Arthropathy refers to degenerative changes in the joints, starting with the loss of cartilage tissue that over time results in limited or complete loss of mobility.The disease is more likely to occur in older people, but people under 40 can also develop it.The diagnosis has a high prevalence - approximately 20% of the world's population, with up to 80% of patients over the age of 70 years.
How does the disease develop?
To understand what joint disease is (another name is osteoarthritis), you need to understand how joints work.A joint of two or more bones is surrounded by a joint capsule and remains mobile due to a cavity filled with synovial fluid.The elastic mass acts as a lubricant, preventing friction and premature wear of the joint surfaces.The cartilage tissue in turn acts as a shock absorber.In a single joint, its function is supplemented by the meniscus or intervertebral disc.
The primary cause of degenerative changes in joints is the difference between external influences and the joint's ability to withstand these influences.The role of motivating factors can be exerted in the following ways:
- Age, injury, overweight;
- lack of nutrients;
- excessive physical activity;
- inflammatory process;
- genetic diseases;
- Autoimmune reaction, etc.
Osteoarthritis in older adults is often the result of natural aging and wear and tear on the bone structure.So, 50 years later, one in three people will be diagnosed with it, and 70 years later, one in two people will be diagnosed with it.In addition, accelerated destruction of certain joints is typical for representatives of many professions: mechanics, loaders, weavers, ballet dancers, etc.
Under the influence of adverse factors, cartilage tissue is damaged and thinned.As a result, the bones shift and begin to rub against each other, causing significant discomfort.This process is accompanied by inflammation and swelling.The joint surface becomes deformed and the lost cartilage tissue is replaced by bone spurs and growths, which impedes movement and leads to disability.In this case, only strong painkillers can provide long-term pain relief.
Types of Arthropathy
Destructive processes inside the joint are called primary destructive processes if they occur for unknown reasons and secondary destructive processes if they occur in the context of certain diseases and conditions.Acute osteoarthritis is associated with infection and stress factors and is characterized by a rapid course.The chronic form develops gradually and may limit physical activity if treatment is refused.Additionally, the type of disease depends on where it occurs.
Hip joint (coxarthrosis)
It is accompanied by pain in the groin area that spreads to the surface of the thigh and occasionally affects the calf area.In the initial stages, there is difficulty walking, climbing stairs and walking for long periods of time - a limp.Subsequently, it becomes difficult for a person to do basic things related to painful joint loading: putting on shoes, riding a bicycle, tying shoelaces, walking without crutches.Muscles atrophy, legs become shorter, and pain occurs in the waist and knees.Without treatment, the potential for disability is high.
Arthritis (arthrosis) of the knee
Usually diagnosed in women, the condition is severe and associated with excess weight and varicose veins.Knee discomfort can be exacerbated by bad weather, climbing stairs, or performing physical activity.As the disease progresses, flexion and extension movements are impaired, and signs of limb deformity, inflammation, and swelling appear.Knee osteoarthritis is often confused with meniscal injury, which is characterized by more rapid progression.
spondyloarthropathy
A common form of degenerative joint process that can be triggered by high loads or mineral deficiencies as well as by many diseases affecting the vertebrae.Diagnosis is difficult because symptoms are masked by clinical manifestations of other pathologies.Spinal osteoarthritis can occur in different locations: thoracic spine, lumbar spine, cervical spine, and sacrococcygeal spine.Therefore, symptoms and names can vary.
ankle joint
This is usually caused by a domestic or occupational injury, excess weight, or ligament problems.It starts with pain and swelling in the ankle area, which worsens after physical exertion and prolonged walking.As the degenerative process progresses, tightness and limited mobility may occur.Diagnosis is complicated by edema, which is associated with other conditions: diabetes, kidney damage, heart disease.
Shoulder joint (arthrosis)
Usually caused by a dislocation, a strong blow, or a broken bone.The pain radiates to the lower limbs and is worrisome mainly at night.As cartilage deteriorates, abduction, rotation, and other movements of the arm can become difficult.The disease must be distinguished from heart problems and spinal disorders that have similar presentations.
