Osteoarthritis of the wrist joint

The main thing about arthrosis of the wrist joint: symptoms and treatment

One of the very important but rather fragile elements of the musculoskeletal system is the wrist joint located at the junction of the arm and forearm bones. The most common problems for this joint are injuries, much less often it suffers from degenerative diseases. Arthrosis of the wrist joint is a rare disease, but it strikes a lot in the quality of the patient's life.

Because of the disease, the mobility of the joint can be reduced to 50%, thereby causing inconvenience and discomfort when doing the usual tasks. Arthrosis in this case is very cunning: slowly destroying the cartilage and deforming the small bones, it can not manifest itself in any way and therefore is difficult to diagnose.

bones of the hand

On the photo - right hand bones

The three main causes of the disease

The main reasons for the development of radiocarpal arthrosis are three:

  1. injury and inflammation of the joint;

  2. excessive burden associated with professional activities;

  3. age changes in the body - wear of cartilage.

Main symptoms of

It is difficult to recognize arthrosis of the wrist joint. For weak pains, the patient usually does not pay attention, and to the medical people is drawn already for the neglected disease. The most typical symptoms of the disease - pain, crunch, mobility restriction.

At first, the pain is usually weak, with time increases. The patient experiences special discomfort when he resting on the palm of his hand or flexes the brush as much as possible, and also after lifting weights. The periodicity of joint crunching as the disease progresses also increases. Swelling is rare.

How to diagnose?

For an accurate diagnosis of writhing arthrosis, a complex of examinations is required, including:

  • external examination,
  • palpation,
  • radiography in 2 or 3 projections,
  • blood test.

Blood tests and X-rays are performed in order to distinguish arthrosis from arthritis, as the signs of both diseases are similar, and the treatment is assigned differently.

Methods of effective treatment of

The traditional treatment of arthrosis of the wrist joint can be conservative and surgical. The latter is usually assigned in the presence of other damage to the brush. Classical methods of treatment, as well as their actions are described in the table:

Type of treatment Action
Drug administration: NSAIDs, corticosteroids, chondroprotectors Anesthesia, stimulation of cartilage restoration
Manual therapy Restoration of limb mobility
Physiotherapy: paraffinotherapy, laser treatment, mud applications, ozocerite, electrophoresis Restoration of blood circulation, stimulation of metabolic processes in the body
Intraarticular injections of hyaluronic acid( after the courseof 3-5 injections, 70 to 80% of patients experience improvement in the condition) Nutrition and stimulation of cartilage restoration, joint surface lubrication
Diet Stimulation of metabolism, cartilage strengthening
Gymnastics Restoration of joint mobility
Wearing elastic bandage, wristband or bandage Stabilizationposition of the joint, minimization of sudden movements, weakening of the pain syndrome
Folk remedies: compresses, self-massage Anesthetic, relaxing, warming effect

Summing up the

Arthrosis of the wrist joint is a rare and insidious disease, which is difficult to "snatch" at an early stage. However, if the moment is missed, do not despair: ailment is treatable, although it is not easy. Complex application of various techniques and procedures allows to remove pain syndrome, restore joint mobility and stimulate the restoration of cartilaginous tissue. In extremely neglected cases, the problem is solved surgically. Patients with arthrosis of the wrist joint recall that the treatment should be prescribed only by a doctor, and is your most important task - to comply with the doctor's recommendations, to save the sick joint and not to overload it.


Symptoms and treatment of arthrosis of wrist and small joints of the hands

arthrosis of the hands Arthrosis of the wrist joint is often a common disease. It can occur in people of any age, so do not think that this is a disease only of the elderly.

People who perform monotonous movements, for example: athletes, builders, people whose specialty is closely connected with the computer( typing), are most susceptible to arthrosis of wrist and small joints of the hands.

The disease can also occur due to trauma, endocrine disruption in the body.

Characteristics of the disease

Osteoarthritis can develop gradually, for example, professional, when the joints of the hands are constantly subjected to a certain load. Or it can develop because of the injury.

