Article by Dr. Evdokimenko© for the book “Arthritis”, published in 2003. Edited in 2011 All rights reserved.
In this chapter I will tell you about special “warning” symptoms that are not typical for arthrosis . but typical for arthritis . These symptoms can serve as a clue and direct your diagnostic search in the right direction.
1. You feel increased joint pain at night . between three and five o'clock in the morning - increased pain at this time often indicates its rheumatic, inflammatory origin, and may be a symptom of some kind of arthritis. You should be especially wary if the pain is so severe that it wakes a person up in the middle of the night amid complete rest. But if the pain arose in the middle of the night from movement. when you roll over from side to side or stand up to go to the toilet, such pain is not an indicator of inflammation. It can be a symptom of any disease - from arthrosis to tendon inflammation.
stiffness throughout your body and joints in the morning, immediately after waking up . which goes away within an hour or during the first half of the day - such stiffness is characteristic of inflammatory diseases of the joints, primarily rheumatoid arthritis, ankylosing spondylitis and polymyalgia rheumatica. A very alarming sign is morning stiffness of the hands . sensation as if tight gloves were worn on hands. The “tight gloves” symptom is one of the manifestations of rheumatoid arthritis . However, the same sensations also occur with some non-inflammatory hand diseases - in particular, with carpal tunnel syndrome.
3. You should be wary if you have inflammation and swelling of the metacarpophalangeal joints . that is, the joints located at the base of the fingers (the protruding bones of a clenched fist). Swelling and inflammation of these joints is most often a sign of rheumatoid arthritis, less often a sign of psoriatic arthritis. Unless, of course, it arose as a result of injury or hitting a wall with your fist.
Rheumatoid arthritis, by its nature, belongs to the group of chronic autoimmune diseases that occur when there is a malfunction in the human body’s immune system. The causes of this disease have not yet been established, but the provoking factors for its development are considered to be genetic inheritance, past infections (hepatitis B, measles, mumps), systemic exposure to toxic substances, other autoimmune diseases, and menopause.
With rheumatoid arthritis, symmetrical inflammation occurs in various joints of the arms and legs (hands, shoulders, elbows, feet, hips, knees). The small joints of the hands are most often affected. In the initial stages of the disease, the membrane covering the entire surface of the joint cavity, the synovial membrane, becomes inflamed; in the next stage, the disease spreads to the cartilage, ultimately causing erosion and irreversible deformation of the articular bones. Rheumatoid arthritis is mainly localized in the joints of the extremities, but in some cases it can spread to other organs, causing atrophy of skeletal muscles, skin damage, enlarged lymph nodes, liver dysfunction, damage to the gastrointestinal tract, heart, lungs, kidneys, eyes and etc.
X-rays of joints make it possible to assess the degree of damage and destruction of the bone structure, cartilage and periarticular soft tissues . It should be taken into account that when staging the X-ray stage of rheumatoid arthritis, the main emphasis is on the joint in which the changes that have occurred are maximum. The total number of erosions in the affected bone tissues is also taken into account. This is due to the fact that radiological signs of rheumatoid arthritis in the same patient in each joint may be different.
This disease is characterized by chronic inflammatory processes in the joints and systemic bone erosion with subsequent damage to organs. The disease occurs after chronic infections, due to the weakness of the immune system and genetic characteristics. Most often occurs in women under 55 years of age.
The main problem of this disease is that the immune system mistakenly mistakes body tissues for harmful ones and begins to fight them, as a result of which the initial signs of rheumatoid arthritis appear.
In the early stages, rheumatoid arthritis has no obvious signs, so months may pass from the onset of the disease in the body to its detection. But when the disease becomes more advanced and serious signs begin to appear, it is much more difficult to fight it. For this reason, despite the complexity, one should try to determine the diagnosis at an early stage.
To determine rheumatoid arthritis, it is important to know what the most common signs are:
The presence of one or two of these symptoms cannot be the basis for making a diagnosis. This especially applies to older people, for whom some signs are characteristic based on age. For final conclusions, it is necessary to have a clinical picture that excludes the possibility of other causes of inflammation.
To create this picture, the American College of Rheumatology set out diagnostic criteria for rheumatoid arthritis in 1987. Their accuracy is in the range of 91-93%. At the moment, this is one of the most likely schemes, however, it cannot always determine the diagnosis when the early stage of the disease occurs. The following criteria exist:
Article by Dr. Evdokimenko© for the book “Arthrosis”, published in 2003. Edited in 2011 All rights reserved.
