Sealing of the articular surfaces of the knee joint. Osteophytes. The prerequisites are laid from childhood ...

Surely, most people at least once in their lives experienced inconvenience and discomfort caused by pain in the back and joints. Of course, it’s good if they are short-term due to banal physical exertion, but what if it’s serious illness requiring the participation of professional specialists?

Changes in cartilage or subchondral sclerosis is the most common cause and one of the radiological symptoms of such unpleasant diseases as osteochondrosis or osteoarthritis. It should be noted that the concept of "osteoarthritis" unites not one, but a whole group of diseases with similar morphological, biological and clinical signs. At the same time, the entire joint is involved in the process, including the subchondral bone, capsule, ligaments, periarticular muscles, and the main clinical symptoms of osteoarthritis include deformity and pain of the joints, which subsequently lead to their insufficient functionality. This is especially felt by the elderly.

In general, osteoarthritis belongs to the group of the most common joint diseases. The reasons for its development can be not only mechanical (bruises, injuries, etc.), but also biological factors (violation of the processes of formation of new cells of the subchondral bone (subchondral sclerosis) and articular cartilage). In addition, the presence of genetic diseases is of great importance in the diagnosis of osteoarthritis.

There are primary and secondary osteoarthritis. The reasons for the former, as a rule, cannot be established. It is also called idiopathic, i.e. special or idiosyncratic. In contrast, the causes of secondary osteoarthritis are obvious - these are mechanical damage to the joints of various origins (metabolic disorders, endocrine diseases, inflammatory processes in the joints, injuries, etc.).

X-ray diagnostics is successfully used to detect osteoarthritis. She points to a number of symptoms that reflect changes in bone tissue and articular cartilage, including subchondral sclerosis. The radiological symptom of osteoarthritis at an early stage is osteophytes - bone growths along the edges, which first manifest as sharpening of the edges of the joint surface (subchondral sclerosis of the articular surfaces), and then, gradually growing, are transformed into massive bony lips and spikes. The presence of significant changes in the articular cartilage is also confirmed by varying degrees of narrowing of the joint space. Moreover, the gap can narrow on one side and simultaneously expand on the other, which also indicates the instability of the joint.

In addition, X-ray diagnostics reveals subchondral sclerosis of the endplates. Their thickening also indicates the instability of the joint and appears, as a rule, due to mechanical trauma or due to age-related changes in the joints in elderly people.

Osteoarthritis often contributes to the loss of the depreciation function of the articular cartilage that protects bone tissue from physical and mechanical overload. The compensating factor in this case is subchondral sclerosis, i.e. hardening or thickening of subchondral bone

The most common in Russia is developed by N.S. Kosinskaya. X-ray classification of osteoarthritis in accordance with the stages of development. So, for example, the first stage of the disease is characterized by the presence of a slight narrowing of the joint space and marginal bone growths. The occurrence of subchondral syndrome and a more distinct narrowing of the joint space indicates the second stage of osteoarthritis. And, finally, the third stage is a sharp and significant narrowing of the gap, accompanied by cystic formations and flattening of the surface of the joints.

Usually, the treatment of osteoarthritis is a rather long and laborious process. Its main principles include, first of all, limitation of physical activity, physiotherapy, compliance with the orthopedic regimen, etc.

Deforming arthrosis is a synonym, another name for osteoarthritis. It is usually used to denote those stages of the disease that are characterized by the presence of characteristic curvature, bone and cartilage growths, and pathological joint settings. That is, when deformations come to the fore out of the whole variety of clinical manifestations.

This is a widespread chronic disease, from which none of our articular joints is immune. The main targets are the most loaded joints of the lower extremities. Depending on the etiological cause, it can be observed both in youth and in the late period of life.

Causes of deforming arthrosis

It is generally accepted that deforming arthrosis can be primary, that is, the lesion begins spontaneously without an established triggering factor. And secondary, when you can trace what was the impetus for the development of pathological processes. There are many reasons for degenerative and dystrophic changes in articular and periarticular structures. Here are the most significant:

Traumatic injuries of the joints and periarticular formations;
Improper development of the skeleton of the limbs (dysplasia);
Inflammatory diseases of the articular and periarticular structures;
Endocrine diseases and metabolic disorders.

Cartilage degradation in deforming arthrosis occurs in several stages:

Loss of fluid by hyaline cartilage, followed by thinning and dehydration;
Formation of defects, cracks and erosions in the cartilage;
Extensive degradation of the cartilage at the articular ends of the bones and a decrease in the joint space;
The formation of osteophytes and the destruction of cartilage in the marginal sections;
Sclerosis of the articular ends of bones devoid of a cartilaginous surface;
Deformities of the joints with a violation of their mobility and support ability.

Diagnosis of deforming arthrosis

The diagnosis is based on the clinical picture, the history of the disease and data from various research methods. There are no vessels and nerves in the cartilaginous cover, which explains the imperfect regeneration and the late onset of pain. Symptoms of the disease appear when the process has spread to the subchondral bone and other structures of the joint. The following diagnostic criteria are used:

Selective damage to the large joints of the legs and end joints of the fingers;
The main patients are women over 40 and more often overweight;
The load causes pain, at rest it calms down;
The presence of deformities and curvatures caused by peripheral bone and cartilage growths, destruction of cartilage and crushing of the subchondral bone of the articular ends;
Decreased range of motion associated with bone deformities, scarring and contraction of the joint capsule;
Transient after exertion or permanent signs of synovitis without inflammation;
"Crunchy" or "clicking" joints;
Dystrophic changes in the periarticular tissues.

Symptoms of deforming arthrosis and their combinations are very variable.

Instrumental diagnostics

Laboratory methods are of auxiliary importance, since in the absence of inflammation, the indicators remain within the normal range. It is used to identify concomitant diseases and differential diagnosis.
Radiography is of undeniable importance, which makes it possible to detect the onset of the disease even in the preclinical, "painless" period.
Arthroscopy makes it possible not only to visually assess the state of the internal articular structures and the degree of their degradation, but in some cases correct some changes.
Ultrasound examination is the most gentle method with high resolution. Allows you to "see" ligaments, tendons, menisci, cartilage, foreign bodies and fluid in the joint cavity. It is possible to detail deviations in development and damage to any structures.
Magnetic resonance imaging. It is possible to reliably assess the state of all articular and periarticular tissues and create three-dimensional models of the organ under study, to control the changes that occur over time.

