Arthritis (Lyceum deformation, folk name - salts deposition) is a chronic disease of degenerative joints, which occurs the destruction of the articular cartilage, the capsules of the joints and the deformation of the bone itself.
It should be noted that arthritis is a whole group of common diseases that have different mechanisms of origin and close growth.Most of the time there are large joints:
- deformity of articular articulation of the knee (fertile),
- distorted arthritis of hip joint (coksarrosis),
- as well as the articulation of the shoulder joint.
These are the most serious types of joints.
The articulation of the small joints is less common.Most of the time there is deformation of the joint joints of the hand interfaces as well as the post -carpacial joints of the thumbs.Patients note pain in interface joints, reducing their mobility, appearance near the joints of the stamps (Geberden nodules and Bushar).This type of articulation is more common in old age.The joints of the foot joints often occur.
Polythyel, or generalized arthritis, is characterized by damage to several joints at the same time.
Arthritis The spine joints - spine - belong to the group of spine diseases, although it has a similar growth mechanism with another arthritis.
The main clinical symptom of articulation is joint pain, reducing its mobility.Specific symptoms are determined by the articulation stage and depend on the degree of catastrophic changes in the joint.
The causes of the articulation
Arthritis It is customary to be divided into primary and secondary.Primary (idiopathic) arthritis is a consequence of breach of recovery processes and increased degeneration in the tissue of the joint cartilage without any deviations in the work of the whole organism.Secondary arthritis occurs as a result of other pathological processes in the body or joint that has already been damaged by any external effect, with partial destruction of the articular surfaces.
Most of the time, traumatic arthritis is diagnosed in young patients.And in elderly patients, it is not always possible to draw a clear boundary between primary and secondary articulated.
Although the exact cause of the optedness cannot be determined, the factors that contribute to appearance and development are known.
The following types of causes that contribute to the development of the original and secondary deformation can be distinguished.
The causes of primary articulation are hereditary factors
The following hereditary disorders have been identified, which may cause the development of primary articles:
- Genetic disorders in the synthesis of the cartilage tissue of the joint, leading to its accelerated destruction.
- Congenital defects of the musculoskeletal system (over -joint, malformation, flat legs and others), which are the cause of the trauma of certain parts of the cartilage tissue of the joint and as a result of the appearance of the articulation.
It was also noted that the deformity of the joints of the Inter -Phalanx of the upper extremities is mainly found in women and is inherited by the female line.
The causes of secondary articulation
Secondary arthritis is a consequence of joint damage.These damage can be caused by various factors.
- Mechanical damage to the joints.This group of factors includes various joint injuries, intra -business fractures, as a result of which the structure of the joint is disturbed.The same result is due to a steady microtropicization of the joints as a result of excessive constant loads, both static and dynamic (for example, athletes).Also, obesity leads to overload and trauma.
Another factor that has a negative impact on the joints (mainly on the hip) is a wrong attitude.
The structure of the joint can also disrupt surgery. - Common diseases.Arthritis can be the result of inflammatory joint diseases (acute and chronic arthritis, arthritis, primary aseptic bone tissue, etc.)
- Metabolism violations, endocrine system diseases, mines in the body.Various metabolism disorders, lack of calcium, phosphorus and other minerals, vitamins and trace elements cause changes in bone and cartilage composition, synovial fluid, which leads to a breach of recovery processes and the gradual destruction of the synthesis.
- Autoimmune diseases(gout, coarse, hemorrhosis, psoriasis, rheumatoid arthritis), hormonal disorders, estrogen deficiency In postmenopausal, women lead to changes in joint tissues and their gradual destruction.
- Vascular diseases (atherosclerosis of the lower extremity vessels, eliminating intraartal, varicose veins), and Hypotherapy They cause traffic disorders in marginal tissues, poor blood supply to the joints and, therefore, dystrophic changes.
The mechanism for the development of the articulation
Development arthritis It begins with the destruction of the cartilage.It is believed that at first there is a violation of blood circulation in the capillary vessels of the perosteus cornea.Since cartilage diet occurs due to the intake of nutrients from intra -business fluid and adjacent bone tissue, traffic disorder leads to the fact that cartilage gradually loses elasticity, becomes thinner, cracks occur in it, the smoothness of the articular surfaces.As a result, it appears Pain and crunching during moves.The width of the joint gap gradually decreases, the bones are formed along the edges of the articular surfaces Spikes.
Eventually, the joint is deformed, the width of the movements in it decreases.It thus develops the inractional arthritis associated with aging of the body.The development of this form of articulation usually occurs gradually, over the years.
Other forms of large joints, for example, post -traumatic, metabolic, metabolic, poisoning have several other development mechanisms, but therefore we take similar changes to the joint.
Joint symptoms of joints.Stages and degree of articulation
"Classical" is the classification of articulation based on clinical and radiological characteristics.According to this, there are three stages of disease development.It corresponds to sorting with the degree of disability maintenance, which distinguishes 3 points of articulation:
- I degree of articulation - the disease does not hinder the work, although it complicates it,
- II Article Degree - The disease prevents work performance,
- III degree of article - Loss of working capacity.
