Arthritis of the elbow joint

In the earliest stages, the disease may manifest itself as minor aching pain in the elbow joint. As the disease progresses, the pain becomes regular, especially intensifying with physical activity.

In advanced stages, it is impossible to easily move the arm, not only because of acute pain, but also because of cartilage degeneration.

Arthrosis is a disease caused by degeneration of cartilage and adjacent bone tissue, and if appropriate treatment is not started in time, this can lead to joint deformation and complete immobility in the elbow area. Since it is almost impossible to restore a destroyed joint to its original healthy state, it is necessary to stop its destruction in a timely manner using medication and physiotherapy.

In the most advanced stages, surgical intervention will be required to partially restore the functions of the joint, but is it worth neglecting your health so much that you do not find the time to undergo diagnostics in our clinic and begin treatment.

Arthrosis of the elbow joint - what is it?

Arthrosis of the elbow joint

is a pathological disease characterized by negative changes in the cartilage and bone tissue of the joint, resulting from excessive friction and the growth of osteophytes (bone growths).

Degenerative-dystrophic processes are triggered as a result of a lack of joint fluid, which acts as a lubricant.

It is important to note that the etiology of the pathology causes damage not only to cartilage and bone, but also to the periarticular bursa, tendons, ligaments and even muscle tissue.

Poor or late diagnosis, as well as lack of necessary treatment, can cause a large number of physiological disorders and loss of mobility.

Causes of development and types of purulent arthritis

The causative agents of purulent arthritis are pathogenic microorganisms. They enter the soft tissues of the joint and begin to actively multiply. Against this background, an inflammatory process occurs. The infection quickly spreads to nearby organs.

In 80% of cases, the causative agent of purulent arthritis is different types of cocci, the remaining 20% are caused by:

E. coli;
Proteus;
salmonella;
Pseudomonas aeruginosa.

Typically, the causative agents of purulent arthritis are streptococci or staphylococci.
The infection enters the body in two ways:

For wounds, operations, injuries, punctures.
Through the blood (with lymphadenitis, osteomyelitis, etc.)

The inflammatory process can develop against the background of infectious diseases (gonorrhea, influenza, pneumonia). Inflammation can begin in any joint. But large joints are more often affected, so arthritis of the hip, knee and elbow joints is not uncommon in medicine. In newborns, purulent inflammation is diagnosed in isolated cases. Young children may become victims as they learn to walk.

The risk group also includes:

athletes;
people suffering from obesity;
people with hereditary diseases;
people with various metabolic disorders;
elderly people.

In medical practice, purulent arthritis is classified according to:

Volume of damage:

bone tissue is not subject to destruction;
ligaments, joints and cartilage are deformed.

Primary ones occur when the pathogen penetrates directly into the joint cavity and can develop with penetrating wounds

Location:

ankle (bone and soft tissues are vulnerable. Inflammation develops quickly and leads to deformation of the foot);
elbow (suppuration of the joints is similar to the development of phlegmon of the joint capsule);
hip (cartilage is damaged first, but without treatment, pathological processes affect the bones. Without treatment, arthritis leads to disability);
knee (develops as a result of fractures, injuries and wounds);
shoulder (inflammation leads to decomposition of cartilage and the formation of abscesses).

Primary

Primary purulent arthritis is a lesion of the joints. Infection is caused by a direct route, that is, pathogens enter the joint cavity through the skin, for example, due to a gunshot wound or severe injury. You can also catch an infection during diagnostic procedures or surgery if the rules of asepsis are not followed.

The disease develops quickly. Pus accumulates in the joint cavity. The inflammatory process manifests itself in the form of skin redness and soreness. If measures are not taken in a timely manner, the capsule, articular ends of the bones and all elements of the joint are involved in the purulent process.

Secondary

Secondary purulent arthritis is diagnosed more often. In this case, the infection enters the joint along with blood or lymph. The source may be internal organs. Purulent damage to the joint can develop against the background of existing infectious diseases (gonorrhea, influenza, erysipelas, sepsis, etc.)

