Since childhood, you love to run, jump, climb boys and play football, girls and more.And when the active lifestyle took a place in this year, in one place, he fell in one place, he does not draw a man's attention - "Well, think about how much the kolenko hurt."Here we will talk about today's article and cause it to the knee, and whether it is always an ordinary result of acute action.
What is Arthroz?
Arthropod The disease group of the musalosheletal system of different origin, but similar biological, morphological and clinical manifestations.The basis of development is the degenerative lesion of cartilage, subtle bone, synovial membranes, gardens, capsules and peredicular muscles, skinny membranes and periarthricular muscles, cords and peredicular muscles.Since this disease, pathological changes seize both cartilage and bone tissue.
Arthrosis is often called osteoarthrosisand sometimes osteoarthritis.
Statistics (epidemiology)
Among all the diseases of the associations are up to 80% of the arthrosis.
The disease is mostly medium and old.Along with the age of arthrosis, compounds, inflammatory processes, inflammatory processes, inflammatory processes, as well as the congenital pathology of the musaloshelet system, arthrosis can occur.
X -Rs The symptoms of arthrosis were found in people aged 65 and above 70 years older than 70 years old.
Women suffer about two times more arthrosis than men.The ratio of the event is growing during the postmenoposis.
The great role in the development of arthrosis is played by hereditary factors.Osteoarthritis patients are twice as high as the development of the disease in their families, and the development of arthrosis in congenital defects of the Musaloshelet system increases 7-8 times.
Arthrosis - ICD
- MKB-10: M15-M19, M47
- MKB-9: 715
- MKB-9 km: 715.3
Symptoms of Artrosis (Clinical Picture)
Clinical manifestations of the disease depend on the localization of the pathological process, the patient's health and the image of his life.
First signs of arthros
Arthrosis often begins to be invisible to the patient.
The first symptom of the disease is generally a short small joint pain (Arthralgia).These are, first of all, the combinations of the lower extremities - the first thumb of the leg is the knees, hip, plus Phalanx joints.From the joints of the upper extremity, interfergeal joints, the brush's thumb is more commonly affected by the carpal patterned combination.
Arthrosis usually begins with a combination lesion, but after a while, the other joints are involved in the process.
The main symptoms of arthropons
Patients with arthrosis complain about pain, crisis, joint, swelling and joint deformation in deformation.
Separately, there is a place of residence in the nature of the pain.Mechanics and starting pain with Arthrosis are possible.Mechanical pain occurs with the burden of affected combination.Such pains are mainly relaxing in the evenings, it disappears after a few hours of rest.The appearance of this type of pain is associated with the gradual increase in bone pressure in physical power.Pressure causes irritation of bone rays and painful bone tissue.
Starting pain, the walk looks at the beginning, then stands quickly and starts physically.Starting pain may appear with the friction of the articular surfaces of the affected combination.The small particles of necrotic cartilage fall on cartilage surfaces.In the first steps, these particles push together the cavity of the bag and the pain is stopped.
Pain with arthrosis can be associated with periarchitis and tendatio (soft peredicular tissues, ligamentaous and articular bag).This pain occurs only during the actions involved in certain positions of the affected tendons, as well as in actions.
Pathological changes, as a rule, begin with large combinations of large physically affected during the day.At the beginning of the disease, pain occurs as a result of inconsistency of opportunities for the needs of articular tissues of the micremekration canal.Therefore, patients slowly take first steps to reduce pain and then then speed up the pace of walking.The pain may appear after a half hours or after working in a permanent position.This is a signal to change the load, short - short relaxation or work type.
In the later stages of the disease, the Arshralgia may occur with minimal loads of the compound and may remain in a long time.This is due to the subsequent stages, the destruction of rough changes in joint tissues, the destruction of articular cartilage and the emergence of secondary synovitis.With the development of gross changes in the bone, individual fragments can be separated and may fall into the gap, a sharp ache.This phenomenon is called the symptom of the joint mouse.
