Osteoarthritis and osteoarthritis

Disease of arthrosis and osteoarthritis - the difference between them

Nowadays, there are many diseases that are similar to each other both in symptoms and in their development. Therefore, very often because of the similarity of their course, even the most highly skilled specialist finds it difficult to diagnose. Nevertheless, a person, based on the symptoms that he read on the Internet, independently makes a diagnosis and begins self-treatment. At the same time, he does not understand that the illness he is treating can be different, but similar to the one he read on the site. Therefore, if a person wants to be treated independently, at first he still needs to turn to a real doctor who will take tests, conduct a survey, and then put the correct analysis.

For example, very often patients confuse diseases such as arthrosis and osteoarthritis. Therefore, it is necessary to find a difference between the two diseases so that patients can orient themselves and determine the form of the disease that torments them. First, we divide the two diseases, consider their concepts and treatment, and after that we will find the difference between them.

What is arthrosis, its main symptoms and stages of development of

Osteoarthritis is a joint disease that leads to destruction of cartilage and deformation of bone tissue. Osteoarthritis can occur due to a birth defect or after severe injuries. The main causes, which also cause arthrosis, are metabolic disorders, decreased thyroid function and impaired functioning of the sex gland. To such a disease can lead even to excess weight. In addition, scientists believe that most of all women are predisposed to arthrosis. Most often, the disease occurs at the age of 40 years.

Stages of development of arthrosis

1 stage passes almost imperceptibly. Most often, there is a slight pain in the joint during movement, which the patient does not pay attention to. This pain indicates a change in the composition in the synovial fluid, which entails a weakening of the joint. In appearance, the joint does not change.

Stage 2 involves the formation of osteophytes, which are a sign of joint destruction. Pain when moving becomes stronger, there is a crunch in the affected joint. Then there is a violation of the muscular function, which leads to a deterioration of the reflex function. At that stage, normal movements become painful and unpleasant.

Stage 3 is an acute form of arthrosis. At this stage, the pathological deformation of the supporting areas of the affected joint occurs, which entail changes in the limb axis. After that, almost complete limitation of mobility occurs. At this stage, the patient can receive disability, because these processes are practically irreversible. Most often at this stage the patient needs prosthetics.

Most often, arthrosis starts at the knee joint, and then it can reach the hip joint. After that, arthrosis extends to the joints of the limbs( including the thumb on the legs).Sometimes the disease acts in reverse order and begins to progress from the joints of the toes or hands.

The main symptoms of arthrosis

  1. symptom is joint pain. The pain may not be strong, but periodic or noisy. Most often manifested when the load on the affected joint.
  2. symptom is a crunch in the joint at its load. Very often a feeling of aches arises in the aching joint. If you do not go to the doctor, then these feelings will increase and thereby limit the ability to move. The
  3. symptom is characterized by the appearance of a tumor( or swelling) at the site where arthrosis has occurred. After that, the swollen joint becomes a reddish hue. This symptom occurs only in the acute form of arthrosis. The pain in the joint is not strong, but aching. If there is a sharp pain in the swollen joint, it is most likely arthritis. The
  4. symptom is characterized by the formation of a strong tumor, which indicates a complete and irreversible modification of the affected joint.

As soon as at least one of the main symptoms appears in the joint, the patient immediately needs to consult a doctor. As each case is individual, and treatment is appointed only after all analyzes.

Treatment of arthrosis

After the first signs of the disease have been found, the patient should consult a specialist. At the first stages of the development of the disease, it is necessary to consult the rheumatologist, and on the later stages - to the orthopedist.

The main methods of treatment include:

  1. It is necessary to reduce the load on the affected joint.
  2. Orthopedic regimen and exercise therapy. Orthopedic regime is the creation of a correct posture by artificial means, by fixing the spine with auxiliary means. In addition, in this mode, you need to eat right and change your lifestyle( that is, sleep and rest time, rejection of bad habits and much more).If we talk about physical therapy, then appoint only the attending physician. All exercises are individual, so one patient can not advise another how to mop the damaged joint. The specialist selects the exercises and the load, depending on the degree of damage to the disease and the state of health of the patient.
  3. Physiotherapy. Physiotherapy has recently been most effective in arthrosis. It includes laser therapy, shock wave, ultrasound, or ultrasound, electromagnetic and pulse therapy. Recently, doctors can use magnetotherapy.
  4. Use of oxygen therapy. Oxygenotherapy involves the oxygenation of the affected joint.
  5. Intraosseous blockade.
  6. Pharmacotherapy, which in translation from Latin means treatment with medicines. That is, it is a medicamentous treatment of arthrosis. All medications the doctor appoints individually depending on the human body and the degree of disease.
  7. Traditional medicine. In the people there are many means that will help both to relieve pain in the joint, and to remove swelling and redness.
  8. Proper nutrition and spa stay.

For arthrosis, a doctor can prescribe a special diet. Some medications should be injected intravenously or intramuscularly and only under medical supervision. To reduce the tumor and pain in the joint, ointments and gels can be used. With an acute form of arthrosis, hormonal drugs can be used, which are placed in the diseased joint. More drugs are prescribed, which contribute to the restoration of cartilaginous tissue in the joint.

