joint degeneration

Introduction

Introduction to joint degeneration The so-called spurs, also known as bone hyperplasia, osteophytes, which are degenerative lesions of the bone, are a manifestation of arthritis. basic knowledge The proportion of illness: 0.078% Susceptible people: good for middle-aged and older people over 40 years old and engaged in weight-bearing, long-standing, sedentary staff Mode of infection: non-infectious Complications: joint pain

Cause

Joint degeneration

The pathogenic factors of this disease are mainly caused by the imbalance of mechanical stress distribution or excessive wear caused by cartilage wear.

1. Age: Old age is the most important risk factor for the onset of this disease.

2. Occupation: This disease is related to occupation. Repeated use of certain joints over a long period of time can increase the prevalence of these joints. Such as the elbow and shoulder joints of the foundry, the spine and knee joint of the miner, the knee joint of the loader, the shoulder joint of the driver, the wrist joint of the repairman and the weaver, the toe joint of the ballerina, long-term embroidery, typing, The cervical vertebrae of the desk workers worked for a long time, such as textile women workers, salespersons, Miss Yingbin, and the calcaneus of the honor guards.

3. Ethnic genetic factors.

4, physical factors: weight gain caused the degenerative joints that have been worn out and heavy load, more likely to be destroyed, so the disease occurs mostly in the hip, knee, calcaneus, lumbar vertebrae and other parts with heavy weight. In addition, due to joint pain, the patient unconsciously restricts the activity and increases the weight, and the mutual influence increases the joint disease.

5, poor posture: such as long-term desk workers, poor sleep posture, inappropriate pillows, the incidence of cervical degenerative lesions is particularly high. This is due to the imbalance of the ligaments and joints of the paravertebral muscles. The side with large tension is liable to cause different degrees of strain, and because some of the muscles of the cervical vertebrae are in a state of constant tension, the muscles are statically damaged for a long time, and the cervical vertebrae are degenerated. Sexual change. At the same time, it is also unevenly affected by the long-term stress of the cervical vertebra joint, so that stress (stress) is concentrated in somewhere in the joint to cause excessive stress and damage the joint.

6. Internal venous stasis and intraosseous hypertension: Abnormal bone blood flow characterized by internal venous stasis and resulting intraosseous hypertension, narrowing the arteriovenous pressure difference, reducing blood flow of nutrient vessels, and nutritional disorders It can cause trabecular bone necrosis, and osteonecrosis of bone may be one of the causes of this disease.

Prevention

Joint degeneration prevention

Prevention should pay attention to the following aspects:

1. Avoid long-term strenuous exercise

Long-term, excessive, intense exercise or activity is one of the basic causes of this disease. Especially for heavy joints (such as knee joints and hip joints), excessive movement increases the joint surface and increases wear. Long-term intense exercise can also cause excessive stress and traction on the bones and surrounding soft tissues, resulting in local soft tissue damage and uneven force on the bones, so long-term strenuous exercise should be avoided.

2, appropriate physical exercise

Avoiding long-term intense exercise is not inactive. On the contrary, proper physical exercise can effectively prevent this disease. Because the nutrition of articular cartilage comes from joint fluid, and the joint fluid can only enter the cartilage by "squeezing", promoting the metabolism of cartilage. Proper exercise, especially the movement of the joints, can increase the pressure in the joint cavity, facilitate the penetration of the joint fluid into the cartilage, reduce the degenerative changes of the articular cartilage, thereby reducing or preventing the hyperplasia and degenerative changes of the articular cartilage.

3, timely treatment of joint damage

Joint damage includes soft tissue damage and bone damage. Degenerative lesions of the joint are often directly related to intra-articular fractures. Due to incomplete fracture reduction, the articular cartilage surface is not flat, resulting in traumatic arthritis. For patients with intra-articular fractures, if they can be treated in time, anatomic reduction can completely avoid the occurrence of traumatic arthritis and joint degenerative diseases.

4, reduce weight

Overweight is one of the important reasons for the degeneration of the spine and joints. Excessive weight will accelerate the wear of the articular cartilage and make the pressure on the articular cartilage surface uneven. Therefore, for people who are overweight, proper weight loss can prevent degenerative diseases of the spine and joints.

