Osteoarthritis in children: what parents need to remember

Arthrosis and osteoarthritis are traditionally considered age-related diseases. However, like many other diseases, joint pathologies tend to grow younger, so today they are increasingly found in very young patients. What is the reason and what treatment is indicated in such cases?

Osteoarthritis in children is being diagnosed more and more often today.

Causes

The root cause of the development of degenerative changes in cartilage in children is often genetic factors. There are so-called defective genes. They are also found among those responsible for the functionality of joints and connective tissue. However, this is far from the only reason:

Congenital pathologies of the musculoskeletal system, such as clubfoot, flat feet, etc., can provoke joint problems at an early age;
against the background of overweight and obesity, joints are subjected to increased stress, which also affects cartilage, bone tissue, and internal organs;
sometimes treatment for arthrosis and osteoarthritis can be prescribed to a child after numerous serious or, conversely, minor bruises, sprains, and microtraumas;
If, due to circumstances, a child has undergone surgery on a joint, the risk of developing osteoarthritis increases significantly.

Injuries, injuries, injuries... It is not surprising that young football players develop arthrosis very early

How to behave correctly if a child complains of joint pain? Advice for parents from a pediatrician:

Causes of the inflammatory process

Arthritis may result from:

infectious diseases: brucellosis, tuberculosis, gonorrhea, syphilis, dysentery, salmonellosis, yersiniosis, etc.;
diseases caused by rubella, herpes, Epstein-Barr, hepatitis C viruses, etc.;
parasitic infestation;
breakthrough of an abscess located next to the hip joint;
non-communicable diseases: lupus erythematosus, psoriasis;
injuries of the ligamentous apparatus or surrounding tissues;
endocrine disorders: diabetes mellitus, thyroid pathologies;
age-related changes in the body.

A special role in the occurrence of this painful disease is played by genetic predisposition, as well as chronic focal infection - inflammation of the tonsils, paranasal sinuses and other factors that weaken the body's protective functions. The reasons may be: allergic reactions, malignant tumors, or even excessive growth of microflora in the intestines after operations.

Excess weight, bad habits, a sedentary lifestyle, hypothermia, and stress also increase the risk of developing the disease. Studies have been conducted that have shown that with a decrease in weight of just one kilogram, the load during movement on each hip joint is reduced by 4 kg.

Signs of osteoarthritis in children

The main symptom of the disease is aching pain after physical activity in the area of a particular joint. At night, the pain subsides, and in the daytime, during physical activity, it resumes. If the pathology has progressed to the second or third stage, the pain may persist even at rest. There are other characteristic signs:

frozen joint syndrome – it is difficult for a child to move the affected limb due to sharp piercing pain;
swelling, which appears in the morning and leads to stiffness of the affected area;
sometimes the disease is accompanied by varicose veins of the lower extremities, and over time, other joints are also involved in the pathological process, especially if the child is not provided with timely medical care.

If your child complains of joint pain, take him to an orthopedist as soon as possible

Main types and symptoms

The ability to quickly recognize the symptoms of hip arthritis is the key to promptly prescribing the correct treatment and reducing the risk of disability. The main clinical manifestations of arthritis of the hip joint, regardless of its form, can be considered:

pain in the groin, outer thigh or buttock;
swelling and pain when touched;
difficulty walking, lameness;
crunch;
redness;
pain that gets worse when walking or lifting heavy objects;
feeling of stiffness in the morning.

Acute arthritis develops rapidly: sharp and often throbbing pain intensifies when trying to move the leg. It can radiate to the groin or buttock. Sometimes a person cannot even walk. All this is accompanied by weakness, fever, lack of appetite and nausea.

The chronic form is characterized by slow development: at first, the joints only ache from time to time after significant stress. Subsequently, the pain increases and bothers the patient even at rest, preventing him from living and moving fully.