Traumatic arthrosis is characterized by pain in the joint and lack of mobility. Limit lateral movements in the joint, and at first they are little noticeable. Edema at first may not be present.

For proper diagnosis it is necessary to perform an X-ray.

What is characteristic:

  1. Unlike arthritis, which worries more at night, arthrosis of appears during the load on the joint .
  2. Pain occurs only in a specific location of the , only one joint, the so-called post-traumatic syndrome, can be affected.
  3. There is no lethargy of , a rise in temperature and a feeling of heaviness, as with rheumatoid arthritis.

What can be the cause of a violation of

Most often, the causes of arthrosis of the wrist and small joints of the hands are:

  • increased joint load;
  • professional factors;
  • injury;
  • endocrine disorders.

Predisposition is more common in women older than 50 years, but men may also appear depending on the profession.

The stages of the development of the disease

Arthrosis develops gradually and has three stages of development:

  1. The first is a small pain after a load or a monotonous work. After rest or at rest, the symptoms disappear.
  2. The second - soreness of the joints and discomfort does not last a longer time. There may be a crunch when you move your hands, a slight puffiness. During periods of exacerbations during inflammation, the phalanx of the radiocarpal region becomes swollen. The temperature may rise and even symptoms of mild intoxication may appear. A person may not associate these symptoms with the disease.
  3. The third stage of is the deformation of the joints. The pain is expressed strongly, and it is noted both in the load and in rest. Some movements to the patient become inaccessible. Since the cartilaginous layer is destroyed, bony overgrowth along the edge of the joints may appear. In addition, osteoporosis may develop, and as motor activity decreases, the tone of the muscles of the entire hand also falls.

Characteristic signs of the disease

Crunch in the joints Patients note a crunch in the joints with the movement of hands, a slight stiffness, weakness of individual muscle groups, joint pain after a load.

After the disease progresses, the pains become more intense.

In addition, there is deformation of the fingers and there is muscle atrophy. Muscular contractures may appear.

Symptoms in different areas of the lesion

Arthrosis of the hands affects both distal and proximal interphalangeal joints. Soreness manifests itself in certain points.


  • crunch;
  • swelling;
  • in the field of distal interphalangeal joints - Geberden's nodules;
  • increases the volume of proximal interphalangeal joints, with a pronounced deformation of the spindle-shaped nodule - Bushar's nodules.

Osteoarthritis can affect any part of the arm:

  • shoulder;
  • elbow;
  • wrist joint;
  • small joints of the hand.

It all depends on where the negative impact was most often directed. For example, office workers who are forced to print a lot may show signs of arthrosis of the joints of the hand.

Signs of arthrosis of the wrist joint:

  • sharp pain in the extreme position of the hand;Roentgen for arthrosis
  • decreases the mobility of this joint;
  • must be differentiated with arthritis.

Symptoms of arthrosis of the hands:

  • Joint compaction on the 2nd, 3rd, 4th finger of the hand( more often presently in people who print a lot) there are Heberden and Bushard nodules;
  • symptoms are manifested fairly quickly, visible without special studies;
  • appears pain, swelling, subsequently contractures can develop.

Diagnosis of

Diagnosis is performed as follows:

  • take blood test for rheumatographic to rule out rheumatoid arthritis if the lesion is on the wrist;
  • X-ray examination of ( look at joint deformation, sprouting of bone processes, narrowing of the gap between the joints);
  • MRI .

The aims and methods of therapy

The purpose of treatment, first of all, to eliminate the cause that caused the disease, and therefore it is necessary: ​​

  • to eliminate the physical load on the joint;Wristwraps

    Wristwraps for the prevention and treatment of hand arthrosis

  • do not expose it to further injury hazards;
  • not to allow metabolic disorders in the cartilage;
  • to eliminate the lack of nutrition, we make up for the lack of cartilaginous tissue.