What is osteoarthritis and its main symptoms

Osteoarthritis is a form of arthrosis that develops due to deformation of the cartilaginous tissue on the joint surface. Osteoarthritis develops in both men and women aged 40 to 50( in women usually during menopause).This form of the disease manifests itself due to mechanical wear of the cartilaginous tissue near the joint. A progression of osteoarthritis is very slow, so when the patient goes to the hospital, the disease has already been neglected.

The causes of osteoarthritis can be different. It can be overweight, occupational trauma, functional overload of joints.

The main symptoms of osteoarthrosis

  1. At the end of the day, there is a crunch in the joints after any physical exertion.
  2. Appearance of joint pain when lifting from a bed.
  3. The formation of nodules in small joints( fingers, toes), which lead to severe deformation on the arms and legs.
  4. It becomes difficult to walk the stairs.
  5. From time to time the affected joint will swell, especially the knee joint.

Treatment of ostearthrosis

At the first symptoms of osteoarthritis, you need to see a doctor( rheumatologist or orthopedist, depending on the degree of disease progression).

Treatment of ostearthrosis includes:

  1. Weight loss, that is, a doctor prescribes a special diet that will help quickly get rid of excess kilos and reduce the burden on the affected joint.
  2. Therapeutic physical training, which is prescribed by the doctor, selecting the method solely from the analyzes and the X-ray image.
  3. Physiotherapy, X-ray and ultrasound( ultrasound).X-rays are necessary to confirm the presence of the disease, osteoarthritis, and through ultrasound can monitor the course of this disease.
  4. Medication. Drugs the doctor writes out only after carrying out all analyzes. Sometimes injections are needed, which are injected into the damaged joint.
  5. Traditional medicine and proper nutrition.

In order to prevent the disease of osteoarthritis, you need to monitor the weight, rationally engage in physical education and not overload the support joints unnecessarily.

What is the difference between arthrosis and osteoarthritis?

Most often, people do not understand the difference between arthrosis and osteoarthritis. And even the Internet issues information that arthrosis and osteoarthritis are the same, but in fact it is not.

Differences:

  • Osteoarthritis involves joint disease, which leads to both deformation and destruction of the cartilage around the joint. In other words, this disease includes the full concept of joint disease, which leads to complete destruction of the patient's cartilage and disability. And osteoarthritis is one of the forms of arthrosis, which includes a separate interval of the course of arthrosis. Osteoarthritis begins only at the time of deformation of the cartilaginous tissue. In other words - it is an acute form of arthrosis.
  • These are the causes of the occurrence. If arthrosis can be transmitted genetically, most often through the female sex, then osteoarthritis occurs due to mechanical overload of the joints.
  • This is the appearance of nodules in the joint. As soon as the doctor notices the formation of nodules on the x-ray or ultrasound, the diagnosis of osteoarthritis is made.
  • Osteoarthritis affects the joints of the fingers or toes, especially the big toes, and arthrosis can occur in any of the joints, most often the knee.

Thus, the differences between osteoarthritis and arthrosis are obvious. Do not say that this is the same disease. If a diagnosis of arthritis has been made, remember that it will entail a more severe, acute form, namely, osteoarthritis. Also, do not forget that arthrosis and arthritis are different diseases, you do not need to confuse them. Therefore, first you need to see a doctor, namely a rheumatologist or orthopedist, so that he correctly diagnoses and prescribes treatment. According to statistics, articular pains bother almost every third person in the age range of 35 to 49 years, every second over fifty and under seventy, to 90% of people suffer from this pathology in the older age group75 years.

According to official sources, in Russia there are about 4 million people, who are troubled by diseases that show tenderness in the joint cavities. On the deterioration of the quality of life, this pathology is on the fourth position in women and on the eighth in men.

Types of joint pathology

Joint pain syndrome manifests various diseases of the musculoskeletal system( ODD), the most common of which are:

  1. Arthritis. Arthritis refers to a disease caused primarily by an inflammatory lesion of the joint surface.
  2. The difference between arthrosis and arthritis is the process of destruction of the cartilaginous tissue and in the area of ​​the bone located below the level of the cartilage.
  3. Arthropathy is a violation of articulations in systemic diseases( the pathology of the supporting-motor system is only one of the symptoms, other systems of vital activity are also affected).

The pathology of periarticular tissues includes changes in all anatomical structures surrounding the joint:

  • tendinitis - inflammation in the tendons;
  • enthesitis( entesopathy) - changes in the place of attachment of soft structures to the bony protuberances;
  • bursitis - articular bag disease;
  • capsulitis is an inflammatory process and damage to the joint capsule.

Differences in the manifestations of

The difference between arthrosis and arthritis is a different manifestation of pain.

Arthritis is accompanied by a constant, aching, intense pain, which does not subside even when completely immobilized. In addition, the general picture consists of additional markers of inflammation.

Skin over the surface of the joint can become reddish, the temperature locally rises, there is a disruption of the motor function: a decrease in the scope of both independent movements and performed with the help of someone. Sometimes the onset of arthritis is preceded by the transferred infectious disease.

Soreness in degenerative arthrosis increases with exercise, becomes maximum with increased articulation function. However, at rest( for example, at night), the pain can completely pass and not disturb at all.