Deformation is noteworthy during the examination of compounds.In addition, the thickening of periods of periostal soft tissues with arthrosis, there is a displacement of the archotrophy of regional muscles, extremity.The thickening of the interfererous joints, which is a stamp of bone growths and periodicular pieces, is called Gerberden's nodes.
Pain, the connection of the joint capsule while feeling together, but this symptom of the disease is not always.The swelling and pain of the combination is determined by secondary synovitis.
In the early stages of Artros, the violation of the joint function shows itself with the restriction of the amplitude of the actions.This is due to the lesion of periodematic tissues and synovite.
In the later stages of the disease, the clinical manifestations of contracts are developing differently in terms of violence.Most, the functions of knee and hip combinations are impaired.
Arthropods depending on the localization of pathology
Damage to knee joints - symptoms
The lesion of knee joint with Arthusus is called gonarthrosis.Women in menopause are developing primitive gonarthroz.Secondary reasons are the most injuries of the knee joint and the status of status with the curvature of the spine, straight legs.Patients complain about pain in the knee combination that occurs in actions, especially when walking stairs.The pain is localized in front or inside the knee joint.Joint actions are limited: first bending and subsequent extension.When moving, a crisis often appears.During the actions of reactive synovitis, pain is intensified and worried about rest.The swelling of the merger during palpation, redness (hyperemia) is determined by the growth at skin temperature.Over time, the deformation of knee joints due to bone growth.
Damage to hip joints - symptoms
The lesion of hip joints is called coxerythrosis.This is the most severe form of arthros.The causes of the disease can be the congenital dysplasm of hip joints, injuries, menopause.Patients have pain in the joints, in a sustainable situation during the actions.Restriction of joint movements increases gradually (first internal and external rotation, subsequent flexes).There is a lamality related to shortening the opposite.It is typical of bilateral damage and ducks.The atrophy of thighs and hip muscles is developing.There is no swelling of joints with cartrolous.The limited pain in the femoral head determines palpationly.
At the initial stage of arthros, joint features are preserved.The ability to work is temporarily limited by the development of the disease, and then the ability to work is completely lost, the patient loses its self-care capacity, requires extraneous assistance.
Reasons for arthros
Arthusz is based on the initial degeneration of articular cartilage with destructive changes accompanied by the bones of the joint.Such degeneration occurs as a result of an imbalance between mechanical loads on the joint surface of the cartilage and the possibility of compensation for this cargo.
Several factors may take part in the development of degenerative changes in articular cartilage:
- Functional excessors, including professional, home and sports, cartilage mycotrauma;
- Joint injuries;
- Infectious and uncertain inflammation of the compound;
- Joint dysplasy that causes a violation of the comparison of joint surfaces;
- Violation of body statistics as a result of the region's curvature (Kymphosis, Skoliosis, Pathological Lordosis, etc.), straight legs;
- Chronic hemarthrosis:
- Diseases with metabolic disorders (gout, obesity, chondrocylsis);
- Osteodistrophythe or pedgetic disease;
- osteomyelitis;
- pathology of peripheral nervous system by loss of sensitivity;
- Endocrine pathology (Akromegali, diabetes, amenorrhea, hypertyroidism);
- Hereditary tendency.
Arthrosis risk factors include old age, female sexual, obesity.
Development mechanism
Metabolic disorders in cartilage are based on quantity and quality changes in the main article of cartilage.The main item consists of proteoglycans that provide stability of collagen.The development of arthropons is accompanied by sufficient formation or increasing destruction of cartilage components.
The composition of osteoarthritis, hyaluronic acid, xondroitin and kerati in the cartilage tissue is declining.In addition, the modified proteoglycans lose the ability to maintain water.Swallow by a collagen causing the reduction in cartilage resistance.
If chondrocites are damaged, they begin to produce collagen and proteoglycans that are not specific to normal cartilage tissue.These modified items cause loss of biochemical qualities of cartilage.
