Diseases of the joints are one of the most common manifestations of disorders of the musculoskeletal system. They develop in the presence of inflammatory, degenerative-dystrophic, 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 fairly similar symptoms (pain, crunching, restriction of movement). This complicates diagnosis and interferes with timely treatment. Therefore, in this article, experts will tell you about the manifestations and developmental features of the most common articular pathologies.
Features 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 the disease restricts it, then the quality and duration 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 needed to protect bones from abrasion when moving. It also ensures their perfect match to each other. It is the wear of the cartilage that becomes a common cause of pain, crunching, stiffness and other signs of the disease in the joints.
The joints are characterized by a complex structure. Joint surfaces, capsule, fissure, synovium, periarticular muscles and ligaments - all these structures provide motor and support functions of the joint. Their 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:
- injuries;
- excess weight;
- physical activity;
- improper posture;
- flat feet;
- hereditary predisposition;
- food with insufficient micronutrient content;
- diseases of internal organs;
- metabolic disorders;
- transferred operations;
- infections.
People of absolutely any age and even those with relatively good health (for example, men and women of working age, adolescents, children, athletes, etc. ) can face the action of these factors.
Therefore, this group of diseases is getting younger - in terms of the frequency of occurrence and disability, it is second only to cardiovascular and endocrinological diseases, and their 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 lesion is characterized by a sudden onset, with a rapid increase in symptoms of inflammation: swelling, pain, redness, fever. Occurs in infections, allergies, autoimmune processes in children and adults.
Juvenile arthritis
It is characterized by an autoimmune process (i. e. the body destroys itself), the cause of which is unknown. Transmitted infections, even in a mild form (for example, vaccinations), are often provocateurs.
The disease affects a large joint (knee, elbow) in children and adolescents, negatively affects their growth and development. Joint pains are accompanied by severe swelling, redness of the skin, and fever.
Rheumatoid arthritis
Also caused by an autoimmune process with no clear cause. More often women are ill, the average age is 45-50 years. Up to 70% of the sick become disabled.
Affects a small joint (or several), for example, wrists, fingers. This affects the ability of patients to work and even self-care. They complain of severe pain, swelling, changes in the shape of the joints and morning stiffness in them.
Psoriatic arthritis
In almost half of the patients diagnosed with psoriasis, the process of inflammation develops in the small joints of the hands, feet, and spine. The cause of arthritis, like the cause of the underlying disease, is unknown.
Psoriatic arthritis can affect the interdigital and large (elbow, knee), one or more joints, symmetrically or not.
The main manifestation is the presence of pain that extends to the ligaments and tendons, swelling and blue discoloration of the skin of the fingers, limitation of mobility.
Gouty 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, age - 40-50 years and over 60 years, respectively.
A characteristic feature is the defeat of one joint, which begins suddenly, lasts several weeks, is accompanied by severe pain and swelling, with the formation of uric acid nodules (tofuses).
Spondyloarthritis with ankylosing spondylitis
A chronic lesion in which the spine, paravertebral muscles and the sacroiliac joint of the pelvis are affected.
Men are more likely to suffer from the disease than women, and it develops at the age of 20-30. Their main complaint is pain in the lower back, in the sacrum, in the hip joints; stiffness of movement after a period of rest (especially in the morning, after sleep).
Even with the removal of symptoms and relative well-being, without eliminating the root cause, the inflammation continues to develop and, over time, will cause a new exacerbation. Therefore, articular pathology often becomes chronic and leads to disability.
Second: the presence of a degenerative-dystrophic process
With this type of lesion, the joint is destroyed by physical factors. Injuries and microtraumas, constant physical exertion in excess of the norm, the 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. Its articular surfaces become rough and sensitive to friction. Over time, the process of destruction goes to 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 limitation of mobility, which increase with physical exertion. In the later stages, even rest and calm does not 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 protrusions 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 in which osteochondrosis has developed, and can be very different.
Deforming spondylarthrosis
This condition is also called "facet syndrome". In this case, the destruction process affects the structures of the intervertebral joints (capsule, ligaments, facets).
Most often it occurs in the most "overloaded" part of the spine - the lumbar. It manifests itself 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 impaired blood supply. As a result, the bones entering 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 sick 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, therefore degenerative-dystrophic changes are more common in old age. Or he must act with superpower, as in sports.
Many professional athletes become disabled in their youth.
Third: congenital joint pathologies
This type of lesion causes abnormalities in the structure and development of joints as a result of infections and injuries to the mother, concomitant pathology, late toxicosis, and genetic diseases.
Frequent manifestations of congenital abnormalities are birth trauma, for example, hip dislocation or collarbone fracture.