Disease group
Disease type Appearance Complaints Clinical picture Supplementary research methods
US X-ray Arthroscopy Blood test
Osteoarthritis Osteoarthrosis Painful sensations occur when loaded. As a rule, the first changes occur in the hip, knee joints, and the elbow, interphalangeal joints may be damaged on the arm in the presence of professional activities( at rest, pain may not bother);the amplitude of movements decreases. The lesion manifests from one joint, but with progression, other articular surfaces may gradually be involved.
Externally visible deformation, change in the anatomical shape, a slight swelling is possible, the scope of movements is sharply reduced during examination. Most worried about older people.
Uneven surface of articular lining, joint joint narrowing, uneven thickness of synovial membranes, intraarticular fluid of cloudy character, with flakes, inclusions . Existence of outgrowths directed to the joint cavity( osteophytes), which change the articular surface and break the anatomy;
Narrow interarticular lumen;bone formation is compacted.
Non-mandatory signs: dislocations, subluxations, "intraarticular mouse" - necrotic tissue torn off.
Bony outgrowths( osteophytes), cartilage defects, narrowing of the distance between two articular surfaces are visualized. Absence or insignificant inflammatory markers in the analysis of blood - the difference between arthrosis and arthritis. Perhaps a slight acceleration of ESR, inflammatory proteins, as a rule, normal;in the analysis of blood( OAK) there is no leukocyte shift - neutrophils do not exceed 50%.
Arthritis Rheumatoid Painful sensations in small joints, intense in the morning hours, subsiding towards evening;
loss of range of motion in the affected joint
Redness, fever over the projection of the joint, rheumatoid nodules in the joint region. Is manifested in middle-aged people Uneven synovial lining and articular capsule, minimal serous effusion, damage to the bones Reducing the lumen of the joint gap, reducing the density of bone tissue( bone looks lighter, transparent than normal). Sagging into the articular cavity of synovial villi, destruction of the joint tissue, fibrous plaque on the synovial membrane. Anemia( in 5% of patients), an increase in C-reactive protein, an increase in neutrophils in the blood( up to 90-92%), a decrease in platelets, acceleration of ESR - the main thing, rheumatoid factor, increase in alpha and beta-globulin levels, the appearance of immune complexes.
m Reactive Defeat, as a rule, one large joint on the lower limb( eg, knee, ankle, hip). Characteristic triad of symptoms - arthritis, conjunctivitis, urethritis. More often the defeat of the joint is preceded by the transfer of infection( chlamydial, salmonella, heat, iersiniosis). To determine the difference between arthritis and arthrosis, it is necessary to determine the inflammatory exudate in the joint cavity( very characteristic for inflammation). Rebuilding of bones epiphyses, rarefaction of bones( osteoporosis insignificant). Single erosions on synovial surfaces Specific antigen HLA-B27 is detected, chlamydial infection can be detected with a smear from the urethra, inflammatory indices in the blood( leukocyte shift to the left, an increase in neutrophils, a sharp acceleration of the ESR
Gout Pain is most often localized in the big toe,burning nature, sometimes intolerable More often affects men 40-50 years old Defects of bone, deposits of urate crystals. Severe rarefaction of bone density. Defined "tofuy"( deposits of urate in the form of crystals), look like a tumor-like growths inside the joint). In the blood, a high content of uric acid
Psoriatic Small joints on the wrist are affected( more often closer to the nail phalanx). Appears in people with psoriasis, the skin over the surface of the joints acquires a bluish-purple hue( a symptom of "radishes"). Damage to the joints, changing the correct shape of the joint. Bone dystrophy with thinning of the epiphyses and diaphyses( "stony tops of the bone"). Erosions at the edges of the synovial membranes. Reduction of hemoglobin, increase in leukocytes, increase in ESR, is determined by an inflammatory protein( CRP).
Arthropathies Systemic lupus erythematosus Soreness in small joints on hands and feet Weakness in the muscles, redness on the face, taking the form of a "butterfly" on the cheekbones and nasal septum, digestive tract damage, sores in the mouth, impaired renal function. Non-homogeneity of the ultrasound signal from soft tissues, thickening. Sealing of the periarticular structures, osteoporosis of bones. Single erosion on the surface of the involved joints. The presence in the blood pathognomonic for lupus LE cells, antinuclear antibodies.
With systemic scleroderma Pain, constrained movements in the joints until they are completely immobilized( ankylosis), most often in the carpus-metacarpal joint of one finger of the hand. "Masklike" face, devoid of facial expressions, vascular sprouts on the skin, violation of peripheral circulation( cold fingers, toes). Inflammation in periarticular tissues, calcification. Calcification of calcitons in bone, bone destruction. Erosive changes in articular joints Increased ESR, excess of blood protein level due to globulin specific
Pathology of periarticular tissues Damage to anatomical structures of the shoulder joint:
Inflammation of the tendon of the supraclavicular muscle
Pain in the abduction of the hand Pain sensations decrease in periodsrest( until disappearance at night) Edema of the periarticular tissues. The pathology is not revealed. Normal picture. Changes in blood, significant for inflammation.
Tendonitis of the subaccess muscle. Pain in external rotation of the hand( for example, when combing hair).
Inflammation of the muscle located under the scapula. With internal torsion of the upper limb.
Damage to the synovial bag. Tenderness for all movements of the
In case of injury to the hip joint:
inflammation of the tendon of the adductor muscle.
Discomfort in the groin, worsening with a leg.
In case of knee injury:
knee joint injury
Severe pain syndrome when trying to rest on your knees( often hockey players, parquet floor workers, miners).

A person feels stiffness of movements, a mechanical obstacle to movements in the joint, even complete immobility can occur in the severe stage of the disease. Another difference between arthrosis and arthritis is the absence of obvious inflammatory signs: no redness, no puffiness, no local temperature reaction.