Stages of deforming arthrosis

Clinical manifestations are minor. On radiographs, one can notice a decrease in the joint space, signs of bone sclerosis under the cartilage in areas subject to the greatest load. Softening of the hyaline cartilage is determined arthroscopically with a probe.
There are moderate functional difficulties. Radiologically, uneven significant narrowing of the gap, bone growths along the perimeter of the articular surfaces and forming cysts against the background of subchondral osteosclerosis are clearly visible. Arthroscopy visualizes cracks and tears in the cartilage. There is no doubt that the patient has deforming arthrosis already at this stage.
Negative changes in the function of the joints are pronounced. On radiography, the height of the joint space is negligible. Bone growths increase the area of the articular surface, which is significantly flattened, deform the contours of the articulation. You can see the ossification of the capsule, free cartilaginous bodies and cysts in the epiphyses. During arthroscopy, the doctor will find swelling and focal detachment of cartilage.
Significant loss of limb function. On x-rays, the gap is almost not traced. Bone growths are excessive and disfiguring. Osteosclerosis alternates with areas of osteoporosis and cystic restructuring of the articular ends. Movement is almost impossible or causes severe pain. Arthroscopic examination shows the absence of cartilage.

Cartilaginous tissue is elastic and during movement cycles of compression are replaced by cycles of expansion. When compressed, the cartilage pushes the synovial fluid out of itself, and when straightened, it sucks in, thus providing nutrition. Therefore it should not long time stay in a static position.

Each degree of pathological changes in the joints corresponds to a certain treatment of deforming arthrosis. It cannot be identical at different stages of the disease and must necessarily be complex.

Therapy Methods

Traditionally, the following methods of healing are distinguished:

Surgery

Corrective osteotomy. The intersection of the bone with subsequent fusion in a pre-calculated position. Allows you to correct curvatures that cause local overstressing of the structures of the joints, remove damaged cartilage from under the load. May relieve pain for several years.

Arthroscopy with debridement. With minimal trauma, fragments of destroyed cartilage tissue are removed through punctures, uneven articular surfaces are smoothed out and, if possible, the causes that caused deforming arthrosis are eliminated (resection of a damaged meniscus, removal of free bodies, restoration of ligaments). Possible remission for one or two years.

Endoprosthetics. Full or partial replacement of the affected joint with an artificial device that duplicates the lost functions. Currently, implants have been developed for most limb joints.

Arthrodesis. In some situations, arthroplasty is contraindicated or impractical. Then it is possible to resect part of the articular surfaces and achieve fusion at the site of the joint in a functionally advantageous position of the limb.

Comprehensive treatment depending on the stage of development

Already at the first stage, despite the meager clinical picture, one should take the doctor's recommendations very seriously. The main emphasis should be on therapeutic gymnastics and physiotherapy. Treatment of deforming arthrosis, started at this stage, can achieve the best results. It is necessary to change motor stereotypes and physical activity. Do not forget about the warm-up after a long forced position of the limbs. Be sure to exclude:

prolonged static standing;
carrying weights over 3-5 kg;
monotonous hand movements of the same type;
long climbs up the stairs;
smoking, overeating and other bad habits;
kneeling work.

Pharmacological intervention should be minimal. If necessary, analgesics in the smallest dosages, chondroprotectors, plus drugs that improve local blood supply.

In the second stage, drug treatment comes to the fore, but the activities of the previous stage should be continued. Depending on the clinic and the activity of the process, the entire arsenal of drug therapy can be used according to indications. How to treat deforming arthrosis in this patient is decided solely by the doctor.

The third, and even more so the fourth stages are progressing due to the structural changes that have taken place. Under the influence of the load, the created unfavorable biomechanical conditions, instability and perverted regeneration of cartilage tissue intensify and accelerate the processes of irreversible deformation. Conservative treatment can no longer affect the course of the disease.

Persistent painful contractures and ankylosis, often in a vicious position, make it difficult to use the limb. They lose their ability to work and take care of themselves. Some deformities lead to pathological fractures and dislocations. Such situations require surgical intervention.

In the later stages, painkillers and anti-inflammatory drugs, intra-articular injection of glucocorticoids and hyaluronic acid provide temporary relief. But such assistance is indicated for elderly patients with severe comorbidities, when operations are contraindicated. Remission periods with symptomatic therapy can reach several weeks and even months.

Deforming arthrosis of the knee or hip joint to redistribute the load and maintain stability is an indication for the use of walking sticks. The handle of the cane should be at the level of the greater trochanter of the healthy leg.

Nutrition for osteoarthritis

Deforming arthrosis requires an integrated approach to treatment. Nutrition is also important. It should be:

moderately high-calorie;
balanced content of proteins, fats, carbohydrates;
enough of minerals and vitamins.

The daily need for proteins should be covered by the use of lean meat, fish and dairy products. Foods high in collagen and gelatin are very useful. For example, jelly, satilsons, aspic. In order for the diet to be complete in terms of vitamin and mineral composition, it is necessary to eat more fruits and vegetables daily.

Undoubted benefit will bring the restriction, but rather the rejection of rich flour products, fried foods and alcohol. Food or biologically active additives (BAA) in the treatment of patients with a diagnosis of deforming arthrosis do not have any reliably significant effect.

Traditional medicine in the treatment of deforming arthrosis

Treatment of deforming arthrosis is associated with the development side effects about non-steroidal anti-inflammatory drugs and an alternative is the use of folk remedies. The main medical achievement folk recipes is a decrease in pain, phenomena of synovitis and inflammation during exacerbations. Here are some simple but effective recipes:

Compress. Mix thoroughly, depending on the size of the joint, one part of vodka and aloe juice with two parts of honey. Let stand 1-2 hours. Make a compress at night for up to 2-3 weeks.
Rubbing. Buy at the pharmacy 50 gr. elecampane root and insist 10-12 days in 125 ml of vodka. Rub into the area of the diseased joint 3-4 times a day.
Ointment. Place in a small container of 100g. vegetable oil and propolis and continuously stirring to simmer in a water bath until a homogeneous mass is obtained. Apply the ointment 2-3 times a day.
Infusion. Boil four strong and washed potatoes in their skins. Set aside until cool, drain the top medicinal layer. Take three times a day for 1/3-1/4 cup.

Conclusion

Success in the treatment of deforming arthrosis can only be achieved by daily methodically fulfilling medical appointments, changing the way of life for the better, maintaining sufficient physical activity and with healthy optimism, being creative in the healing process.

subchondral sclerosis

One of the degenerative-dystrophic diseases of the musculoskeletal system is subchondral sclerosis. The disease affects the tissues of the spine and articular surfaces. For many people, the word "sclerosis" is associated with aging, impaired brain function. But few people know what it is in relation to bone tissue. In fact, this pathology manifests itself in the growth of subchondral tissue, that is, the one that covers the surface of the joints under the cartilage. This tissue lined the articular fossa and the heads of the bones. Such a degenerative process can occur in the joints or endplates of the vertebral bodies.

Development mechanism

Osteosclerosis is not an independent disease. This is just a sign of damage to the articular surfaces, condyles of the bone, found on x-rays. When, for some reason, blood circulation and metabolic processes in the subchondral tissue are disturbed, it begins to deform. There is growth, compaction of bone tissue, cartilage is destroyed. Arthrosis, spondylitis and osteochondrosis manifest themselves in this way. Joints that can withstand the greatest load are most often affected: the hip joints, hands, and tibial heads. In the spine, subchondral sclerosis is most susceptible to lumbar and cervical region.

