Osteoarthritis is not an inflammatory disease of the joints, where there is a way that is destructive-dystrophic process, such as the defeat of the articular cartilage, ligaments, and bones, pathological changes in the synovium (the membrane) and the capsule (the shell of the joint, to seal his covering, and the connection to the bones in the joint). With osteoarthritis, the pain is felt in the joint, maybe a mobility limitation.
The causes of osteoarthritis
Until now, no one knows what causes osteoarthritis, but there are a number of factors, of a nature to aggravate the state of the joint, modification of its structure and functioning. Pushed to the oa can be used:
- trauma (sprains, tears, ligament, fracture, contusion, wound penetrating);
- static and dynamic loads related to the professional activity (in athletes, dancers, miners and other persons working with serious mobility expenses);
- obesity is a constant load on the joint);
- hypothermia;
- the infectious diseases (tuberculosis, chlamydia, influenza);
- circulation disorders;
- hormonal changes (pregnancy, menopause, menopause);
- metabolic disorders (osteoporosis (decreased bone density), arthritis (inflammatory disease of the joints), gout (deposits of salts of uric acid in the joints));
- autoimmune diseases (systemic lupus erythematosus (a disease in which the immune system recognizes the cells as foreign and fights with them), rheumatoid arthritis (the immune system mistakenly hits healthy joint));
- hemophilia (because of the hemophilia, frequent bleeding in the joints);
- disorders of the endocrine system (thyroid disease);
- degenerate-degenerative changes disease (Perthes (aseptic necrotizing process in the head of the hip), necrotizing the process by which a part of the cartilage detaches from the bone and moves into the articular cavity of, causing death of the bone spongy, in consequence of which, formed of small diseases;
- congenital diseases (dysplasia of connective tissue (improper formation of the tissue), hip dysplasia (abnormal development of the elbow joint, congenital deformities of the upper and lower limbs);
- at the age;
- poisoning (overdose of drugs, excessive alcohol consumption, drug abuse);
- deferred operation of the joint;
- a sedentary lifestyle;
- heredity;
- the beriberi.
The degree of osteoarthritis
By the process of the defeat of osteoarthritis are divided into 4 levels:
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Zero degree of osteoarthritis – explicit morphological changes is not observed, but the allusions to the disease are already available. It is a change in the composition of the synovial fluid, therefore, the nutrition of the cartilage deteriorates, therefore, its resistance to the load decreases. In the morning, after waking up or after a long rest period is to the judgment, pointed out the difficulty of movement of the joints, but during the day, and stiffness of the password. This state is called "pain". During the movement of the joint emits a crackling sound, but the pain during movement is lacking. For the first level characterized by pain after long duration, resistant to the load on the joints, but the pain disappears immediately after the rest.
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The first degree of osteoarthritis – the second degree is characterized by the destruction of the hyaline cartilage. Start from the morphological evolution. The radio shows of the newly formed osteophytes on the edges of the bone surface. Synovial capsule thin. Celebrated the narrowing of the joint space (reduce the distance between the heads of the bones of the joint). Muscle function is also subject to the negative influence. For the second degree of the osteoarthritis, the familiar constant pain, creaking of the joints, sometimes, lameness. The characteristic feature of the emergence of a "mechanical pain", occurring during running, walking, exercises because of the reduction of the damping capacity of the cartilage.
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The second degree of osteoarthritis – articular cartilage is completely worn away, marked by extensive lesions. At this stage, the disease progresses dramatically. The characteristic of a total lack of synovial fluid, a sharp pain, atrophy of muscles, shortening of the ligaments and destruction of the menisci, development of a reactive synovitis (inflammation of the synovial membrane, the formation of pus or accumulation of liquid, the increase of the joint). The axis of the member deforms (X-shaped and o-ring to the curvature of the feet). Almost entirely disappear in the cleft of the joint to deform the articular surfaces evolving from the proliferation of osteophytes. The range of motion is limited or impossible. You will receive the sensitivity to changes in weather conditions (humidity, low temperature, high atmospheric pressure). The third degree of osteoarthritis in said on the basis of disability.
