Degenerative osteoarthritis, also known as osteoarthritis, degenerative arthritis, senile arthritis, and hypertrophic arthritis, is a degenerative disease caused by age, obesity, strain, trauma, joint congenital abnormalities, joints Degeneration and damage of articular cartilage, joint edges and subchondral bone reactive hyperplasia caused by many factors such as deformity.
This disease is more common in middle-aged and elderly people, and it is more common in weight-bearing joints and joints with a lot of activity (such as the cervical spine, lumbar spine, knee joint, hip joint, etc.). Excessive weight-bearing or use of these joints can promote the occurrence of degenerative changes. The clinical manifestations are slow development of joint pain, tenderness, stiffness, joint swelling, restricted mobility and joint deformities.
The etiology is not yet clear and may be related to factors such as advanced age, female, obesity, and occupational overuse.
The main symptom is joint pain, often rest pain, which manifests as pain after rest, which is relieved after a short period of activity, but after too much activity, the pain increases. Another symptom is joint stiffness, which often occurs when you get up in the morning or after the joints stay in a certain position for a long time during the day. Examination of the affected joints reveals joint swelling, tenderness, friction or "clicking" sounds during activities. In severe cases, muscle atrophy and joint deformities may occur.
1. Imaging examination
① X-ray films showed unequal width or narrowing of the joint space, osteoporosis at the joint, bone hyperplasia or joint enlargement, and even joint deformation, hardening of the subchondral bone plate and osteophyte formation. ②CT can clearly show different degrees of joint bone hyperplasia, intra-articular calcification and free body, and sometimes meniscus can also be shown.
2. Laboratory inspection
There were no abnormal changes in the blood cell sedimentation rate and blood picture, and the heat agglutination test was positive. The synovial fluid is often clear, yellowish and highly viscous. The white blood cell count is often within 1.0×109/L, mainly monocytes. The mucin clot is firm.
According to the relevant medical history, clinical manifestations and X-ray findings, the diagnosis of this disease is not difficult. If necessary, joint synovial fluid can be checked.
The main treatment for this disease is to reduce the weight-bearing of the joints and excessive and large-scale activities to delay the progress of the disease. Obese patients should lose weight and reduce the load on joints. Crutches or walking sticks can be used when the joints of the lower limbs are diseased to reduce the burden on the joints. Physical therapy and proper exercise can maintain the range of motion of the joints. Splints and canes can be used when necessary to help control the acute symptoms. Anti-inflammatory and analgesic drugs can reduce or control symptoms, but they should be used with caution after assessing the patient's risk factors and should not be taken for a long time. Cartilage protective agents such as glucosamine sulfate have the effects of relieving symptoms and improving functions, and long-term use can delay the structural progression of the disease. For advanced cases, under the condition that the whole body can tolerate the operation, artificial joint replacement is currently recognized as an effective method to eliminate pain, correct deformity, and improve function, which can greatly improve the quality of life of patients.
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