Joint diseases are one of the most common manifestations of disorders of the musculoskeletal system. They develop in the presence of inflammatory, degenerative-dystrophic and infectious processes in the body, as well as as a result of trauma and congenital anomalies.
Doctors distinguish dozens of different joint diseases that have quite similar symptoms (pain, crunching, restriction of movement). This complicates the diagnosis and interferes with prompt treatment. Therefore, in this article, experts will tell you about the manifestations and features of development of the most common joint pathologies.
Characteristics of the joints and the causes of their diseases.
A joint is any connection of two or more bones. There are 38 pairs of joints in the human body (a total of 76 joints). They provide mobility and flexibility to our body. Movement is a vital function, and if restricted by disease, the quality and length of life are reduced.
Each joint has articular surfaces: these are the surfaces of the bones that enter it, covered with a special hyaline cartilage. It is dense, elastic, and is necessary to protect bones from abrasion when moving. It also ensures their perfect match with each other. It is the wear and tear of cartilage that becomes a common cause of pain, crunching, stiffness, and other signs of joint disease.
The joints are characterized by a complex structure. Articular surfaces, capsule, fissure, synovium, muscles and periarticular ligaments: all these structures provide motor and support functions of the joint. Its damage can provoke the development of the disease.
Causes of diseases
Many people mistakenly believe that only the elderly suffer from joint diseases, due to age-related changes and weakness of the body. But this is not the case!
Joint diseases can develop as a result of:
- injury
- overweight;
- physical activity;
- wrong posture;
- flatfoot;
- hereditary predisposition;
- foods with insufficient micronutrient content;
- diseases of the internal organs;
- metabolic disorders;
- transferred operations;
- infections
People of absolutely any age and even those in relatively good health (for example, men and women of working age, adolescents, children, athletes, etc. ) can cope with the action of these factors.
Therefore, this group of diseases is becoming younger: in terms of frequency of occurrence and disability, it is second only to cardiovascular and endocrinological diseases, and its treatment is associated with high financial costs.
The mechanism of development and types of diseases.
In the pathogenesis of joint damage, doctors distinguish 4 possible paths:
First: the presence of inflammation in the body.
This type of injury is characterized by a sudden onset, with a rapid increase in symptoms of inflammation: swelling, pain, redness, fever. It occurs in infections, allergies, autoimmune processes in children and adults.
Juvenile arthritis
It is characterized by an autoimmune process (that is, the body destroys itself), the cause of which is unknown. Transmitted infections, even mild (eg, vaccines), are often provocative.
The disease affects a large joint (knee, elbow) in children and adolescents, negatively affects their growth and development. Joint pain is accompanied by severe swelling, redness of the skin, and fever.
Rheumatoid arthritis
Also caused by an autoimmune process without a clear cause. Most often women are sick, the average age is 45-50 years. Up to 70% of the sick are disabled.
It affects a small joint (or several), for example, wrists, fingers. This affects the ability of patients to work and even take care of themselves. They complain of severe pain, swelling, changes in the shape of the joints, and morning stiffness in the joints.
Psoriasic arthritis
In almost half of patients diagnosed with psoriasis, the inflammation process develops in the small joints of the hands, feet, and spine. The cause of arthritis is unknown, as is the cause of the underlying disease.
Psoriatic arthritis can affect the interdigital and large joints (elbow, knee), one or more joints, symmetrically or not.
The main manifestation is the presence of pain that spreads to the ligaments and tendons, swelling and bluish skin of the fingers, limitation of mobility.
Gout Arthritis
It develops against the background of gout, as a result of the deposition of uric acid salts in the joints. Men suffer more often than women, between 40 and 50 years and more than 60 years, respectively.
A characteristic feature is the defeat of a joint, which begins suddenly, lasts for several weeks, is accompanied by severe pain and swelling, with the formation of uric acid nodules (tofuses).
Spondyloarthritis with ankylosing spondylitis
Chronic injury involving the spine, paravertebral muscles, and the sacroiliac joint of the pelvis.
Men are more likely to have the disease than women, and it develops between the ages of 20 and 30. Its main symptom is pain in the lumbar area, in the sacrum, in the hip joints; stiffness of movement after a period of rest (especially in the morning, after sleeping).