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The third degree of osteoarthritis – on the fourth degree of the disease the function of the joint is irreparably lost. The same phenomenon suddenly a sharp pain in the affected joint, which does not relieve of medication. Can occur ankylosis (the junction of the os), or a false joint, is structure is not characteristic of a place. The fourth degree of osteoarthritis reflects the disability. The treatment involves surgery with the implantation of the prosthesis.
Types of osteoarthritis
Osteoarthritis of the knee joint
Knee osteoarthritis is also called and deforming osteoarthritis of the knee. The progression of osteoarthritis book of pain and in the future, distorts the knee for the increase of volumes and inflammatory of the exodus.
In athletes, as a result of regular loads on the knees can develop so-called because of the osteoarthritis that hits the knee joint, the pain is felt at the front of the part affected at the knee, the patella has sharp edges). For the pain it is necessary to outline and clicking of the joint.
Osteoarthritis of the hip
Door also the name of the osteoarthritis of the hip. This type of osteoarthritis is difficult and progresses more rapidly than other types of this disease, which leads to disability. The defeat of one of the hip way (osteoarthritis) can result in the defeat of the second (in both senses of osteoarthritis (oa). With a high probability, available launched the osteoarthritis in the hip joints will cause the defeat of the knee joint and the spine. There is a lameness, a shortening of the sick member, the cracking, a muscle-wasting.
uncovertebral osteoarthritis
When the uncovertebra suffers of cervical arthrosis articulation.
In addition to these factors with the onset of the disease of the joints, causes of uncovertebra of osteoarthritis may become a burden in cervical, lower back pain (degenerative changes of the vertebrae, cartilage, spinal discs, and tissues), intervertebral hernia (protrusion, the protrusion of a disc of the spine).
Osteoarthritis in the joint of the cervical spine is accompanied by a decrease in the cartilage, compaction and deformation of the shoots of the cervical spine, the reduced space, the growth of bone hips as a result of the narrow space in the cervical region, compression of the nerve roots and narrowing of the spinal canal.
For uncovertebral osteoarthritis is characterized by the manifestation of headaches, pain in the neck, dizziness, vomiting, the low sensitivity of the neck or sensations of tingling in this area, improving the blood pressure.
Osteoarthritis of the jaw joint (temporo-mandibular joint)
TMJ – the temporomandibular joint is a joint. The joint is near the ear, between the jaw and the temple of the two sides of the skull. The cartilage of the jaw joint is not so strong as in the other joints, so its a defeat causes rendering of the pain. The disease is very prevalent among the elderly of 50 years, are mostly women. The consequence of osteoarthritis of the TMJ is the difficulty of the grinds the food with the chikungunya fever, hearing loss, pain in the conversation. In this case, the causes of osteoarthritis are the following: the modification of the occlusion, congenital anomalies of the jaw, jaw injuries, the stress, the failure of a dental treatment, the destruction of the teeth, advanced age. Making the movement of the jaw, published the click and the squeak, when you try to open the mouth of the jaw may be deviated to the side.
Osteoarthritis of the elbow joint
This variety of osteoarthritis is more rare, the other species of the disease, so that the load on the elbow is a joint that is virtually insignificant. In the presence of inflammation place of location of the arthritis swells and reddens, this clicking, squeaking, crackling at the movement of the hand, painful caudal slightly the temperature of the body increases.
Osteoarthritis of the foot
This variant of osteoarthritis which bears the same name coxarthrosis. Disease of the ankle joint is characterized by fatigue, the walk, the swelling (when the connection of inflammation in the process), the syndrome (especially at night). Taking a stroll in the person feels by clicking in the ankle. When the coxarthrosis damage is caused to the joint, muscles, tendons, nerves, and blood vessels. The weakening of the tendons causes a subluxation (joint surfaces, partially in contact). When the dislocation of the joints of the extremities completely disagree.
