Overview of polyosteoarthrosis: symptoms, disease diagnosis, treatment and prognosis

Author of the article: Yachnaya Alina, oncologist surgeon, higher medical education with a degree in General Medicine.

Article publication date: 08/08/2016

Article updated date: 01/28/2020

Polyosteoarthrosis is a chronic disease of the joints and their constituent bones, which leads to their deformation, impaired mobility, gradual destruction and, if the disease is not treated for a long time, to disability. This pathology is a type of osteoarthritis and has its own distinctive feature - multiple joint damage (three or more). Polyosteoarthritis indicates more serious disorders in the body than those observed with “ordinary” osteoarthritis, but otherwise these diseases (their causes, symptoms and treatment) are the same.

Polyosteoarthrosis is characterized by the destruction of articular cartilage and adjacent bone tissue. To compensate for this process, the body activates restorative forces to the best of its ability, but this does not end very favorably: calcium salts are deposited in the ligaments and capsule of the joints, which should normally be elastic, which reduce their elasticity and mobility, and along the edges of the articular surfaces new bone growths are formed. Ultimately, this leads to overgrowth of the joint cavity and complete loss of mobility in it.

Polyosteoarthrosis and its location

This is a widespread disease, and it occurs mainly in older people (50–60 years old). It is accompanied by persistent pain and limited mobility, which inevitably worsens the quality of life.

It is impossible to recover completely from polyosteoarthrosis; once it begins, this disease will accompany the patient throughout his life. However, there is good news: modern methods of conservative and surgical treatment make it possible to completely get rid of unpleasant symptoms and slow down the development of pathology as much as possible.

This disease is treated by doctors of various specialties: therapists, rheumatologists and orthopedists.

How can you forget about the symptoms of polyosteoarthrosis once and for all? How to prevent further destruction of joints? The answers to all questions are in the article.

Causes of the disease

The exact immediate causes that trigger the process of destruction of joint components are unknown. Scientists have made a big breakthrough in studying the mechanisms of development of this pathology and ways to influence it, but the specific cause still remains a mystery.

Six known factors that reliably increase the likelihood of developing the disease polyosteoarthrosis:

1. old age, when natural aging of the body occurs;
2. sedentary lifestyle;
3. bad habits;
4. injuries;
5. excessive physical activity (not necessarily when playing sports);
6. excess body weight.

Reasons that increase the possibility of developing polyosteoarthrosis

Typically, polyosteoarthritis develops as a result of the combined action of several risk factors.

Diagnosis of osteoarthritis

Diagnosis of osteoarthritis in many cases does not cause great difficulties. But there are exceptions, for example, patients with damage to the shoulder joint and symptoms of joint inflammation. Difficulties may also arise in diagnosing primary and secondary osteoarthritis, the occurrence of which is associated with metabolic or other diseases. During X-ray examination, signs of osteoarthritis are detected quickly (especially in older people) if clinical signs of osteoarthritis are present. In order to make a final diagnosis, X-ray and laboratory data are not enough. To do this, it is necessary to conduct a number of additional studies to identify the exact cause of joint pain.

Characteristic symptoms

Polyosteoarthritis is difficult to miss because it has pronounced symptoms. Only in some cases the disease is asymptomatic (and this happens only in the early stages).

Signs of the disease:

• joint pain, the intensity of which usually increases with physical activity;
• sensation of crackling, crunching, clicking when moving in the joints;
• restriction of mobility up to complete impossibility of movement;
• deformation of the articular area.

In some situations, arthritis (inflammation of the joints) is superimposed on the symptoms of arthrosis. In this case, the above symptoms are accompanied by swelling and redness of the skin, as well as a local increase in temperature.

In the absence of adequate treatment, the destruction of joint tissue progresses steadily, which ultimately leads to the formation of ankylosis. Ankyloses are strong adhesions between articular surfaces that interfere with movements in the joints or make them completely impossible. At this stage, there is only one treatment for polyosteoarthrosis - endoprosthetics.

Formation of ankylosis between articular surfaces. Click on photo to enlarge

What are the symptoms and clinical signs of this disease?

The manifestation of osteoarthritis is expressed by severe pain and deformation of the joints, which leads to disruption of their functions. This disease most often affects weight-bearing joints (hip and knee joints) and small joints of the hand. The spine is also involved in the process. But most often the knee and hip joints are affected. The most basic symptom of osteoarthritis is severe pain in the affected joints. These pains cause damage to bones, joints or periarticular tissues. Typically, such pain increases with physical activity and decreases with rest. Night pain, swelling of the joint, as well as the appearance of a feeling of “gel viscosity” in the affected joint in the morning - all this indicates the occurrence of osteoarthritis. The intensity of such pain depends on many reasons (atmospheric pressure, air humidity and temperature changes). All these factors begin to influence the pressure in the joint cavity, which causes these pains. The next main symptom of osteoarthritis is the appearance of crunching or creaking in the joints, not only when walking, but even with any movement. The appearance of such a crunch or squeak is associated with a violation of the articular surfaces, which causes a limitation of mobility in this joint. With osteoarthritis, there is an increase in the volume of the joints, which is a consequence of the appearance of swelling of the periarticular tissues. Swelling or fever in the area of ​​the affected joint is extremely rare. Clinical forms of osteoarthritis:

1. Gonarthrosis.
2. Coxarthrosis.
3. Osteoarthritis of the distal interphalangeal joints of the hand.
4. Osteoarthrosis of the proximal interphalangeal joints of the hands.
5. Spondylosis deformans.
6. Intervertebral osteochondrosis.