There are more than a hundred different forms of this disease. For example, with osteoarthritis, symptoms usually develop gradually: pain with movement can be felt anywhere in the thigh, but usually in the front, and does not radiate to the tissues that are located above. Some patients complain of pain in the area of the iliac wing.

Rheumatoid arthritis can manifest itself in different ways. Patients most often complain that they experience joint stiffness and swelling in the morning. The danger is that this disease can also damage a person’s internal organs: lungs, kidneys and heart. The infectious form is characterized by a severe course: the pain is usually severe and acute. The affected area swells and becomes hot. The patient's body temperature rises to 38-40 °C.

Treatment tactics in childhood

Treatment of arthrosis and osteoarthritis in children is complex: it includes medication and physiotherapeutic components. With the help of painkillers in a dosage specially selected for age, it is possible to relieve pain spasms. Sometimes it is advisable to use anti-inflammatory ointments and balms only as prescribed by the attending physician.

In some cases, intra-articular injections of a synovial fluid substitute, for example the safe synthetic drug Noltrex, help cope with the disease. As a rule, this method is used if the disease has progressed to the second or third stages and is accompanied by a severe course.

In the initial stages, physiotherapeutic measures - massage, electrophoresis and UHF, as well as a course of special exercise therapy - help cope with symptoms. During the period of remission, it will not be superfluous for a small patient to go for sanatorium treatment. In general, tactics depend on the child’s health status, physical capabilities, and lifestyle.

A child with osteoarthritis should be seen by an orthopedist at least once a year

Effective diagnostic methods

As you know, the hip joint is the most difficult to access for examination, because it is anatomically complex. Therefore, inspection and palpation, which are often used to detect signs of arthritis in other joints, will not be enough in this case. To diagnose a lesion in the hip joint, the doctor may prescribe:

OAC and OAM, biochemical and immunological research: allow to identify rheumatoid, gouty and allergic forms of the disease;
general clinical analysis of synovial fluid: displays the processes occurring in the cartilage tissue and synovial membrane;
arthroscopy is a diagnostic and therapeutic method during which the doctor can carefully examine the articular cavity, femoral head, acetabulum, and cartilage tissue;
X-ray examination - will help establish the stage of the disease and assess the degree of destruction of bone elements;
ultrasound diagnostics – helps to identify pathological processes even in the early stages;
computed tomography is a non-invasive method that allows you to obtain layer-by-layer images of various areas of the skeletal system;
magnetic resonance imaging with signal suppression from adipose tissue - will help to see inflammatory changes that precede the formation of structural damage.

Some methods make it possible to differentiate inflammatory changes in the hip joint area even in the absence of clinical manifestations.

How parents can help

Arthrosis and its forms are a disease with which a child will have to coexist for many years. Therefore, it falls on the parents to worry about how to teach their son or daughter proper nutrition and daily routine, as well as instill necessary, healthy habits.

To prevent excess weight, which is so dangerous for joints, it is important to adjust your diet - enrich it with vegetables and fruits, dairy products, removing flour and chocolate.
As prescribed by your doctor, it is advisable to take vitamins that include calcium.
The specialist will recommend special exercises for the joints, which will have to be performed regularly to avoid relapses.
The task of parents is to provide their son or daughter with the correct workplace (a chair with a straight back), and also to take care of a bed with a hard base or an orthopedic mattress (depending on the form of the disease).
Shoes are also of great importance: they must be made of high-quality materials.

The most important thing for a caring parent is to find a competent doctor who will not only prescribe treatment, but also discover the root cause of osteoarthritis at such an early age. This is the only way to keep the disease under control and stop its progression. So, if the source of the problem is a malfunction of the endocrine system, it is necessary, first of all, to restore the balance of hormones, and if the knees suffer from excess weight, the child will have to be offered a strict diet.

Be that as it may, if your child complains of pain in the knee, elbow or other joint, do not self-medicate. The sooner you get an appointment with a good orthopedist, the more chances your heir has for a full life, full of physical activity!