When, for various reasons, the cartilage that covers the inner surface of the joint is damaged, it begins to be replaced by bone tissue. It grows, thickens, osteophytes are formed - bone growths. Sometimes they do not cause any inconvenience to a person, but most often the joint space narrows, and movement becomes difficult, causing pain. A hip injury can lead to complete immobility. And with degenerative processes in the joints of the spine, often there is an infringement of the nerve roots by osteophytes. Therefore, there are back pains, as well as various neurological problems.

Varieties

The most common subchondral sclerosis of the endplates in the spine. They are located between the vertebrae and discs. Plates in the cervical region and lower back are affected. Pathology also occurs in the joints of the limbs, subjected to heavy loads. Subchondral sclerosis of the knee, hip, foot, shoulder, or hand joints is common.

According to the features of development, primary and secondary sclerosis are distinguished. The primary form can occur even in healthy cartilage tissue with increased stress or injury. Secondary sclerosis develops on articular surfaces already affected by degenerative processes, for example, with arthrosis.

In addition, four stages are distinguished in the classification of the disease.

The initial stage is characterized by marginal osteophytes, which almost do not impair joint mobility.
Moderate subchondral sclerosis is detected on x-ray by narrowing of the joint space.
The third stage is a pronounced subchondral sclerosis, in which osteophytes grow to large sizes, the joint space is very narrowed.
At the last stage, the joint is completely deformed, the depression is smoothed out, its surfaces become flat. Osteophytes greatly interfere with its normal functioning.

Causes

Degenerative-dystrophic processes in the subchondral tissue can be caused by various reasons. Most often, adjacent plates wear out with age as a result of a slowdown in metabolic processes or disruption of the vessels.

But this condition can be caused by other factors:

hereditary predisposition;
congenital pathologies;
endocrine disorders;
overweight;
injuries;
prolonged stay in one position;
inflammatory diseases.

Different joints are affected for different reasons. For example, due to excess weight, increased physical activity or injuries, the ankle joints or knees are most often affected. And due to a sedentary lifestyle and impaired blood supply, the end plates of the vertebrae are affected.

In addition, the growth of bone tissue in the joint can be triggered by certain diseases. First of all, it is arthrosis, arthritis, osteochondrosis, spondylitis, joint dysplasia. But diseases of the internal organs can also cause impaired blood circulation and nutrition of the subchondral tissue. These are diabetes mellitus, gout, systemic lupus erythematosus.

Symptoms

Sclerosis of the subchondral plates is not an independent disease. This is a symptom that manifests itself in degenerative-dystrophic processes in bone tissue. But they combine these processes with one concept, because they have common features. First of all, it is pain, crunching during movement and limitation of joint mobility. Muscle weakness, lack of coordination, problems with movement may also appear.

There are also specific symptoms depending on the location of the pathological process. If the knee or elbow is affected, pain occurs when the limb is extended. When the patient bends the arm or leg, he experiences only slight discomfort, but it becomes problematic to unbend it. Sclerosis of the roof of the acetabulum or other surfaces of the hip joint causes pain in the lower back, as well as disruption of the pelvic organs.

With subchondral sclerosis of the endplates of the vertebral bodies, often there is an infringement of the nerve endings and a violation of blood circulation. This is manifested by numbness of the limbs, loss of sensation. If the degenerative process occurs in the cervical region, problems with memory, concentration, headaches, hearing loss and depression may begin. emotional condition. Even chest pains and palpitations can be symptoms of this pathology.

Treatment

In order to stop the growth of osteophytes, it is necessary to correctly determine the cause of this condition. Only the treatment of the underlying disease that caused the pathological process will help alleviate the patient's condition. Therefore, therapeutic measures are selected individually depending on the patient's condition, the severity of the disease and the localization of the pathological process.

The goal of treatment is to relieve pain, slow down degenerative processes, and increase joint mobility. In the early stages, this can be done with conservative treatment. Most often, manual therapy, physiotherapy exercises, acupressure or classical massage, acupuncture are used. Physiotherapy helps, especially thermal, as well as electrophoresis and mud baths.

From medicines non-steroidal anti-inflammatory and analgesics are prescribed to relieve pain - Indomethacin, Diclofenac, muscle relaxants and antispasmodics to relax muscles, chondroprotectors to restore cartilage tissue - Artra, Chondroitin, Teraflex. Antihistamines, antibacterials, or hormonal preparations. Useful injections of B vitamins, multivitamin complexes.

Severe growth of osteophytes that interfere with movement is an indication for surgical treatment. Only with the help of an operation can they be removed. It can be arthroscopy or joint arthroplasty.

In the absence of therapy or the appointment of improper treatment, serious complications are possible. The friction of the articular surfaces against each other provokes the development of the inflammatory process. And the growth of osteophytes can cause damage to soft tissues. In severe cases, a purulent process may develop.

The earlier the patient went to the doctor and began treatment, the greater the chance of maintaining the mobility and function of the joint.

For arthrosis of the maxillofacial joint, symptoms and treatment are associated with dystrophic changes in the structure. What are the main causes of such a disease, its symptoms, methods of therapy and methods of prevention, as well as what kind of treatment with folk remedies can be used?

Why the disease can develop

This pathology of the musculoskeletal system has a chronic origin. Arthrosis of the TMJ is caused by long-term dystrophic processes in the tissues. They are accompanied by a violation of the performance of the lower jaw. The problem is widespread. According to the latest data, signs of this disease occur in about half of patients after 50 years. In persons older than 70 years, this pathology occurs already in 90% of cases, regardless of gender.

Osteoarthritis of the jaw is diagnosed most often in young women. The treatment of such a pathology is carried out by specialists of various specialties - dentists, orthopedists, orthodontists, surgeons, traumatologists, physiotherapists.

Osteoarthritis of the jaw joint refers to a multifactorial pathology. The reasons for it are both local and general. Local factors in the development of the disease include:

chronic arthritis of the maxillofacial joint;
bite pathology;
adentia (most often the absence of molars in the lower jaw);
enamel pathology;
bruxism;
improper installation of seals;
errors in the process of prosthetics;
trauma;
a history of operations on the jaw joint.

Among the common factors for the occurrence of such a disease:

unfavorable heredity;
disturbances in the work of the endocrine glands;
vascular pathologies;
systemic diseases;
infections;
in women - menopause and a drop in the production of female sex hormones due to age-related changes;
pathology of bone tissue and cartilage.

The pathogenesis of this disease is associated with an additional load on the articular part, which is above the limit of normal endurance. This happens as a result of constant microtrauma, inflammation, metabolic disorders in the body. Gradually, the pathology of the masticatory muscles develops. All these processes provoke changes in the tissue nutrition of the articular part, there is a loss of the elastic properties of its tissues.