1. Gonarthrosis is a lesion of the knee joint due to osteoarthritis. In this case, pain in the knee joints is pronounced when walking, and they are especially intense if you go down the stairs. The location of these pains is in the inner and anterior parts of the affected knee joint. Increased discomfort occurs when the knee is bent. In addition, in many cases with gonarthrosis, deviation of the knee joint occurs. The disease begins gradually, and the pain is increasing. A crunching sound may be heard during active and passive movements. The pain begins to intensify, and in many cases synovitis develops - inflammation of the lining of the joint capsule or tendon. 2. Coxarthrosis is a lesion of the hip joint. Initial pain when the hip joint is affected does not appear in the hip area, but in the knee, groin or buttock. They intensify when walking, and subside at rest. These pains, which occur even with minor changes on the x-ray, are associated with muscle spasm. When the hip joint is damaged, there is a gradual increase in limited mobility in the joint. This disease is a consequence of injury or arthritis. With coxarthrosis, there is a gait, developing lameness, wasting of the muscles of the buttock and thigh. There is also pain on palpation in the area of ​​the femoral head. 3. Osteoarthritis of the distal interphalangeal joints of the hand or Heberden's nodes . The appearance of such nodules is most often observed in women during menopause. Initially they appear on the 1st and 3rd fingers of the hand. Over time, namely after several months or even years, symmetrical damage is observed in other distal interphalangeal joints. Such nodules are located on the dorsolateral surface of the joints. 4. Osteoarthritis of the proximal interphalangeal joints of the hands or Bouchard's nodes. Unlike Heberden's nodes, these nodes appear on the lateral surface of the joint, resulting in lateral enlargement of the joint. As a result of this enlargement, the finger acquires a spindle-shaped shape. 5. Spondylosis deformans - as a result of this disease, marginal bone growths appear in the vertebral area. This disease appears at the age of 20. Osteophytes (bone growths) look like swellings - due to compression of blood vessels, swelling appears. As a result, spinal stiffness occurs, and in some cases, neurological disorders occur. 6. Intervertebral osteochondrosis occurs in combination with spinal curvature or spondylosis deformans. With this disease, disc degeneration occurs and the nucleus protrudes in different directions, and this leads to spinal trauma. Osteophytes also grow and the joint surface increases. In this case, the choroid of the joint suffers, resulting in vasculitis - inflammation of the walls of small blood vessels. The pain syndrome is very pronounced and intensifies with physical activity or hypothermia.

There are two main forms of osteoarthritis - primary or idiopathic (the causes of the disease are not clear) and secondary (the disease occurs against the background of other diseases).

Primary osteoarthritis is localized when less than 3 joints are affected. With localized osteoarthritis, the spine, joints of the hands and feet, knee joints, hip joints and other joints are affected. There is also generalized osteoarthritis, when 3 or more joints are affected. In this case, large joints and distal interphalangeal joints are affected. In addition, erosive osteoarthritis also occurs in the generalized form. Secondary osteoarthritis can be post-traumatic. Also, the causes of secondary osteoarthritis can be metabolic diseases such as Gaucher disease, which is a genetic disease; Wilson's disease is a rare form of liver damage in which copper metabolism is impaired; Hemochromatosis or, as this disease is also called, bronze diabetes, or pigmentary cirrhosis, is a hereditary disease in which iron metabolism is disrupted and it accumulates in organs and tissues. Diseases such as diabetes mellitus, hypothyroidism - decreased thyroid function, acromegaly - hyperfunction of growth hormone, can also be causes of osteoarthritis. In addition to the diseases listed above, osteoarthritis can also be caused by calcium deposition disease, neuropathy and many other diseases.

Four diagnostic methods

The diagnosis of polyosteoarthrosis can be made even in a clinic, since this does not require complex research.

1. Radiography of the affected joint is available everywhere, and in most cases it is a necessary and sufficient diagnostic method. With polyosteoarthrosis, the pictures clearly show changes in the joint space and surfaces, osteophytes (marginal bone growths) and some other changes (depending on the stage of the pathology).
2. Magnetic resonance imaging (MRI). This method better visualizes soft tissues: ligaments, muscles, tendons, joint capsules.
3. General and biochemical blood test.
4. In difficult diagnostic cases, arthroscopy may be indicated. During this procedure, an endoscope is inserted into the joint cavity through a small incision in the skin, through which the doctor can directly examine the articular surfaces. Also, during arthroscopy, you can take a piece of tissue for microscopic examination and a sample of synovial fluid for analysis.

