Polyosteoarthrosis: symptoms, types and treatment

In medical practice, the term “polyosteoarthrosis” is rarely used; often in official medical terminology the more familiar formulation is used – “polyarthrosis”.

Regardless of which term is used, the essence of the pathological condition does not change. The diagnosis refers to a chronic form of degenerative-dystrophic damage to the articular system, where several areas of the human musculoskeletal system act as foci.

Lack of timely diagnosis, as well as refusal of treatment or neglect of the components of complex treatment can cause intensive progression of the pathological condition and a significant deterioration in the patient’s health, including disability.

What is polyosteoarthrosis?

Polyosteoarthrosis (polyarthrosis)

is a chronic disease of the joints of the musculoskeletal system of the human body, leading to deformation of bone tissue or disruption, gradual loss of joint mobility.

The pathological condition under consideration is a representative of the varieties of pathologies of the “osteochondrosis” group, but at the same time it has a striking distinctive feature - the number of focal lesions (more than three). However, despite this, the causes, symptoms and treatment of diseases of the general group are almost the same.

During the development of the disease, destruction of articular and adjacent bone tissues is observed. Activation of the compensatory function of the body causes the accumulation of calcium salts in elastic tissues, which significantly reduces their elasticity and mobility, thus forming new bone formations.

Causes of osteoarthritis

Degeneration of articular cartilage in osteoarthritis occurs due to excessive overload of healthy cartilage, which exceeds physiological load, and a decrease in the resistance of articular cartilage to normal physiological load. Mechanical (primary) osteoarthritis is caused by the following reasons:

Professional, household, sports overload;
Dysplasia;
Static violations.

Structural arthrosis is based on changes in the structure and trophism of articular cartilage, as a result of which it cannot cope with normal physiological load. These are secondary osteoarthritis, since degeneration of previously modified cartilage occurs.

Osteoarthritis develops due to a mismatch between the mechanical load placed on the articular surface of the cartilage and its ability to resist this load. A similar situation is created by severe obesity, heavy physical work with frequently repeated stereotypical movements that load the same joints (osteoarthrosis of the wrist joint in a painter, shoulder in a blacksmith, spinal joints in a loader), or excessive sports (arthrosis of the knee joints in football players). , hockey players, runners).

Overload of the cartilage is caused by a violation of the normal ratio of the articular surfaces of healthy cartilage. As a result, the load is unevenly distributed over the entire surface of the cartilage, with the main load falling on a small area at the point of greatest convergence of the articular surfaces. For this reason, the cartilage in this area quickly degenerates.

Sometimes the load remains normal, but the physicochemical properties of the cartilage change significantly. This makes it less resistant to normal load. The reason for this is the following factors:

Violation of subchondral circulation;
Changes that occur in the synovial membrane;
Infectious and non-infectious arthritis;
Hemorrhage into the joint;
Metabolic disorders (gout, hemochromatosis, pyrophosphate arthropathy;
Diseases of the endocrine and nervous systems (diabetes mellitus, acromegaly);
Burdened heredity.

Factors that cause the development of osteoarthritis include dysplasia, excessive mobility, functional overload, and joint trauma.

What is the true danger for a patient with such a diagnosis?

Diagnosed polyarthrosis signals serious disorders occurring in the human body. In most cases, the disease develops in the presence of other pathological conditions, which indicates a not very favorable prognosis, unlike other types of osteochondrosis (elbow, knee or hip joint).

The true danger of lack of control over degenerative-dystrophic processes lies in the limited mobility of the limbs and spine. If left untreated, the joint tissues wear out greatly, which causes intense pain to the person.

A large number of lesions of articular and bone lesions can lead to irreversible consequences and cause a significant deterioration in a person’s quality of life, namely, obtaining the status of “disabled” and the inability to self-care.

Causes of polyosteoarthrosis

Like other diseases, the pathological process in question has certain causes of development, which are in many ways similar to the pathology of the group of osteochondrosis.

The causes of polyosteoarthrosis include factors such as:

genetic predisposition, hereditary factor;
abnormalities in the formation of connective (cartilage) tissue, causing a deterioration in its structural properties;
insufficient strength of the muscular frame;
the presence of a disease such as diabetes;
violation of metabolic processes;
diseases of the endocrine system, as well as other endocrine glands.