For this use such methods of treatment of arthrosis of wrist and small joints of hands:

  • reception of chondroprotectors, non-steroid preparations;
  • protection of joints from injuries by special wristbands;
  • intraarticular injections with hyaluronic acid;
  • physiotherapy, namely: mud therapy, massage, ozocerite and paraffin applications, baths with bischofite, compresses with dimexid and medical bile, laser therapy, manual therapy.
In extreme cases, the doctor can recommend surgery, but such a measure is very rarely used, mostly treated conservatively.

Traditional medicine

Traditional medicine recommends self-massage, exercise therapy, and various compresses, for example, from cabbage juice.

In addition, apply:

  • tincture of vodka on the vodka - for grinding;
  • tincture of wormwood, celandine and lilac - for grinding;
  • tincture of lemon, celery and garlic roots - for oral administration;
  • tincture of comfrey or marigolds - for oral administration;
  • some folk healers recommend the intake of gelatin in food( for example: jelly, jellied, jelly) - this helps to restore cartilage tissue.
Before treatment of arthrosis of the hands, folk remedies should be consulted with a doctor.

Such methods, especially receptions of infusions, inside can turn back for the patient negative consequences. Therefore it is not necessary to save on treatment if the diagnosis is already set, but it is better to go to the hospital.

Chances of recovery

If the disease is not neglected and has not moved to the third stage, then recovery of the patient is possible. The truth is, it will be slow.

If the violations of the cartilaginous tissue are noticeable, then you can only stop the process, remove the pain.

In serious cases, the doctor may suggest surgery.

Hazards and Risks

The disease can cause the following complications:

  • destruction and deformation of the joint;
  • biomechanical disorder and disability;
  • impossibility of movements.

In addition, a person will not be able to fulfill his duties, in extreme cases, disability is possible.

Prevention of the disease

For prevention purposes, reduce the burden on the affected area. In addition, it is necessary to improve the recovery of impaired cartilage with food.

In addition to improving the condition of the joints it is necessary: ​​

  • to reduce the weight of the patient;
  • gymnastics, the development of the joints of hands;
  • sanatorium treatment;
  • reduced load on the joint;
  • prevention of endocrine system diseases.

The more attention will be paid to the prevention of the disease, the more likely that the disease will pass. Any disease is much easier to prevent than treat.

Osteoarthritis is a very dangerous disease, which not only interferes with the performance of its professional duties, but also conducts ordinary life, and does household work. Stop the disease until it stops you.


Arthrosis of the wrist - Sustavy-Bezboli.ru

Despite the fact that arthrosis of the wrist joint is a rare enough disease, it poses a serious problem for patients, since in this case the hands that play the main role in the processself-service and labor.

With arthrosis of the wrist joint, the mobility of this bone articulation decreases by 30-50%, however, its appearance remains practically unchanged or it has a very slight deformation. The appearance of strong joint deformities provokes fractures of the bones of the wrist with displacement.

Developmental mechanism

Arthrosis of the wrist joint: radiography

For this form of pathology, the "degradation" of the joint, accompanied by the deformation of its small bones, is characteristic. In this case, the articular hyaline cartilage loses some of the necessary moisture, dries up and becomes rough. At the same time, its thinning occurs, because of which the ability to depreciation decreases. Also, in the joint, the amount of healthy joint fluid that plays the role of lubrication when moving the joints is reduced.

Causes of the disease

  1. Trauma( dislocation or fracture of the bones of the wrist) and inflammation.
  2. Age changes.
  3. Systematic joint overload.

Symptoms of

During the development of the pathological process, there is a crunch in the joint and pain that occurs only with certain movements, as well as when trying to bend the joint as much as possible "to the stop."In a state of rest with osteoarthritis of the wrist joint, pain occurs only when several hours earlier the joint was subjected to overload.

Externally diseased wrist joint is not much different from a healthy one, however, its mobility decreases almost in half. At the latest stages of the pathological process, the joint can completely lose its mobility.

Diagnosis of the disease

To determine the degree of arthrosis changes, the patient is obliged to have an X-ray examination of the affected area. Also this study will help not miss inflammation in the joint( arthritis).