For the diagnosis of arthropathic changes, it is important to remember that they are part of the symptom-complex of pathology, because the nature of this disease is systemic. So, other organs undergo changes, more often it's the digestive tract, eyes, urinary system and dermatological manifestations.

Diseases of periarticular tissues are most often expressed by local( point) pain sensations. The patient points to the specific place where the soreness is most painful, with difficulty performs specific movements that give him discomfort( for example, a leg or arm reduction).

Distribution of different types of articular pathology in the general population is given in the table below.

Disease Frequency of occurrence
Osteoarthrosis 60-70% of all joint diseases( registered in 20% of the world's population), women are more likely to get sick than men.
The most common localizations:
• hip joint( coxarthrosis) - 25%;
• changes in the knee( gonarthrosis) - 38%;
• distal( closer to the nail plate) interphalangeal joints( Geberden's nodules) - 20%;
• proximal( closer to the wrist) joints of the fingers( Bushar's nodules) - 10%.
Rheumatoid arthritis 0.7-1.4%
Psoriatic Occurs in 5-7% of psoriatic patients
Gouty 7-8% among all ODA diseases, 0.1% of the total population
Reactive 1-3% inof the general population
Arthropathies with 0.5% of all
residents With scleroderma 0.012% of the population
Lesion of periarticular structures Disturbs 2-3% of the population

Differential diagnosis

The characteristics of the main pathologies of ODD are given in the table below. The main complaints, the features of the clinical picture and some results of the additional examination are given.

Despite the difference in arthritis from arthritis, according to the above classification, in some cases there is a combination of two pathological processes. The destruction of the cartilaginous tissue can be complicated by the attachment of an inflammatory reaction.

In this case, the diagnosis is "arthrosis-arthritis," which indicates a multifactorial lesion of articulatory tissues. The clinical manifestations of this disease are very diverse, because they include both the signs of the development of inflammation, and the processes of tissue destruction.

Medical treatment

  1. In the presence of an infectious agent, antibacterial drugs( active against reactive, septic arthritis) are prescribed:
  • tetracyclines - "Doxycycline", "Tetracycline";
  • macrolides - "Erythromycin", "Clarithromycin";
  • fluoroquinolones - "Ofloxacin", "Lomefloxacin".
  1. To eliminate symptoms of inflammation, use non-steroidal drugs that have anti-inflammatory activity: Diclofenac, Ketoprofen, Naproxen, Aceclofenac, Meloksikam, Ketorolac, etc.
  2. Glucocorticosterids possess marked immunosuppressive( suppression of the immune system) properties: "Prednisolone", "Methylprednisolone", "Hydrocortisone", "Deflazacort."
  3. Suppress the growth of microorganisms and reduce the severity of the inflammatory reaction preparations of gold( "Auranofin", "Krizanol").
  4. D-penicillamine preparations( "Tiopropin", "Piritinol", "Bucillamine") exhibit immunosuppressive activity.
  5. Quinoline drugs( "Delagil", "Plakvenil") exhibit an immune, analgesic, antiaggregatory ability.
  6. Cytostatics( treatment of diseases that are not amenable to therapy with other drugs) - "Methotrexate", "Azathioprine", "Cyclophosphamide".
  7. Sulfonylamides( "Sulfasalazine") have antimicrobial activity.
  8. Anti-cytokines( "Remicade") - these drugs eliminate the production of their own inflammatory agents in the body( cytokines), reduce the response of immunity, improve the prognosis of the disease.
  9. Enzyme therapy( Longidase, Wobenzym, Phlogenzym).The drug "Longidase" has, in addition to proteolytic ability, also immune, antioxidant action.
  10. Vitamin E( "Tocopherol") is an immune activity.
  11. Allopurinol and some uricosuric( urate-releasing) drugs( "Sulfinpyrazon") are highly effective in the treatment of arthritis of gouty arthritis.

Other therapies

  1. Intra-articular drug administration( effective administration of glucocorticosteroids).
  2. Application of the drug on the projection of the joint( various ointments).
  3. Therapeutic physical training helps to correct movement disorders, prevent the development of contractures, reduce the pain syndrome and feel the stiffness of the joint.
  4. Sanatorium treatment.
  5. Magnetotherapy.
  6. Laser treatment.
  7. The adoption of paraffin baths.
  8. Ozone therapy.
  9. Hydrophortisone phonophoresis.
  10. Therapeutic massage.
  11. Maintaining a diet( it is very important to follow a diet for gouty arthritis).It is necessary to observe a low-protein, diet with the use of fatty acids, which reduce the concentration of urate in the body.
  12. The methods of plasmapheresis( plasma replacement) are the purification of blood using special filters. Rheumatology often uses selective apheresis, in which large molecules( immune complexes, antibodies, various proteins) are absorbed, which contribute to the development of inflammation.
  13. Photochemotherapy is a treatment in which human lymphocytes, which take an important part in the mechanism of the immune response, are irradiated.
  14. Drainage of the lymphatic duct - this method consists in removing a large number of lymphocytes.