Causes of hip arthritis

Purulent arthritis of the hip and other joints can be a complication of injuries, wounds, diagnostic punctures of the joint, and operations that result in direct infection of the joint cavity. In other cases, septic coxitis can develop when a purulent focus breaks through from adjacent tissues (perphlegmon, osteomyelitis, etc.) or metastatic infection of the joint cavity from distant inflammatory foci (furunculosis, tonsillitis, otitis, pneumonia, etc.). In addition to infectious arthritis caused by nonspecific pyogenic flora, there are specific coxitis associated with tuberculosis, brucellosis, gonorrhea, and syphilis.

Diagnosis of hip arthritis

When examining a patient with inflammatory lesions of the hip joints, one cannot limit oneself to making a syndromic diagnosis; It is imperative to determine the root cause of arthritis. For this purpose, the nature and intensity of pain, the duration of the disease, and concomitant pathology are clarified from the anamnesis. The patient is examined in a lying position, standing and while walking. In this case, special attention is paid to the shape of the joints and the position of the limbs, the presence of muscle atrophy and contractures, gait, the ability to perform and the amplitude of passive and active movements.

Along with the clinical examination, radiation diagnostic methods play a decisive role in the diagnosis of arthritis: radiography of the hip joint, ultrasound, MRI, contrast arthrography, etc. To assess the nature of the inflammation, a diagnostic puncture of the hip joint is performed under ultrasound guidance. In some cases, in order to confirm the diagnosis, it becomes necessary to perform diagnostic arthroscopy and biopsy of the synovium of the hip joint.

Coxarthrosis in systemic diseases

Gouty coxarthrosis

Etiological phenomena
The etiological mechanism of arthritis has not yet been fully elucidated, but certain patterns of the onset of the disease have been studied in detail. In general, there are two areas of causes leading to this pathology:

infectious lesion;
endogenous factor of an autoimmune or allergic nature.

Infectious lesions are caused by the action of the following pathogenic microorganisms on the body:

intestinal infection (salmonellosis, shigellosis, yersiniosis);
infection of the urogenital tract (chlamydia, mycoplasma, ureaplasma);
Group A and B streptococci (cause rheumatoid arthritis).

In this case, the infection extremely rarely penetrates the joint itself, but damage to the body is sufficient, and then the autoimmune mechanism is activated. Quite often the cause is diseases such as meningitis, Lyme disease, tuberculosis, brucellosis, rubella, and gonorrhea.

Inflammation in the joint can occur without infection. In this area, allergic reactions, metabolic disorders, hereditary diseases with damage to the immune system, ankylosing spondylitis and Crohn's diseases, and malignant formations are highlighted. The following factors provoke the activation of the etiological mechanism:

hereditary predisposition;
frequent and prolonged physical overload of the joint;
injuries in the hip area;
hypothermia;
diseases of the musculoskeletal system;
hormonal disorders;
taking certain medications.

Symptomatic manifestations

Symptoms of hip arthritis depend on the type of pathology, but in general they have common features. There are several categories of symptoms:

manifestation of an inflammatory reaction: pain, swelling, redness, increased temperature in the area of the affected joint;
signs of structural disorders: limited mobility, up to complete immobilization; stiffness; joint deformity; lameness;
signs of general intoxication of the body: fever, general weakness, fatigue, headache, loss of appetite.

Coxitis can develop in acute, subacute and chronic forms. Depending on this, the intensity of symptoms also changes. The acute and subacute stages of the disease are characterized by a sharp, unexpected manifestation of pain, swelling, and blocking of movement. The general condition of the sick person worsens significantly. The untreated acute form becomes chronic. This development of pathology is characterized by alternating phases of exacerbation and complete remission. There is a slow destruction of joint tissues, which can lead to loss of joint mobility.

