4Mar

Osteoarthritis: symptoms, signs and differential diagnosis

Osteoarthritis is a serious not only medical, but also social and economic problem, as it is a frequent cause of loss of working capacity and development of disability. Unfortunately, at the first stage of the development of the disease, when it is possible to stop the pathological process, the diagnosis is rarely established, because there are no characteristic symptoms.

Often this lesion of the joints is hidden, without any signs, or on the nonspecific symptoms of osteoarthritis, many people simply do not pay attention, because they are perceived as ordinary physical fatigue. Therefore it is important to know exactly how osteoarthritis is manifested in order to suspect the disease and contact a doctor for specialized care.

General signs of osteoarthrosis

Osteoarthritis is a chronic degenerative-dystrophic disease of the joints of the body, which is characterized by damage and destruction of the cartilaginous tissue and underlying bone with gradual development of persistent deformations of affected joints. The disease develops slowly. All joints of the body may suffer, but most often those that are subject to maximum loads( hip, knee, ankle, small joints of hands and feet) are affected. Depending on which joints are affected, the clinical picture will also differ.

Pain in the knee
Joint pain - the main sign of osteoarthritis

General signs of osteoarthritis:

  • pain in the affected area;
  • sensation of crunching in the joint with its active and passive movements;
  • short-term stiffness in the limbs in the morning;
  • rapid muscle fatigue;
  • periodic occurrence of synovitis;
  • gradual limitation of mobility;
  • development of deformation and deflamation of affected joints.

Pain syndrome has some characteristics. At the beginning of the illness, pain or discomfort( not all patients characterize them as pain) arise after heavy physical labor and at the end of the day, disappear after rest, even without the use of medication. As osteoarthritis progresses, the pain becomes permanent and does not go away after rest. Often the patient can not fall asleep, tormented by pain. First, pain relievers and anti-inflammatory drugs are good, but over time their effect is weakened and the pain becomes unbearable.

A characteristic symptom is the "starting" pain, when painful sensations occur at the patient's first steps and decrease with each subsequent passed meter. But, if the load is large, the pain appears again.

Also often occurs acute pain, which is caused by blockade of the joint. The fact is that in a degenerative process, loose bodies( fragments of osteophytes, particles of articular cartilage) enter the articular cavity and during movement they can get between the articular surfaces and block the articulation. The pain in this case( this condition is often called the "joint mouse") is very sharp and intense, accompanied by complete immobility of the sick person. But in a certain position of the leg, the pain passes as quickly as it appeared.

Degrees of osteoarthrosis of the foot joints
Deformation of the foot at various degrees of osteoarthritis

Osteoarthritis is usually chronic, without clear exacerbations and remissions. Gradually the pain syndrome, deformity and stiffness in the aching joint progresses. If the provoking factors( overfatigue, infection, trauma, etc.) act, the disease becomes aggravated by the development of reactive synovitis with signs of inflammation.

Symptoms of hip osteoarthrosis

Coxarthrosis, or osteoarthrosis of the hip joint, is the most severe form of the disease, occurring in 40% of all localizations of arthrosis lesions. Patients complain of pain in the affected joint, which is accompanied by lameness. There is also pain in the intact knee joint, in the lower back, which is associated with a pathological spasm of skeletal muscles.

Over time, the pain increases, there is a "duck" gait, limiting flexion, extension, abduction and hip reduction. Rapidly developing atrophy of the hip muscles, flexing the hip contracture is formed and the supporting function of the limb is lost, which requires the replacement of the destroyed hip joint with an artificial endoprosthesis.

Pain in the hip joint
Pain in the hip - a dangerous sign

Symptoms of knee osteoarthritis

Women are most often sick. Defeat, as a rule, is two-sided. Patients complain of pain at the end of the day, inability to climb and fall on the stairs. Often there is a feeling of "podkashivaniya" feet. First, the flexion in the knee joint is limited, and then the extension. During the movement, there is a crunch in the knee.

With time, muscle atrophy at the knee joint, deformation( O or X-shaped legs) begins to form. Also, patients complain of instability and hypermobility of the knee joint. Periodically arises blockade of articulation and reactive synovitis.

Symptoms of osteoarthritis of interphalangeal joints

Most often this variant of the disease occurs in women during the menopausal period. Clinically characterized by the formation of nodular outgrowths in the area of ​​distal interphalangeal joints( nodes of Geberden).As a result, the joint is deformed and its function is impaired. Sometimes bony growths develop in the area of ​​proximal interphalangeal joints( Bušar's nodes).

Diagnosis

Diagnosis of osteoarthritis is based on clinical data and some additional methods of investigation. There are no specific laboratory signs of pathology, but laboratory tests are routinely performed to exclude similar pathologies.
The main diagnostic method is radiological. On the radiographs, narrowing of the joint gap, the presence of osteophytes, osteosclerosis, cystic formations in the joint part of the bone are revealed.

Roentgenogram of the knee
Radiography is the main method for diagnosing osteoarthrosis

. Additional methods use ultrasound, thermography to determine inflammatory changes, MRI and CT.

Differential diagnosis of

Differentiate osteoarthritis with several articular pathologies:

  • rheumatoid arthritis,
  • reactive arthritis,
  • psoriatic arthritis,
  • gouty arthritis,
  • pyrophosphate arthropathy.

Often it is necessary to conduct differential diagnostics of osteoarthritis with rheumatoid arthritis, especially when the small joints of the hands are affected. Unlike osteoarthritis, rheumatoid arthritis begins with severe inflammatory joint changes( pain, swelling, redness, increased local temperature, impaired function).Almost always the small joints of the hands and feet are affected. There is a morning stiffness in the joints, rheumatoid nodules are formed. There may be violations of the internal organs, which is not the case with osteoarthritis.

You can also read: coxarthrosis Hip Osteoarthritis of 2nd degree

In the blood, rheumatoid factor, an increase in ESR is detected. On roentgenograms, osteoporosis is noticed instead of osteosclerosis, the presence of usur( edge ​​defects of bones).

Infectious arthritis is characterized by the following symptoms:

  • acute onset and rapid development of symptoms;
  • pronounced pain syndrome and exudative manifestations;
  • fever;
  • inflammatory changes in the blood;
  • high efficiency antibacterial therapy.

Gouty arthritis is characterized by acute attacks of articular syndrome with severe inflammatory symptoms and acute pain. Most often affects the first metatarsophalangeal joint of the foot. In the blood, an increase in uric acid, an increase in ESR, a characteristic symptom in the radiography.

When making the conclusion, it should be noted that in each case, you need to be careful about your health and when you have any suspicious signs you need to seek specialized medical help. Since the detection of osteoarthritis at an early stage can slow or completely stop the pathological process.

A doctor examines an elderly man
Contents:
  • Common signs of osteoarthritis
  • Symptoms of hip osteoarthritis
  • Symptoms of knee osteoarthritis
  • Symptoms of osteoarthritis of interphalangeal joints
  • Diagnosis
  • Differential diagnosis