19Feb

What is subchondral osteosclerosis of the spine and articular surfaces

Osteosclerosis is a change in the normal structure of bone tissue, which is the increased density of the latter. Among pathological changes in bones, sclerosis ranks second after osteoporosis.

Why is this condition considered dangerous? Despite the increased density, bones with osteosclerosis lose elasticity. This leads to the risk of fractures, even with a minor effect of the traumatic factor.

It's important to know! Osteosclerosis is not a separate disease. This is only one of the symptoms and radiographic signs of a large number of ailments, both inborn and acquired.

What is the pathology of

Subchondral osteosclerosis is one of the main manifestations of such degenerative-dystrophic diseases of the musculoskeletal system, like osteoarthritis and osteochondrosis, as well as the most common form of compaction of bone tissue. The word "subchondral" should be understood as "subchondral", that is, the densification of the bones takes place in those areas that are directly adjacent to the pathological process affected by the articulations. Such subchondral areas of bones are called end plates.

Physiological osteosclerosis
Osteosclerosis can also be physiological, for example, in children in areas with bone growth, there is an increased density( indicated by arrows).

Subchondral sclerosis of articular surfaces does not develop immediately. It appears with the progression of degenerative dystrophic changes in the joints, if the causative factor is not eliminated and effective treatment is not prescribed.

Learn more about the causes of osteosclerosis and its forms here.

By itself sclerosis of the closure plates does not cause any symptoms, all manifestations are caused by the primary pathology, which causes such changes in the bones. But, nevertheless, compaction of the subchondral areas of bone tissue can cause compressive fractures of the vertebral bodies and deformity of the limbs.

Subchondral sclerosis is also of diagnostic importance, as it is one of the main radiographic criteria of deforming osteoarthritis of joints and osteochondrosis of the spine.

Causes of

As it becomes clear, the causes of subchondral osteosclerosis are no different from those of arthrosis and osteochondrosis:

  • excess weight;
  • permanent microtraumatic joints( heavy physical work, professional sports);
  • hypodynamic way of life;
  • long stay in one pose;
  • endocrine and metabolic disorders;
  • genetic predisposition;
  • advanced age;
  • concomitant rheumatological and vascular diseases;
  • injury in history;
  • congenital or acquired pathology of the musculoskeletal system;
  • unhealthy eating;
  • poor development of the muscular corset.
Overweight
Overweight and unhealthy diets are the direct route to joint arthrosis and spine osteochondrosis

Symptoms of

Symptoms of subchondral sclerosis depend on the disease that caused changes in the bones, its stage and localization. At the initial stages of degenerative-dystrophic changes, sclerosis does not manifest itself in any way and can be detected only when carrying out an X-ray study. As the pathology progresses, characteristic clinical signs appear. The most common types of subchondral osteosclerosis will be discussed further.

Subchondral sclerosis of the spine

The consolidation of the bone tissue of the vertebrae is observed with osteochondrosis in the area that is directly in contact with the damaged intervertebral disc.

The manifestations of subchondral sclerosis of the spine depend on the location( cervical, thoracic or lumbar), the degree of damage to the spinal tissues and the presence of complications( intervertebral hernia, narrowing of the spinal canal, infringement of the nerve roots, etc.).

Patients complain of chronic pain in the neck and back. From time to time there are exacerbations with acute pain syndrome. In the later stages, neurological complications arise, deformities of the spinal column, which can lead to the loss of working capacity and disability.

MRI of the spine
MRI of the spine will allow not only to establish the fact of osteosclerosis, but also to find its cause

The main danger of sclerosis of vertebral bodies is to increase the risk of spontaneous compression fractures that can appear even with minimal physical exertion. Therefore, we need to identify the problem as early as possible and do everything possible to prevent its progression and the development of complications.

Osteosclerosis of the hip joint

This localization of sclerosis almost always complicates the course of arthrosis of the hip joint. Patients complain of chronic hip pain, which first occurs during exercise, and then worries and at rest. Gradually, the amplitude of movements in the joint is limited, lameness develops.

