Department of Orthopaedics, West China Hospital, Sichuan University
Degenerative osteoarthropathy is also called bonearthritis, degenerative arthritis, senile arthritishypertrophySexual arthritis is a kind ofDegenerative lesion, due to aging, obesitystrain, trauma, congenital abnormality of jointsJoint deformityAnd many other factorsArticular cartilageDegenerative injury, reactive hyperplasia of articular margin and subchondral bone.This disease is mostly seen in the middle-aged and elderly people, and tends to occur in load-bearing joints and joints with more activities (such as cervical vertebra, lumbar vertebraKnee joint、hip jointEtc.).Excessive weight bearing or the use of these joints can promoteDegenerative changeOccurrence of.The clinical manifestation is slow developmentArthralgia, tenderness, stiffness, joint swellingRestricted activityAnd joint deformity.
The etiology is still unclear, which may be related to the elderly, women, obesity, occupational overuse and other factors.
clinical manifestation
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The main symptoms areArthralgiaIt is often a pain at rest, which is manifested as pain after rest and will be relieved after a moment of activity, but the pain will be aggravated after too much activity.Another symptom isJoint stiffnessIt often occurs when getting up in the morning or after the joints have been in a certain position for a long time in the daytime.Swelling and tenderness of the affected joint can be seen through inspection, and there is a sense of friction or "clicking" sound during the activity, which can occur in serious casesMuscular atrophyandJoint deformity。[2]
X-ray films showed unequal width or narrowing of joint space, osteoporosis, hyperosteogeny or joint enlargement at joints, and even joint deformation, subchondral bone plate sclerosis and osteophyte formation.
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CT can clearly show different degrees of joint bone hyperplasia, intra-articular calcification and free bodies, and sometimes the meniscus.
According to relevant medical history, clinical manifestations andX-rayIt is not difficult to diagnose degenerative osteoarthropathy.Joint synovial fluid can be checked if necessary.
treatment
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The main treatment of degenerative osteoarthropathy is to reduce the weight bearing and excessive large range of activities of the joint to delay the process of the disease.Obese patients should reduce weight and joint load.Crutches or crutches can be used when the joints of lower limbs are diseased in order to reduce the burden on the joints.physiotherapyAnd proper exercise can keep jointScope of activities, splint can be used if necessaryBraceAnd walking stick, etcacute stageThe symptoms are helpful.Antiinflammatory and analgesic drugs can reduce or control symptoms, but patients should be evaluatedrisk factor After that, it should be used carefully and should not be taken for a long time.cartilageProtective agentasGlucosamine sulfateIt can alleviate symptoms and improve functions, and long-term use can delay the structural progress of the disease.For late cases, if the general condition can tolerate surgeryArtificial joint replacementIt is recognized as an effective method to eliminate pain, correct deformity and improve function, which can greatly improve patients'Quality of life。[1]
