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  • Osteoarthritis: symptoms, treatment, causes, diagnosis

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    What is it? Deforming osteoarthritis is the most frequent disease of the musculoskeletal system. It accounts for almost 80% of all pathological processes affecting the joints.

    Mostly elderly and senile patients are exposed to it, but the onset of the disease is observed as early as childhood and adolescence. That is why preventive measures should begin as early as possible.

    According to modern ideas, deforming osteoarthritis is a pathological process in which degeneration and degeneration of articular cartilage occurs with its partial or complete destruction, which is accompanied by a violation of the function of the joints of one degree or another. The defeat of this pathological process of the knee joint is called gonarthrosis.

    Causes and risk factors for osteoarthritis


    From the etiological point of view, it is common to distinguish two forms of the disease:

    1. 1) Primary osteoarthritis that develops on unchanged articular cartilage as a result of excessive load on the knee joint
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    3. 2) Secondary osteoarthritis. In this situation, the load on the joint does not exceed the allowable, but there are pathological processes that initially led to the destruction of articular cartilage, so the reserve of its strength is significantly reduced.
    The main risk factors that lead to osteoarthritis are:

    • Excessive joint load
    • Overweight
    • Induction
    • Disturbance of microcirculation in the articular cartilage against a background of thromboses and atherosclerosis
    • Carried away in childhood Rickets
    • x- or O-shaped bending of the legs
    • Dysplasiaknee joint
    • flatfoot
    • injuries - bruises and fractures inside the joint
    • elderly people when there is a decrease in water and chondroitin in the articular cartilage
    • inflamedjoint diseases in which secondary involvement of the articular cartilage in the pathological process( rheumatoid arthritis, infectious-dependent arthritis)
    • of accumulation disease is observed, when certain chemicals are deposited in an increased amount inside the joint( gout, hemochromatosis)
    • diabetes mellitus
    • is a hereditary strain.


    Symptoms of osteoarthritis


    In osteoarthritis of the knee joint, the process is usually one-sided. At the beginning of the disease, minor clinical symptoms appear, which gradually increase and are replenished with new ones in the course of the progression of the pathological process.

    The first symptom of gonarthrosis is the increased sensitivity of the knees to cold. Then there are such signs as:

    1. 1) Slight stiffness, which is observed at the very beginning of the movement, and then passes
    2. 2) Dull-looking pains that appear at the slightest physical exertion and completely stop at rest. However, with the progression of the disease, the pains become more pronounced and can not pass by themselves and disturb the patient even at night
    3. 3) In the morning, mechanical pain is absent
    4. 4) Start pains arising at the beginning of movement
    5. 5) Irradiation of pain when there is a transition to a healthy onejoint. So, with gonarthrosis, pain can be localized not only in the knee, but also in the hip and ankle joints of the
    6. . 6) Crunching in the knee during movement( however, this symptom may be normal, so when it appears, one should not think only of osteoarthritis)
    7. 7) Jamming of the joint, that is, the appearance of sudden acute pain, which is caused by the ingress of a piece of necrotic cartilage between the joint surfaces of
    8. . 8) Feeling of rapid fatigue and heaviness in the lower extremities.

    Diagnosis of osteoarthritis


    Diagnostic search for suspected osteoarthritis begins with an objective examination of the joint. This disease is characterized by such signs as:

    • the shape of the joints does not change for a long time, but gradually, due to bony growths, a defoguration appears( persistent change in their shape)
    • local tenderness when palpating the joint
    • , the skin temperature above the joint is not increased, in contrast to arthritis
    • , passive joint movements are accompanied by a crunch
    • the volume of movements in the knee.
    Data from objective research may change when secondary synovitis is attached, that is, inflammation of the synovial membrane.

    In this case, there are:

    • persistent pain that disturbs the patient even at night
    • an increase in joint volume due to the accumulated exudate( inflammatory fluid)
    • the skin reddens and the temperature rises
    • The volume of both passive andactive movements in the joint.
    After an objective evaluation of the joint, an x-ray study is shown. Based on its results, one can judge the neglect of the pathological process( it is exposed in the diagnosis of the stage of the disease).

    The main radiographic criteria used for diagnosis are:

    • formation of bony growths around the joint
    • increasing bone density directly under the articular cartilage
    • narrowing of the joint gap, which usually starts from the inner surface of the knee( is a reliable sign of osteoarthritis)
    • formation of cystic cavities in the bone inlimits of the affected joint
    • change in the shape of the bone involved in the formation of the knee joint
    • at the last stage notesdeposition of calcium salts in the joint capsule.
    However, a qualitative x-ray diagnosis of osteoarthritis involves taking pictures in three mutually perpendicular planes. This makes it possible to detect even minimal changes in the width of the gap between the bones involved in the formation of the joint. Therefore, the radiograph should be carried out in the frontal, axial and lateral projections.

    Also for early diagnosis of deforming osteoarthritis of the knee joint, methods such as:

    • computed tomography
    • scintigraphy
    • arthroscopy can be used.
    All of them can detect even a minimal narrowing of the joint gap, which is observed at the very beginning of the disease. With the help of roentgenography, this happens almost impossible to do.

    Treatment of osteoarthritis


    Treatment of osteoarthritis is carried out for a long time, which is associated with poor regenerative capacity of cartilage. The main goals that must be finally achieved are as follows:

    • reduction in the processes of progression of the pathological process
    • fight with the reactive synovitis that developed the second time
    • the maximum possible restoration of the function of the joint.
    To realize these goals, the following treatment measures are shown:

    1. 1) Reducing the load on the affected joint. For this, long walks are excluded. Staying on the legs for 30-40 minutes should be followed by a 15-minute rest
    2. 2) Selection of appropriate exercises that will strengthen the muscular corset joint
    3. 3) Carry out physiotherapy procedures, which include UHF, electrophoresis, electromagnetic therapy
    4. 4) Using crutches ororthopedic canes in the case of development of reactive synovitis to reduce the severity of the pain syndrome
    5. 5) Conducting drug therapy.
    The last task is implemented by prescribing drugs from the following groups:

    1. 1) Chondroprotectors, which are preparations of pathogenetic therapy. They can slow the progression of the pathological process, prevent the destruction of cartilage and accelerate its recovery
    2. 2) Nonsteroidal anti-inflammatory drugs
    3. 3) Corticosteroid drugs that are injected into the joint
    4. 4) Drugs that restore impaired microcirculation in the subchondral zone( antiplatelet agents).
    Patients in the high-risk group need to follow preventive measures, such as:

    • timely treatment of background pathological processes( X or O curvature of the lower limbs, rickets, joint dysplasia, kyphosis, scoliosis, joint hypermobility)
    • restriction of joint load,including a rational choice of the future profession in the presence of weighed heredity for osteoarthrosis
    • control of body weight and its reduction in the presence of obesity
    • regular performance of the complexeksa gentle exercise.


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