Knee arthroscopy

Treatment

Polyosteoarthrosis can be successfully treated with both conservative and surgical methods. The choice of a specific direction of therapy depends on the stage of the disease and the number of affected joints.

Medicines

Apply:

• non-selective painkillers: ibuprofen, diclofenac, nimesulide and others;
• selective painkillers: meloxicam, celecoxib;
• corticosteroids, which are prescribed both in tablet form and as intra-articular injections;
• chondroprotectors - drugs that protect cartilage tissue from further destruction and accelerate its recovery: chondroitin sulfate, hyaluronic acid.

Medicines that help in the treatment of polyosteoarthrosis

Physiotherapy

This auxiliary therapy method increases the effectiveness of the medications taken and stimulates the renewal of bone and cartilage tissue. For the treatment of polyosteoarthrosis the following is used:

1. electrophoresis,
2. magnetic therapy,
3. UHF,
4. warming up the joints (but only in the absence of acute inflammatory phenomena).

There are special sanatoriums and medical resorts that specialize in the treatment and rehabilitation of patients with joint diseases.

Physiotherapy for the treatment of polyosteoarthrosis

Exercise therapy

For polyosteoarthrosis, much attention is paid to therapeutic exercises. Each joint has its own set of exercises aimed at strengthening the muscles and ligaments of that area. However, you cannot overdo it in this matter, since excessive physical activity will only be harmful.

Operation

If the process is extremely severe and ankylosis develops, surgical intervention is indicated. The most common procedure is joint replacement - an operation in which the affected joint is removed (completely or partially) and a custom-fitted prosthesis is placed in its place. After the operation, there is a long and difficult recovery period, but upon completion, the patient returns to normal life.

Endoprosthetics of joints in the hand

Forecast

Properly selected therapy at an early stage of the disease is a sure way to completely eliminate the symptoms of polyosteoarthrosis for many years. With strict adherence to the treatment program, more than half of patients achieve significant clinical improvement.

With conservative treatment of polyosteoarthrosis, a positive effect is observed within the first week of treatment. In the first 2–3 days, depending on the individual characteristics of the patient, the pain syndrome is significantly relieved. After 1–1.5 months of treatment, mobility in the affected joints increases, but only if therapeutic gymnastic exercises are performed regularly.

To date, polyosteoarthrosis continues to be an incurable disease, so its therapy must continue for life. Drug treatment is carried out in courses at least 1-2 times a year, which depends on the severity of the disease and the number of affected joints. Therapeutic exercises must be performed continuously; During the period of taking medications, exercises should be done daily, while the rest of the time it is enough to exercise 1-2 times a week.

Joint replacement is a fairly safe operation (among operations of a similar level of complexity). Postoperative complications occur in less than 1% of patients. Proper rehabilitation allows you to quickly restore joint function and restore the lost quality of life.

Cause of the disease

The definitive reason is currently unclear. DOA is a multifactorial disease, that is, the disease can be caused by several factors simultaneously.

The development of the disease is influenced by:

• excess weight, especially in women over 40 years of age;
• excessive load on the joints (among weightlifters, knee joint pain is almost an occupational disease);
• injuries and diseases of the musculoskeletal system (delayed detection or untreated);
• age-related changes (almost 60-70% of elderly people are diagnosed with DOA);
• heredity or congenital pathologies (in this case, DOA can occur in young, completely healthy people);
• weather and working conditions (hypothermia negatively affects joints, especially in old age).

Prevention measures for DOA:

1. Loss of body weight, which is achieved through a balanced diet;
2. Adequate physical activity (gymnastics, physical therapy);
3. Reducing the load on joints (long-term stress is especially negative);
4. Timely detection and treatment of injuries and diseases of the musculoskeletal system;
5. Avoiding hypothermia of joints;
6. In old age, it is possible to use a cane or walker to unload the joints when walking;
7. Quitting bad habits (smoking tobacco, drinking alcohol);
8. To prevent DOA, chondroprotectors are prescribed.

The main components of chondroprotectors are:

• Chondroitin sulfates – normalizes metabolism in cartilage tissue. Stimulates the production of collagen and hyaluronic acid;
• Glucosamine – stimulates the production of your own chondroitin, relieves inflammation.

Currently, there are many drugs in this series. The difference between them is in the percentage of components and the degree of purification. For a noticeable therapeutic or preventive effect, chondroprotectors are usually prescribed in long courses, which must be completed 1-2 times a year.

There is constant debate about the effectiveness of this group of drugs. Therefore, they should be taken only after consulting a doctor.

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