The head of the jaw gradually changes its shape (becomes club-shaped, mushroom-shaped, hook-shaped). It shows signs of osteoporosis.

How are they classified

Jaw arthrosis can be classified as follows:

Sclerosing arthrosis. It is manifested by sclerosis of the bone surface, narrowing of the joint spaces.
Deforming arthrosis is manifested by flattening of the joint fossa, its head and articular tubercle. At the same time, the formation of osteophytes on the surfaces of the joint is determined radiographically. In advanced cases, arthrosis of the mandibular joint is manifested by a very severe deformation of the head.
Primary arthrosis develops in a person without previous diseases. This type occurs mainly in the elderly.
Secondary arthrosis is associated with frequent and severe injuries, inflammation, metabolic or vascular dysfunction.

There are 4 stages of jaw pathology:

At the first stage, instability in the jaw joint is noted. The radiological sign of such instability is an intermittent narrowing of the joint gap (it is mild or moderately pronounced). There is moderate degradation of the cartilage.
In the second stage, pronounced changes are noted. X-ray diagnosed sclerosis and ossification of the condylar process in the lower jaw.
At the third (late) stage, the function of the jaw joint is limited. Radiologically, almost complete degeneration of the cartilage is determined, massive sclerosis of the joint surfaces occurs. The condylar process is gradually shortened, the articular fossa becomes denser.
At the advanced stage, fibrous degradation of the joint occurs.

What are the symptoms of pathology

This disease develops for a long time. At first, the patient does not notice the changes that occur in the body. Among the earliest signs of a degenerative change in the organ are clicks and crunches, stiffness in the morning. During the day, these symptoms gradually disappear. In the future, pain joins such stiffness: first when talking and chewing, and then at rest. Pain symptoms are aggravated by changing weather, often in the late afternoon.

In the future, the function of the joint is gradually limited. This becomes noticeable when the range of motion in the joint is limited. The following symptoms are noted:

poor mobility;
facial asymmetry;
change in the position of the jaw during opening of the mouth;
numbness on the affected side;
pain in the tongue;
pain in the ears, in the eyeballs, head, sometimes hearing loss.

On palpation and auscultation, a crunch and crepitus are determined. When probing the pterygoid muscle, the patient usually does not feel pain. Often the patient cannot open his mouth wide; in rare cases, the width of the opening of the mouth is no more than 0.5 cm. Sometimes a person shifts the lower jaw to the sides in order to open the mouth normally.

In addition, with active movements, patients feel very sharp pain. At the same time, the condition worsens sharply, the temperature rises, and there is a chill. With purulent mumps, further spread of the inflammatory process to the salivary glands, the inner ear is possible. There are characteristic symptoms of parotitis, otitis media.

Pain dysfunction

With an uneven (one-sided) load on the joint, a pronounced pain dysfunction occurs. It is characterized by the appearance of constant aching pain. It usually radiates to the cheek, ear, and back of the head. The ability to open the mouth normally is usually impaired. Probing the masticatory muscles usually causes pain.

Treatment of pain dysfunction is aimed primarily at eliminating its manifestations. This can be achieved through the use of analgesics and sedatives. Showing drugs with muscle relaxant properties. Sirdalud is most often used for this purpose.

Methods for diagnosing a disease

The sooner you start treating arthrosis, the greater the likelihood of a favorable outcome. The diagnosis is made on the basis of functional data, radiography. If the patient goes to the dentist, then complaints are analyzed, the oral cavity is examined, muscles and joints are palpated. The regularity of movements in the joint is carefully determined.

The main method of diagnosis is radiography of the joint. With its help, the initial signs of arthrosis are detected. Computed tomography allows you to more accurately determine such changes in the joint. Additionally, the following examinations are carried out:

arthrography;
orthopantomography of the jaw;
electromyography;
rheography;
arthrophonography;
axiography.

Consultation of an orthodontist, endocrinologist, rheumatologist is indicated.

This disease is differentiated from arthritis, muscle and joint dysfunction, chondroma, osteoma.

Principles of treatment of arthrosis

In case of detection of arthrosis of the jaw joint, complex treatment is mandatory. Necessary therapeutic, orthopedic, orthodontic measures are provided. The entire period when the treatment of arthrosis of the TMJ is carried out, a sparing diet is shown, with restriction of solid food, in addition, it is necessary to chew foods intensively. Talk restriction is sometimes indicated to limit intense stress on the joint.

The dental stage of treatment involves the elimination of factors that lead to joint overload. There is an elimination of defects of teeth, bite correction. Sometimes the patient needs to grind the teeth, with the replacement of fillings. Eliminate excessive load and the installation of crowns, wearing prostheses and orthodontic systems. It must be remembered that this method of treating arthrosis of the jaw joint is quite lengthy.

It is very important to stop the pain that occurs with such a disease. And this is often used traditional method pain relief - non-steroidal anti-inflammatory drugs. Most often, these funds are used in tablet form. Less commonly used ointments with NSAIDs. Chondroprotectors are used to improve tissue trophism and slow down the degenerative process in tissues. A remedy such as Chondroxide has proven itself well.

Physiotherapy techniques

Physiotherapy in case of illness has a positive effect on the jaw joint and prevents its further damage. Among the physiotherapy procedures, the following are often used:

ultrasonic phonophoresis;
electrophoresis (exposure to weak electric shock);
treatment of the affected joint with a laser;
magnetotherapy;
galvanotherapy;
fluctuation;
treatment with paraffin;
treatment with ozokerite;
irradiation of the joint with infrared rays;
microwave treatment;
massage.

If correct, adequate treatment is carried out, arthrosis of the temporomandibular joint has many chances for a successful outcome.

Treatment of traumatic arthrosis

This type of disease occurs as a result of severe injuries in this area. The main task of the surgeon is to achieve immobility of the joint. This can be achieved by applying the so-called sling bandage. It securely fixes the jaw and prevents sudden movements.

Wearing a sling bandage is recommended for 2 to 3 days if the patient develops arthritis of an infectious nature. The period of wearing a bandage for injuries of the jaw joint increases to 10 days. During this period, to avoid complications, it is recommended to eat only liquid food.

If traumatic arthritis is accompanied by edema, then the patient is usually prescribed drugs to stimulate impaired blood circulation in diseased tissues. To reduce the intensity of the inflammatory process, antibiotics are prescribed. Additionally, immunomodulators are recommended to improve the functioning of the nervous system.

Features of surgical therapy

Surgical treatment of such a disease is indicated in severe cases. Currently, minimally invasive operations are used to help quickly restore the normal functions of the jaw joint. At the same time, there are no violations of bite, chewing functions, as it happened earlier when performing traditional joint operations.

Usually the doctor chooses one of the following methods of surgical treatment of arthrosis of the jaw joint:

resection of the head of the joint;
removal of a disc inside a joint (meniscectomy);
transplantation of the articular head;
prosthetics (in especially severe cases, when there was a complete destruction of the joint).