Arthropathy of foot joints
Affects the large and small joints of the foot.Many times, destructive processes develop in the thumb area, which is why it is mistaken for gout.The trigger is usually not a foot injury but flat feet combined with incorrect shoe selection.In tight spaces, joint areas can become injured, thickened, inflamed, and lose mobility.
Arthropathy of joints and fingers
Generally speaking, injuries to the facet joints are multifactorial and occur on both hands.This process is often associated with changes in hormonal levels and is therefore often observed in women going through menopause.In the acute stage, the joints become swollen, red, and may develop nodules.Gradually, the pain lessens, but the finger deformity increases and mobility is lost.
Injuries and pinched nerves in the hand area can lead to degenerative processes in the wrist joint.A prerequisite is usually tunnel syndrome, which causes circulation to be affected.Radix arthropathy caused by loading at the base of the thumb is also common.The pain from this type of arthrosis is moderate, but mobility may be impaired, and a crunching sound may occur with exertion.
Temporomandibular joint arthropathy
Often it occurs in the context of dental problems, autoimmune and endocrine pathologies.The precipitating factor is usually chronic stress, which causes muscle tension and spasmodic clenching of the teeth, compromising nutrition of the joint capsule.The disease is associated with jaw discomfort and can cause dizziness, hearing, sleep, and facial symmetry impairment.
Among the large lesions, the most common are arthropathy of the knee, hip, and shoulder.Among the facet joints, those of the hands and spine are most commonly affected.Degenerative processes are much less frequently observed in the patella, clavicle, talonavicular and elbow joint regions.They are often caused by injury or specific stress, especially professional sports or jobs with monotonous movements.
Other types of arthropathy
Another classification of the disease is related to the nature of the destructive process and what triggers it.If degenerative changes are associated with the aftermath of an injury, what they're talking about is post-traumatic arthropathy.Rheumatoid and psoriasis types are distinguished when autoimmune diseases are factors that trigger cartilage tissue depletion.
If the disease affects one joint, they say it's partial arthropathy.If multiple joints are affected, the term "polyarthrosis" (or systemic osteoarthritis) is used.The progressive form of the disease refers to the rapid destruction of cartilage that occurs over just a few years.If this process occurs along with bone growth and affects ligaments and nearby tissues, it is diagnosed as osteoarthritis deformans.
Stages of Arthropathy
The degenerative process of the joints progresses gradually, leading to complete thinning and destruction of the cartilage over time.Initial changes are only evident at the cellular level, but as we move into subsequent degrees of arthropathy, clinical symptoms become increasingly evident.Their properties, as well as X-ray indicators, form the basis of disease classification.
Arthropathy stage 1
Accompanied by minor changes in bone and cartilage tissue.They are still less visible on ultrasound and X-rays, but are already visible on CT.Due to the greater load, there will be short-term pain, swelling, and some restriction of movement in the affected area.There is some narrowing of the joint space and sharpening of the bony edges.At this stage, the disease responds well to medical treatment.
Arthropathy stage 2
A destructive process is taking place.The photos showed that the joint space was significantly narrowed and the cartilage damage reached 50%.The pain remains moderate but becomes permanent.Each type of arthropathy presents with characteristic symptoms such as lameness, reduced range of motion, creaking, and fluid accumulation in the synovial cavity.Treating joint arthritis during this stage of the disease can slow down the damaging changes.
Arthropathy stage 3
The disease causes complete destruction of cartilage.Due to bone growth, the joint surface expands significantly and the gap almost disappears.Cavitation, cyst formation, and deformities may occur.Bones begin to break down and muscle fibers near joints become thinner.Flexion and rotational movements are restricted.The pain is severe.Without treatment, the joint structures begin to fuse and ossify, accompanied by a complete loss of mobility.The patient loses the ability to care for himself and requires ongoing care.
Early-stage joint disease responds well to medication, which can keep you as mobile as possible and halt the degenerative process.In advanced cases, relief can only be achieved with physical therapy, chondroprotectants, anti-inflammatory drugs and painkillers.In some cases, the only treatment option is surgery.