Osteoarthritis most often affects the knee and hip joints, as well as the big toe joints. Slightly less common are the ankle joints and those joints of the fingers that are located closer to the nails (distal interphalangeal joints). The remaining joints are rarely by arthrosis
Each type of arthrosis has its own “individual” characteristics. However, there are characteristic symptoms that are common to most types of arthrosis.
1. Joint pain . One of the first and main symptoms of arthrosis is pain in the affected joint. As a matter of fact, pain is characteristic of all types of joint and periarticular diseases. But there are features of pain that may indicate that the pain is caused precisely by arthrosis. Thus, with arthrosis, pain in the joint most often occurs when moving.
For example, if a patient has arthrosis in the knee joint, then pain will appear when walking, running and squatting; but as soon as the sick person decides to go to bed and finds a comfortable position for the sore leg, the pain will begin to subside little by little and in about an hour will disappear without a trace - until the next load. In contrast to such pain, pain caused by inflammation of the joint ( arthritis ) manifests itself less during the day, when moving. But at night, at rest, somewhere between three and five o’clock, it begins to “gnaw” the person the most. People who have experienced such inflammatory pain in the joints at night sometimes compare it to toothache - it can be so severe.
Among the many types of division of stages (degrees) of rheumatoid arthritis, we will focus on the most used approach - radiological. It classifies the signs of rheumatoid arthritis into stages depending on the x-ray appearance.
The first stage is characterized by the presence of signs of bone thinning. As a rule, at this stage no other damage is visible on x-rays. The first manifestations of arthritis occur in the joints of the hands and metatarsophalangeal joints. On an x-ray, you can notice thickening of the soft tissues and their compaction. The first signs of periarticular osteoporosis are also diagnosed. Already at the first stage, areas of clearing of bone tissue – cysts – are visible in the image. If the joint spaces are narrowed, this indicates the progression of rheumatoid arthritis and the prediction of the second stage.
The first stage can occur at any stage of a person’s life; stage 1 rheumatoid arthritis is observed even in children and adolescents; it is called juvenile arthritis. The peculiarity of the first stage in its course is that arthritis can proceed sluggishly for a long time, progressing already in adulthood, but it can also be rapid - deterioration occurs much earlier, after the first manifestations. After establishing the diagnosis of “rheumatoid arthritis of the first degree,” you should not necessarily expect deterioration immediately - in some cases, rheumatoid arthritis occurs in waves - the symptoms of arthritis either subside for a significant period, then appear again.
A disease such as arthrosis has quite characteristic symptoms. Their manifestation is directly related to the degree of development of this pathology. That is why it is so important to know what signs the initial stage of the disease has, and what manifestations are characteristic of the second and third stages of the disease. It is depending on the stage of arthrosis that an effective treatment regimen is formed.
Arthrosis is diagnosed when destruction of the cartilage tissue of the joint is detected (the photo clearly shows this process). When discomfort appears when moving at the points of contact of two articulating bones, and when this feeling intensifies with increasing physical activity, the body itself tells you that it is time to start sounding the alarm and seek help from an orthopedic doctor. If the state of rest brings visible relief, if the patient does not notice a loss of muscle volume, if the range of movements is not limited, the patient will be diagnosed with the first stage of arthrosis. The listed symptoms indicate the onset of a disease that will certainly progress. X-rays help verify the correctness of suspicions. The image shows minor deviations (microtraumas in the cartilage tissue - minimal damage to the surfaces of the articulating bones). The photo shows what this phenomenon looks like.
The second stage of arthrosis development is diagnosed if arthrosis constantly makes itself felt. At this stage, severe pain may occur. They occur with increasing physical activity (even short-term work makes you suffer, while rest and a state of rest do not bring relief). This is the main symptom of the transition of the first stage of arthrosis to the second. When the patient begins to experience pain, he intuitively tries to relieve the affected joint. This creates stiffness in movement, limiting a person’s mobility. Arthrosis of the second degree may be indicated by such a sign as atrophy of the muscles adjacent to the diseased node. To make a more accurate diagnosis, the doctor will definitely order the sick person to undergo an x-ray. If arthrosis has entered the second stage of development, the image will clearly show the deformation of the bone (in the photo), as well as the presence of bone processes in the form of spikes, a narrowing of the gap between the two bones in the ligament.