Arthroplasty is used in advanced cases when other methods of restoring the normal function of the joint are not possible.

Treatment with folk methods

The goal of treating osteoarthritis of the jaw joint with the help of folk remedies is to eliminate the symptoms of the disease and its causes. The most commonly used ointments, compresses, tinctures.

The best ways to treat osteoarthritis at home are as follows:

A mixture of cranberries, honey and garlic is crushed with a meat grinder. The internal intake of such a remedy significantly improves the nutrition of diseased tissues, relieves inflammation and pain. It is advisable to take this mixture before eating.
Before each meal, it is advisable to drink apple cider vinegar diluted with water. Such a medicine very well removes salt deposits in the body. A course of treatment lasting at least 1 month helps to normalize metabolic processes in the muscles.
Treatment with bee products gives a powerful anti-inflammatory and restorative effect. The use of bee venom as a remedy helps to activate the immune system and strengthen body tissues. Before using bee products for medicinal purposes, you need to make sure that there is no allergy.

Before using folk remedies, it is advisable to consult a doctor.

Preventive actions

Prevention of such a disease comes down to certain measures:

improving the quality of nutrition;
increase in physical activity;
fight against bad habits;
meticulous oral hygiene;
timely correction of bite defects, sanitation of the oral cavity;
regular visits to the dentist.

Osteoarthritis of the jaw joint is a fairly common disease. It responds well to treatment early stages. If you start the disease, then the results of therapy will not be so high.

Everyone has the power to prevent the disease. It is very important to visit the dentist regularly to treat possible joint dysfunctions. In advanced cases, the patient is recommended surgical treatment to restore the joint. Modern medical technologies make treatment simple and painless.

Pathologies of the musculoskeletal system are distinguished by a variety of symptomatic complexes. Subchondral sclerosis of the articular surfaces is one of these syndromes that develops not as an independent disease, but against the background of other serious pathologies.

More often than others, radiographic images reveal subchondral sclerosis of the articular surfaces of the hip joints, which is a typical clinical sign of impaired blood supply to the periosteum of the acetabulum and femoral head. In this case, the patient may experience pain in the thigh, radiating to the groin, buttocks and knee.

The second most common is subchondral sclerosis of the articular surfaces of the knee joint, often associated with deforming osteoarthritis, malpositioning of the foot, and cicatricial deformity of the ligaments of the ankle joint.

Pathology develops with constant compression exerted by cartilage tissue on the endplate. It is located directly between the head of the bone and the cartilaginous fibers of the synovial tissue. if the synovial cartilage tissue has a sufficient level of hygroscopicity, then it protects the endplates from excessive cushioning pressure when performing various movements.

If, against the background of a violation of diffuse nutrition, dehydration of the cartilaginous tissue occurs and it loses its depreciation properties, then a gradual compression destruction of the endplate begins. As a result of this, tissue degeneration occurs, its replacement with scar cells and fibrous fibers. This is how sclerosis develops. The term subchondral refers to the localization directly under the layer of cartilage (chondral tissue).

Treatment of this syndrome is possible only in combination with the treatment of the underlying disease. if efforts are directed only at stopping the clinical symptoms of subchondral sclerosis, then no positive results can be obtained.

If subchondral sclerosis of the articular surfaces was found during an x-ray examination, then begin treatment immediately. This condition quickly leads to the fact that the secondary destruction of bone tissue begins. This entails the formation of bone growths, cracks on the surface of the bone head.

You can contact our manual therapy clinic. Here, each patient is given the opportunity to receive a completely free consultation with an orthopedist. This doctor will conduct an examination, get acquainted with medical records, make a diagnosis and tell you about the possibilities and prospects for treatment using manual therapy methods.

Causes of subchondral sclerosis

In principle, subchondral sclerosis is an age-related degenerative change in the structural tissues of the body. Over the age of 50 years, this condition is detected in almost half of patients. But here in more young age subchondral sclerosis is a clinical sign of tissue degeneration and dystrophy, as a result of which osteoarthritis or deforming arthrosis may soon develop.

The causes of subchondral sclerosis may be the following aspects of the negative impact:

problems of blood supply at the capillary level (for example, in violation of the tone of the vascular wall);
endocrine disorders (for example, diabetes mellitus, leading to the appearance of angiopathy and neuropathy, weakening of the blood supply);
disruption of the immune system with the development of reactive inflammatory processes;
rheumatoid disorders;
systemic lupus erythematosus, scleroderma and psoriasis;
pathologies of metabolic processes, for example, uric acid with the development of gout;
traumatic compression effect (for example, complex soft tissue injuries from the charter with the formation of an extensive internal hematoma);
contractures and other complications after fractures and cracks of the articular surfaces.

The following factors can lead to the development of subchondral sclerosis:

excess body weight, the higher it is, the greater the depreciation load is on the articular surfaces in terms of their compression (squeezing);
incorrect positioning of the foot (clubfoot or flat feet negatively affects the condition of the ankle, knee and hip joints);
tunnel syndromes, leading to impaired innervation in large joints;
increased physical activity;
engaging in active sports without the use of special equipment, including orthoses and protective bandages.

Hereditary predisposition can lead to the fact that subchondral sclerosis of the articular surfaces begins to develop at a fairly young age. Therefore, it is difficult to exclude the negative impact of the genetic factor. The development of this factor is facilitated by a sedentary lifestyle, the wrong choice of shoes and clothes, pregnancy and chronic intoxication of the body. Smoking and drinking alcohol accelerate the process of destruction of articular surfaces and the development of subchondral sclerosis.

Subchondral sclerosis of the acetabulum of the hip joint

When diagnosing a condition such as subchondral sclerosis of the joints, most often pathological changes are observed in the area of \u200b\u200bthe largest articulation of bones in the human body.

Subchondral sclerosis of the hip joint is the initial stage of development of deforming osteoarthritis. With the development of subchondral sclerosis of the acetabulum at the initial stage, patients do not experience any discomfort. However, after some time there is pain in the upper thigh. It is associated with physical exertion, prolonged standing.

With prolonged development, subchondral sclerosis of the acetabulum of the hip joint gives the following clinical symptoms:

stiffness of movements in the morning, immediately after waking up;
sharp pain in the head of the femur;
constant pulling pain in the sacrum, radiating to the groin and thigh;
during a long walk, cramps in the calf muscles associated with insufficient blood supply may occur;
with a total narrowing of the joint space, a tunnel syndrome occurs, clinical signs of neuropathy appear;
restless legs syndrome, which manifests itself in the fact that when trying to fall asleep at night, the patient cannot find a comfortable position for his legs;
dysfunction of the large intestine, expressed in the form of persistent atonic constipation, followed by long periods of diarrhea;
urinary retention or hyperactivity Bladder;
lameness, change in gait, gradual loss of the ability to move independently in space.

