From childhood, we were used to running, jumping, boys like to climb and play football, girls on ropes, and more.An active lifestyle is so entertaining the human mind that over the years, when muscles pull somewhere, where joints get sick, the person doesn't even notice - "Well, think about how many times Kolenko has been hurt." In today's post, we'll talk about, and why knee injuries are hurt, and whether this is always the usual result of keen movement.
What is arthritis?
joint- A group of diseases of the musculoskeletal system of different origins, but with similar biological, morphological and clinical manifestations.Their development is based on degenerate lesions of all components of the joint, mainly cartilage, elongated bone, synovial membrane, ligaments, capsules and surrounding muscles, and the formation of marginal bone botany and transparent or invisible synovitis.The pathological changes of this disease capture both cartilage and bone tissue.
Arthritis is often calledOsteoarthritisSometimesOsteoarthritis.
Statistics (epidemiology)
Among all arthritis, arthritis is in up to 80% of cases.
The disease develops mainly in middle age and in the elderly.At a young age, joint injury, inflammation processes, and congenital pathology of the musculoskeletal system can occur joint.
In most people over the age of 65, X-ray signs were found, nearly 95% in 70 years.
Women suffer from arthritis almost twice as often as men.The incidence rate during menopause increases.
Genetic factors play an important role in the development of joints.It has been determined that the development frequency of the disease in the osteoarthritis patients is twice as frequent than the entire population, and that arthritis development is 7-8 times higher in patients with congenital defects in musculoskeletal system.
Arthritis - ICD
- MKB-10: M15-M19, M47
- MKB-9:715
- MKB-9-km: 715.3
Joint symptoms (clinical pictures)
The clinical manifestation and severity of the disease depend on the location of the pathological process, the patient's health status and his life image.
The first sign of the joint
Arthropathy usually begins gradually, for patients.
The first symptom of the disease is usually short-term mild joint pain (Artralgia), which has the largest load.First, these are the joints of the lower limbs - the knees, hips, and the joints of the toe.The joints of the upper limbs, the joints of the meninges, and the wrist joints of the brush thumb are more often affected.
Arthritis usually begins with a lesion in one joint, but after the other joints are involved in the process.
The main symptoms of joints
With the impact of the joint, the patient complains about pain, tightness, limitations of joint movement, swelling and joint deformation.
Also, it is worth living in the nature of pain.As the joints act, mechanical and onset pain are possible.Mechanical pain occurs with load on the affected joints.This pain mainly takes a break at night and disappears after a few hours of rest.The occurrence of this type of pain is related to the gradual increase in bone pressure during physical fatigue.Stress can cause stimulation of bone bundles and painful bone tissue.
Pain occurs when the walk begins, then stops quickly and occurs again during physical fatigue.The friction of the joint surface of the affected joint may cause pain.Small particles of necrotic cartilage fall on the surface of the cartilage.In the first step, these particles are pushed into the cavity of the joint bag and the pain stops.
As the joints work, pain may be associated with peripheral arthritis and inflammation of tendons (soft surrounding tissue, ligament instruments, and joint pockets).This pain occurs only in movements in which the affected tendons participate and in certain locations in the joints during the movement.
Usually, pathological changes begin with large joints that are subject to great physical effort during the day.At the beginning of the disease, pain occurs due to the possibility of microcirculation channels not consistent with the needs of joint tissue.Therefore, in order to relieve the pain, the patient slowly took the first few steps and then accelerated the pace of walking.Pain may occur after half to two hours of walking or working in a standing position.This is a signal that changes the load, short-term break or work type.
In the later stages of the disease, the load on the joint is minimal and remains stationary for a long time.This is due to the fact that in the later stages, rude changes in joint tissue, destruction of articular cartilage and secondary synovitis formation.As huge changes in the huge bone-cheese tissue develop, its individual pieces can separate and fall into joint gaps, causing severe pain.This phenomenon is called a symptom of joint mice.