In carrying out differential diagnosis( in order to distinguish arthrosis from arthritis), a clinical analysis of blood from the finger and rheumacomplex( from the vein) is prescribed. It should be emphasized that, in almost all forms of arthrosis, blood values ​​are within the normal range, whereas in arthritis, their changes are observed.

Treatment and prevention

Treatment of arthrosis of wrist joint

To treat the disease effectively, first of all, it is necessary to eliminate the damaging effect that caused the disease.

  1. In the treatment of arthrosis of the wrist joint for saturation of damaged articular cartilage with nutrients, patients are recommended course treatment with chondroprotectors.
  2. To restore the mobility of bones articulated in the radiocarpal joint, a method of mobilization( manual therapy) is conducted. As a rule, 3-4 sessions are enough in this case.
  3. In order to improve blood circulation and accelerate the metabolism in the joint, the patients are prescribed the following treatment procedures: ozocerite, therapeutic mud, paraffinotherapy, electrophoresis, laser treatment, massage and self-massage, etc.
  4. In severe cases, the patient is saturated with hyaluronic acid derivatives( intraarticular injections)which is performed after manual reposition of the joint.

For prophylaxis, care should be taken to monitor the load on the wrist joint, and also to use special protective and fixing devices.

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Treatment of arthrosis of the wrist joint in the Orthopedics clinic in Moscow. Treatment of osteoarthrosis of the wrist joint

Experts of the Orthopedists clinic have been treating arthrosis and osteoarthritis of the wrist joint for many years in Moscow. During this time, the medical center has accumulated a unique knowledge base, which doctors actively use in working with this disease. The clinic gives preference to modern conservative methods of treatment.

Relieve pain for 1-2 visits to the clinic Effective methods of treatment of sutavas Consultations of a specialist free of charge

Arthrosis of wrist joints, what is it?

Arthrosis of the hands is a disease in which the cartilage tissues of the wrist joints are affected. Diseases are more likely to affect men after the age of 40.However, the disease can develop earlier due to injuries of the hands.

Also, the disease often develops due to systematic overload of joints( hard work) and due to age-related changes.

In the photo, an x-ray with arthrosis of the wrist joint.

Arthrosis in the joints of the hands: symptoms

With arthrosis, right and left wrist joint osteoarthrosis, the following symptoms stand out:

  • A crunch in the wrist joint.
  • Drawing pains in the hands. Depending on the stage of the disease, pain syndromes can vary from mild to acute.
  • Restriction in mobility.
  • There are almost no external deformations. The symptom may appear more vividly when complicating with arthritis.

Degrees of arthrosis of the wrist joint

For arthrosis, osteoarthrosis of the right and left wrist joint, there are three stages of the disease:


Arthrosis of the wrist joint

Symptoms of arthrosis of the wrist joint

Arthrosis of the radiocarpal joint is not very common. In general, it is post-traumatic, that is, it develops as a complication after a dislocation or fracture of the bones of the wrist( usually arthrosis does not occur immediately, but several weeks or months after the injury).

For arthrosis of the wrist joint, such symptoms as crunch in the joint with motion and pain sensations that occur only in certain movements or at extreme positions of flexion-extension of the joint( i.e., when trying to bend and unbend the joint to the maximum, "up to the stop").At rest, without pain, pain occurs only if a person has reloaded a sick joint several hours earlier.

The mobility of the pelvic joint with arthrosis is always reduced by 30-50%.

But the appearance of the wrist joint affected by arthrosis remains practically unchanged, from the side it looks almost healthy or the joint is deformed very little. Strong deformations of the wrist joint with arthrosis occur only when the disease was provoked by a fracture of the bones of the wrist with their displacement.

The defeat of wrist joints with arthritis proceeds differently. Painful sensations are more often manifested at rest, at night or in the morning. When the pain moves, on the contrary, they often decrease( although the extreme attempts of flexion-extension of the joint with arthritis, as well as with arthrosis, are also almost always painful).After noon, especially towards evening, arthritic pains almost always completely subside - until late at night.