The most characteristic symptom of hip arthritis is pain. As a rule, pain is concentrated in the groin, buttocks, trochanteric area of the thigh, as well as along the anterior femoral surface, spreading along the lower limb to the knee. The intensity of pain depends on the type of lesion and its severity. As the pain syndrome progresses, it becomes the main factor limiting mobility. At the initial stage, restriction of movement is associated with pain due to increased muscle tone, and then with disorders in the joint capsule.

Pain syndrome is directly related to mechanical stress. The most severe pain appears in the morning, immediately after getting up, and also after being in a sitting position for a long time. After a short walk they calm down. In general, the manifestation of pain increases with the progression of the disease. If at the initial stage it has the appearance of the indicated “starting pain” or appears only during physical activity and disappears after rest, then in the advanced stage the pain is fixed and at rest can continue in an intensive mode for up to 2 - 3 days.

It is pain that gradually leads to a change in gait. A sick person instinctively seeks support so that the discomfort is minimal, which gradually becomes a habit. The so-called Trendelenburg gait is quite typical for the pathology, when the pelvis, when moving, falls more towards the leg opposite the lesion. In the last stages of coxitis, pronounced signs of joint deformation appear. Stable contractures are formed, and shortening of the lower limb is observed.

Diagnosis of gouty arthritis

The key point of diagnostic procedures is the detection of sodium urate crystals in the synovial fluid of the joints, both during an attack and during remission. Synovial fluid for analysis can be taken from any large joint, even one that has never been subject to inflammation, for example, from the knee. Also, the contents of the tophi or any other biological material can be taken for research.

Hyperuricemia (increased levels of uric acid in the blood) in combination with periodic inflammation of the joint of the big toe is not considered a confirmation of gout, it is only a marker of impaired purine metabolism. Many people with hyperuricemia do not have gout.

With a long course of the disease, it makes sense to conduct an x-ray examination. At the early stage of the disease there are no characteristic changes. Then, on x-rays, signs typical of gout appear: destruction of cartilage, defects in the end sections of bones, punctures.

When gout develops on the upper extremities, it is quite difficult to differentiate it from other joint diseases: rheumatoid arthritis, osteoarthritis, etc.

Causes of gouty arthritis

The etiology of the disease is not fully understood. The main risk factors for its occurrence include:

Hereditary predisposition;
Poor nutrition: excessive abuse of meat products, sausages, chocolate, strong coffee and tea, alcohol. (Gout used to be called “the disease of aristocrats”);
The presence of concomitant diseases, such as heart failure, hemoblastosis, kidney disease, hormonal abnormalities;
Use of certain medications: drugs for high blood pressure, diuretics, cytostatics, etc.

There are also primary and secondary gouty arthritis:

Primary gout develops as a result of a combination of genetic predisposition and high intake of purines from the foods listed above;
Secondary gout occurs due to the presence of these diseases and medications.

The accumulation of sodium urate microcrystals in the joint cavity can occur asymptomatically for a long time, until some factor provokes an acute attack: physical fatigue (long walking), injury, infection, stress, hypothermia, fasting or consumption of large amounts of “purine” foods in combination with alcohol.

Preventive actions

In order to avoid or reduce the likelihood of developing pathology, especially for people after 35 years of age, one should remember about preventive actions. Prevention of gout involves simple steps, for these purposes you should:

control body weight;
avoid colds and infectious pathologies;
prevent joint injuries;
wear comfortable shoes that do not restrict movement;
monitor blood pressure;
Avoid drinking alcoholic beverages, especially beer;
adhere to proper nutrition;
lead an active lifestyle and do physical exercise;
systematically take a biochemical blood test to monitor urea levels;
Do not take medications without supervision.

General information

The concept of arthropathy unites almost all forms of joint damage. When it comes to children, pathologies, as a rule, are hereditary in nature, and as they grow older, inflammatory, reactive and autoimmune lesions, including juvenile rheumatoid arthritis, come to the fore. Most often, arthropathy in children affects large joints: knee, hip, elbow. In the absence of timely treatment, the lesion can cause serious dysfunction of the joint, including complete immobilization (ankylosis).