Secondary arthritis develops as a result of infection through surrounding tissue, blood or lymph

Causes of deforming arthrosis of the elbow joint

When studying the causes of arthrosis of the elbow joint, it should first of all be noted that the development of pathology, as a rule, is accompanied by factors of both external and internal influence.

Among the main causes of arthrosis of the elbow joint it is worth noting:

changes associated with natural changes in the human body;
inappropriate lifestyle of a person;
harsh conditions of professional activity;
consequences of previous injuries;
disruption of the body's metabolic processes;
prolonged inflammatory processes;
intoxication;
hormonal disbalance;
past infectious diseases.

Prevention

It is easier to prevent a disease than to treat it. By following simple preventive measures, you can avoid many diseases, including purulent arthritis.

To do this you need:

protect joints from injuries, bruises, fractures;
for open wounds, carry out primary treatment correctly;
promptly treat inflammatory and infectious diseases;
to live an active lifestyle;
follow a diet;
avoid hypothermia;
strengthen immunity;
be examined by a doctor annually.

Particularly useful preventive measures for persons at risk. Purulent arthritis is not a death sentence. Timely treatment will help avoid negative consequences and maintain health.

Symptoms of arthrosis of the elbow joint

All symptoms of the disease can be divided into several groups:

Pain felt as a result of movement.
A clear symptom of arthrosis of the elbow joint, which manifests itself gradually. As the disease progresses, the pain increases and does not go away even at rest.
Visually noticeable changes
Another important and at the same time quite noticeable symptom of arthrosis of the elbow joint are external signs, which usually include a change in the color of the skin in the area of localization of pathological processes, as well as swelling.
Characteristic crunching Lack
of joint fluid causes a painful crunching sound that occurs when the joint moves and becomes stronger each time, which indicates the progression of the disease.
Restriction of mobility
A striking symptom of arthrosis of the elbow joint in the later stages of development of the pathology is restriction of movement, which is caused by muscle tone and proliferation of bone tissue.

A striking symptom of arthrosis of the elbow joint in the later stages of development of the pathology is limitation of movement, which is caused by muscle tone and proliferation of bone tissue.

In addition, it is worth noting that arthrosis of the elbow joint has three degrees of development

, each of which is characterized by certain symptoms.

Arthrosis of the elbow joint 1st degree

The initial stage of development of pathological processes inside the joint. No external changes are observed, however, upon palpation, a competent specialist is able to determine insufficient muscle tone.

The main symptom of grade 1 arthrosis of the elbow joint is difficulty performing simple movements (flexion/extension of the joint), accompanied by painful sensations.

Arthrosis of the elbow joint 2nd degree

The second degree of arthrosis of the elbow joint is accompanied by increased pain that spreads to the forearm and appears not only during movement, but also at rest.

The functionality of the joint is impaired, and the performance of the affected upper limb gradually decreases. The pain intensifies, which forces you to seek qualified medical help.

Arthrosis of the elbow joint 3rd degree

An advanced stage of pathological processes, pain in which does not go away even during a night's rest. Pain is significantly reduced when the joint is completely fixed in one position.

Visually, the deformation of the joint becomes noticeable, there is quite severe swelling, and the limb is greatly modified in the elbow area. Mobility is minimal.

Diagnosis, symptoms of epicondylitis

Epicondylitis manifests itself as pain in the elbow joint, often during exercise, less often at rest, at night, the pain can be quite severe. With lateral epicondylitis, palpation is painful along the outer edge of the elbow joint, Welsh and Thomsen's symptoms are positive. With medial epicondylitis, palpation is painful along the inner surface of the elbow joint. Welsh and Thomsen's signs are positive with movements in the opposite direction to those with lateral epicondylitis.

X-rays usually show no changes, but sometimes there are signs of calcium salt deposition in the ligaments. There are no changes in the blood test.

Diagnosis of arthrosis of the elbow joint

Before forming a treatment plan for arthrosis of the elbow joint, it is important to promptly and correctly diagnose the disease and the degree of its development.

A feature of the pathological processes of arthrosis is that it can hide signs of other problems or be accompanied by inflammatory processes, which largely determines treatment methods and the list of therapeutic measures.