Diagnosis of subchondral syndrome begins with a thorough physical examination and diagnostic functional tests. Then the doctor prescribes radiographic images, as necessary - an MRI and CT examination.

Subchondral sclerosis of the knee and ankle

Primary subchondral sclerosis of the knee can develop due to improper foot placement and deformation of the ligamentous apparatus. Often the syndrome is associated with inflammation of the menisci and their proliferation. Approximately half of the cases of primary subchondral sclerosis are associated with inflammation of the joint capsule (bursitis).

The signs are very similar to the clinical symptoms of destruction of the articular surfaces in the area of the acetabulum of the hip joint. Soreness, fatigue of the calf muscles, lameness and gait disturbance are the main manifestations.

Subchondral sclerosis of the ankle joint can be diagnosed in young people who lead an active lifestyle and are fond of outdoor sports. As a result of increased physical activity, they often develop various soft tissue injuries, such as sprains and ruptures of ligaments and tendons. As a result of their improper treatment, fibrous scar tissue develops. It interferes with normal blood supply at the capillary level. Lack of arterial blood supply to the articular surfaces leads to deformity and development of subchondral sclerosis.

Subchondral sclerosis of the joint spaces of the foot

One of the most severe types of pathology is subchondral sclerosis of the foot - a condition in which there is an increased risk of deforming osteoarthritis of small joints between the phalanges, metatarsal bones, etc. Subchondral sclerosis of the joint spaces in the foot area develops for the following reasons:

wearing improperly selected shoes (high heels, with a deformed shoe, after a person with an incorrect foot position);
clubfoot and flat feet, as a result of which the small bones of the foot are displaced, wedge-shaped and metatarsus are more affected;
squeezing the leg;
rheumatoid processes;
diabetic foot;
violation of blood microcirculation against the background of increased platelet aggregation.

Diagnosis of this syndrome is carried out using an x-ray image. it can detect the narrowing of the joint spaces, the displacement of the small bones of the foot relative to each other.

Subchondral sclerosis of the shoulder

Subchondral sclerosis of the shoulder joint is a condition that can accompany osteoarthritis, habitual dislocation of the shoulder, stretching of the ligamentous apparatus, osteochondrosis of the cervical spine, humeroscapular periarteritis and a number of other pathologies.

Subchondral sclerosis of the shoulder joint manifests itself in the form of the following clinical symptoms:

pulling unpleasant pain in the shoulder and forearm;
inability to fully extend the arm in the elbow joint;
difficulty when trying to raise the upper limb in the lateral plane;
decreased muscle strength on the affected side;
feeling cold, pale skin.

If these symptoms appear, you should consult a doctor and take a series of x-rays. If it is difficult to make a correct diagnosis, the doctor may recommend an MRI examination.

Treatment of subchondral sclerosis

For the treatment of subchondral sclerosis of the articular surfaces, it is important to restore blood microcirculation and improve the condition of the cartilage tissue. Of the modern pharmacological preparations, not a single agent is able to perform such a task.

Treatment with manual therapy allows you to achieve positive result. Our manual therapy clinic uses the following techniques:

osteopathy and massage restore microcirculation of blood and lymphatic fluid in the area of the affected joint;
reflexology will start the process of natural regeneration of damaged tissues;
therapeutic exercises and kinesiotherapy improve the condition of muscle tissue, which provides complete diffuse nutrition of all cartilage fibers of the joint;
laser exposure accelerates the healing process and prevents the development of deforming osteoarthritis;
physiotherapy can improve joint mobility and prevent the appearance of fibrous scar tissue.

If you need treatment for subchondral sclerosis of the articular surfaces, you can make an appointment with an orthopedist at our chiropractic clinic. The doctor will conduct an examination, make a diagnosis and talk about how to conduct a comprehensive effective treatment. The first consultation is free of charge for all patients.

Subchondral sclerosis of the hip joint is a degenerative process in the head of the femur that develops with deforming arthrosis.

What is subchondral sclerosis?

Sclerosis is the replacement of a normally functioning tissue with connective tissue, which cannot perform the necessary functions. In subchondral sclerosis, the pathological process occurs in the so-called endplate. It is located under the articular cartilage and is a peripheral section of the epiphysis - the head of the femur.
The development of subchondral sclerosis is provoked by dystrophic changes in cartilage: a decrease in its thickness, a decrease in elasticity, and the appearance of roughness. In this regard, the depreciation ability of the cartilaginous tissue is deteriorating, which is why the epiphysis, located under it, experiences heavy loads. This leads to a violation of calcium metabolism and a deterioration in blood circulation in bone tissue, as well as to subsequent necrosis of its sections. The dead osteocytes are replaced by actively dividing connective tissue cells.

Why is this condition dangerous?

Subchondral sclerosis is accompanied by the appearance of osteophytes - pathological growths on the surface of the damaged bone. Their size and number increase, which seriously limits the range of motion in the joint, up to contracture - its complete immobility.
In addition, the formation of "bone spurs" is accompanied by increased pain. This causes the person to spare the limb when walking.
As this pathological process progresses, it leads to deformation of the articular surfaces of the bones, which is fraught with destabilization of the joint, the development of subluxations, dislocations and pathological fractures.
Violation of the mobility of the hip joint in the long term leads to destabilization of the spinal column when walking. This becomes a predisposing factor for the development of spinal curvature, which, in turn, is one of the causes of osteochondrosis.

What are the causes of subchondral sclerosis of the hip?

This condition is not considered an independent disease, it is a pathological process that develops most often with degenerative-dystrophic joint disease - arthrosis. Accordingly, the causes of subchondral sclerosis of the hip joint may be as follows:

injuries that have not been properly treated (fractures of the pelvis or head of the femur, dislocations);
metabolic disorders (for example, diabetes mellitus);
endocrine diseases;
infectious inflammation of the joint;
rheumatoid arthritis;
joint inflammation in systemic lupus erythematosus or psoriasis;
dysplasia - a congenital pathological feature that leads to dysfunction of the joint;
Perthes disease - aseptic (non-infectious) necrosis of the femoral head.

Particular attention should be paid to the presence of factors predisposing to the development of arthrosis and subchondral sclerosis. They are:

elderly age;
irrational nutrition;
smoking;
excess body weight;
hypodynamia;
heavy physical activity;
systematic hypothermia.
postmenopausal period;
osteoporosis.

What are the signs of subchondral sclerosis?

Symptoms of such a pathological condition are signs of arthrosis of the hip joint (coxarthrosis), namely, its second and third stages, since it is at these stages of the disease that sclerosis begins and osteophytes are formed:

Characterized by pain in the joint, which can occur at night, when walking, standing for a long time and sitting.
There is stiffness, stiffness of the joint immediately after waking up, passing after some time.
Over time, the limitation of walking distance progresses, it becomes more and more difficult to overcome certain distances.
Lameness occurs, eventually leading to a pathological type of movement.
There is a need to use additional support - a cane or crutch.