The appearance of wrist joints affected by arthritis, as a rule, varies significantly: either pronounced edema and "swelling" of the wrist joint, or a "dip zone" in the area of ​​this joint with atrophy of its muscles( especially often in rheumatoid arthritis).

It is also characteristic that in the case of arthritis, the damage to wrist joints alone is extremely rare - any arthritis often leads to the inflammation of several joints;and on the contrary, arthrosis of the wrist joint is an isolated post-traumatic pathology affecting usually one single damaged wrist joint.

Another distinctive feature: the general condition of the arthrosis of the wrist joint usually does not change, and with most arthritis there may be fever, weakness, chills, body aches, etc.

Mechanism of arthrosis development of the wrist joint

Arthrosis of the wrist joint most often happensposttraumatic and develops usually after fractures and dislocations of the bones of the wrist. But, in addition, there are also "professional" arthrosis of the wrist joint, associated with his professional overload or micro-trauma. Such overloads and micro-traumas often occur in athletes and workers in construction specialties, actively loading hands.

More arthrosis of the wrist joint often develops in people who by virtue of their profession are forced to work a lot with a jackhammer, a drill with a perforator, etc. In fact, in such cases, one more damaging factor, vibration, is added to the overloads and microtrauma.

As a result of the above-mentioned adverse effects, the joint begins, as the doctors say, to "degrade": the small bones of the wrist joint are deformed, and the articular cartilage loses some of its moisture, becomes dry and less smooth, rough. In addition to this, it becomes thinner and loses its ability to absorb the load on the joint bones. And to top it off, the joint can reduce the amount of healthy joint fluid that performs a "lubricating" function when moving the joints.

All this leads to the appearance of those unpleasant symptoms: a decrease in the mobility of the wrist joint, the appearance of a crunch and pain in motion.

Diagnostic arthrosis of wrist joint

First, it is necessary to carry out an X-ray examination of the wrist joint to determine the degree of arthrosis changes in the patient's wrist joint. And also in order not to miss a possible inflammatory process( i.e., arthritis).

And, secondly, again, in order to "not miss" arthritis, it is necessary to conduct blood tests: clinical( from the finger) and biochemical plus rheumatic tests( from the vein).Characteristically, with arthrosis, blood tests from the finger and from the vein remain within normal limits, and with arthritis, almost always there are some deviations( an increase in such indicators as ESR, C-reactive protein, seromucoid, uric acid, globulin levels, etc.)).


Osteoarthritis of joints symptoms and treatment |How to treat joint arthrosis

Arthrosis( osteoarthritis, deforming osteoarthritis) is the most common joint disease and therefore is of great importance, their frequency increases with age. Symptoms of arthrosis develop in 87% of women and in 83% of men aged 55-64 years. Depending on the absence or presence of a previous pathology of joints, arthrosis is divided into primary and secondary.

Primary arthrosis includes forms that begin without a noticeable cause( over the age of 40 years) in the joint cartilage that has not been changed so far. They usually affect many joints at the same time, i.e.are polyarticular. Secondary arthrosis develops at any age due to trauma, vascular disorders, static anomalies, arthritis, aseptic bone necrosis, congenital dysplasia and affect only one or more joints.

Treatment of joint arthrosis

How to treat joint arthrosis? Treatment of arthrosis of the wrist joint should be comprehensive, taking into account the etiological factors and pathogenetic mechanisms. The most important aspect of the treatment of arthrosis of the wrist joint is the restoration of normal relationships with surrounding structures, aimed at the removal of local muscle hypertonia, relief of pain, improvement of mobility in the affected joints.

Various methods of reflex therapy have been widely used in the treatment of arthrosis: physiotherapy, massage( classical, segmental, reflex, point, etc.), manual therapy, means of therapeutic physical training. In order to begin treatment of arthrosis of the joints, it is necessary to carry out studies of the wrist joint.