The diagnosis of arthrosis of this type is carried out by an orthopedist or surgeon. If it is impossible to contact specialists of a narrow profile, it is enough to visit a therapist.

Diagnostic measures include a visual examination, palpation of the affected joint, physical tests, as well as collecting the patient’s medical history (previous injuries, the presence of other diseases of various kinds).

Arthrosis

Compared to arthritis, this disease is not an inflammatory joint disease. However, damage to the articular cartilage occurs. The cause may be both involutional changes and injuries or wear of cartilage tissue due to excessive loads. Osteoarthritis can manifest as swelling and pain. Also, in some cases, the disease can lead to changes in other organs and systems. It can lead to both a decrease in range of motion and range of motion. Most often, arthrosis affects the hip joints, knee joints, and spinal joints. Osteoarthritis, an infrequently used term to describe degenerative joint diseases. To understand, it is important to first understand the anatomy of the joint. The ends of the bones that form the joint have a smooth surface called the subchondral bone. Behind this is articular cartilage, which is a strong but elastic connective tissue that protects bones, facilitates movement between surfaces, and also acts as a shock absorber. It is this cartilage that forms the articular surface, and not the bones themselves. The joint has synovial membranes that secrete synovial fluid into the joint space, which lubricates the joint surfaces and acts as a shock absorber. The outer joint capsule provides strength to the joint.

Cartilage is elastic connective tissue. Cartilage cells (chondroblasts) produce and secrete a large number of different substances, such as collagen, into the extracellular matrix. It is this matrix that is responsible for the properties of cartilage, namely its strength and flexibility. Sometimes chondroblasts remain inside the matrix and are called chondrocytes. Cartilage is constantly subject to wear and damage. Cartilage cells constantly replenish the cartilage matrix and thus maintain the integrity of the cartilage.

With age, the ability to regenerate any tissue decreases, but does not stop completely. Even in young people, the body's ability to repair tissue is limited by time. If there is constant and excessive wear and tear on the articular cartilage beyond the time required for repair, then the cartilage will weaken. This is the reason why the disease is more common in older people and more often in those who lead an active lifestyle. There are other factors that complicate regenerative processes, such as inflammatory mediators, which affect normal cartilage regeneration when there is even slight inflammation. Likewise, if there are some medical diseases (such as diabetes) that slow down or stop the activity of cartilage cells, the cartilage gradually wears out. When the cartilage weakens, cartilage ruptures occur, and fragments can float in the joint cavity. Bone tissue is also affected by arthrosis and a condition called osteoarthritis occurs.

Symptoms

Symptoms develop very slowly. In the early stages of cartilage erosion, there may be no symptoms. In addition, arthrosis is a degenerative disease, not an inflammatory condition, and therefore may not manifest itself for a long time. Once symptoms begin, the condition gradually worsens, also over a long period of time. The leading symptom of arthrosis is pain.

The pain is usually isolated to the affected joint. The pain usually worsens during and after movement in the affected joint. In milder cases, pain does not appear during movement, but only some time after exercise. There may also be pain on palpation in the joint area. But pain with arthrosis is usually not accompanied by swelling, as is the case with inflammatory phenomena in the joint (for example, with rheumatoid arthritis).

Joint stiffness is another common symptom. This is most noticeable when waking up in the morning and after a long period of rest. Movement can reduce stiffness, but excessive movement will eventually lead to pain. Joint stiffness tends to get worse over time as the disease progresses. Even when joint stiffness decreases, normal range of motion is not restored. Over time, this leads to a significant decrease in motor activity. The joint may also experience a crunching sound when moving, especially as the disease progresses. Normally, the articular cartilage at the ends of bones rubs against each other, but due to the smooth surface and good lubrication by synovial fluid, this friction does not lead to the appearance of sounds. With arthrosis, the cartilage surface is not so smooth and this leads to the appearance of sounds when moving in the joint (crunching, grinding). Firming – large joints, such as the knees, become firmer to the touch. Bone growths that occur with arthrosis (osteophytes) form over time and can be felt under the skin in the form

Diagnostics

As a rule, diagnosis does not present any particular difficulties and is based on a combination of examination data and instrumental data (radiography, CT, MRI, ultrasound of joints). But given that arthritis also causes changes in cartilage tissue, a careful differential diagnosis of degenerative changes in joints with the consequences of a long-term inflammatory process is necessary. Therefore, laboratory diagnostics are also necessary when diagnosing arthrosis.