Such symptoms indicate a long course of pathological processes and the presence of irreversible changes. Therefore, one should not wait for the onset of subchondral sclerosis, it is necessary to consult a doctor at the initial stage of the development of arthrosis, when unpleasant sensations regularly occur in the joint when walking, and a crunch is periodically heard.

How to diagnose subchondral sclerosis?

In order to detect changes, the doctor prescribes. With arthrosis, the pictures show:

narrowing of the joint space;
the presence of bone points of various sizes - osteophytes;
thickening of the shadow under the endplate and in some areas of the femoral head (directly a sign of subchondral sclerosis);
the appearance in the area of the head of the bone oval enlightenment with clear contours - bone cysts.

At later stages, impression occurs - crushing of the end plate, which in the picture is manifested by a discrepancy between the articular surfaces of the bones to each other.
As an additional examination, ultrasound or magnetic resonance imaging may be performed. These methods allow assessing the condition of the joint capsule, its ligaments, menisci (if we are talking about the pathology of the knee joint), surrounding soft tissues, clarifying the location and size of cysts and osteophytes, and assessing the degree of subchondral sclerosis.
To choose the most appropriate treatment tactics, it is important for the doctor to know what causes led to the development of arthrosis and sclerosis. To this end, he can prescribe various blood tests that will help identify inflammatory processes, metabolic and endocrine disorders, the presence of rheumatoid factor and signs of other conditions.

Treatment and prevention

Elimination of subchondral sclerosis occurs in the treatment of arthrosis.

If possible, the doctor tries to conduct etiotropic therapy, which is aimed at eliminating the root cause of the disease.

For this, various medications are used: antibiotics, non-steroidal anti-inflammatory drugs, corticosteroids. In addition, chondroprotectors are used as a drug treatment, which contribute to the restoration of cartilage tissue.
Physiotherapeutic treatment plays an important role, it includes the implementation special exercises in water, massage, ultrasound therapy, heating, stimulation with electric current. In addition, it is important to carefully dose the load on the joint. Excessive activity will lead to the progression of subchondral sclerosis, as well as physical inactivity, accompanied by atrophy of the muscles and ligamentous apparatus. Of great importance in the treatment of arthrosis is the correct implementation of physiotherapy exercises.
and subchondral sclerosis includes the elimination of predisposing factors. This means that it is necessary to give up bad habits, ensure that all the necessary nutrients enter the body, get rid of excess weight, and do physical education. Such measures will help maintain the normal nutrition of the cartilage tissue and relieve part of the load from the joint by training the muscles.

Separately, it should be said about the timely detection and elimination of congenital hip dysplasia in children. It is possible to eliminate such a feature without any consequences conservatively, but only on condition that treatment is started at an early age. As the child grows older, irreversible changes occur in the joint, which in the future become the cause of arthrosis and subchondral sclerosis. It is usually possible to eliminate dysplasia with late diagnosis only promptly. Consultation with a pediatrician is required if a child has a clear asymmetry of skin folds (there are more folds on one leg) and shortening of one leg.

Without a special education, it is sometimes quite difficult to understand the intricacies of medical terminology. For example, there are not so many people who understand what subchondral sclerosis of the articular surfaces of the spine is. Let's try to explain in an accessible language, understandable to everyone.

Subchondral sclerosis of the elbow, shoulder, knee, hip or any other joint and endplates of the vertebral bodies is not a separate disease, but a manifestation of the disease, which can be determined using x-ray examination. The pathological process affects the subchondral bone, leading to serious structural changes in it. Most often it is observed in old age, but sometimes it also occurs in young people whose professional activities are associated with a high load on the joints.

Standard radiography allows you to assess the degree of damage to the subchondral bone.

Causes

As a rule, subchondral sclerosis develops in diseases such as arthrosis and osteochondrosis of the spine. It is worth noting that the pathological process is chronic and progressive. Quite naturally, what leads to the development of arthrosis and osteochondrosis can be considered the cause of the appearance of subchondral sclerosis of the spine and joints. Provoking factors include the following:

Trauma and damage to the musculoskeletal system.
Obesity.
Elderly age.
sedentary work and sedentary image life.
Endocrine pathology (diabetes mellitus).
Weakened heredity.
Congenital malformations (joint dysplasia).
Diseases accompanied by metabolic disorders (gout).
Lack of minerals and vitamins in the body.

At risk for arthrosis are professional athletes, dancers, ballerinas, builders. By eliminating provoking factors, it is possible to avoid the occurrence of pathological changes in the musculoskeletal system.

Without a comprehensive effective treatment subchondral sclerosis of the endplates of the vertebrae and joints will inevitably progress.

Development Features

As mentioned earlier, subchondral sclerosis of the spine and joints is not a separate disease, but only a clinical symptom. Depending on the stage of the pathological process, corresponding manifestations will be observed in the articular surfaces of the bones. Based on the X-ray data, several degrees of severity are distinguished:

First. It is also called the initial stage. There is an increase in bone tissue (the appearance of osteophytes), but the joint space is unchanged. The patient notices that in the affected joint or section of the spinal column, mobility is limited to some extent.
Second. For a pronounced stage, intensive growth of bone tissue will be characteristic. In addition, narrowing of the joint space is fixed. At this stage, the patient will feel significant restrictions on mobility, which will undoubtedly affect professional activity and self-service at home.
Third. At an extremely pronounced stage, a serious deformation of the joint is observed, which is practically destroyed. Intra-articular structures are changed beyond recognition. At the third degree of severity there will be a complete loss of function.

By preventing the appearance of arthrosis and osteochondrosis, you will protect yourself from subchondral sclerosis of the endplates of the vertebral bodies and joints.

Treatment

The complex of therapeutic measures for subchondral sclerosis of the spine and joints is similar to that for arthrosis and osteochondrosis. The main goal of therapy is to eliminate all clinical manifestations of the pathological process and stop the progression of degenerative-dystrophic changes. The therapeutic course is selected individually, taking into account the patient's condition and the severity of subchondral sclerosis. To date, the main methods of treatment are:

Medical therapy.
Physiotherapy.
Manual therapy and therapeutic massage.

Subchondral endplate sclerosis can occur in any part of the spine: cervical, thoracic, or lumbar.

Medical therapy

If the patient has a pain syndrome, then in most cases non-steroidal anti-inflammatory drugs are prescribed (Diclofenac, Voltaren, Ibuprofen, Ketorol, Dexalgin, Flamadex). Do not forget that prolonged and uncontrolled use of NSAIDs can lead to serious consequences. One of the most common side effects is erosive and ulcerative lesions of the gastrointestinal tract. The use of any drug must be agreed with your doctor.

In the early stages, when degenerative-dystrophic changes in the joints are not yet too pronounced, chondroprotectors have a positive effect. Their prolonged use allows you to slow down the destructive and stimulate the regenerative processes in the cartilage tissue. The most popular types of chondroprotectors:

Chondroitin sulfate.
Chondrolon.
Structum.
Rumalon.
Arteparon.