Let us consider in more detail the clinical symptoms and signs of articulation in each of these stages
Articulation of the 1st degree (initial stage of the articulation)
At the initial stage of the disease in the morning, after rest, stiffness, difficulty in the joints, which gradually passes some time after the start of movement.Perhaps some restriction of mobility in the joint.Periodically, "starting" pains (pain at the beginning of movement after a long stay in rest) occur.With sharp movements, common crises, but there is no pain during movement.The pain at this stage of articulation occurs only with a significant and prolonged load and recedes after rest.There is no pain alone in low loads.At this stage of the disease, patients rarely see a doctor.
In Figure X -Ray with articulation of the 1st degree of special changes in the joint is not visible, sometimes small osteophytics along the edges of the joint can be visible, the articular gap is slightly limited.
2 points (second stage of articulation)
With the further development of the articulation, the pain becomes more important, it becomes acute.A separate joint crisis occurs with any movements, there is a remarkable restriction of mobility in the joint (tightening), functional reduction in extremity, weakened industrial movements, but joint mobility is still maintained.This stage is characterized by a remarkable boot pain, becoming acute and larger.Under the effect of the physical activity of the day, constant fatigue occurs, a feeling of pressure on the affected joints, the SO -called "mechanical pains" resulting from the reduction in the absorption of cartilage shocks of the joint tissues of the joint.
The damage to the joint is already quite significant, the joints are already partially deformed.
In radiographs, they are visible notable osteophytes, there is a stenosis of the joint gap 2-3 times compared to the rule, the hardening of the substrate bone and the formation of cystic cavities in the surface area.
The 2nd degree article is characterized by a decrease in working capacity, the inability to perform certain types of work.
Article of 3 points (third stage of articulation)
Arthritis 3 degrees is a serious, neglected stage of the disease.At this stage, there are:
- Significant deformation of the joint (due to the growth of the bones and the accumulation of liquid in the joint cavity).
- A strong limitation of movements, until maintaining the moving movements alone.
- Accurate pain not only when it moves, but also in a state of complete rest - stable pain associated with reflective muscle cramps, as well as the development of reactive arthritis.
- inflammation of joints,
- The sensitivity of the joints to the change in weather.
- The muscles around the knee are ugly and atrophic.
The axis of the limbs is distorted, significantly the Varus or the curvature of the Valgus of the feet (ie in the form of the letter "O" or "x").
In the 3rd degree arthritis, almost complete disappearance of the common gap, a severe deformation of the articular surfaces, huge peripheral osteophytics are observed.The articular mice and calcification of the annexial tissues can be determined.
In 3 degrees, the disease has gone too far, it is often the cause of persistent disability.Manifested as follows:
- Pain becomes stable and painful: walking, and especially the descent and climbing on the stairs - a difficult test for the patient.
- Strong judgment in any moves, well -with others.
- The deformation of the joints is strongly expressed, the movements are limited by a small range or even impossible.
The images show the destruction of intra -business structures (ligaments and meniscus), as well as the complete friction of cartilage and sclerosis (replacement of functional organs and connective tissue structures).
Articulation of 4th degree
The state of complete destruction of the joint arthritis, when the joint completely stops the function is often distinguished in a separate - 4 degree of article.There is a so - called "joint blockage" - an acute pain syndrome, which is even limited movement in a sick joint.The fourth degree of articulation is accompanied by unbearable joint pain, which are not even removed from powerful drugs and intensive physiotherapy.Completely ankle (joint fusion) or neostraction (false joint formation between displaced bone edges).Independent movement in both cases is almost impossible.
In the pictures, the rough hardening of the Sattime surfaces with intense cystic enlightenment is visible to fusion of the bones associated with the gap.The development of the disease at this stage almost always means a disability, which can only be prevented by implanting the artificial common intentions.
Articulation
Treatment of articulation at the initial stage of the disease
It is best to start treating arthritis as early as possible, with the appearance of the first points - crunching the joints, difficulty in movement.At this stage, the drugs are useful -modrogenic that improve cartilage structure, as well as vitamins -small complexes.
Medical physical education, proper nutrition, as well as preventive measures are significant.It should be noted that the prevention of the articles is also very important to prevent the deterioration of the disease.
Treatment of Article 2 - 3 degrees
Although it is already impossible to fully cure the articulation of 2-3 degrees, the process of its development can be suspended significantly.The treatment of articulation at this stage includes the following stages:
- Removal or reduction of pain syndrome
- Remove inflammation in the joint.
- Improve cartilage restoration and slow down degenerative processes.
During the acute period, the treatment of articulation begins with the elimination of pain.Therefore, non -dietary anti -inflammatory drugs (NSAID), analgesics are used.Intraarma injections of corticosteroids are possible.It is necessary to reduce the load on the joint, you cannot walk or stand for a long time, lift heavy objects.
After removing acute pain syndrome, the main task is to ensure, as far as possible, to enable joint recovery processes and marginal tissues: improved blood circulation, increased metabolism, elimination of inflammatory processes.Chondrophotters, vasodilators, as well as therapeutic exercises and physiotherapy are prescribed.
Treatment of arthritis 4 degree
At this stage of the disease, the joint is almost completely destroyed.In this case, there remains an output - the function and replacement of the lifting of the hinge with intra -protection.The endoponia significantly improves the mobility of the joint, allows the patient to reiterate active life, at least, to get rid of the pain.