Even with symptom relief and relative well-being, without eliminating the root cause, inflammation continues to develop and will eventually lead to a new exacerbation. Therefore, joint pathology often becomes chronic and leads to disability.
Second: the presence of a degenerative-dystrophic process
With this type of injury, the joint is destroyed by physical factors. Injuries and microtraumas, constant physical exertion exceeding the norm, harmful effects of the environment (hypothermia, vibration) - all these pathological factors cause the destruction of cartilage and narrowing of the joint space.
Deforming osteoarthritis
It develops as a result of damage and destruction of the articular cartilage. Their joint surfaces become rough and sensitive to friction. Over time, the destruction process reaches the bones, capsule, synovium, ligaments, and muscles. Chronic inflammation and changes in the shape of the joint appear.
Osteoarthritis is the most common joint pathology. It reduces the quality of life of patients, causes disability and is difficult to treat. In youth, men are more likely to get sick, in old age - women.
Clinically, osteoarthritis is manifested by severe pain and limited mobility, which increase with physical exertion. In the later stages, not even rest and calm bring relief.
Osteochondrosis
It affects the spine and is caused by degenerative processes in the intervertebral discs. Under the influence of negative factors, the nutrition of the discs is disrupted, which leads to the loss of their shape (up to the formation of bulges and hernias), aging and destruction.
As a result, the spine loses its mobility, pain, numbness, stiffness of movement, muscle weakness, difficulty urinating and emptying the intestines, headache, dizziness appear. Symptoms depend on the part of the spine where osteochondrosis developed and can be very different.
Deforming spondylarthrosis
This condition is also called "facet syndrome. "In this case, the process of destruction affects the structures of the intervertebral joints (capsule, ligaments, facets).
Most of the time it occurs in the most "overloaded" part of the spine: the lower back. It manifests as pain that radiates to the leg and intensifies with prolonged walking or standing in one place.
Osteochondropathy
Caused by aseptic (non-infectious) bone necrosis, for example due to poor blood supply. As a result, the bones that enter the joint are prone to frequent fractures. In advanced cases, patients can be seriously injured even while sleeping.
In the early stages, the disease does not manifest itself in any way. Many of the patients are athletes and people who lead a "healthy" lifestyle. The former are subject to excessive stress, the latter deliberately limit their diet and deprive the body of necessary substances.
To destroy the dense and elastic cartilage, the pathogenic factor must act on the joint for years, which is why degenerative-dystrophic changes are more common in old age. Or he must act with super power, as in sports.
Many professional athletes are disabled in their youth.
Third: congenital joint pathologies.
This type of injury causes abnormalities in the structure and development of the joints as a consequence of infections and injuries of the mother, concomitant pathology, late toxicosis and genetic diseases.
Common manifestations of congenital anomalies are birth trauma, for example, hip dislocation or clavicle fracture.
Congenital dysplasia of the hip joints.
It develops as a result of a violation of the formation of all joint structures in the prenatal and postnatal period. Predisposing factors are heredity and tight diapers. Girls are more susceptible to this pathology than boys: the incidence rate is 80% and 20%, respectively.
With dysplasia, the shape of the joint changes and its ligaments are too elastic. This causes displacement of the femur and prevents mobility of the hip joint, which can lead to disability.
Congenital clubfoot
Deformity in which, due to the defeat of the ankle joint, the foot deviates inward relative to the lower leg.
Clubfoot usually affects children and is bilateral in half of the cases. If the defect is not removed in time, the child will not be able to walk normally and will remain disabled.
Marfan syndrome
Genetic pathology in which the patient has elongated bones in the arms and legs, as well as hypermobility (excessive mobility) of the joints.
In the early stages, many congenital joint pathologies can be completely eliminated or development can be slowed down using conservative methods. Late diagnosis and treatment can lead to impaired movement and support functions, up to and including disability.
Fourth: diseases of the muscles and ligaments of the joint.
Pathologies in this group often develop as a result of increased physical exertion and hypothermia.
Tendinitis
Inflammation and destruction of the tendon. It is accompanied by its tension and painful sensations, especially in the weather.
Myositis
Development of inflammation in the periarticular muscles. It is accompanied by pain when palpating the affected area, which increases with movement.
Bursitis
The inflammatory process is located in the joint capsule. It often affects professional athletes (wrestlers, runners, weightlifters).