The symptoms of osteoarthritis
In the initial phases of osteoarthritis, the symptoms may not bother, but beyond that the disease is gaining speed, and show the first and follow the signs. The main symptom of osteoarthritis is pain in the function of the location of the lesion (in the jaw and the neck, the shoulders, the spine, the elbows, the wrists, the fingers of the hands and feet, tribes, hip, and ankle). Pain ominous nature clumsy, but intense progression of the disease strengthen economic and unbearable. The main symptoms of osteoarthritis:
- starting to pain, stiffness of the joint after sleep or rest, passing during the day);
- manual of pain (occurs after the work, the pressure, the horse races, exercises, walks);
- night of pain (venous stasis causes the pain in the middle of the night);
- dependent on the weather (change the weather make the situation worse);
- the creaking, squeaking, crackling or unusual popping sounds in the joint;
- a reduced mobility;
- the deformation of the affected joints;
- cramps, muscle spasms;
- lameness;
- redness is and swelling at the site of the affected joint (inflammation).
The diagnosis of osteoarthritis
A diagnosis of osteoarthritis of do not put. The disruptive pain, crackling sound in the joints should first contact your general practitioner. He will examine the patient and gives direction to the location of the orthopedic surgeon, trauma, a rheumatologist, ben the ado or a neurologist.
Osteoarthritis is diagnosed, the orthopedist. Before the examination, the doctor collects the medical history (information about the patient, hereditary or chronic diseases) and of the inspection. Then, the patient is sent for investigation.
The inspection of the laboratory
When the diagnosis of osteoarthritis may require such analyses:
- total analysis of blood (blood with the fingers);
- the biochemical analysis of blood (rheumatology test, sampling of venous blood);
- the analysis of the urine;
- the analysis of synovial fluid or the puncture of the joint of the patient (closing by means of the introduction of the needle into the joint).
Diagnostic table
The spectrometry of this study will show the stage of osteoarthritis, the slightest change of the structure of the joint and deformation using x-rays. Before the examination, the patient must remove jewelry in order not to distort the result on the photo. You must remove the clothes of the part of the body that will be examined if the x-rays of the knee, it is necessary to remove a pair of pants; the plaster is removed). Then, the doctor said, in what situation you need to take photos ill phase. At the time of diagnosis, the patient is served in the lead, apron, adductors and to the area of the thyroid, apron will prevent the passage through these places of polycarbonates. And then the photo is taken.
The x-ray beam passes through soft tissue, but absorbed hard (bone, tooth). Therefore, the soft tissue on the shadow, he proves to be a dark color, and the hard tissue of the light. An x-ray of the best method of tissue diagnosis in bone, as in the photos are well displayed the bones and joints.
CT (computed tomography) – beam method of diagnosis, showing the authority, of the bone or tissue at the cut of the layers. CT fact, if x-rays not quite informative and exactly osteoarthritis is not found. The procedure is performed in a few minutes. The patient lies on the table, having removed the clothing and ornaments of metal. Then, a ring of detectors (ct) rotates around a patient lying down, and shooting. Grow during the CT still need.
MRI (magnetic resonance imaging) is a method of beam diagnostics. Different from CT which is better distinguished from the soft tissues, but does not distinguish the presence of calcium in the bones, unlike CT, which examines in detail the bone tissue. MRI with osteoarthritis is appointed, for more information on the state of the tissues or to investigate the root cause of the disease. The diagnosis using the MRI is expensive, but informative.
Ultrasonography (ULTRASOUND) – safe, non-invasive method, without radiation and harmful substances. The doctor leads the sensor problem area and on the screen is displayed the internal structure of the joint. This method of diagnosis of osteoarthritis in a safe, secure and informative.
Forecast
Osteoarthritis is a good prediction, if it concerns the life of the patient, the disease is not fatal, but complications can lead to disability. However, to completely cure the osteoarthritis is not possible, because with the age of the destruction occur more rapidly than the restoration of the spoiled. The disease progresses slowly and can grow for decades. To see the first signs of oa, it can slow down the prosecution of the deformation and of the violation of the functions of the joint through treatment at the initial phase.
Prevention
Often the fact of the non-uniform, additional expenses are suffering from knees and hip joints, it is thus necessary to count the power of the load and get rid of excess weight, if any, for the joints are worked fully and in a transparent way.