Treatment

The disease is more often observed in older people and therefore treatment is most often symptomatic. The key to conservative treatment is to reduce symptoms of pain and improve joint functionality. Drug treatment (for example, NSAIDs) should be prescribed taking into account the concomitant somatic pathology present in older people. A good effect is achieved by intra-articular injection of synovial fluid endoprostheses (Fermatron, Ostenil, etc.), which reduces friction in the joint, improves joint function and reduces pain. Intra-articular administration of long-acting steroids (for example, diprospan) is also possible. Recently, prolotherapy has begun to be used, which consists of introducing substances into tissues that improve the regeneration of connective tissue.

Physiotherapy can quite effectively reduce pain and reduce inflammation.

Exercise therapy. Dosed physical activity allows you to maintain the functionality of the joints, but the loads must be selected carefully, since excess loads lead to increased pain.

Surgery. In case of severe arthrosis of large joints (for example, coxarthrosis or gonarthrosis) and significant dysfunction of the joint and persistent pain, endoprosthetics is recommended.

Treatment of arthrosis of the elbow joint

The process of treating arthrosis of the elbow joint is a complex complex therapy

, using both medications and physiotherapeutic techniques, gymnastics and following the general recommendations of a specialist.

Physiotherapy as a method of treating arthrosis of the elbow joint

Physiotherapy for arthrosis

– an integral part of complex treatment, prescribed during the period of remission or absence of pronounced, acute symptoms.

Among the benefits of physiotherapeutic treatment it is worth noting:

improvement of metabolic processes at the location of the pathology;
stimulation of blood flow, removal of toxic substances;
improvement of lymph flow;
removal of residual effects of the acute phase of the disease.

The most common and at the same time very effective treatment methods are considered to be:

electrophoresis;
therapy using a magnetic field, laser or ultraviolet irradiation;
warming up;
mud therapy.

Surgery as a method of radical treatment of arthrosis of the elbow joint

Surgical intervention belongs to the category of radical methods of treating arthrosis of the elbow joint and is used exclusively in the presence of irreversible pathological changes

, which include:

deformation;
destruction of cartilage tissue;
the presence of a large number of massive bone growths.

Surgery offers patients three solutions:

Easy cleaning of surfaces, removal of the articular membrane.
Restoration of the surfaces of damaged joint elements through the use of arthroplasty.
Partial replacement of affected articular elements with artificial implants (endoprosthetics).

Partial or complete restoration of joint functionality occurs 1.5–4 months after surgery.

Exercise therapy in the treatment of arthrosis of the elbow joint

Physiotherapy

– an excellent method included in a set of measures aimed at treating arthrosis.

Exercise therapy involves a selection of simple exercises that can be performed in various conditions (on the street, at home or even at work). Moderate movements allow you to saturate the affected joint and adjacent tissues with oxygen, due to the activation of blood flow, which also has a healing effect.

Today there are a large number of complexes developed with the participation of experienced specialists. The main goal of each of them is to improve the mobility of the affected joint, as well as inhibit degenerative processes.

Exercise therapy is contraindicated in patients who have:

increased body temperature;
having an injury to the affected joint;
acute inflammatory process or complications of the pathological process.

Medicines used in the treatment of arthrosis

Treatment of arthrosis of the elbow joint with the use of medications is the basis of an integrated approach at various stages of progression of the pathology.

As part of therapy, drugs of various forms are used:

ointments/gels for topical use;
tablets/capsules;
injections (blockades).

Predominantly non-steroidal anti-inflammatory drugs, one of the most effective of which is considered to be “Artradol”

In addition, antispasmodics

and
analgesics
, and to restore the functionality of the joint -
chondroprotectors
.