Complication

Joint degeneration complications Complications joint pain

Can cause joint swelling and muscle atrophy.

Symptom

Joint degenerative symptoms Common symptoms Cervical hyperplasia morning stiffness knee pain pain back pain backache sore neck pain

1, cervical degenerative disease

The neck has a strong feeling, limited activity, and a rattling sound in the neck. The pain is often radiated to the shoulders and upper limbs. The hands and fingers have numbness and electric shock, which can be aggravated by the neck movement to a certain angle. Different lesions involve different parts, and different symptoms appear. In severe cases, the cervical spinal cord can be pressed to cause paralysis.

Certain types of cervical vertebrae can also cause cervical vertigo, cervical spondylosis, cardiovascular and cerebrovascular diseases, gastritis, angina pectoris, and difficulty swallowing.

2, lumbar degenerative disease

Good hair parts, the waist three, waist four are the most common. Clinically, lumbar and lumbar soft tissue pain, pain, stiffness and fatigue often occur, and even bending is limited. If the adjacent nerve root is compressed, it can cause the corresponding symptoms, local pain, stiffness, post-root neuralgia, numbness and so on. Such as compression of the sciatic nerve can cause sciatic neuritis, radioactive numbness, burning pain, pain, string pain, radiation to the entire lower extremity, resulting in intermittent claudication.

3, knee degenerative disease

In the early stage, the knee pain is not serious, the pain is persistent, the pain is aggravated when the temperature is lowered, it is related to climate change, the activity starts in the morning, the long walk, the strenuous exercise or the sedentary start and the knee joint pain is stiff. After a little activity, it is getting better. It is difficult to go up and down. When you go downstairs, your knees are soft and easy to fall. Pain, stiffness, severe, joint pain and pain, claudication, joint function is limited, the following sputum is most obvious, the flexion and extension activities have a sound, some patients can see joint effusion, local swelling, tenderness, merger Rheumatism is red and swollen and deformed.

Examine

Joint degenerative examination

If patients do blood tests, erythrocyte sedimentation rate, C-reactive protein, anti-chain "O", rheumatoid factor and other tests, generally in the normal range, a small number of severe inflammation, ESR and C-reactive protein may be slightly elevated.

1, synovial fluid examination

Involved joints such as associated with synovitis can increase the amount of synovial fluid. Typical is clear, sticky, and the number of cells is not high (<20 × 10 / liter), mostly mononuclear cells. Cartilage or cartilage debris can be seen, and chondrocytes can be seen in cartilage fragments.

2, arthroscopy

Can directly observe the internal conditions of the joint, can clearly observe the articular cartilage and its surrounding tissue, but because this examination is a traumatic examination, may be associated with adverse reactions such as infection or bleeding, and the cost is high, it is impossible to be a routine examination.

3, X-ray film

Track changes in the condition. When taking a knee joint piece, the patient should take the front and back position and the lateral position piece of the standing position, and the hip joint and the hand joint can only take the front and rear position piece. In the early stage, most of the X-ray films are normal. In the middle and late stages, the asymmetry of the joint space is narrow, the articular surface is hardened and deformed, the joints of the joints are formed, the cystic changes of the articular surface and the free body of the joint cavity. The x-ray features of osteoarthritis are: 1 joint space stenosis, such as less than 3 mm in the knee joint; 2 articular surface hardening deformation; 3 joint edge osteophytes; 4 joint mice; 5 subchondral cystic changes, the edge Clear boundaries; 6 bone deformation or joint subluxation.

X-ray films can be divided into five levels. Grade 0: no change; Grade 1: minor osteophytes; Grade 2: obvious osteophytes, normal joint space; Grade 3: moderate stenosis of the joint space outside the epiphysis; Grade 4: severe stenosis of the joint space outside the epiphysis, with subchondral Osteopathy.

4, other

With the application of new imaging techniques such as microfocus photography; CT, magnetic resonance and three-dimensional reconstruction, in addition to the diagnosis of osteoarthritis, it has reference value for detailed understanding of the pathological progress of osteoarthritis and drug efficacy.

Diagnosis

Diagnosis of joint degeneration

Corresponding diagnosis can be made based on clinical manifestations and related examinations.

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