In addition, there is a set of provoking factors, on the basis of which a risk group of people who may encounter this type of pathology is formed.

Risk group

Representatives of the risk group (category of people most likely to develop multifocal joint pathology) are:

those in adulthood (mostly over 50 years old);
experiencing increased stress on the joints;
leading an insufficiently active lifestyle;
survivors of various types of joint injuries.

There are types of the pathology in question that are inherited, for example, polyosteoarthrosis of the fingers.

Polyosteoarthrosis of the fingers

Other names for this disease are multiple arthrosis of the joints of the fingers, “knotty fingers.”

Polyosteoarthrosis of the fingers (multiple arthrosis of the joints of the fingers, “knotty fingers”) is a predominantly female disease. And although men also sometimes get it, this fate befalls them about 10 times less often than women.

As a rule, in women, the onset of the disease is directly related to hormonal changes in the body - polyosteoarthrosis usually begins during menopause, at the age of over 40-45 years (people under 40 years old suffer from this disease in extremely rare cases). The heyday of the disease most often occurs at the age of 50-60 years.

Causes of polyosteoarthrosis of the fingers

To date, scientists have not been able to identify any single cause for the development of polyosteoarthrosis. It is assumed that there is a hereditary predisposition - there are families in which several generations of women suffer from polyosteoarthritis of the fingers. Apparently, in these families some unfavorable features of metabolism and the structure of the cartilage tissue of the joints are inherited. And due to the congenital weakness of cartilage tissue in people with a burdened heredity during menopause, the cartilage of the joints begins to degrade, that is, they become inferior.

The degradation of cartilage is that it gradually loses its natural “lubrication” and becomes dry and cracked. From the friction of “dried up” articular cartilage, inflammation develops in the joints and abnormal “inflammatory joint fluid” is produced. It expands the joints from the inside, sometimes causing quite strong pain, while the joints themselves become deformed.

Although the risk of getting arthrosis of the fingers is somewhat higher in those people whose parents or close relatives were (suffer) from polyosteoarthrosis, there are other circumstances (in addition to hereditary predisposition) that contribute to the appearance of this disease. It is quite obvious that polyosteoarthrosis is more common in those people who suffer from metabolic disorders, diabetes mellitus or diseases of the endocrine glands (thyroid, parathyroid glands, etc.).

Symptoms of polyosteoarthrosis of the fingers

With polyosteoarthrosis, special nodules appear on the fingers - the so-called Heberden's nodes and Bouchard's nodes .

Heberden's nodes form on the dorsal or lateral surface of those finger joints that are located closer to the nails (on the distal interphalangeal joints). Most often they develop symmetrically, that is, on the right and left hands at the same time and in the same places. Moreover, they can form on any fingers: from thumbs to little fingers. The size of Heberden's nodes can vary from the size of a grain of rice to the size of a small pea.

During the formation of Heberden's nodes, the joints underneath them often become swollen and red. Burning and pain may occur in the joints (but in a third of patients, the formation of Heberden's nodes occurs asymptomatically, without pain or burning).

Approximately half of the patients experience exacerbations at the onset of the disease, and then greasy, throbbing pains appear in the places where nodules form, which decrease after the skin over the vesicle bursts and its contents leak out. If the vesicle does not break through, then the exacerbation continues from several weeks to several months, after which the swelling, redness and pain disappear, and the nodules become dense and almost painless.

Subsequently, as polyosteoarthrosis progresses , the deformation of the finger joints and their stiffness increase. At times, without any apparent reason, exacerbations may occur again with the development of phenomena characteristic of the initial period of the disease - pain or burning appears in the nodules again. Then these exacerbations just as unexpectedly, sometimes even without treatment, subside.

Bouchard's nodules are distinguished by another feature - they most often develop gradually, slowly, without exacerbations. They are formed on the joints of the fingers located a little further from the nails (that is, in the area of the joints located approximately in the middle of the distance between the nails and the base of the fingers).