The study of the wrist joint

  • the doctor faces the patient and, seizing his wrist joint with both hands, palpates the wrist of the patient, putting the first fingers on the back of the wrist, and the 2nd and 3rd fingers on the palmar. The patient's wrist should be relaxed, lying freely on a hard surface( palm down).Palpating I finger moves upward, and the remaining palpating fingers - down and from side to side along the entire affected area, lying over the joint, distally to the protuberances of the radial and ulnar bones;
  • the doctor holds the relaxed wrist of the patient with one hand, with the palm facing down;with the other hand he palpates the wrist, placing his finger on the back side, and the second and third fingers on the palm, moving the fingers on both sides of the wrist proximally and distally to the affected area.

After examining the wrist, the doctor moves his fingers distally to palpate the palm and wrist joints. Putting the fingers on the back of the patient's hand and the rest of the fingers on his palm, the doctor, palpating his wrist, tries to detect pain sensitivity or crepitus, swelling. Palpation of the palmar surface can reveal nodular structures on one or more flexor tendons. Usually they appear at the level of the head of metacarpal bones, where an enlarged or thickened deep fascia forms a proximal annular ligament in the vagina of the flexor tendon;This portion of the thickening is called the "proximal block".

Study of the wrist joint( "joint game")

The general scheme of the "joint game" with fixation of the head bone is as follows:

  • capitate - bone-trapezoid;
  • capitate - semilunar bone;
  • the head bone is a hook-shaped bone.

The head bone is fixed( •);basic movements( -►): trapezoid bones ( a); scaphoid bone( b);the semibound bone ( in) and the crooked bone( g).

When fixing the scaphoid bone, the following "joint play" is possible:

  • scaphoid bone - bone-trapezoid;

The navicular bone is fixed( •);basic movements of bone-trapezoid( a) and trapezoid bone( b).

When fixing the radius, the following "joint play" is possible:

  • radius - scaphoid bone;

Radial bone is fixed( •);movement of the navicular ( a) and the semi-lunate ( b) bones - in the rear and palmar sides( -►).

- When fixing the ulna, the following "joint play" is possible: the elbow bone is a triangular bone.

The ulna is fixed with two fingers of the doctor( •);the movement of the trihedral bone - in the rear and palm sides( -►).

When fixing a hook-shaped bone( with two fingers of a doctor), the "joint game" looks like this.

Hook-shaped bone is fixed( •);movement of the triangular bone( -►).

When fixing a triangular bone, the following "joint play" is possible:

Triangular bone is fixed( •);the movement of the pea( -►).

The pectoral joint of the first toe is an almost constant focus of degenerative changes. Often, if this joint is affected, osteophytes and crepitations can be found at the base of the first finger. Inspection of the joint is carried out as follows:

a) the doctor grasps the patient's finger near the carpometacarpal joint, and his muscles should be relaxed to avoid muscle strain or soreness in the area of ​​attachment, and pushes the patient's finger to the wrist joint. This method causes aggravation of pain in the joint area if it is affected;

b) crepitus in the carpometacarpal joint I of the finger is marked best when the finger of one hand of the doctor palpates, while the fingers of the other hand grasp the patient's finger in the proximal phalanx and rotate it clockwise.

Palpation of the carpometacarpal region of the 1st toe: a - definition of pain;b - definition of crepitus.

Study of the wrist area - medical diagnostic testing

The general outline of the "game of joints" is shown in the figure. Wrist movements include flexion and extension, radial and ulnar abduction. The combination of these movements is called the circular movement of the wrist. These movements are associated with a different degree of mobility of the wrist and inter-articular joints. Limited flexion-extension and slight rotation are possible in the intercostal joint. In the pronation and supination of the hand and forearm, the proximal and distal radial-lobe articulation takes part.

General scheme of "joint play": a - wrist bones( bone-trapezium and trapezoid bone) are fixed with two fingers of the doctor's hand( •);b - possible movements in the carpometacarpal joint of the first finger: 1 - traction or compression;2-3 - palm and back movement;4-5 - radial-fiber movement.