Surgery

  1. Manipulation during medical arthroscopy( removal of intraarticular pathological tissue: osteophytes, "articular mouse").
  2. An arthrodesis is the creation of an artificial immobilization of an articular joint in a physiologically correct position in order to reduce inflammatory changes. At the moment it is practically not applied.
  3. Arthroplasty is an operation to create new articular surfaces using biological pads, on the site of a damaged joint with the possible restoration of its normal functioning.
  4. Endoprosthetics - is the creation of a new joint using an artificially created mechanism of inert materials. Most often perform prosthetics of the hip( largest) and knee joints.

Diseases of the support apparatus are very diverse in the nature of the damage. In some cases, there are similar symptoms, but the pathological mechanisms that occur in the joints are different, and accordingly, different methods of treatment are needed.

To date, a wide range of drugs for the treatment of joint pathology is available. Drugs have different mechanisms of action and application points. Some are active against certain types of lesions of the musculoskeletal system, while others will be completely ineffective with similar nosologies.

It is important to understand that it is not necessary to determine what arthritis is different from arthrosis, and prescribe drugs. Therefore, you need to come to the doctor for a competent differential diagnosis using additional research methods. When receiving the data, the doctor will prescribe the necessary treatment suitable for the patient.

Sources:

  1. Rheumatology. National leadership, edited by E.L.Nasonova, E.A.Nasonova, 2008.
  2. Diseases of the joints. Ryabov SI, 2008.
  3. Anti-inflammatory therapy of rheumatic diseases. E.L.Nasonov.
  4. The problem of pain in osteoarthritis. N.V.Chichasova, MMA them. Sechenov, Moscow. Journal «The attending physician», №2, 2007.
  5. Chronic diseases of joints. N.V.Chichasova, G.R.Imametdinova, E.V.Igolkina, E.L.Nasonov, GBOU VPO The First Moscow State Medical University. THEM.Sechenov Ministry of Health of the Russian Federation, Moscow. Journal «The attending physician», №5, 2013.
  6. Treatment of pain in patients with osteoarthrosis of different localization N.V.Chichasova, GBOU VPO First Moscow State Medical University. THEM.Sechenov Ministry of Health of the Russian Federation, Moscow. Journal "The Attending Physician", No. 7, 2014.

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Osteoarthritis, osteoarthrosis

Osteoarthritis or osteoarthritis is the most common joint disease, which is one of the main causes of disability of older people.

Osteoarthritis does not lead to fatalities.

The prevalent age of onset of osteoarthritis is 40-60 years. In osteoarthritis, the joints of the hands, spine and lower extremities, experiencing gravitational load( hip and knee) are mainly affected.

Prevention of osteoarthritis. The basis for the prevention of osteoarthritis is a reduction in the load on the joint. This is facilitated by maintaining normal body weight. The optimal muscular load is important. Clinical studies have shown that training the quadriceps femoris reduces the risk of osteoarthritis of the knee joints. This is due to the fact that with weakness of the quadriceps muscle, the hip also decreases the ability to distribute the load in the joints and maintain its stability. It should be noted that damage to knee joints in youth increases the risk of osteoarthritis in the elderly. An important factor is the prevention of injuries, including sports( in the frequency of developing a training regimen for athletes with a graduated load, using special devices that protect the joints under load.)

Classification of osteoarthritis

  • Localized: joints of the hands, joints of the feet, knee and hip joints, spine andetc.
  • Generalized: lesions of three or more different joint groups
  • Secondary osteoarthritis develops due to a number of reasons:
  • Posttraumatic
  • Vroacquired, and other diseases
  • Endocrine diseases( diabetes mellitus, hypothyroidism, hyperparathyroidism, etc.)

Clinical picture of osteoarthritis

  • The following symptoms are typical for osteoarthritis:
  • gradual onset of pain
  • pain relief under load and in standing position
  • crunchesactive movement in the joint
  • limitation of the joint motion
  • atrophy of the surrounding muscles

Laboratory tests for osteoarthritis

Specific laboratory tests for diagnosisThere is no osteoarthritis, however, a certain set of laboratory tests is necessary for differential diagnostics( in osteoarthritis, unlike other types of arthritis, there are no inflammatory changes in the clinical analysis of the blood, there is no rheumatoid factor, there is no increase in the level of uric acid in the serum. In addition, a certain set of tests may be necessary to identify possible contraindications to prescribing medications( general urine analysis, serum transaminase).

To determine the stage of osteoarthritis, joint radiography is performed.

Treatment of osteoarthritis

The aims of the treatment:

- to provide patients with understanding of their illness and the ability to manage it, to teach the patient how to use joint protection( avoid prolonged standing, lifting of weights, sports associated with shaking and increased cartilage load( tennis, running, jumping)

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Osteoarthritis | create-avatar-online.ru

Intra-articular oxygen therapy

Gas cushion in the upper turn( A); contours of the fatty body( B) on the arthropneumogram of the knee

Intra-articular oxygenatorpi is pathogenetically justified, as glycolysis in the tissues of the joint increases in the conditions of oxygen deficiency, as a result of which under-oxidized metabolites accumulate: lactic, pyruvic acids. The oxidation requires the increased delivery of oxygen to the joint tissues. In addition, oxygen stretches the joint capsule and creates an unloading"Gas" pillow.

Laser therapy is used as the main method of treatment( anti-inflammatory, analgesic, stimulating effects) in the early stage of the disease, soas a factor in reducing risk of corticosteroids and manipulation of the bones and joints in the later stages.

