What is arthrosis? Stages of arthrosis, symptoms, treatment methods

Deforming arthrosis or simply osteoarthritis is a disease characterized by the destruction of cartilage, articular surfaces of the bones of the extremities and the spinal column. The leading mechanism of pathogenesis is the loss of cartilage tissue and the appearance of inflammatory, dystrophic changes in nearby structures.

deforming arthrosis

Natural processes of aging and destruction of joint tissues are normal after 60 years. In osteoarthritis, similar, but much faster transformations occur. Often, under the influence of certain factors, there is a high probability of arthrosis in children.

Risk Factors for Disease

Our joints carry a tremendous load every day. Their damage and inflammation greatly reduce the quality of life. Knowing the reasons that can lead to such an unpleasant disease, you can save yourself and reduce the risk of pathology of the musculoskeletal system.

Arthrosis of the joints is primary and secondary.

Primary arthrosis

This type is most often associated with congenital inferiority and a tendency of cartilage tissue to damage and destruction as a result of metabolic disorders. The most common causes of this disease are:

  • hereditary and genetic;
  • climax;
  • frequent and seemingly minor injuries (for example, in athletes).

Secondary arthrosis

The secondary type is most often deforming arthrosis and progresses against the background of a decrease in the resistance of the cartilage tissue to normal stress. The development of this pathology is facilitated by:

  • injuries;
  • obesity;
  • weakness of ligaments and muscles;
  • arthritis.

Mechanisms of deforming arthrosis

arthrosis in the knee joint

The substance that makes up the joint, under the influence of the noted reasons, becomes thinner and gradually disappears, being replaced by coarse connective tissue. Chondrocytes (cartilage cells) die, cracks appear in the cartilage, elasticity and shock-absorbing properties are lost. Sclerosis and marginal growths - osteophytes - develop in the bones. Destruction covers the capsule and the synovial (inner) membrane. In the ligaments and muscles, foci of fibrosis begin to form and calcifications are deposited.

Concomitant inflammation may resolve with the formation of so-called articular "mice" (pieces of cartilage that have fallen out into the joint cavity).

Clinical presentation and symptoms

Osteoarthritis occurs mainly in women over 40. Criteria for the diagnosis of deforming arthrosis of the joints are found in half of people over 55 years old.

Signs of arthrosis

Patients complain of dull aching pains that worsen with exertion and subside at rest. Malaise and short-term stiffness in the morning are characteristic. At first, only mild soreness, which appears in the evening, causes anxiety. Over time, the pain gets worse and longer. Joint elements cease to withstand normal loads.

Deforming arthrosis is often accompanied by the onset of pain at the beginning of the movement.

This is often favored by static loads and requires a change in posture to get relief. There may also be swelling and a slight increase in temperature.

Osteoarthritis variants

There are several variants of this pathology. Depending on the type of disease, certain symptoms will appear. The following options are distinguished:

  • Coxarthrosis - osteoarthritis of the hip joint. The most severe variant of the disease occurs in 25% of all cases. There is both primary (against the background of menopause) and secondary coxarthrosis - with hip dysplasia or previous arthritis.
  • Gonarthrosis - osteoarthritis of the knee joint. The specific gravity is 75% of cases. The primary form is also recorded in women after 40 years, and the secondary is, as a rule, a consequence of trauma.
  • Osteoarthritis of the interphalangeal joints of the hand with the appearance of bony growths and tubercles, called Gaberden's nodules, occurs in 60% of cases.
  • Spondylosis and osteoarthritis with lesions of intervertebral discs form the concept of "osteochondrosis".

Classification

healthy joint and arthrosis

In medicine, an approved classification of this pathology has been adopted. Depending on the clinical and radiological changes, arthrosis is subdivided as follows:

  • Arthrosis of the 1st degree is accompanied by the appearance of a slight limitation of movements. At rest, nothing usually bothers you. In the images in the initial stages, minimal narrowing of the joint space and small bone growths are visible.
  • Grade 2 arthrosis is characterized by a progressive decrease in mobility, the appearance of a noticeable crunch. With deforming arthrosis of the hip joint, deformities with shortening of the leg are observed, leading to a distortion of the pelvis, scoliosis and excessive stress on the spine. The slit is narrowed 2–3 times as compared to the norm.
  • Grade 3 arthrosis (compared to grade 2 arthrosis) is manifested by almost complete immobility of the joint. With coxarthrosis, patients move only with crutches, and the legs move with the pelvis. The pubic joint may hurt. With gonarthrosis, a curvature of the axis of the limb develops. The joint gap is almost completely absent, there are pronounced bone deformities.