Congenital dysplasia of the hip joints
It develops as a result of a violation of the formation of all articular structures in the prenatal and postnatal period. Predisposing factors are heredity and tight swaddling. Girls are more susceptible to this pathology than boys - the incidence rate is 80% and 20%, respectively.
With dysplasia, the shape of the joint is changed, and its ligaments are too elastic. This causes displacement of the femur and impedes the 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 often affects boys and in half of the cases it is bilateral. If the defect is not eliminated 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 eliminated completely or development can be slowed down using conservative methods. Late diagnosis and treatment can lead to impaired support and movement functions, up to and including disability.
Fourth: diseases of the muscles and ligaments of the joint
Pathologies of this group often develop as a result of increased physical exertion and hypothermia.
Tendinitis
Inflammation and destruction of the tendon. It is accompanied by his tension and painful sensations, especially in the weather.
Myositis
Development of inflammation in the periarticular muscles. It is accompanied by soreness when feeling the affected area, which increases with movement.
Bursitis
The inflammatory process is localized in the joint capsule. It often affects professional athletes (wrestlers, runners, weightlifters).
Synovitis
Damage to the synovial membrane with the accumulation of fluid in the joint cavity. It is accompanied by soreness, swelling, stiffness of movements.
The relationship between disease and joint type
There is a certain pattern in which joint is affected by which pathology. Some of them even have their own specific names.
For example,knee-jointcan be affected at any age, regardless of the patient's gender and occupation. But the defeat of the meniscus and cruciate ligaments is more common in athletes. Gonarthrosis - in elderly people. Arthritis of infectious origin - in children.
Soreness inshoulder jointcan be caused by shoulder-scapular periarthritis, cervical osteochondrosis, osteoarthritis.
Forelbow jointtypical damage to the periarticular tissues - epicondylitis or "tennis elbow", "golfer's elbow".
The hip joint is more commonly affected in older people. As a result of osteoporosis and coxarthrosis, they are at risk of fracture of the femoral neck.
Soreness insmall jointshands and feet is observed in rheumatoid, psoriatic, gouty arthritis.
But despite the specific manifestations, the diagnosis of articular 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 articular pathology, there are:
- Soreness;
- Swelling and puffiness;
- Shape change;
- Stiffness of movement;
- Inability to perform normal range of motion.
Doctors call them joint syndrome. Doctors call them joint syndrome. It is also possible the appearance of redness of the skin, rashes on it and dense nodules. Of the general symptoms, patients often complain of an increase in temperature in the area of the lesion or the whole body, increased fatigue.
Reading the previous section, you might have noticed that all 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 examination and 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 time of their occurrence, which joint is affected, one or several of them, whether this lesion is symmetrical and other factors.
Let's take a closer look at each symptom:
Soreness:
It occurs in almost every pathology. Doctors distinguish several types of it:
- Inflammatory- increases towards morning, after a period of rest. Typical for rheumatoid, juvenile, gouty arthritis, spondyloarthritis.
- Mechanical- appears during physical exertion or a change in body position, often in the late afternoon, disappears after rest. Typical for osteoarthritis, osteoarthritis, osteochondrosis, pathology of periarticular tissues.
- "Start"- occurs in the first 15–20 minutes of physical activity after a period of rest. Typical for osteoarthritis.
- "Blockade"- caused by pinching in the joint space of a cartilaginous fragment, as a result of which the joint "wedges". May be accompanied by crunching sound. Occurs in osteoarthritis.
- Constant- persists, regardless of the load and time of day, may increase at night. Typical for osteochondropathy, osteomyelitis, tumors and tuberculosis of the bones.
Number of affected joints:
- One (monoarthritis): with juvenile, gouty, psoriatic arthritis.
- Two-four (oligoarthritis): with rheumatoid arthritis, spondyloarthritis.
- More than four (polyarthritis): with rheumatoid, gouty arthritis.
Symmetry of the lesion:
- Symmetrical: for rheumatoid arthritis.
- Asymmetric: for spondyloarthritis, gout, osteoarthritis.
- "Migratory": with gout.
Morning stiffness in joints:
It is felt by the patient as the impossibility and tension of movement. It happens in the morning and is associated with the accumulation of fluid in the articular cavity overnight. Typical for rheumatoid arthritis, spondyloarthritis.
Also, the doctor pays attention to general complaints:
- Increased body temperature;
- Redness of the skin, the presence of a rash on it;
- The defeat of the internal organs.
To make an accurate diagnosis, laboratory (blood, joint fluid analysis) and instrumental studies (X-ray, CT, MRI, ultrasound) are required.
Conclusion
Joint pain and dysfunction can be caused by a variety of reasons. There are pathologies that cannot be treated, but many of them, with adequate and timely treatment, allow a 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.