During joint examination, there are noticeable deformations.In addition, with the influence of joints, the left and right muscles atrophy and the limb axis displacement.The thickening of the sealed interphalangeal joints of the surrounding fabric is called the nodes of Gerberden.
The pain when the joint is located in the inter-joint space, i.e. the attachment of the joint capsule, is not always the symptoms of this disease.Swelling and soreness in the joints are determined by secondary synovitis.
The combined function is violated in the early stages of arthritis, indicating the limitations of the amplitude of movement.This is due to the lesions of periosteal tissue and synovitis.
In the later stages of the disease, the clinical manifestations of Parties develop differently in terms of severity.In most cases, knee and hip function is impaired.
The symptoms of arthritis depend on the pathology
Arthritis, damage to the knee joint - Symptoms
Knee lesions of arthritis are called contributions.The main gonadotropism occurs in menopause women.The secondary causes are most common in knee injuries and violate the static static of the spine.Patients complain about knee pain during exercise, especially when walking on stairs.The pain is located in the front or inside of the knee joint.Movement in the joint is limited: first bend, then extend.When moving, tightening often occurs.With the development of reactive synovitis, pain during exercise increases and concerns arises in a static state.Swelling of the joints, pain during palpation, redness (congestion), and increased skin temperature.Over time, knee deformation occurs due to the growth of bones.
Arthritis and Hip Damage - Symptoms
The lesions of the hip joint are called Coksartrosis.This is the most serious form of arthritis.The cause of this disease may be hip, injury, congenital dysplasia during menopause.During exercise, joints will suffer during exercise in a standing position.The limitation of movement in the joint is gradually increasing (first internal and external rotation, later flexion).La rows related to shortening of limbs.Duck gait is typical.The atrophy and development of thigh and hip muscles.The joints have no cartridge swelling.Palpation determines limited pain in the femoral head.
In the initial stage of arthritis, joint function is preserved.As the disease develops further, it is first temporarily restricted, then completely loses the ability to work, and the patient loses the ability to self-care and needs external help.
Causes of joints
Articity is based on the main degeneration of articular cartilage, which is accompanied by destructive changes in the bones that form the joint.This degeneration occurs between the mechanical load on the joint surface of the cartilage and the possibility of this load compensation.
In the development of articular cartilage changes, some factors can be involved at the same time:
- Functional overload, including professional, family and exercise, leads to chondromycorrhizal;
- Joint damage;
- infectious and nonspecific inflammation of the joints;
- Comparison of joint dysplasia resulting in violation of joint surfaces;
- Due to the curvature of the spine (spine disease, scoliosis, pathological spinal disease, etc.), it violates the statics of the body.
- Chronic hematoma:
- Diseases with metabolic diseases (gout, obesity, cartilage calcification);
- bone plants or Pedget's disease;
- osteomyelitis;
- Pathology of the peripheral nervous system, loss of sensitivity;
- Endocrine pathology (acute hypertrophy, diabetes, amenorrhea, hyperthyroidism);
- Genetic tendency.
Risk factors for arthritis include age in older age, females, and obesity.
Development mechanism
Metabolic diseases in cartilage are based on quantitative and qualitative changes in the main cartilage substances.The main substance consists of proteoglycans that provide collagen stability.The development of arthritis is accompanied by the formation or increased damage of cartilage components.
The content of osteoarthritis, hyaluronic acid, chondroitin and keratin in cartilage tissue is reduced.Additionally, altered proteoglycans lose their ability to retain water.It is absorbed by swollen collagen, resulting in reduced cartilage resistance.
If chondrocytes are damaged, they start producing collagen and proteoglycans instead of the characteristics of normal cartilage tissue.These altered substances lead to loss of biochemical mass of cartilage.
The development of arthritis is very important for immune diseases.Destruction of chondrogenan is accompanied by the emergence of immune responses of cellular and humoral types.This in turn leads to progressive fibrosis and sclerosis of the synovial membrane, pathological changes in intra-articular synovial fluid, and behaviors that violate cartilage.The lower electric shell supports the progress of changes in articular cartilage changes.