Treatment of epicondylitis

Patients are prescribed rest, anti-inflammatory drugs locally and internally, blockades with diprospan or Kenalog bring good results.

Indications for blockades are limited; they cannot be done for diabetes mellitus or some other diseases.

It is advisable to include physiotherapeutic treatment in complex therapy. For recurrent epicondylitis, periarticular injections with the drug Traumeel are recommended.

In recent years, the kinesiotaping technique has been successfully used to treat epicondylitis. With this method, special adhesive elastic tapes are applied to the forearm and elbow joint area. With their help, it is possible to relax muscles, the overstrain of which causes pain in the places of attachment to the bones. Below are examples of kinesio taping for lateral and medial epicondylitis.

Possible complications

In the absence of timely diagnosis, proper treatment or an unfavorable outcome of surgical intervention, a patient with a disease such as arthrosis of the elbow joint may face a number of complications, including:

loss of the ability to hold the joint in an anatomically correct position;
contracture (inability to fully bend/extend the joint);
fusion of the joint space;
complete loss of mobility.

Surgery

If conservative therapy does not bring results, then doctors are forced to resort to a radical method of treatment. In this case, purulent arthritis is treated surgically.

For extensive purulent wounds and open fractures, secondary surgical treatment is performed

In medical practice, there are several types of operations:

Arthrotomy. During surgery, the doctor opens the joint and drains it. Pus is pumped out of the joint cavity along with dead tissue. The cavity is washed with an antiseptic. To avoid infection, the patient is prescribed antibiotic therapy.
Resection. Damaged ends of bones and cartilage are excised. The surgeon places tissue between them to prevent fusion. These manipulations help stop the inflammatory process and maintain limb mobility. Upon completion of the operation, the patient is given a plaster cast.
Installation of an articulating cement spacer. This operation is performed when large joints are affected. An articulating cement spacer is a special form that is temporarily installed in the bone tissue.

If the disease progresses rapidly, then a solution to remove the affected joint is used to save the patient's life. In rare cases, doctors are forced to amputate a limb.

Disease prevention

As an excellent preventive measure that can prevent the occurrence of pathological processes in the elbow joint, it is recommended:

systematic moderate load on the joint;
giving up bad habits;
protection of the elbow joint from mechanical damage during professional activities or sports;
saturating the daily diet with vegetables and fruits high in vitamins and beneficial microelements.

IMPORTANT! When the first signs of the disease appear, consult a specialist. Remember that self-medication can not only aggravate the situation, but also cause serious harm to the body, which can cause irreversible consequences

Purulent arthritis - main symptoms

The clinical picture of purulent arthritis may vary depending on the form of the disease itself. The acute form begins suddenly, with a sharp deterioration in the patient’s condition.

Added to the symptoms:

high body temperature;
fast fatiguability;
nausea;
vomit;
swelling of the joint;
muscle weakness;
redness of the affected area.

Sometimes there is cyanosis or yellowness of the skin, profuse sweating and headache. When palpating the affected area, the patient experiences sharp pain, and an accumulation of fluid is felt at the site of inflammation. In especially severe cases, the patient experiences tachycardia, fever and intoxication syndrome. If appropriate measures are not taken, the patient may lose consciousness.

Depending on the nature of the ongoing pathological process (serous, purulent or putrefactive), characteristic changes may be observed in the joint.

The disease manifests itself with swelling, sharp pain

The chronic form is more difficult to recognize. Clinical symptoms are less pronounced. Inflammation in the joint makes itself felt in attacks. In the acute stage, the patient experiences nagging pain, mainly at night. Symptoms may include joint stiffness, swelling and redness. With purulent advanced arthritis of the knee or hip joint, joint closure may occur. With timely initiation of therapy, remission occurs. If ankle arthritis is left untreated, you may lose the ability to walk.

If you experience one or more signs of arthritis, you should consult your doctor immediately. Based on the existing symptoms and the results of clinical tests, the doctor decides to prescribe medical or surgical treatment.