Measurements of the volume of motion are performed with the wrist and wrist straightened with respect to the forearm( 0 °).The most important functional impairment of wrist mobility is loss or restriction of extension.

Arthrosis of the wrist joint - treatment with the use of mobilization techniques


When fixing the bones of the wrist, the radial bone is moved towards the ulnar with light traction( Fig.).


When fixing the radial and ulnar bones( distal part), the wrist movement is directed towards the ulna.


When fixing the bones of the wrist, the radial bone movement towards the palm is performed with a slight traction along the forearm axis.

Mobilization of the bones of the wrist( a);scheme of movements( b): T - traction,( •) - fixation by the doctor's hands.

Mobilization is carried out towards the ulna( a) with light traction( T →);scheme of motion( b).

Mobilization of the radial bone for arthrosis side of the palm( a);scheme of motion( b).

Mobilization of bones in arthritis of the wrist carbide during fixation of the radial bone( a);scheme of motion( b).

4. When fixing the radius( distal section), the movement of the bones of the wrist is carried out in the direction of the palm.

5. With fixation of the ulnar and radial bones, the traction movement is directed distally.

Traction movement in the distal direction( a);scheme of motion( b).

6. When fixing the ulnar( a) or ray( b) bones, the movement is carried out in the ventral direction.

Fixation of the ulna or radius( •) - basic movement( →).

Mobilization of the distal row of the wrist bones for the treatment of arthritis of the wrist joints

With the restriction of dorsal flexion, it is necessary after a study to mobilize the distal row of the wrist bones relative to the proximal thrust in the palmar direction. The method of treatment of wrist arthrosis is as follows:

1. A physician with one hand grasps the patient's forearm with a brushed hand, the other - his brush at the level of the proximal row of metacarpal bones. The hand that fixes the patient's forearm is on the thigh of the doctor, with the other hand a push is made from above in the palmar direction.

Palmar displacement of the distal row of the bones of the wrist relative to the proximal one. Mobilization of the articular joint.

2. The patient's pierced brush is bent in the palmar direction, with the head bone protruding. Both I fingers are placed on the area of ​​this bone, and the rest of the fingers cover the patient's hand and perform a dorsal flexion of the wrist with the straightened arm, while the fingers of the doctor on the head bone play the role of the fulcrum of the lever. From this position, traction in the distal direction is carried out.

Manipulation of the head bone with respect to the semilunar: a - contact search;b - prestressing and traction( Levit K. et al., 1993).

With limited palmar flexion, research and mobilization is performed by pushing the proximal row of bones relative to the forearm dorsally posteriorly. For this, the doctor grasps the forearm of the patient in the wrist area with one hand, the brush is supine;The other hand is located at the level of the distal row of the bones of the wrist. The hand that fixes the forearm is on the thigh of the doctor, with the other hand the mobilizing push down is performed from the prestress position.

Dorsal wrist displacement relative to the radius.

When the ulnar movement is limited, the doctor first applies pressure in the dorsal direction to the ulnar side of the wrist relative to the ulna;with the tips of both I fingers on both sides of the doctor presses on the pea, and the radial edge of the bent fingers II - on the distal radius. The so-called "cutting" movement is being countered.

Another technique radially shifts the wrist relative to the forearm. For this, the doctor grasps the distal end of the penetrated forearm with one hand, with the other hand - the wrist from the ulnar side, after which a push is made in the radial direction( downwards).At the end of the jogging movement, the doctor flexes the wrist relative to the forearm in the ulnar direction, with the doctor's 1st fingers at the level of the elusive process of the ulna as the point of fixation of the lever.

Mobilization of the distal radius relative to the ulnar for the treatment of arthrosis of the wrist

The distal radius of the lung is also part of the wrist. The technique of mobilizing the distal radius of the radial arm relative to the ulnar bone consists in the following: with the supine forearm, the physician has bent II fingers of the dorsal under the distal ulnar bone, and the pads of the first fingers are on the palmar side to the region of the styloid process of the radius bone. Then the radial bone is mobilized relative to the ulnar in the dorsal direction( downwards).Then, with the penetrated forearm II fingers, the doctor places under the ulna bone and mobilizes the radius with the tips of the first fingers toward the palm( down).