Synovitis
Damage to the synovium with accumulation of fluid in the joint cavity. It is accompanied by pain, swelling, stiffness of movements.
The relationship between disease and type of joint.
There is a certain pattern in which the joint is affected by what pathology. Some of them even have their own specific names.
For instance,knee jointIt can be affected at any age, regardless of the sex and occupation of the patient. But the defeat of the meniscus and cruciate ligaments is more common in athletes. Gonarthrosis: in older people. Arthritis of infectious origin - in children.
Pain inshoulder jointcan be caused by shoulder scapular periarthritis, cervical osteochondrosis, osteoarthritis.
Forelbow jointtypical damage to periarticular tissues - epicondylitis or "tennis elbow", "golfer's elbow".
The hip joint is affected more often in older people. As a result of osteoporosis and coxarthrosis, they are at risk of femoral neck fracture.
Pain insmall jointsHands and feet are seen in gouty, psoriatic, rheumatoid arthritis.
But despite the specific manifestations, the diagnosis of joint pathology often causes difficulties, which is fraught with a late start of treatment and the risk of complications.
Symptoms and diagnosis
Among the complaints that bother patients with joint pathology are:
- Pain;
- Swelling and swelling;
- Change of form;
- Stiffness of movement;
- Inability to perform a normal range of motion.
Doctors call them joint syndrome. Doctors call them joint syndrome. Skin redness, rashes, and dense nodules are also possible. Of the general symptoms, patients often complain of an increase in temperature in the area of injury or throughout the body, increased fatigue.
As you read the previous section, you may have noticed that all of these symptoms are found in almost any joint pathology. Therefore, it is impossible to make a clear diagnosis based only on your complaints; you need an exam and a consultation with a doctor.
During the examination of the patient, the doctor not only pays attention to his complaints. To make an accurate diagnosis, it is important to know the moment of its appearance, which joint is affected, one or more of them, if this injury is symmetrical and other factors.
Let's take a closer look at each symptom:
Pain:
It occurs in almost all pathologies. Doctors distinguish several types:
- Inflammatory- increases towards the morning, after a period of rest. Typical for rheumatoid, juvenile, gouty, spondyloarthritis.
- Mechanical- appears during physical exertion or a change in body position, often in the late afternoon, disappears after rest. Typical of osteoarthritis, osteoarthritis, osteochondrosis, pathology of periarticular tissues.
- "Start"- occurs in the first 15-20 minutes of physical activity after a rest period. Typical of osteoarthritis.
- "Blocking"- caused by pinching in the joint space of a cartilaginous fragment, as a result of which the joint "fits". It can be accompanied by a crunch. It occurs in osteoarthritis.
- Constant- persists, regardless of load and time of day, may increase at night. Typical of osteochondropathy, osteomyelitis, tumors and tuberculosis of the bones.
Number of joints affected:
- One (monoarthritis): with gouty, juvenile psoriatic arthritis.
- Two-four (oligoarthritis) - with rheumatoid arthritis, spondyloarthritis.
- More than four (polyarthritis): with rheumatoid arthritis, gouty.
Symmetry of the lesion:
- Symmetric: for rheumatoid arthritis.
- Asymmetric: for spondyloarthritis, gout, osteoarthritis.
- "Migratory": with gout.
Morning stiffness in the joints:
The patient feels it as the impossibility and tension of movement. It occurs in the morning and is associated with the accumulation of fluid in the joint cavity during the night. Typical of rheumatoid arthritis, spondyloarthritis.
Also, the doctor pays attention to general complaints:
- Increase in body temperature;
- Redness of the skin, presence of a rash on it;
- The defeat of the internal organs.
To make an accurate diagnosis, laboratory studies (blood tests, joint fluid) and instrumental studies (X-rays, CT scan, MRI, ultrasound) are required.
conclusion
Joint pain and dysfunction can be due to a variety of reasons. There are diseases that cannot be treated, but many of them, with adequate and timely treatment, allow the person to live a full life. Therefore, if you have at least one of the listed symptoms, contact your doctor: do not diagnose yourself, do not prescribe treatment, and even more so, do not tolerate pain.
We use a holistic approach to the treatment of joint pain, thanks to which many of our patients have regained the joy of movement.