Arthropathy is a chronic joint disease associated with degenerative dystrophic changes in joint structures, primarily damaging cartilage tissue.The disease progresses slowly and is asymptomatic in the early stages.The cartilage and bone tissue of the joint, the joint capsule and the bursa around the joint are gradually destroyed, and then the surrounding muscles, ligaments and subcutaneous tissue also participate in the pathological process.
According to the World Health Organization, one in 10 people has the disease, and people over 50 are at significantly increased risk.The knee and hip joints are most commonly affected.Arthropathy is caused by the inability of the joints to bear the load placed on them.In response to the effects of trauma, inflammation occurs, leading to pathological processes in the joint tissue.
Patients with arthropathy require complex treatment, otherwise the disease can lead to reduced work ability and quality of life, limitations in sports and occupational activities, and ultimately disability.
Classification of joint diseases
According to the cause, this disease is divided into:
- Primary Arthropathy - Occurs because the cells of the joint cartilage tissue are destroyed faster than new cells can be formed.Most often, this is related to age-related changes rather than the result of any specific pathological process in the body;
- Secondary arthropathy - occurs in the context of a specific disease or as a result of joint damage.
Based on location, arthropathy is divided into localized (affecting fewer than 3 joints) and generalized (affecting more than 3 joints).The latter is also called polyarthrosis.
Causes of Arthropathy
The disease ranks first in the world as a cause of pain and mobility impairment.It is often diagnosed in younger patients, although age-related changes are thought to be the primary cause.Women are more likely than men to develop joint disease, although this difference becomes almost imperceptible as they approach age 70.
Arthritis of the hip, knee, ankle, and shoulder joints has the greatest negative impact on a patient's quality of life and ability to work.Less common are the elbow joints, temporomandibular joints, and joints in the hands, feet, and spine.
Predisposing factors include:
- old age;
- genetic predisposition;
- Strenuous physical activity associated with sports or occupational activities, or on the contrary, a sedentary lifestyle, disrupts the normal nutrition of tissues, especially large joints;
- Joint damage (fractures, cracks, dislocations);
- wearing inappropriate shoes;
- Systemic diseases (metabolic disorders, endocrine diseases, neuropathy, gastrointestinal diseases, hemorrhagic diseases);
- malnutrition;
- overweight.
Women are more susceptible to this disorder because they are more susceptible to hormonal imbalances.
Symptoms and extent of joint disease
The main clinical symptom of arthrosis is pain.In the early stages, it may be absent, mild, or intermittent.As the disease progresses, the pain becomes more pronounced and may be painful with movement and, in advanced stages, bothersome even at rest.
Secondary manifestations of the disease depend on the localization of the process.Most commonly, there is limited movement in the affected area (especially during sleep or after a long rest), deformation, swelling and redness of the joint area, creaking and crepitus when moving, sleep disturbances due to pain and the inability to find a comfortable body position, changes in gait and coordination, muscle spasms.
It is important to note that pathological processes in one joint may be transferred to adjacent joints due to improper load distribution or movement restrictions.
According to the severity of the disease, it can be divided into:
- Grade 1 arthropathy - no symptoms or obvious signs, the patient can still work, and diagnosis is difficult;
- 2nd degree arthropathy - accompanied by severe symptoms, reduced quality of life of the patient, and obvious disease at diagnosis;
- Tertiary arthropathy - characterized by increased clinical symptoms, externally visible joint deformations, and diagnostic methods indicating severe intra-articular disease;
- Fourth degree arthropathy - causing partial or complete disability; disease of all structures of the joints, surrounding muscles and ligaments.
Diagnosis of joint disease
The orthopedic traumatologist makes a preliminary diagnosis based on data on the patient's lifestyle and work activities, the nature and duration of the complaints, the dynamics of symptoms, the presence of arthropathy in relatives, and conducts examinations and orders tests or consults relevant specialists (endocrinologists, hematologists, nutritionists, gastroenterologists).
Laboratory tests include general blood tests, including white blood cell count, hemoglobin levels, and ESR.These indicators indicate inflammation in the body, which must be related to joint disease.Biochemical parameters measured levels of rheumatoid factor and C-reactive protein.If certain pathology is suspected, other laboratory blood parameters are checked.Synovial fluid analysis also has diagnostic value, revealing pathological cells and inclusions, allowing you to confirm the diagnosis or differentiate between another disease.
Instrumental and visual methods of diagnosing arthropathy not only help detect pathology but also help determine the stage of the disease and the extent of involvement of surrounding tissues.The most effective of these are:
- Radiography - mainly two projections used to detect narrowing of the joint space and the formation of bone growth (osteophytes) in areas of damaged cartilage;
- Magnetic resonance and computed tomography scans - performed in the early stages, before X-rays reveal subtle changes;
- Ultrasound - used in addition to these methods, helps identify excess fluid that accumulates in the joint cavity (such as Baker's cyst in knee arthropathy), assesses the condition of surrounding tissue, and measures the thickness of articular cartilage;
- Scintigraphy – involves the intravenous injection of a radioactive drug that accumulates in tissues during inflammation, and these areas of accumulation are shown on the image, so joints can be identified at an early stage and differential diagnosis made;
- Arthroscopy - the introduction of a tiny camera into the joint space through a small incision allows the joint to be examined from the inside, therefore, you can collect detailed data on the ongoing pathological processes and injuries, as well as take biopsies from the affected areas;
- Histological examination of the synovium - reveals changes in the proportion of healthy cells and the presence of pathological inclusions in the joint, allowing for differential diagnosis.
Differential diagnosis allows you to distinguish arthritis from other conditions with similar clinical manifestations, including:
- Various types of arthritis (ankylosing arthritis, reactive arthritis, rheumatoid arthritis, psoriatic arthritis, infectious arthritis);
- Gout and pseudogout;
- Muscle and ligament disorders (fibromyalgia, polymyalgia rheumatica);
- Arthropathy (diabetes, paraneoplastic disease);
- Congenital disease (hypoplasia of the femoral head).
Treatment of Arthropathy
There is no treatment for arthropathy, despite the disease's widespread prevalence and well-studied methods.Treatment is designed to eliminate pain, relieve inflammation, restore joint function, and prevent complications.
The choice of treatment depends on the cause, location and extent of the joint disease:
- Medication, including tablets for joint disease (analgesics and NSAIDs, corticosteroids, chondroprotectants), injections of these drugs into or around joints, and additional ointments and gels;
- Physical therapy during remission (medical electrophoresis, electroplating, acupuncture, electrical stimulation, shock wave therapy, massage, magnetic and laser therapy, cryotherapy);
- Joint therapy exercises are performed individually and sessions are conducted under expert supervision;
- In advanced cases, surgery is performed (partial or complete joint replacement, suturing or removal of torn meniscus, removal of bony growths and Baker's cysts).
Prevent joint disease
It is recommended to control joint load, maintain a healthy lifestyle, perform therapeutic exercises, monitor body weight and adhere to proper nutrition.
An orthopedic traumatologist will help patients with arthrosis choose knee braces, orthotics, or bandages to immobilize the affected joints, reduce load on the joints, and prevent injury.
When joint discomfort occurs, preventive examinations and prompt consultation with a doctor can detect problems early and avoid serious complications and disability.