, which is accompanied by painful sensations and decreased mobility. As the disease progresses, this manifestation becomes more pronounced.

In later stages, the axis of the limb bends and the joint membrane is deformed. This indicates that the bone connection has practically collapsed and healthy tissues have been replaced by osteophytes. At this stage, the adjacent joints are under strong stress, then the likelihood of damage to their cartilaginous lining increases.

Establish a diagnosis

If you notice signs of osteoarthritis, seek medical attention immediately. The diagnosis of DOA is established after taking anamnesis, conducting laboratory and instrumental studies.

First, a visual examination is performed, during which the doctor may notice swelling in the affected area. In addition, palpation is performed, which allows you to determine pain, nodules, changes in temperature and moisture of the skin.

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

Osteoarthritis is diagnosed by the following instrumental studies:

• X-rays help to see the change in the shape of the joint.
• Arthrography with contrast medium is a more accurate diagnostic method than X-rays.
• CT is used to evaluate the structure of the joint.
• Radionuclide diagnosis is carried out using radiopharmaceuticals. This study allows you to assess the anatomical and functional status of the connection.

MRI is a modern and highly informative diagnostic method. During the examination, you can see the deformation of the damaged joint, rupture of the menisci or ligaments.

To examine the synovial fluid, doctors prescribe a puncture in the affected limb.

After diagnostic measures, the doctor works out a treatment regimen.

Healing methods

With osteoarthritis of any stage, medical attention is needed. Complex therapy in the early stages helps to stop pathological changes and restore the functionality of the joint. If the patient seeks a doctor in a late stage of DOA, the prognosis is poor.

With osteoarthritis of the first degree, drug treatment is carried out. Chondroprotectors are used to restore the structure of the cartilage lining. The patient is prescribed drugs in the form of tablets and capsules. They should be taken in 3-4 month courses twice a year. The medicine contains the structural elements of the cartilage lining.

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

Treatment with DOA is carried out by physiotherapeutic methods:

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

Physiotherapy and physical therapy exercises are performed after the pain has disappeared. The doctor develops a series of exercises that the patient must perform systematically. Exercise therapy increases muscle tone, strengthens ligaments, normalizes blood circulation, and helps restore the joint.

During and after treatment, it is recommended to provide rest, reduce the load on the diseased joint with the help of bandages, crutches and canes.

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

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

For osteoarthritis, intra-articular injections are used:

• Glucocorticosteroids help to normalize the blood supply to the affected area, stop the inflammatory process, and increase the elasticity of bone tissue.
• Analogs of synovial fluid with chondroprotective properties. These medications reduce pain, improve joint mobility, and speed up the production of collagen and elastane.

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

• Endoprosthesis.
• Arthrodesis
• Arthroscopy.

In advanced cases, doctors replace the destroyed compound with a metal prosthesis. Most often, this method is used to treat large joints. After surgery, 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 it does not restore motor activity to the joint.

During arthroscopy, a miniature camera and manipulators are introduced into the joint cavity, with the help of which bone growths are removed and the cartilage structure 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 early.

Reviews (2)

According to patients who have had osteoarthritis, it is easier to cure the disease at an early stage. In advanced cases, only surgery will help. But in both cases, the treatment must be comprehensive.

• The first review: "I was diagnosed with 2nd degree knee osteoarthritis 1 year ago. I took special medications, underwent physical therapy, went on a diet. At first, the pain disappeared, mobility was restored, but after 3-4 months the symptoms reappeared. Sometimes the pain was accompanied by an increase in temperature. The doctor recommended that I take capsules with deep protectors. With them my condition improved, for six months I have not felt any pain ".
• Second review: "A couple of years ago I was diagnosed with grade 3 coxarthrosis. I suffered from pain all the time, even at night, I could not move my leg normally. The doctor recommended surgery, but at first I refused and decided to try injections. intra-articular. However, after the procedures, my condition did not change much. As a result, I decided on a radical method. After the endoprosthesis, she recovered for 1 year and 3 months. During this period, she took medications, performed special exercises , went to massages, physical therapy, followed a diet. Now I am living a full life. I advise everyone not to hesitate in treatment. "
• Third revision: "I was diagnosed with a tear of the internal meniscus of the knee and grade 1 gonoarthrosis after an MRI. The doctors prescribed chondroprotectors. I also used the ointment twice a day. To protect the knee I wore an orthosis, I took it off alone at home during rest. After the course of injections he started electrophoresis, paraffin therapy, he also bought a magnetotherapy device, he had already performed 10 sessions. After another diagnosis, the doctors said that the joint had recovered in a 70%. I continue the treatment and hope to fully recover my leg. "

As you can see, there are different types of osteoarthritis. To avoid surgery and restore joint function, you should seek medical help at the first suspicious signs. Only a doctor will be able to determine the type, degree of complexity of the disease and work out a competent treatment regimen. DOA is easier to deal with early on.