Decompression of metaepiphysis and intraosseous blockade

Pathogenetically substantiated and effective enough is the decompression technique of the hip metaepiphysis zone. Elimination of increased intraosseous pressure can "break" the ischemic cycle of the disease. The success of applying this technique ranges from 40 to 90%.The effectiveness of treatment is enhanced by the application of a low-traumatic and available in ambulatory conditions tunneling method of the metaepiphysis zone with bone decompression and the treatment blockade. Decompression is carried out in the area of ​​a large trochanter, condyles of the hip, lower leg, inner ankle and calcaneus.

Multi-channel electromyostimulation in walking

Electrode arrangement for multi-channel electromyostimulation

It is used in patients, including older age groups, with pronounced impairment of muscle function and motor stereotype with the use of a 6-channel stationary electrostimulator under clinical-biomechanical-electromyographic monitoring. This method is combined with muscle, conduction, intraosseous blockades, with intra-articular injection therapy and electromyostimulation at rest. The positive effect of treatment is possible if, in case of manual testing, the muscle strength is at least 2 points. In addition, an indispensable condition for the procedure is the possibility of independent movement of a patient with or without additional support for a distance of at least 10 meters, as well as the absence of a pronounced pain syndrome.

Comparative characteristics of MESM and other methods of increasing the functional state of muscles( electromystimulation at rest, therapeutic gymnastics):

  • muscles work in the phase of their natural stimulation and shortening in a step cycle, rather than in artificial mode;
  • the training effect of MESM is achieved with the use of medium physiological muscle tension sufficient to correct this movement, which is tolerated more comfortably by patients;
  • training of muscles is carried out by mutual reinforcement of natural and artificial cuts, weakening the involvement of "unnecessary" motor units caused by electrical contraction;
  • simultaneous multichannel stimulation of the complex of muscles of the lower limb and trunk allows to make a full correction of several movements, which contributes to faster recovery of the walking function, development and maintenance of an approximate motor stereotype.

Endoprosthetics of joints

Condition after arthroplasty of the right hip joint. Outcome of right-sided coxarthrosis

If there are indications for surgery, the choice method may be arthroplasty of the joints. At present, endoprostheses of the hip and knee joints have been developed and successfully applied. In osteoporosis, endoprosthetics are performed with cement-fastened structures. Further conservative treatment contributes to the reduction of the period of rehabilitation of operated patients and to increase the effectiveness of treatment.

Diet and nutritional supplements for arthrosis

No special diet or the need for biologically active additives( BAA) for osteoarthritis does not exist. The diet and the need for dietary supplements are determined by age or professional needs, concomitant pathology, overweight or environmental conditions.

However, some foodstuffs are traditionally considered useful or harmful in degenerative joint diseases.

Useful products include cold meat or hash. When cooking cartilage, beef and pork legs, ears and bones collagen, providing their strength, goes into the broth. The substances formed during the splitting of gelatin provide many vital functions of the body: they preserve the gastric mucosa, improve memory, prevent the gluing of platelets. And this in turn reduces the risk of developing acute circulatory disorders, slows down aging.

Preparations similar to food gelatin are called chondroprotectors and are used in official medicine for intramuscular administration( see also: Pharmacotherapy) or in dietary supplements( Inoltra, etc.).Supplements are not medicines and have a reputation, spoiled by obsession, but, in principle, can be recommended for osteoarthritis. It should be noted that none of these chondroprotectors currently have the evidence base of a high level of reliability.

In case of osteoarthritis, also foods rich in calcium( lactic acid diet) and vitamins of group B and C are recommended, as well as therapeutic starvation.

Alcohol intake is traditionally and reasonably considered a provoking factor that causes joint and muscular pain in cases of osteoarthritis. The mechanism of this effect is unclear, perhaps the pain associated with drinking alcohol is due to a violation of bone flow as a result of hypercoagulability syndrome.

Do not confuse diet with arthrosis with a diet for gouty arthritis, the observance of which involves the rejection of meat broths.

Sanatorium treatment

Sanatorium treatment allows to carry out complex rehabilitation, including the positive effect of therapeutic muds, baths, saunas, physiotherapy, massage, physical therapy. An important role is played by a change in the situation, the removal of stressful effects, and being in the open air. Sanatorium treatment can be carried out only without exacerbation of the disease.

Prophylaxis of

Among the numerous ways of preventing osteoarthritis, the following are the most significant:

  • prevention and effective treatment of joint injury
  • sufficient motor activity throughout life
  • reduction of excess body weight
  • timely correction of acquired or inherited biomechanics of the joint( eg, flatfoot correction,correction of traumatic deformity of the limb axis, treatment of congenital dislocation of the hip, etc.)

Physical Exercises

The view that physical stress can lead to premature "wear of the joint" is erroneous. Studies show that sport itself does not lead to osteoarthritis. On the contrary, any motor activity aimed at maintaining joint mobility, to strengthen the muscles, to coordinate movements allows a long time to maintain a good function of the joint and resist illnesses.

For patients who are at risk for arthrosis( joint trauma or dysplasia, overweight, low physical fitness), exercises with a measured load on the joint( dosed walking, climbing, biking, swimming) are recommended.

Walking is the main natural locomotion of a person. Everyday walking a person is busy a few hours a day. This is in any case more than the time of special daily physical training. Therefore, it is important that walking is the main means of preventing osteoarthritis. That is why with the consequences of injuries and arthrosis of the joints of the lower limbs, recommended dosed walking as the main method of prevention and treatment. Recommending to increase the motor activity, first of all, they mean the kilometers traveled during the day( up to 7 km).The dosage of walking is the restriction of the time of a continuous( without rest) stay "on the feet" no more than 30-40 minutes, but not a distance traveled a day.