If the pathological process is not stopped in time, the joint is completely destroyed in time, the function of the lower limb is lost. Such patients will be able to regain the ability to move independently only by surgery for hip joint endoprosthetics.

Osteosclerosis of the hip joint
The second radiograph shows the absence of an articular joint of the hip joint and an increase in the density of subchondral bone tissue, which are signs of coxarthrosis of

. The risk of sclerosis of this localization is to increase the risk of such severe pathologies as fracture of the femoral neck and aseptic necrosis of its head. Therefore, in detecting osteosclerosis of the hip joint, it is first necessary to address the prevention of possible severe consequences.

Sclerosis of the knee joint

It is revealed in the development of deforming osteoarthrosis of the knees. Patients complain of pain in the knees with physical activity, and then at rest, a crunch when moving, a gradual decrease in their amplitude, deformation of the knees and lower limbs.

A frequent consequence of subchondral knee sclerosis is the development of varus or valgus deformity( O and X legs).

O- and X-shaped deformities of the legs
O- and X-shaped deformities of the lower extremities

Osteosclerosis of the shoulder joint

Brachial articulation refers to the most mobile joints of our body. Therefore, it is often affected by arthrosis. On the development of pathology indicates pain during movements, clicks and crunch, amplitude limitation.

Despite the fact that sclerosis of the shoulder joint is not a cause of severe disability, such as osteosclerosis of the hip or knee joint, it significantly impairs the quality of life of such people due to chronic pain and functional joint failure.

Diagnostic methods

We also recommend reading: Changes in arthrosis of joints Deforming arthrosis of joints

The main method of intravital diagnosis of changes in bone tissue, including osteosclerosis, is an X-ray study. On radiographs of good quality, it is possible to examine lesions of multiple sclerosis in different locations. But, unfortunately, it is not enough to make a diagnosis. As first of all it is necessary to reveal the reason of compaction of an osteal tissue. For this purpose, a number of diagnostic procedures are performed:

  • MRI or CT;
  • densitometry( measurement of bone density);
  • laboratory tests of blood and urine;
  • joint ultrasound;
  • genetic tests to exclude hereditary forms of osteosclerosis.

Principles of treatment of

Since subchondral sclerosis is not a disease, but only a term that denotes changes in bones in various pathologies, there is no specific treatment. Therapy should be directed to the primary ailment, which will prevent the progression of sclerosis and its complications.

Treatment should be comprehensive. It includes such events:

  1. Medication therapy. It is used, as a rule, in the presence of exacerbations of arthrosis and osteochondrosis, which are accompanied by severe pain syndrome. Applied drugs from the following groups: analgesics and nonsteroidal anti-inflammatory, chondroprotectors, muscle relaxants, B vitamins, vasodilators and decongestants, glucocorticoids and local anesthetics for blockades.
  2. Medical gymnastics. It is the main method of therapy of degenerative-dystrophic diseases of the musculoskeletal system. It allows you to strengthen the muscles that will protect and maintain damaged joints.
  3. Massage and other manual techniques for the impact on the joints( manual therapy, osteopathy, post-isometric relaxation).
  4. Various physiotherapeutic procedures( laser, ultrasound therapy, magnetotherapy, electrophoresis, UHF, balneotherapy, therapeutic mud, spinal traction, etc.).
  5. Dietary food.

It is important to understand that you can not get rid of osteosclerosis, you can only slow down the pathological process or suspend it. Therefore, at the first alarming symptoms it is necessary to seek specialized medical help in order to establish a diagnosis and make an optimal program of prevention and treatment. This is the only way to protect yourself from the severe consequences of subchondral osteosclerosis.

Subchondral osteosclerosis of the knee joint
Contents:
  • What is the pathology of
  • Reasons for
  • Symptoms of
  • Diagnostic methods
  • Principles of treatment