These nodules cover mainly the lateral surfaces of the joints, causing the fingers to acquire a spindle-shaped shape. Although Bouchard's nodes form more slowly than Heberden's nodes and are less painful, they also aggravate joint stiffness.

Over time, Heberden's and Bouchard's nodes increasingly deform the hand, changing its appearance and leading to what is called "knobby-fingered hands." But for all that, the disease, fortunately, does not change the general condition of the body; The activity of internal organs in polyosteoarthrosis, unlike arthritis, is not affected.

Arthrosis of the joints of the thumb (rhizarthrosis) is often combined with Heberden's and Bouchard's nodes. Rhizarthrosis affects the joint located at the base of the thumb and connecting the metacarpal bone of the thumb to the wrist joint.

Most often, rhizarthrosis develops in people whose profession involves increased stress on the thumb. But it can also develop in those who once injured their thumb or simply overloaded it greatly. For example, I have repeatedly seen rhizarthrosis that arose after summer exercise and even after banal rolling up jars of sauerkraut, mushrooms or jam, especially when the jars were rolled up for several days in a row.

The disease manifests itself as pain at the base of the thumb when moving, as well as stiffness of the joint and a crunching sound in it when moving. In addition, when examining the hand, we can almost always see a deformation of the bones of the diseased joint (in the place where the thumb articulates with the wrist joint), which is clearly visible on an x-ray.

Attention! When faced with pain in the thumb, we must remember that the thumb is the “favorite place” for inflammation in gout and psoriatic arthritis. Therefore, if redness, swelling and severe pain develop in the thumbs, you should immediately consult a doctor who will conduct a differential diagnosis, determining what caused the inflammation - arthrosis or another disease.

Diagnosis of polyosteoarthrosis of the fingers

Diagnosis of polyosteoarthrosis usually does not require any extra effort. As a rule, the diagnosis becomes clear immediately, you just have to look at the patient’s hands. But still, in a number of cases, doctors, in order to prevent a diagnostic error, refer the patient for x-rays of the hands and blood tests - clinical (from a finger) and analysis for rheumatic tests (from a vein ).

With polyosteoarthrosis, the characteristic signs of the disease are clearly visible on x-rays - narrowing of the joint spaces of the affected joints and characteristic deformations of the bones of the affected fingers. In blood tests for polyosteoarthrosis, we usually do not detect any abnormalities; all indicators remain normal.

Attention! If in a patient with arthrosis we find in blood tests taken from a finger or from a vein, some “inflammatory” abnormalities, for example, an increase in ROE, C-reactive protein, seromucoid, etc., we should be wary - after all, arthrosis does not cause any changes in the tests. And if inflammation indicators are elevated, there is a high probability that we are dealing not with arthrosis, but with arthritis. And this is a completely different disease, more serious and complex. Then we need to continue examining the patient until the diagnosis of arthrosis or arthritis is finally confirmed or refuted.

Consequences of polyosteoarthrosis of the fingers

Polyosteoarthrosis of the fingers is not a dangerous disease. Even without proper treatment, polyosteoarthrosis does not produce any consequences other than “knottyness” of the fingers, and timely treatment can minimize this nuisance.

READ MORE:

Treatment of polyosteoarthrosis of the fingers
You can read the first chapters from the book “The Secret Formula of Health” here
Where to buy books by Dr. Evdokimenko

Types of polyosteoarthrosis

Today, there are several types of polyosteoarthrosis of the joints. Let's try to understand their features and define the classical classification of the disease in international medicine.

Based on external signs characterizing the condition of the joints of the musculoskeletal system, there are two main forms of polyosteoarthrosis:

knotless;
nodular (visually noticeable thickening, the so-called “Bouchard or Heberden nodes”).

Based on the characteristics of the course of the pathological condition and the degree of its intensity, osteoarthritis is classified somewhat differently:

low-symptomatic – characteristic mainly of young people, it is practically asymptomatic. Instead of the characteristic soreness, a cramp in the calf muscles may be observed, as well as a change in the appearance of the fingers;
manifest – a slowly progressive form, the intensity of symptoms in which is determined by the patient’s level of health. Moderate pain may be experienced (as the weather changes, when performing various movements, etc.)