Body Weight Control

  1. Small Medical Encyclopedia.- Soviet Encyclopedia, 1996. - Vol. 4. - 577 p.- ISBN 5-225-02819-5
  2. ICD-10: International Statistical Classification of Diseases and Related Health Problems. In 3 tons( in 4 books).- 10 th ed.- Kazan: Medicine, 2003. - 2438 p.- ISBN 5-225-03268-0
  3. ↑ Osteoarthritis - approaches to treatment // The diagnosis of orthopedics of traumatology and prosthesis .- 2004. - No. 3. - P. 75-79.
  4. WHO Disease and injury country estimates. World Health Organization ( 2009).Archived from the source August 20, 2011. It was checked on November 11, 2009.
  5. Benevolenskaya LI, Březovsky MM Epidemiology of rheumatic diseases.- Moscow: Medicine, 1988. - 237 p.- ISBN 5-225-01653-7
  6. Kovalenko VN, Bortkevich O. P. Osteoporosis. Practical guidance.- K.: Morion, 2003. - 448 p.
  7. Osteoarthritis: Encyclopedia of Medicine. CNET.It is checked up on November, 25 2007.
  8. ↑ Complex treatment of patients with severe disturbances of function of the lower limbs in outpatient conditions. A manual for doctors.- Moscow: CITO, 1999. - 28 pp.
  9. Kosinskaya NS Degenerative and dystrophic lesions of the osteoarticular apparatus.- L.: Medgiz.- 1961. - 196 p.
  10. Lequesne M. et al.// Scand. J. Rheumatol.- 1987. - Suppl.65. - P. 85-89.
  11. Burmakova GM, Natsvlishvili ZG The use of the drug Records in the treatment of patients with osteoarthritis of the knee joints // Bulletin of Traumatology and Orthopedics. N. N. Priorova.2005, No. 3. P. 52-53
  12. X-ray diagnosis of diseases of bones and joints. Medicine, 1958. T 1. S. 366
  13. Epifanov VA A. Therapeutic physical culture and sports medicine. Textbook. M.: Medicine, 1999. 304 p.
  14. Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines.// Osteoarthritis Cartilage.2008 Feb; 16( 2): 137-162.
  15. Evidence level: Ia - meta-analysis of randomized controlled trials, Ib - randomized controlled trials, IV - expert opinion;ES - the magnitude of the therapeutic effect, is a standardized difference in means, that is, the average difference between the main and control groups, divided by the standard deviation of the difference;ES = 0.2 is a small effect, ES = 0.5 is moderate, ES & gt; 0.8 is large. OA - osteoarthritis, COP - knee joints, TC - hip joints, NSAIDs - nonsteroidal anti-inflammatory drugs
  16. Golikova NM, Vyalko VV, Ugnivenko VI Laser and intra-articular injection therapy in complex treatment of patients with deforming arthrosis.// Preventive and curative work of polyclinics at the new stage of perestroika. Tez.doc. V-th Inter-Policlinic Conference. Polyclinic and curative work at the new stage of perestroika. M.: 1988. P. 60-62.
  17. Low-energy lasers in traumatology and orthopedics Moscow: 1998. 83 p.
  18. Ugnivenko VI, Parshikova MV, Zhilyaev AA Restoration of the walking stereotype by the method of multichannel electrical muscle stimulation in patients with severe dystrophic lesions of the lower extremities // Tez.doc. VI Congress of Traumatologists and Orthopedists of Russia. Nizhny Novgorod, 1997. P. 880
  19. Lane N. E., Michel B., Bjorkengren A., et al. The risk of osteoarthritis with running and aging: A 5-year longitudinal study. J Rheumatol, March 1993;20( 3): 461-8.
  20. Osteoarthritis and Exercise: Does Increased Activity Wear Out Joints? The Permanente Journal / Fall 2000 / Vol.4, No. 4
  21. "Also, during pregnancy, pain occurs when the natural weight gain. Severe pain, swelling, swelling, inflammation of the joint can cause a rise in severity. Patients already from the first stage are not recommended to lift the load more than 2 kg "/ / Alekseeva LI The main achievements in the treatment of otooarthritis. The quality of life. Medicine, № 3, 2003 С. 34-38
  22. Osteoarthritis threatens. Articles on health and medicine: "Osteoarthritis threatens"
  23. Guriev VN Bilateral sosarthrosis and its surgical treatment. Tallinn: Valgus, 1975, 275 p.
  24. Diagnosis and treatment of dysplastic coxarthrosis in outpatient conditions Disease and hip joint damage. Scientific and practical conference. Ryazan, 2000.

Excess body weight is an important factor in the development and progression of osteoarthritis. Reducing the body weight reduces the risk of developing the disease and is accompanied by an improvement in the function of the joints, so the program of treatment must include diet therapy.

It is generally believed that a reduction in body weight per 1 kg reduces the load on the joint by 4 kg. That is why in the treatment of arthrosis, LFK programs are used to reduce the body weight of the patient, based on aerobic training.

Prevention of dysplastic coxarthrosis

Main articles: Dysplastic coxarthrosis , Hip dysplasia

Timely unplaced joint dysplasia( incorrect treatment of congenital dislocation of the hip) leads to disruption of the hip joint biomechanics and the development of a serious disease called "dysplastic coxarthrosis", often bilateral.