Genetic factors have certain value in the development of joints.
Classification of arthritis
Arthritis is divided into two groups: primary and secondary.
Distribution (main arthritis):
- Local (causing damage to three joints)
- Common or common polyarticulation (three or more joint failures).
Depend on the destination (secondary):
- A. tasobed joint (Cokesarrosis);
- Answer: Knee joint (swelling of gonadotropin);
- Answer: Elbow joint;
- Answer: Shoulder joint;
- A. Spine;
- A. Cervical (Unkoallthrise);
- A. Hand;
- A. Ankle joint (Kerva)
- A. Stop.
Etiology:
- Posts - Trauma
- metabolism
- Due to endocrine pathology.
Diagnosis of arthritis
The clinical manifestations and variants of arthritis make it difficult to diagnose the disease early.The false nature of the diagnosis is also associated with the lack of specific symptoms (hidden disease attacks).It is very important that factors that lead to joint development are defined:
- Chronic joint trauma;
- The long-term execution of stereotyped movement;
- Joints exercise physically within a certain period of time;
- Violation of salt or fat metabolism;
- Genetic vices of the musculoskeletal system.
X-ray examination is the most important meaning of diagnosing joints.Observation X-rays of both knee joints were performed in a direct position (bending position) and were also in a lateral position.Classic signs of jointization of X-rays are: stenosis of joint space, the presence of bone plants, subchondral bone sclerosis and subchondral cysts.The radiological changes of joints have the following stages:
- 0- No changes.
- I- Radiologically suspicious signs.
- ii- Minimal changes (slight reduction of joint space, subsidiary bone sclerosis, single bone plant).
- iii- Medium performance (medium narrowness of the charter, multiple bone plants).
- iv- Changes in expression (the joint space is not visible, multiple rude bone plants are identified), often present with synovitis.
In the presence of these symptoms, no further tools are needed.
In the absence or low severity, joints, MRI, scintillation diagrams were performed.
Clinical tests of blood, urine, and intra-articular synovial fluid were not included in the list of mandatory studies to diagnose joints.But these tests are necessary to rule out this joint pathology.
Major clinical and diagnostic signs of joints:
- Mechanical joint pain;
- fatigue;
- The feeling of instability in the lower limb joints;
- Damage to the joints of the first finger of the foot and hand;
- The gradual onset of the disease;
- Slow progressive current;
- joint deformation;
- Regional muscle atrophy;
- recurrent synovitis;
- Limitations of joint movement;
- X-ray changes.
Arthritis must be distinguished from joint damage in rheumatoid arthritis, infectious, metabolic and reactive arthritis.
Rheumatoid arthritis, unlike arthritis, begins with inflammation of the small joints of the hands and feet.It is characterized by severe pain in the inflammatory type, morning stiffness of the joints, and the presence of rheumatoid nodules.
Getric arthritis is mainly found in men.In the first plus lentil joint of the thumb of the foot, high local activity of acute paroxysmal pain is characterized.With gout, the presence of tofus is typical, with "punching" on X-rays.
Psoriatic arthritis is characterized by skin lesions, especially the scalp, spindle deformation of the fingers, and bright raspberry color of the skin above the affected joints.
Infectious arthritis is characterized by acute initiation, rapid development and course of disease, acute pain, high temperature, and the effectiveness of antibacterial treatment.
Joint therapy
The treatment of arthritis should be complicated for a long time.Basic principles of joint therapy:
- Unloading of joints (correct mobility and mechanical loading patterns, dosage walking, weight loss, excluding long standing, wearing weight, using physical therapy exercises, massage, electrical stimulation to enhance muscle toughness equipment).
- Conservative static disease correction (using orthopedic shoes, corsets, supervisors).
- Effects on overall metabolism and blood circulation (using biostimulators, vasodilators, Barney therapy and physical therapy classes twice).