Symptoms of polyosteoarthrosis

Symptoms of polyosteoarthrosis have certain specifics. According to existing information, treatment of arthrosis is not always a suitable solution, because the pathology has very unusual manifestations.

Symptoms of polyosteoarthrosis include:

nodularity of several predominantly symmetrical joints at once (with a generalized type of arthrosis);
quite severe pain, causing dizziness, ophthalmological disorders, migraine and other signs of compression of large vertebral vessels (if intervertebral tissue is damaged);
proliferation of bone tissue and harmful, pathologically dangerous changes in connective tissue, accompanied by numbness of the limbs and other signs (with spondylosis of the lumbar and cervical region);
inflammatory process, local swelling (with periarthritis or tendovaginitis).

The expanded range of symptoms of polyosteoarthrosis somewhat complicates the diagnostic process, which certainly affects the treatment process.

Diagnostic techniques

Diagnosis in the presence of appropriate symptoms is carried out in a clinic. To receive professional diagnostic and treatment assistance, it is enough to have an appointment with a therapist, who, based on the results of the initial examination, will draw certain conclusions and refer the patient to a more specialized specialist.

There are 4 most effective diagnostic methods:

X-ray examination is the optimally accessible diagnostic method that allows you to assess the degree of change in the joint space and bone surfaces, etc. transformations, allowing you to draw a conclusion about the stage of the pathology.
Magnetic resonance imaging (MRI) is the best solution that allows you to visualize the condition of soft tissues (muscle frame, ligaments and tendons, as well as the surface of the joint capsule).
Laboratory blood testing - makes it possible to assess the general health of a person and test for the presence of rheumatoid markers.
Arthroscopic examination - a therapeutic and diagnostic operation allows you to penetrate into the articular cavity in a minimally invasive way and examine in detail the surfaces of the articular tissues. If necessary, it is possible to take a tissue fragment and a small amount of synovial fluid for analysis.

Where does osteoarthritis come from?

The main cause of polyosteoarthrosis is chronic overload of the joints. Provoking factors are hypothermia, genetic predisposition, wearing uncomfortable shoes, excess weight, lack of calcium during menopause, etc.

Polyosteoarthrosis of the small joints of the hands usually develops in pianists, typists, programmers, and secretaries. Representatives of these professions regularly perform active movements in the interphalangeal joints, which leads to their injury.

Mechanisms of disease development:

Poor blood circulation in the periosteum , located under the cartilage tissue. Lack of oxygen and nutrients leads to loss of elasticity and thinning of articular cartilage. Over time, they become covered with cracks and collapse.
Reduced hydrophilicity of cartilage due to impaired metabolism of their main substance and proteoglycan deficiency. The joint tissue loses its ability to absorb nutrients from the synovial fluid, which accelerates its destruction.
Reduced elasticity and viscosity of synovial fluid , due to which it becomes unable to perform its main functions (cushioning, lubricating, metabolic).

Osteoarthritis of stages I-II is characterized by damage only to articular cartilage. At stages III-IV, the disease leads to exposure of bone surfaces and gradual destruction of bones. The small joints of the fingers become deformed, making it difficult for a person to perform usual work. The patient experiences pain, a feeling of stiffness, and difficulty performing flexion/extension movements.

Treatment of polyosteoarthrosis

The key to successful treatment of polyosteoarthrosis is compliance with the instructions of the attending physician, maintaining a healthy lifestyle and, of course, following the basics of dietary nutrition.

Even the most complex disease can be treated if medical help is sought at the right time. Polyosteoarthrosis can be successfully cured using both a complex of conservative techniques and surgical operations.

The choice of the most promising direction of treatment is determined on an individual basis, taking into account the characteristics of the course of the disease and the number of affected joints.

Let us consider the components of the treatment of polyosteoarthrosis in more detail.

Drug therapy

The basis of conservative treatment is drug therapy. The complex of drugs, as well as the dosage and duration of their use, are determined by the treating specialist on an individual basis, taking into account the intended treatment plan.

As part of drug therapy, the following groups of drugs are used:

painkillers;
corticosteroids;
chondroprotectors.