Prevention of dysplastic coxarthrosis consists in observing the orthopedic regime( avoid injuries, physical exercises or work related to inertial loads on the joint: running, jumping, lifting weights), as well as in active physical training aimed at strengthening the muscles stabilizing the hip jointgroup of gluteus muscles, quadriceps femoris, extensors of back and abdominal muscles): swimming, skiing, etc. For women, it is important to observe the orthopedic regimen and exercise therapy before and afterthe generic period.

Notes

References

  • Ugnivenko VI Diagnosis and treatment of dysplastic coxarthrosis in outpatient settings. Archived from the source on January 28, 2012.

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What is the difference between arthritis and arthritis?

lafonova

Arthritis is an inflammatory disease of the joints, an arthrosis-degener.dystrophy.joint diseases

point Arthrosis is a lesion of the cartilaginous tissue in the joint.
Cartilage in this disease ceases to cope with the load that
is on, and it begins to break down more than it can restore itself - the cartilaginous interlayer between the bones, which ensures normal sliding of the articular surfaces of bones, does not cope with its function, begins to deteriorate.
arthritis is a disease that is accompanied by inflammation of one or more articular joints.
The main symptom of the disease is inflammation of the joint, which is accompanied by pain, swelling of the affected area, an increase in temperature.
Arthrosis often affects large joints of the human body, resulting in the formation of osteoarthrosis of the knee( gonarthrosis),( coxarthrosis), spine( spondylarthrosis), shoulder joint and others. Of course, this does not mean that small joints can not suffer in this disease - they can, of course, but according to statistics, the above-mentioned joints are most often affected.
Thus, with osteoarthritis, the cartilage tissue is destroyed, and arthritis is inflamed for some reason. This is the main difference between osteoarthritis and arthritis. Let's see how these diseases differ.

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Physical manifestations
This is a rheumatic joint disease that has an inflammatory character and is accompanied by all the characteristic signs of inflammation( swelling, redness, temperature, pain) that can occur on one or more joints. With arthritis, the pain is felt both in motion and at rest, so the patient suffers both day and night. Thus, if joint pain and inflammation occur in your body at night, it is most likely arthritis. This helplessness reduces the mobility of the joints, severely limiting the physical capabilities of the patient.
Emotional causes of
In medicine, there are several types of arthritis. The seriousness of this disease speaks about the seriousness of emotional, mental and spiritual blockages.
As a rule, arthritis occurs in a person who is too strict towards himself, does not allow himself to stop or relax, does not know how to express his desires and needs. He believes that others know him well enough to offer him everything he can need. When others do not live up to his expectations, he experiences frustration, bitterness and resentment. He may also have a desire to take revenge, although they feel powerless to do anything. This causes him anger, which he hides deep inside. Such a person has a very well developed "inner critic".
The place where arthritis occurs, points to the sphere of life in which to look for the source of all problems. So, if arthritis affects the joints of the hands, a person should reconsider their attitude to what he does with his hands. If he needs help, he should ask her, and not wait for others to read his thoughts or guess that he needs help.
People suffering from arthritis usually seem very submissive and quiet, but in reality they suppress the anger that they really want to manifest. Emotions paralyze in the same way as arthritis. A patient with arthritis should stop accumulating these paralyzing emotions in himself.
Mental causes of
If you suffer from arthritis, think about why it is so difficult for you to show your needs and desires. Perhaps it seems to you that if you satisfy your desires, then you will not be able to stop in time and become an egoist. Check this and you'll see that you were wrong. Also, check your definition of the word egoist. Let yourself say "no" when you do not want to do something, but if you decide to do something, do it with pleasure and do not criticize yourself.
If you do not give yourself a break because you want to achieve recognition, realize this and understand that you are doing it for yourself, and not because someone is forcing you. Give yourself the right to seek recognition from others, helping them, working for their benefit. If you work with joy and pleasure, and not under the pressure of inner criticism, life will seem more pleasant to you, you will become more flexible and energetic.(See also Amendments)
Spiritual causes and elimination
In order to understand the spiritual causes that interfere with the satisfaction of the important need of your sincere Self, ask yourself the questions contained in the monadotherapy material. Answers to these questions will allow you, not only to more accurately determine the true cause of your physical problem, but also to eliminate it.

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Osteoarthritis is a disease of the joints, which is based on the degenerative process, which starts with the articular cartilage, then it is disassembled until it disappears completely. The most common osteoarthritis or arthrosis is the deforming primary. To its development leads to premature aging, articular cartilage wear associated with a violation of its metabolism. The causes of arthrosis are still not accurately determined. It is believed that professional arthrosis occurs as a result of permanent microtrauma, the wear of the joint under the influence of large loads, for example, in athletes. Doctors and the role of the hereditary factor, as well as endocrine disorders and circulatory disorders, do not exclude medicine.
Arthritis is manifested by joint pain and impaired function. Due to changes in soft tissues, joints deform, the temperature and color of the skin change. Pain in arthritis is most intense at the end of the night and in the morning, and decreases after a person rises and paces. Having endured the pain, many postpone visiting a doctor. Once or the pain is not strong, you can and suffer. Such a frivolous attitude towards one's health and in time not begun treatment can lead to destruction of the cartilage so that inside the joint the bone becomes naked.

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