The author - Chuklin Olga, general practitioner, internist. Work experience since 2003.
Osteoporosis is a systemic disease of the joints, in which developing bone loss and fragility appears articular surfaces of bones. Because osteoporosis occur degenerative processes of the cartilage tissue.
From the washed fabrics calcium. Bone tissue are exposed to the risk of fractures.
It is most often affected large joints - knees, hips - those joints, which account for maximum physical exertion.
Less commonly occurs defeat ankle, shoulder, elbow joints.
Osteoporosis affects not only the joints but also the spinal column. For more information on osteoporosis of the spine - in our separate article.
Types and causes of
Two mechanisms can lead to osteoporosis:
The most common - disturbance of calcium metabolism in various pathologies.
Second, relatively rare, this violation regeneration processes of bone - disrupted activity of osteoclasts and osteoblasts (cells that contribute to the formation and destruction of bone tissue). In the absence of disease using them is updated joint bone tissue.
It decided to allocate the following types of osteoporosis:
- Senile - in the elderly is a violation of the processes of renovation of bone tissue of the joints.
- Postmenopausal - typical for women in menopause.
- Secondary - develops as a result of other pathological conditions.
- Combined - a combination of several types of osteoporosis.
Typical causes of secondary osteoporosis:
- malicious smoking (active or passive);
- underweight;
- alcoholism;
- abuse of drinks with a high content of caffeine;
- genetic predisposition;
- hormone long courses - hormonal preparations to treat thyroid disorders; corticosteroid therapy;
- insufficient intake of dietary calcium;
- menopausal women;
- Hip Dysplasia;
- violation of calcium absorption in chronic diseases of the digestive organs;
- presence of endocrine disorders (diabetes mellitus, hyperthyroidism, Cushing's disease);
- frequent and prolonged excessive exercise;
- hypodynamia (reduced physical activity);
- overweight.
Symptoms of osteoporosis joints
The long period of the disease goes unnoticed for the patient. No signs of the disease not, may then receive the general indirect signs of osteoporosis (calcium deficiency):
- fragility, brittleness of nails;
- night cramps in the calf muscles;
- the patient complains of fatigue, general weakness;
- tachycardia;
- early appearance of gray;
- frequent dental disease;
- weakness in the legs;
- weight loss;
- growth reduction (due to the "sagging" of the spinal column due to reduced bone density).
With the progression of osteoporosis, the patient has pain in the large joints. At the beginning of painful sensations arise upon awakening in the early movement.
The patient said that the pain goes away after he was "at odds".
Pain may also occur after exercise, if they are more intense than usual.
As the progression of osteoporosis, joint pain becomes prolonged, and later permanent. And also increases the severity of pain.
- In osteoporosis, hip pain can be given in the groin area.
- In osteoporosis, knee pain spread to the entire foot.
Often the disease is diagnosed after the onset of the patient's frequent fractures in the joints. Fracture occurs when a minor injury, there is increased bone fragility.
Diagnostics
If signs of the disease need to see a general practitioner, rheumatologist or traumatologist.
On examination can reveal the shortening with a damaged joint.
The doctor will examine and prescribe complex surveys:
- Bone densitometry to assess its density. This method makes it possible, and assess the effectiveness of therapy.
- Radiography of the joints in two projections. In osteoporosis on radiographs has the following features:
- increased transparency of the bone;
- presence of outgrowths of bone tissue in the form of pins on the articular surfaces of the bones;
- fractures near the joints.
- Ultrasound examination of the joints.
- If necessary, possible to carry out magnetic resonance and computer tomography.
It is also necessary to take a blood test for
- determining the level of calcium in the blood;
- determining the level of female hormones (estrogen), thyroid hormones.
For suspected secondary nature of the disease full inspection is carried out to eliminate the disease, leading to osteoporosis.
Treatment of osteoporosis joints
osteoporosis treatment begins only after a complete examination and determine the cause of the disease.
osteoporosis therapy takes place over a long period of time (several months).
When determining the required primary disease being treated and the underlying disease, and osteoporosis.
The main objectives of treatment include:
- calcium metabolism correction;
- increasing bone density;
- elimination of pain;
- prevention of complications.
Drug-free treatment includes:
- elimination of caffeine-containing beverages;
- avoiding alcohol and nicotine;
- regular training of medical physical culture. through physical exercise improves blood circulation in the joints. good acting lessons in the pool.
- can be carried bracing massage.
Proper nutrition plays an important role in osteoporosis joints. Diet includes the mandatory use of calcium-rich foods (dairy products, fatty fish).
More detail about nutrition in osteoporosis - in our separate article.
The positive effect of providing and physiotherapy:
- ultrasound with hydrocortisone;
- electrophoresis with novocaine;
- paraffin;
- magnetic therapy;
- mud.
Drug therapy:
To relieve pain patients shows analgesic therapy drugs from the group of nonsteroidal antiinflammatory analgesic:
- meloxicam;
- Nise;
- ketonal.
Calcium:
- miokaltsiks;
- calcium gluconate;
- calcium-D3 Nycomed.
recommended intake of vitamin D to improve calcium absorption:
- aqueous solution of vitamin D;
- Akvadetrim.
Drugs that slow down the destruction of the bone:
- calcitonin;
- bisphosphonates;
- estrogens.
Formulations that promote formation of bone tissue:
- androgens;
- anabolics;
- a growth hormone.
The last 2 groups of drugs compulsorily chosen and appointed by the doctor on the basis of the diagnostic results.
Consequences and complications
The consequences of osteoporosis, bone fractures are joint tissue in the joints.
Particularly common hip fractures that result in patient immobilization. This is the most dangerous in the elderly, when the bone regeneration process has slowed down. Sometimes surgery is performed in fractures. rehabilitation period can sometimes last up to a year or more.
Very often hip fracture leads to disability, the patient bedridden.
In order to prevent the development of complications it is recommended to patients:
- avoid pronounced physical exertion;
- to avoid a variety of traumatic effects;
- use protectors hip, knee protectors.
Prevention of osteoporosis joints
Since the period of treatment of the disease is very long, it is better to deal with this disease is the development of a warning.
Diagnosis of osteoporosis at an early stage helps to prevent the development of severe consequences and duration of treatment is significantly reduced.
It recommended the following measures aimed at the prevention of osteoporosis, joints:
- adequate calcium intake from food;
- abstinence from alcohol;
- limit the use of caffeine-containing beverages;
- regular exercises;
- achievement of a normal body weight;
- women in menopause and for males over 55 years old need to annually monitor the level of calcium in the blood, bone densitometry carried out;
- if there is pain in the joints required to undergo X-ray examination;
- during therapy, hormonal therapy required monitoring of calcium levels in the blood.