Physiotherapy

With subchondral sclerosis of the spine and joints high efficiency possess various methods physiotherapy. When there are no clinical signs of inflammation and severe pain, several types of treatment are usually involved: physiotherapy, exercise, and relaxing massage. In addition, manual therapy has proven its effectiveness in various pathologies of the spinal column and joints. In some cases, special devices may be used to develop joint mobility. This treatment is called mechanotherapy.

It should be noted that therapeutic exercises and massage are recommended to be performed regularly and at home. A set of physical exercises should be planned by a specialist, taking into account the patient's condition and the functional capabilities of his body. Exercise therapy will help improve joint mobility and strengthen the musculoskeletal system.

ethnoscience

Currently, there is no convincing evidence that folk remedies are effective in subchondral sclerosis of the spine and joints. Most experts are very skeptical about the use of folk remedies in this pathological process. If you still decide to use non-traditional methods of therapy, but first it is better to get approval from your doctor. Do not forget, self-treatment often ends with rather disastrous results.

Prevention

In order to prevent the occurrence of subchondral sclerosis of the spine and joints, it is necessary to prevent the development of degenerative-dystrophic changes in the musculoskeletal system, which are observed in diseases such as arthrosis and osteochondrosis. Everyone knows that the importance of disease prevention cannot be overestimated. Therefore, you may not know what subchondral sclerosis of the articular surfaces of the spine and joint (elbow, knee, hip, etc.) is if you perform the following preventive measures:

Exercise regularly active view sports. Physical activity should be appropriate for age and health. Even the daily morning work-out will bear fruit.
Do not freeze or overcool. Joints should be kept warm.
The fight against excess weight. A large body weight only accelerates the progression of pathological changes in the spinal column and joints.
Avoid injury to the musculoskeletal system. Permanent microtrauma in the best way may affect the joints.
Stick to a balanced diet. Do not engage in diet therapy without consulting a specialist.
If necessary, take chondroprotectors. These medications help restore cartilage tissue and protect joints from premature destruction.

At the first signs of injury musculoskeletal system do not delay visiting a doctor. Arthrosis and osteochondrosis can be dealt with if you seek help in the early stages of the disease.

Subchondral osteosclerosis

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

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

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

What is the essence of pathology

Subchondral osteosclerosis is one of the main manifestations of such degenerative-dystrophic diseases of the musculoskeletal system as osteoarthritis and osteochondrosis, as well as the most common type of bone density. The word “subchondral” should be understood as “subchondral”, that is, bone compaction occurs in those areas that are directly adjacent to the joints affected by the pathological process. These subchondral areas of bones are called endplates.

Subchondral sclerosis of the 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.

You can learn more about the causes of osteosclerosis and its types here.

By itself, sclerosis of the endplates does not cause any symptoms, all manifestations are due to the primary pathology, which causes such changes in the bones. But, nevertheless, compaction of the subcartilaginous areas of the bone tissue can cause compression fractures of the vertebral bodies and deformation of the limbs.

Also, subchondral sclerosis is of diagnostic value, as it is one of the main radiological criteria for deforming osteoarthrosis of the joints and osteochondrosis of the spine.

Causes

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

excess weight;
constant microtrauma of the joints (hard physical work, professional sports);
hypodynamic lifestyle;
long stay in one position;
endocrine and metabolic disorders;
genetic propensity;
advanced age;
concomitant rheumatological and vascular diseases;
history of trauma;
congenital or acquired pathologies of the musculoskeletal system;
unhealthy diet;
poor development of the muscular corset.

Symptoms

Signs of subchondral sclerosis depend on the disease that caused changes in the bones, its stage and localization. On early stages sclerosis does not manifest itself in any way and can only be detected during an X-ray examination. As the pathology progresses, characteristic clinical signs appear. The most common types of subchondral osteosclerosis will be discussed further.

Subchondral sclerosis of the spine

Compaction of the bone tissue of the vertebrae is observed with osteochondrosis in the area that is in direct 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 tissues of the spine and the presence of complications (intervertebral hernia, narrowing of the spinal canal, infringement of the nerve roots, etc.).

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

The main danger of sclerosis of the vertebral bodies is an increased risk of spontaneous compression fractures, which can occur even with minimal physical exertion. Therefore, it is necessary 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

Such 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 bothers at rest. The range of motion in the joint is gradually limited, lameness develops.

If the pathological process is not stopped in time, then over time the joint is completely destroyed, the function of the lower limb is lost. Only a hip arthroplasty can restore the ability of such patients to move independently.

The danger of sclerosis of this localization lies in the increased risk of such severe pathologies as a fracture of the femoral neck and aseptic necrosis of its head. Therefore, when detecting osteosclerosis of the hip joint, it is first necessary to deal with the prevention of possible serious consequences.

Sclerosis of the knee joint

It is detected with the development of deforming osteoarthritis of the knees. Patients complain of pain in the knees during physical exertion, and then at rest, crunching during movements, a gradual decrease in their amplitude, deformity of the knees and lower extremities.

A common consequence of subchondral knee sclerosis is the development of varus or hallux valgus(O- and X-shaped legs).

Shoulder osteosclerosis

The shoulder joint is one of the most mobile joints in our body. Therefore, it is often affected by arthrosis. The development of pathology is indicated by pain during movements, clicks and crunch, amplitude limitation.

Although sclerosis of the shoulder joint does not cause 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 insufficiency of the joint.

Diagnostic methods

The main method of intravital diagnosis of changes in bone tissue, including osteosclerosis, is an X-ray examination. On radiographs good quality in detail it is possible to consider the centers of a sclerosis of various localization. But, unfortunately, this is not enough to make a diagnosis. Since first of all it is necessary to identify the cause of compaction of bone tissue. For this purpose, a number of diagnostic procedures are carried out:

MRI or CT;
densitometry (measurement of bone density);
laboratory blood and urine tests;
Ultrasound of the joints;
genetic tests to exclude hereditary forms of osteosclerosis.

Principles of treatment

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

Treatment must be comprehensive. It includes such activities:

Medical therapy. It is used, as a rule, in the presence of exacerbations of arthrosis and osteochondrosis, which are accompanied by severe pain. Medicines from the following groups are used: analgesics and non-steroidal anti-inflammatory drugs, chondroprotectors, muscle relaxants, B vitamins, vasodilators and decongestants, glucocorticoids and local anesthetics for blockades.
Therapeutic gymnastics. It is the main method of therapy for degenerative-dystrophic diseases of the musculoskeletal system. Helps strengthen the muscles that will protect and support damaged joints.
Massage and other manual methods of influencing the joints (manual therapy, osteopathy, post-isometric relaxation).
Various physiotherapy procedures (laser, ultrasound therapy, magnetotherapy, electrophoresis, UHF, balneotherapy, therapeutic mud, spinal traction, etc.).