It is important to pay special attention to chondroprotectors, which protect the remaining cartilage tissue from the further destructive effects of pathological processes and create optimal conditions for its restoration. Among the drugs of this kind is Artracam, which is distinguished by its effectiveness and optimally affordable cost.

Physiotherapeutic treatment

Physiotherapeutic treatment of polyosteoarthrosis belongs to the category of auxiliary therapeutic techniques, the beneficial effects of which help stimulate the renewal of bone and cartilage tissue of the human body.

In order to prevent the development of pathologically dangerous processes and restore damaged structures, methods such as:

electrophoresis;
exposure to magnets/laser;
warming up (provided there is no inflammation).

As part of the implementation of a complex of physiotherapeutic procedures, patients are recommended to visit specialized sanatoriums and medical resorts that specialize in the treatment and rehabilitation of people with pathologies of the musculoskeletal system.

Therapeutic physical education (PT)

Of particular importance in the treatment, rehabilitation and prevention of pathologies of the musculoskeletal system is physical activity, in particular, exercise therapy.

A set of exercises is selected taking into account the location of pathological processes, as well as the characteristics of clinical manifestations.

It is important that the exercises must be performed under the strict guidance of a specialist, because deviation from the norm can cause overexertion and harm to health.

Surgery

In some particularly advanced cases, when conservative therapy does not produce the desired results, the patient may be indicated for surgical intervention.

The most popular and optimally effective solution is endoprosthetics - an operation that involves removing the affected joint and its full/partial replacement with an individually formed prosthesis.

After surgery, there is a long and rather difficult recovery period. If all recommendations are followed, the patient can return to a full standard of living.

Osteoarthritis - symptoms and treatment

The main nutrient medium of the joint is synovial fluid. It also acts as a lubricating agent between the articular surfaces. A huge and major role in the development of osteoarthritis is played by metabolic processes in the joint and in its structures. At the initial stage, when biochemical disorders develop in the synovial fluid, its properties decrease, which triggers the destruction mechanism. The first to be affected is the synovial membrane of the joint, which plays an important role as a membrane and is like a filter for the most important nutrient of cartilage - hyaluronic acid, preventing it from leaving its main place of work - the joint cavity. The saturation of the properties of the joint fluid is determined by its circulation, which cannot happen without regular movement of the joint itself. Hence the famous phrase “movement is life.” Constant circulation of synovial fluid in the joint cavity is the key to full metabolism in it. With a lack of nutrients, the cartilage becomes thinner, the formation of new cells stops, the articular surface becomes uneven, rough, with areas of defects. There is a known relationship between diseases of the veins of the lower extremities (for example, varicose veins) and the development of metabolic disorders in the joints, mainly the knees.[6] The bone structure, located under the cartilaginous structure, responds to the process with a compensatory mechanism - it thickens, becomes rougher and expands the coverage area, resulting in the formation of exostoses and osteophytes, which is the main cause of joint restrictions and deformities. The synovial fluid is saturated with inflammatory cells and decay elements, the joint capsule in response to this thickens, becomes rough and loses elasticity, the soft tissues literally become dry (dehydration occurs), hence the complaints of morning stiffness, “starting pains”. The pathological process in the final stages provokes the body to turn on the last compensatory mechanism - immobilization. At rest and in the so-called physiological position, pain is minimal, the ligamentous apparatus is maximally straightened. In this position, the joint strives to fix itself, and it succeeds in this by the rapid formation of coarser exostoses, which “fix” the joint, while the patient loses the ability to fully move it. The muscles of such a limb hypotrophy, become weaker and smaller. Such changes are already considered irreversible.

Forecasts

Seeking qualified medical help at an early stage is the key to success and the most favorable scenario for the complete elimination of the symptoms of polyosteoarthrosis, and, sometimes, the complete recovery of the patient. If the intended treatment plan is followed, most diagnosed cases can be successfully treated.

Conservative therapy gives positive results within the first week of treatment, depending on the individual characteristics of the patient. After just 1-1.5 months, the mobility of the affected joints improves significantly.

Polyosteoarthrosis is one of the incurable diseases, which means that it is necessary to follow medical recommendations for life.