It is great importance to the development of Arthosus.The destruction of the proteoglycary of the cartilage is accompanied by the appearance of mobile and humoral immune reactions.In turn, this leads to pathological changes and sclerosis of the synovial membrane and sclerosis, intaarticular synovial liquid violations.The lower synovial shell supports the progress of degenerative changes in the cartilage.
There is a certain value in the development of arthrosis of a hereditary factor.
Classification of arthrosis
Arthrosis is divided into two groups: primitive and secondary.
In the Distribution (Initial Arthrovy):
- Local (with damage to three joint
- General or generalized, polyoltrose (to defeat three joint plays or more).
Depending on the destination (secondary):
- A. Tasobed Joint (Kokesarthrosis);
- A. Knee joint (gonarthrosis);
- A. Elbow joint;
- A. Shoulder combination;
- A. Spine;
- A. Cervical department (unkoarthrosis);
- A. Hands;
- A. Ankle combination (Cruzartrous)
- A. to stop.
By etiology:
- Post -traumatic
- metabolic
- due to endocrine pathology.
Diagnosis of arthrosis
Diversity of clinical manifestations and arthrocy options make early diagnosis of the disease.Falsification of diagnosis is also associated with the confidential start of the disease.The definition of factors contributing to the development of Arthososis is of great importance:
- chronic joint trauma;
- Execution of stereotypical movements;
- physical activity over play for a certain period of time;
- violation of salt or fat metabolism;
- Hereditary evil of the musaloshelet system.
X -Ray examination has the most important meaning in the diagnosis of arthrosis.The view of both knee joint stays are carried in a position in a position in a single position in a lateral position.The classic signs of Artros in the radiography are: the shortage of joint cavity, osteophylls, subchondral bone sclerosis and the presence of subsections.There are the following stages of radiological changes in Arthusus:
- 0 - No change.
- I - Radiologically suspicious signs.
- Ii - Minimum changes (joint space, auxiliary osteosclerosis, single osteofayt).
- Iii - Medium manifestations (a moderate contraction of the charter, a large number of osteofitis).
- Iv- Corrected changes (not visible in common space, very rough osteophylls are identified), Sinovit is often available.
There is no need for additional means with the participation of these symptoms.
In their absence or low magnitude, joints, Mri, Skintigraphy are carried out.
Clinical tests are not included in the list of compulsory research for the diagnosis of clinical tests of blood, urine and intraarticular sinovial sinovial fluid.However, these tests are needed to exclude such articular pathologies.
The main clinical and diagnostic signs of Arthosus:
- Mechanical joint pain;
- fatigue;
- the feeling of instability in the combinations of lower extremities;
- Damage to the joints of the first finger of the foot and hands;
- the beginning of the disease;
- slowly progressive current;
- joint deformation;
- hypothrophy of regional muscles;
- repeated synovite;
- Restriction of actions in combinations;
- X -Ray changes.
Arthropists damage the combinations from rheumatoid arthritis, infectious, metabolic and jet arthritis.
Rheumatoid arthritis, unlike arthritis, begins with inflammation of small joints of hands and feet.The inflammatory type is characterized by the tight pain of the joints in the morning, the presence of rheumatoid nodules.
Gotric Arthritis is mostly found in men.The first plus-Phalax combination of the thumb of the foot is highly local activity with acute paroxismal pain.With Gut, the presence of tofus is typical, there are "fist" in radiography.
Psorized arthritis, especially the scalp, especially scalp, shape of fingers are characterized by a bright raspberry color of the skin on top of the deformation and affected joints.
Infectious arthritis is characterized by a sharp start, rapid development and course, sharp pain, high temperature and effectiveness of antibacterial therapy.
Treatment of arthrosis
Treatment for arthrosis should be long, complex.Basic principles of Arthosis treatment:
- Discharge of compounds (migration and proper mode of mobility and mechanical loads, ride, body weight reduction, weight, weight, massage, electric stimulation), reduce weight
- Conservative correction of static disorders (orthopedic shoes, corsets, supervisors).