- Eliminate reactive synovitis, anti-inflammatory therapy.
Patients with arthritis showed diet and restricted their diets in salt, sugar, strong tea, coffee, smoked meat, summer.This can increase the sensitivity of blood vessels and joint receptors, restore blood vessel tension, and normalize exchange in chondrocytes.By arthritis, it is necessary to drink enough liquid (at least 8 glasses of water per day).
Drug treatment for arthritis includes the use of rapid-acting anti-inflammatory drugs and painkillers (nonsteroid anti-inflammatory drugs-NSAIDS), essential drugs-cartilage protective agents.No-?NSAID uses non-selective and selective TSO-2 inhibitors.
As a topical treatment for the affected joint, NSAIDs in the form of ointments or gels were used.
In the case of reactive synovitis, tendinitis or tendinitis, when treatment of NSAID is ineffective, treatment of creatine in intramuscular or intramuscular muscle is ineffective.
Basic therapies for cartilage protectors (chondroitin, glucosamine, hyaluronic acid) are used to prevent articular cartilage degeneration.
The treatment of cartilage protective agents is shown in the I-III clinical and radiological stages of arthritis.
In addition to direct cartilage protectors, drugs that stimulate cartilage tissue (biostimulants) are also used.In the absence of reactive synovitis, use these drugs during remission.
With the effect of the joints, drugs that improve microcirculation are also pointed out.Correction of venous blood flow is necessary in the presence of varicose veins in the lower limbs.
In patients with arthritis, it is necessary to diagnose and treat osteoporosis in a timely manner.
Physical therapy for joint therapy
Physical treatments are also related to basic therapies for arthritis.Under its influence, the microcirculation of blood and tissue fluid is stimulated and neurotumour regulation is restored.
Complexes for joint therapy include inductive type, microwave therapy, pulsed current, drug electrophoresis, and magnetic therapy.To eliminate synovitis, ultraviolet irradiation in the affected joint areas of the erythema dose was used, and an ultra-high frequency electric field was used, with electrophoresis with isolation, dimexide or hydrocortisone.
To prevent the progression of arthritis, it is recommended to lose weight, avoid increased joint load, walk in inhibited areas, increase humidity and hypothermia.The shoes and supervisor of your personal choice are important.
With foot delivery, regular physical exercise, swimming, and cycling can strengthen muscles.It is not recommended to participate in heavy sports and light track and field sports.
In the sitting position, lying in the sitting position in the swimming pool for different treatment exercises.Exercise should not be intense, trauma, and the number of repetitions and repetitions gradually increase to avoid overload.
Popular and effective treatments for arthritis also include massage and exercise therapy.
With significant changes in joint deformation and limited mobility, surgical treatment is recommended.Perform joint replacement, internal main and osteotomy.
Disease prognosis
Primary arthritis rarely leads to complete disability.In the presence of reactive synovitis, patients temporarily become disabled and sometimes they are forced to change their specialties.With secondary common structures, the prognosis is unfavorable as significant joint function develops due to the rapid progress of the disease.In this case, disability can occur over years of illness.
Prevent arthritis
The main prevention of arthritis should start from childhood.as follows:
- Prevent and treat scoliosis;
- Use a special supervisor to calibrate the flat feet;
- Physical education courses strengthen muscles and ligaments;
- Rational nutrition and prevention of metabolic diseases;
- Limitations of heavy exercise in childhood and adolescence;
- Alternate work sits at the table and walks;
- There is a correct organization of labor force and other employees in the enterprise.
Secondary prevention provides measures to prevent the development of recurrent reactive synovitis.These include walking agents, limiting physical fatigue, supporting support and other joint unloading measures.If you have severe joint symptoms, it is necessary to continue to take basic medicines.General enhanced treatment, improvements in blood circulation and metabolism are recommended, and annual hydrotherapy treatments are recommended.
Which doctor will he go to?
- Rheumatologist
- Orthopedic doctor