Osteoarthritis of the ankle: symptoms, treatment, photo

The term "arthrosis of the ankle joint" is understood as a pathology in which a gradual destruction of the articular cartilage occurs, followed by the involvement of the bones of the joint and the supporting ligaments and muscles in the deforming process.

The disease most often develops in the elderly, has specific symptoms.

Treatment of pathology is complex, without this cure is impossible.

Causes of ankle arthrosis

The main reasons for the development of arthrosis of the ankle are several:

1. 1) Constant increased load on the joint. This is typical for athletes: swimmers, runners, players, ballerinas.
   
2. 2) Excess weight.
   
3. 3) Joint injuries: dislocations of the foot( for example, on ice), ankle fractures, sprains, microtraumatic muscles surrounding the joint.
   
4. 4) Continuous walking on high heels( more than 1/5 of the length of the foot).
   
5. 5) Hereditary impairment of metabolic processes in the articular cartilage, which is why its resistance to loads is reduced.
   
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6. 6) Inflammation in the joint, for example, with rheumatoid arthritis or gout.
   
7. 7) Diseases in which metabolism is disturbed, including, in the articular cartilage:
   
8. 8) Diabetes mellitus;
   
9. 9) Diseases of the thyroid gland;
   
10. 10) Gout.
    
11. 11) Disturbance of blood supply to the joint due to atherosclerosis, thrombosis or sclerosis of vessels feeding it.

Under the influence of etiological factors in the cartilage lining the joint bones, the metabolism is disturbed, and it becomes thinner, and this does not happen immediately on the entire surface, but islets. He can not recover.

In those areas where the cartilage has become thinner, the load is no longer on it, but on the underlying bone. As a result, the bone as well, islets, grows, forming spines - osteophytes. They injure the adjacent and opposite areas of the articular cartilage, and it, too, is damaged. The joint is deformed. Bunches and muscles, trying to return it to a normal position, on one side spasmodic, on the other - overstretch.

And also, we recommend to familiarize yourself with other forms of the disease:

• arthrosis of the knee joint
  
• arthrosis of the shoulder joint
  
• arthrosis of the hip joint
  
• arthrosis of the foot

Symptoms of arthrosis of the ankle

In order not to miss the development of the disease, it is necessary to know the early signs of arthrosis. And so, arthrosis of the ankle is characterized by pain in the affected joint, which can occur after rest, in the morning hours, increasing with loads, as well as symptoms such as:

• crunching, clicks in the joint;
  
• joint stiffness;
  
• rapid fatigue when walking due to pain;
  
• due to the weakening of the muscles and ligaments can occur the usual subluxation of the joint;
  
• visual deformation of the joint.

1) At the beginning there are no symptoms. Then appear:

• fatigue of the foot with habitual physical exertion, including walking on heels;
  
• initially discomfort, then - the pain in the joint that appears when moving the foot, disappears at rest or when the joint is fixed with bandages or orthoses;
  
• crunching or other sounds when moving in the joint is not audible.

2) Pain in the joint occurs even with lower loads. In order for it to disappear, you need a longer rest. Pain can also occur at night, because of which a person wakes up. In the mornings the joint almost does not function for a while, then it passes. The ankle responds to the weather.

3) This is the extreme degree of the degenerative process in the joint. The joint after the night is long developed to allow it to take place in it the minimum volume of movements. At work of a joint in it the crunch, click is audible. Pain during motion of the ankle is strong, does not pass after rest, it is only necessary to take painkillers.

Diagnosis

The diagnosis of arthrosis of the ankle joint is made by the traumatologist( if there is a visible connection with the development of the disease after an injury) or a rheumatologist. For this they need:

• to hear complaints;
  
• ask in detail about the suffered injuries, infections and joint diseases;
  
• inspect the joint, determine its mobility and volume of movements;
  
• assess the radiograph of the joint performed in two projections( in the initial stages, a computer tomography of the joint can be recommended);
  
• the presence of fluid in the joint with the attachment of synovitis can be determined by ultrasound.

Treatment of arthrosis of the ankle

For arthrosis of the ankle joint conservative and surgical treatment is used, the choice depends on the stage of the disease. Conservative treatment should be carried out in a complex, and consist of medical treatment, exercise therapy, physiotherapy, complementary therapies. Consider them in order.

As medical therapy apply:

1. 1) Drugs that anesthetize and eliminate inflammation: Diclofenac, Indomethacin, Nimesulide. If the first stage of arthrosis drugs can be used even in the form of ointments or gels, then in the second stage you need to use them in the form of tablets or injections. If a person suffers from gastritis or peptic ulcer, then instead of the listed drugs, either "Movalis" or "Piroxicam" or coxibs are prescribed: "Celebrex", "Rofika".
   
2. 2) Chondroprotectors: Dona, Structum, Arthra. The effect of these drugs is aimed at maintaining the structural integrity of the remaining cartilage. These funds are prescribed only in 1-2 stages of the disease for at least six months.
   
3. 3) To improve the nutrition of the joint, use vascular drugs: "Nicotinic acid", "Trental".
   
4. 4) For the relief of pain and inflammation in the joint, hormones can be injected several times: "Kenalog", "Solu-Medrol", "Hydrocortisone".
   
5. 5) Hyaluronic acid preparations - analogues of natural joint lubrication are very effective.

LFK

The complex of exercises is selected individually, depending on the stage of the process and individual load tolerance. When performing a training program, there should be no pain, but slight discomfort should be felt.

Physiotherapy

The following types of procedures are used:

• magnetotherapy;
  
• phonophoresis;
  
• laser therapy;
  
• diadynamic therapy;
  
• thermal procedures;
  
• massage.

Surgical treatment

It is used only in advanced stages. For arthrosis of the ankle joint, the following types of surgical interventions are performed:

1. 1) Arthroscopy: introduction of a special endoscopic device into the joint cavity, with which bone outgrowths and necrotic cartilage are removed. The surfaces of the articulating bones are leveled.
   
2. 2) Atrodez - the creation of an artificial fusion between the articulating surfaces.
   
3. 3) Replacement of the damaged joint with an endoprosthesis.

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