Isolated dorsal displacement of the trihedral bone relative to the ulnar can be carried out by 2 methods: a) with the four fingers of his hands the doctor fixes the distal row of the wrist bones, and I places in the region of the trihedral bone, which is followed by a push;b) the mobilization of the trapezoid is performed in the i.p.patient sitting and( or) lying on his back, his hand is supine. The procedure is performed in the dorsoventral direction with a light traction along the forearm axis.

Isolated dorsal displacement of the trihedral bone relative to the ulnar bone.

Symptoms of arthrosis of joints

Symptoms of arthrosis of individual joints consist of pains, feelings of stiffness, rapid fatigue, stiffness, deformities, crunches, etc. Pains are usually blunt, they are fickle, amplified in cold and wet weather, after prolonged exercise( for example, in the evening)and with the initial movements after the state of rest( the so-called "starting pain").In the elderly, instead of the symptoms of pain, only aches and feelings of heaviness in the bones and joints are noted. This sensation is very close to a feeling of stiffness in the symptoms of rheumatoid arthritis, but it is characterized by short-term and low intensity. The true limitation of mobility with arthrosis is rare, more often it is a question of stiffness and quick fatigue of the joints.

Joint arthrosis symptoms are caused by violation of congruence of joint surfaces, changes( thickening, calcification, sclerosis) in the joint capsule, tendons and other soft tissues and spasm of muscles. Deformities of the joints are best seen in the distal interphalangeal joints of the hands and are caused by bone growths, rather than swelling of soft tissues, as with arthritis. The cause of crunching joints are uneven joint surfaces, calcareous deposits and sclerosis of soft tissues. In contrast to the small, creping crunch with synovitis for arthrosis is characterized by a coarse crunch.

Clinical radiologic course of joint arthrosis

The first stage of arthrosis is characterized by minor changes, there is a barely noticeable narrowing of the joint gap, especially in places of the greatest functional load;there are minor bone growths, mainly along the edges of the joint cavity.

The second stage of joint arthrosis is characterized by more pronounced changes. Symptoms of joint arthrosis at this stage: narrowing of the joint gap becomes easily visible;In parallel with changes in the articular fissure, surgery of the articular surfaces is determined. The surfaces of the epiphyses of bones are deformed, flattened and become uneven;Bony growths reach considerable dimensions and lead to deformation of the articular ends of bones. The character of deformation of the articular ends of bones is affected by the static-functional load on a certain limb segment, as a result of which the configuration changes not only the head but also the joint cavities.

Deformation of articular surfaces with arthrosis is accompanied by a violation of congruence, up to the development of subluxations and dislocations in the joint. Violation of the relationship between the articular sections of the limbs entails redistribution of the lines of static-functional loads, which, in turn, leads to the development of deformation by the type of arcuate bending of bones, etc.

In the third stage of joint development arthrosis, changes occur in deeper parts of the bones accompanied by sclerosis of the subchondral bone tissue. In addition, different foci of cystic perestroika are detected, which, when located in the marginal subchondral areas of the bones, form usuras resembling tuberculous lesions.

Causes of joint arthrosis

Symptoms of joint arthrosis are no longer considered a simple consequence of aging and degeneration of articular cartilage. Rather, the cause of arthrosis are active processes, not only destructive, but also reparative. It is even possible that this is not a single disease, but a whole group of separate diseases with similar symptoms. At present, the polyethological approach to the origin of the disease has been adopted and it is customary to speak not of specific causes, but of the risk factors for the development of arthrosis. These factors can be conditionally divided into three main groups:

Development of arthrosis - genetic factors

  • hereditary disorders of collagen 2( syndrome of Stickler);
  • mutations of the gene of collagen 2;
  • is another hereditary pathology of bones and joints;
  • is the ethnicity of the individual.

Non-genetic factors of articular arthrosis development


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