The arthritis chronic condition affecting the connective tissue structures of the musculoskeletal system. Of the disease the characteristic phase for the gradual destruction of the articular cartilage tissue. With the win, it is detected in the majority of patients after the age of 65, as well as one of the reasons for its growth and development makes it a natural aging process of the body.
The occurrence of reports from degenerative degenerative pathology, leading to earlier trauma, endocrine, and inflammatory conditions, excessive exercising, or, on the contrary, a sedentary lifestyle. The main symptoms of osteoarthritis are pain in the joint, the swelling, limitation of motion.
For the diagnosis of disease are carried out for research tools that are available — x-ray, arthroscopy, magnetic resonance imaging, computed tomography. With the win, and the 1-and 2-degree-of-gravity is considered a conservative course in the use of medications, physical therapy, beauty treatments and massage therapy for a year. If it is irreversible, changes that are destructive of the joints shown in the operation — arthrodesis, arthroplasty.
The mechanisms to do the job
When you read occur, as expressed by the change of the internal connective tissue structures. The cartilage tissue is formed, the deformation of the erosion, and becomes the cause of the destruction of fibers of collagen as well as proteoglycans consisting of a protein (5 to 10%), and glycosaminoglycans (90-95%). As a result of the collagen mesh, you lose stability and begin to release matrix metalloproteases, and destroying all the types of proteins in the extracellular matrix. Damage is accelerated by an increase in the biosynthesis of collagenase and stromelysin. Generally, the normal values of the quantity of enzymes that control the inflammatory cytokines are small peptide information molecules. However, when the progression of the arthritis, the concentration of these proteins is reduced, which results in the release of a large number of enzymes, which affect the tissues of the cartilage.
Proteoglycans are restructured will begin to absorb water molecules, which is not able to hold it. Therefore, the excess of oxygen in the liquid reaches the fibers of the collagen protein. They will "swell up", lose their strength and elasticity. Qualitative and quantitative composition of the oxygen from the joint fluid also changes to negative. When you win, it diminishes the concentration of the acid. The hyaline cartilage of emptying is sufficient for the regeneration of the nutrients and oxygen supply. The cartilage tissues are formed in the foci of softening, and then to appear against a specific necrotic tumors. The bones of the head of the un, are beginning to microtraumatic of the deviation with respect to each other.
The causes and factors that may cause the
The reasons for the development of primary (idiopathic) osteoarthritis has not yet been set. This is when, in the absence of any provoking factors, therefore, are the theories of a pre-disposition to premature spoilage of the articular cartilage. Secondary osteoarthritis develops as a result of other diseases or joint pains prior to the trauma. What can cause degenerative diseases-degenerative diseases of the ailment.
- trauma to the joint or nearby tissue, connective tissue structures, fracture, dislocation, injury to the meniscus, a partial wrap of the muscles, ligaments, tendons, or their complete detachment from the bone marrow of the foundation;
- the innate dysplastic violation of the development of a joint;
- a violation of the functioning of the endocrine glands, disorder of metabolic processes;
- rheumatism, or rheumatic fever;
- rheumatoid arthritis, on the jet, metabolic, psoriatic arthritis, or gouty arthritis;
- purulent arthritis, which is driven from streptococcus mutans, the epidermal, or golden staph;
- the tb from any location, brucellosis, chlamydia, gonorrhea, and syphilis;
- degenerative diseases-degenerative disease, for example, the cut-Legg.
For the development of the arthritis, it makes hypermobility the joints, due to the issue of special needs. Such a condition is found in about 10% of the population of the planet, and it is not considered to be a form of pathology. But the hypermobility is accompanied by weakness in the tendon-ligament apparatus, leading to frequent injury, especially in view of the joint of the ankle (strains, sprains and tears of ligaments, strains, sprains).
The cause of osteoarthritis, at times, become a violation of hematopoietic, for example, haemophilia. Hemarthrosis, or bleeding into the cavity of the joint, leading to deterioration of trophic cartilage, and the destruction of the.
The predisposing factors include advanced age, the frequent stress on the joints that are in excess of the limits of its strength, excess weight, surgeries, hypothermia.
In the at-risk group are women in the period of menopause, the the people who live in the harsh conditions of the environment, or in contact with toxic chemicals. With a deficit in the diet, foods, vitamins, and trace elements are primarily created conditions for the gradual degradation of hyaline cartilage.
The condition of the
This is the danger of arthritis is the symptom in the first stages of its development. The pathology is clinically manifested as the symptoms arise in the midst of the great destruction of the cartilage tissue. At first, the person feels the pain is mild, you do not have a clear location. It appears that after the end of weight lifting, athletic training. At times, this is the first clinical manifestation becomes a crush, and noise for the flexion and extension of the thin hinge. A person begins to realize that some of the movements are given only with great difficulty. However, in the early stages of arthritis, stiffness occurs in the morning, and it just goes away.