Stages of diagnostics of deforming arthrosis

Diagnosis of osteoarthritis for the purpose of treatment is not difficult. It usually consists of several parts.

History taking and physical examination

First, patients are questioned to find out the complaints and the degree of dysfunction. Movement in the joint is slightly limited, but as destruction develops, the volume sharply decreases up to a complete blockade. Sometimes, due to the infringement of the articular mouse, movement becomes almost impossible. This is typical only for deforming arthrosis.

With arthrosis of the joints of the hand, stiffness, subluxation and nodular neoplasms develop - Gaberden's nodules.

In coxarthrosis, gait may be disturbed due to the shortening of the leg due to the destruction of the femoral head. Muscle atrophy is formed. With gonarthrosis, a crunch is clearly heard during passive movements, tenderness is determined by palpation along the joint space and in the places of attachment of the tendons.

Instrumental studies

diagnosis of arthrosis on x-ray

The main diagnostic method is radiography. The images show marginal bone growths, osteosclerosis, narrowing of the joint space, calcification of cartilaginous tissue and tendons.

Arthrosis Treatment

Often patients are interested in the following questions: “How to treat arthrosis? Can arthrosis be cured using only pills? How to treat osteoarthritis »The treatment plan for deforming arthrosis is based on the location of the lesion, the degree of arthrosis, and the presence of changes in the surrounding tissues. Medical care for patients with deforming arthrosis is provided at the level of a family doctor, as well as a rheumatologist and orthopedic traumatologist.

We need to be prepared that the treatment of osteoarthritis is a long process that requires a systematic approach and patience.

Conservative treatment of arthrosis of the joints is multicomponent, usually both traditional and non-drug means (various corsets, compresses with medical bile, physiotherapy exercises) are used.

Pain Management

Relief and complete elimination of pain in the treatment of arthrosis of the joints, provided by non-steroidal anti-inflammatory drugs. As a rule, in the form of short courses of tablets. An excellent analgesic effect is provided by local applications of medical bile and other well-known agents. This should be especially taken into account when there are contraindications for the treatment of the above group of drugs (diseases of the gastrointestinal tract).

Injections into the joint for the administration of hormones are prescribed only when inflammatory manifestations occur, with dysfunction.

Metabolic Recovery

dressing for arthrosis

An indispensable condition for the treatment of arthrosis is weight loss. Obesity contributes to increased stress on the joints. To improve metabolism, chondroprotectors are prescribed for arthrosis, the purpose of which is to stop the degeneration of cartilage. They are usually used for a long time, especially with arthrosis of the 2nd degree.

Compresses with medical bile can be made in parallel.

Contraindications to local osteoarthritis treatment with bile - diseases of the skin and lymphatic system.

Normalization of joint function

Physiotherapeutic procedures are prescribed to stabilize the functioning and treatment of arthrosis of the joints. These are ultraviolet radiation, ultrasound and medical bile dressings. For the same purpose, drugs are injected intra-articularly to facilitate the sliding of the articular surfaces relative to each other.

When acute symptoms subside, depending on the degree of arthrosis, the spa treatment of arthrosis of the joints and chondroprotective tablets have an excellent effect.

Usually with 2 degrees of arthrosis conservative treatment can achieve long-term remission. If, despite the methods used, the deterioration continues, the question of the appointment of surgical treatment is decided.

Prevention of arthrosis

Prevention of arthrosis consists in the stabilization of metabolism, adequate treatment of other diseases and injuries. Adequate exercise should be given to the locomotor system, especially in the presence of risk factors. You need to start acting at the slightest suspicion of this disease. Medical bile will not be superfluous in your medicine cabinet to provide pain management.

Also at this stage, chondroprotective tablets are prescribed for arthrosis.

05.03.2021