- Impact on general metabolism and blood circulation (twice a year, twice the use of biostimuluulus, balleotherapy and physiotherapy courses).
- Eliminate jet synovitis, anti -inflamic therapy.
Arthrosis patients show a diet with restricting salt, sugar, strong tea, coffee, smoking meat, sharp meals.This improves the sensitivity of vascular and articular receptors, restores the tone of blood vessels, normalizes the exchange of chondrocites.You need to drink enough liquid with Arthrosis (at least 8 cups of water per day).
Arthrosun drug treatment includes fast-faciellflamational and painkillers (non-metRaking drugs - NSAIDs), key medicines - xondroprotants.NSO-2 inhibitors of non-human voters and non-voters are used from NSAIDS.
For affected combinations, NSAIDS in the form of an ointment or gel is used as local therapy.
NSAID's treatment is ineffective, with the participation of tendinity or tendovajajajinite, tendinite or tendovajajajajajajajajajajajajajajajajajajajajajajajajaginit, relevant discipline or intramuscular management of corticosteroids.
Basic therapy is used with xrondroprotants (chondrotic, glucosamine, hyaluronic acid) to prevent joint cartilage degeneration.
The treatment of chndroprotants is shown in the radiological stages of the I-III clinical and arthrosis.
Along with direct chondroprotants, medications that stimulate the restoration of cartilage tissue (biogenic stimulates) are used.These drugs are used in the absence of a jet synovite during remission.
The drugs developed by Artrosis and microcirculation are also shown.It is necessary to adjust venous blood flow with the participation of the varicose veins of the ledgez.
In patients with arthrosis need to diagnose and treat osteoporosis in a timely manner.
Physiotherapy of arthros
Treatment physical treatment methods are also related to the main therapy of arthrosis.Under the influence of metabolic processes, the micro period of blood and tissue fluids is stimulated, neurogenal regulation is restored.
Includes a treatment complex with arthrosis, microwave therapy, pulse currents, medicines and magnetotherapy are electrophoresisy.To eliminate Sinoviti, the ultraviolet radiation of the affected joints of the affected joints in the erythema is used electrophorezes with electricity area, analgin, dimexide or hydrocourse.
To reduce body weight to prevent the progress of the arthropist, increase the growing cargo in the joints, walk in the compressed area, increasing humidity and hypothermia.The individual choice of shoes and supervisors is important.
Gonarthrosis, regular physical exercises, swimming, bike drags are shown to strengthen muscles.Heavy and light athletics classes, football is not recommended.
Therapeutic classes are carried out in a different way, in the position of sitting, while sleeping.The actions should not be tight, traumatic, their volume and repetitive loads should be avoided.
Popular and effective methods treating arthrosia also massage and kinomsapi.
It is recommended to restrict the mobility with significant changes in the joints with deformation, to limit surgical treatment.Arthroplasty, endoprostetics, osteotomy are carried out.
The forecast of the disease
Initial arthrosis rarely causes disability.With the participation of jet synovite, patients are temporarily disabled and sometimes they have to change the profession.With a second-class Cookbridge, the forecast is less favorable due to the development of a significant partner of a significant shape.In such cases, disability may exceed the disease for several years.
Prevention of arthrosis
The initial prevention of arthrosis should begin in childhood.This is the case:
- Prevention and treatment of scoliosis;
- Straight legs using special supervisors;
- Physical education classes to strengthen the muscles and ligaments;
- Prevention of rational nutrition and metabolic disorders;
- Restriction of heavy sport in childhood and adolescence;
- Alternative work sitting at a table with a walk;
- Proper organization of labor and the rest of the employees in the enterprises with severe physical activity.
Medium cases provide measures to prevent recurrent jet synovite.These include friends, the future, physical exertion restriction, support and other measures to empty the joints.With the heavy symptoms of arterioose, you need to constantly take the main drug.General enhance therapy, blood circulation and metabolism are recommended for the treatment of annual spas.
Which doctor will go?
- Rheumatologist
- Orthopedist