As the disease progresses, pain is felt, and, during the night, resulting in not only a sleep disorder, but it is also the onset of chronic fatigue. The manifestation of the starting point of the pain syndrome in the second stage increases as the change in the weather, the worsening of the pathologies of chronic diseases, viral infections, RESPIRATORY infections. It decreases the amount of movement. The ratio of the stiffness of it, if the thinning of the articular cartilage, and there is also a restriction on the conscious of man's movements in an attempt to prevent the onset of a headache. This is resulting in an increase in the work load to the opposite side of the joint, which leads to the aggravation of the injury. For the arthritis, that are characteristic of other specific symptoms:
- the pain causes spasms of the skeletal musculature, and in the development of muscle contractures (restriction of the movements in the liabilities in the joint);
- crunch in the joints, it clicks, sounds like a cracking, popping or snapping sound when moving, if they become persistent, are almost always, that is, the displacement of the bones relative to each other;
- come often, painful muscle cramps;
- the joints become deformed, which leads to violations of posture, and gait;
- in the third stage of the arthritis, the deformation is expressed as bright, with the joint bent, and the amount of movement to them significantly reduced or completely missing;
- when you read in the third grade, the knee, the ankle, the hip, the patient to move, it enjoys of a cane or crutches.
In the absence of treatment, the disease will progress, and the period of their remission, they are replaced with relapse, and the frequency of exacerbations increasing as well. The rigidity of the motions of the morning, and now it does not go away for a long period of time, it becomes a constant.
Seeing a patient with osteoarthritis of 1 degree, and the physician observes only a small swelling of the joint and the overall security of the amount-of-movement. When the condition of the 2-level, the palpation causes pain, and evil is expressed in the strain. In the area of the joint crack may occur in the formation of bones and thickening.
For osteoarthritis characteristic of the development of the synovitis — inflammatory process in the synovial shells of the hip, the knee, the ankle, the straps of the hinges. Their leader, it becomes a sign of education, rounded to the sealing area of the joint, when the pressure which is related to the movement of a fluid (a float). Keen for the synovitis may be accompanied by an increase in temperature up to 37-38°C), headaches, stomach upset.
The diagnosis
The diagnosis is explained, based on the results of the characteristics of the clinical picture, the patient, the complaints of the patients. The general blood and urine only) — all the values remain in the normal limits, if the arthritis is not induced metabolic disease. With the development of a synovitis increases the speed of sedimentation of red blood cells (30 mm/hr) in the blood, increasing the level of white blood cells and the fibrinogen. This indicates that flows in the body, an acute or chronic inflammatory process. The changes in the biochemical and immunological indicators, occurs when the secondary forms of arthritis.
The most informative method of diagnosis of degenerative diseases-degenerative diseases-of-pathology — radiography and the lateral side of the projection.
| The stage of arthrosis according to the classification of Kellgren-Lawrence (1957) | Regarding the signs, clinical pathology |
| Home | In the absence of a signal from the x-ray |
| The first | Indistinct, irregular narrowing of the joint cleft. With a little flattening of the edges of the plates of bone, initial formation, bone spurs, or the lack of |
| The second | The expressed narrowing of the joint gap, the greater the value of the usual 2 or 3 times, and the formation of a large number of osteophytes, subchondral osteosclerosis. With the advent of the kistevidnyj the lighting in the epiphyses |
| The third | The rise expressed in subchondral osteosclerosee, and of great value, out the bone spurs, and a significant reduction in the articular cleft |
| The fourth | The training is tough, huge bone spurs, the nearly complete fusion, of the crack, joint deformity, and label the epiphysis of bones forming the joint |
After exploring the x-ray image to a doctor and don't have any questions to suggest to a diagnosis, it is assigned to a TC. And an examination of the state located within a joint, connective tissue structures will be carried out in a magnetic-resonance imaging. When you use contrast, you can be in the dynamics of the rate of flow of blood in the tissues, and to determine the stage of the inflammatory process with the development of synovitis.
The main methods of therapy
The osteoarthritis is still an incurable disease, there are no drugs in the drug for the regeneration of tissue and cartilage. The main task of the therapy becomes a warning of the progression of the disease, and the preservation of the mobility of the joint. The treatment is long-lasting, built-in, with the use of local and system medications. Patients need to avoid acute and loads on the joint, if it is necessary to limit the number of motion devices, braces — the braces, elastic bandages. In patients with excess weight, you will need to make some adjustments in your diet is to gradually reduce the mass of the body and follow a proper diet.
Once you achieve a sustainable remission, and the patients are shown as classes in daily medical exercise. The first exercises are carried out under the supervision of a medical therapy for a year, then the patient performs the exercises at home. Therapy can be supplemented by swimming, yoga, bicycle riding.
To reduce the signs of the start point of the pain of the syndrome is attributed to the drug in different clinical-pharmacological groups:
- anti-inflammatory drugs are not steroids, in the form of creams, tablets, solutions for parenteral, and the introduction of the active ingredients;
- the injection into the joint of the solutions of the anesthetics in combination with corticosteroids;
- relax your muscles, to solve muscle spasms and restrictive of the cp.
In the treatment scheme are included in the B group vitamins, sedatives and, if necessary, the anti-anxiety and anti-depressants. Necessarily, they are assigned to chondroprotectors for a long term course which would be nice for the front desk. This is the only group of drugs that have the ability to recover, as part of tissues of the cartilage.
To improve the clinical activity and carry out physical therapy treatment — laser therapy, magnetic field, the UHF-therapy.
Pain in the joints, it should be a signal for an immediate treatment to a doctor. The treatment, carried out in the early stages of arthritis, it will stop the destruction of the articular cartilage, to prevent the loss of health and disability.