The third stage is characterized by the appearance of more severe symptoms. Any movement brings unbearable pain; it torments a person constantly, even when he is in a state of complete rest. A person is looking for a comfortable position that brings him a little relief for a short time. The patient can only move in such a situation with the help of crutches. The joints practically do not move. A symptom of the most advanced stage is the fusion of articular surfaces (the photo shows an x-ray of such a pathology). This phenomenon is called ankylosis.
The localization of the symptoms described above makes it clear which node is affected. Most often, the largest motor nodes of the lower extremities are subject to the described degenerative changes: the hip and knee joints. Arthrosis affects the ankle joints, the joints of the big toe, and the phalanges of the fingers. The remaining joints are affected quite rarely.
The symptoms of hip damage are obvious. All of the above symptoms can be completely attributed to it with only one difference: they are all localized in one place - in the hip joint. The first signs of arthrosis of the hip joint are discomfort that occurs after walking or rising from a chair, bed, or stairs. Then pain appears in the groin, somewhere deep in the thigh. Any movement is accompanied by an unpleasant crunch. Over time, the sore leg loses its mobility, atrophy of the thigh muscles occurs - a formidable symptom of the described disease. A sick person becomes lame. This pathology (it is clearly visible in the photo) is constantly progressing. If treatment is not started on time, dangerous complications will arise:
Treatment of arthrosis of the hip joint is carried out on a strictly individual basis, taking into account the progress of the disease.
At the initial stage, slight pain appears, it subsides in a state of complete rest. This condition can last for months and years, until the next portion of high physical activity brings severe pain that does not disappear even when the person holds his leg in a state of complete rest. To get rid of such discomfort, you need to rest longer and longer. But the initial signs of arthrosis do not end there.
Since the cartilage tissue is not yet damaged, deformation of the knee joint itself is not observed. But at this stage it becomes possible to increase the amount of synovial fluid in the joint cavity. This phenomenon is called synovitis. When the amount of synovial fluid becomes greater than normal, a cyst (Baker's cyst) forms on the back wall of the knee - an indirect symptom of the pathology. This new formation has a dense elastic consistency. You can see a Baker's cyst with the naked eye if you completely open the leg. Its presence is a characteristic symptom of arthrosis of the knee joint with synovitis.
Symptoms of the second stage of the disease indicate the presence of significant damage to the cartilage tissue, a significant narrowing of the gap between the two articulating bones. You can clearly see this phenomenon in a photo or x-ray. It shows a huge bone growth. It gives rise to a crunching sound - an obvious symptom of arthrosis. The bone deformation becomes visible to the naked eye. The knee gradually stops moving, bending and straightening. Acute pain bothers the patient even in a state of complete rest. They intensify even with minimal leg movement.
When the cartilage tissue becomes thinner, a diagnosis of third-degree arthrosis of the knee joint is made. Two bones touching each other at the point of movement become like a club with spikes. Bone growths severely deform the articulating bones, the knees swell and become lumpy. The pain does not go away even for a minute. The combination of such symptoms gives the right to talk about significant progress of the disease.
Pain, the most characteristic symptom of the disease described, which appears in the foot when a person tries to get to his feet after sitting for a long time, is the main sign of damage to the ankle. Then, when walking, a characteristic crunch appears, which occurs even during the simplest habitual movements. Gradually, the intensity of the pain increases, and restriction of foot mobility is formed along all axes of movement - and these are also characteristic symptoms of ankle arthrosis. Over time, the ankle becomes noticeably deformed: it increases in size, the foot bends (in the photo), and is fixed in a position unusual for normal physiology. In the most advanced stages of ankle damage, pain is felt in both the knee and hip joints.
Analyzing the manifestations of arthrosis of the joints, we can conclude that they are largely similar. There is only one difference – the localization of the manifestations described above. They focus where the cartilage tissue begins to be damaged.
Currently, there are many examination methods used for various diseases. Radiography plays a vital role in the diagnosis of many diseases of the musculoskeletal system. And when examining a knee it is impossible to do without it. Therefore, it is important to know what can be seen on an x-ray of the knee joint, what it looks like normally on an x-ray, and how the picture changes as pathology develops. We'll talk about this further.
This study is necessary in case of injury to the knee area, for making a primary diagnosis, and for dynamic monitoring of the restoration of the bone structure after fractures.
Indications for x-ray examination are as follows:
Many people are afraid of X-ray examinations, because they think that the resulting radiation exposure will have a negative effect on the body. However, this is not the case. Radiation exposure during X-rays corresponds to the permissible daily norm, which each person currently receives when using household appliances, smartphones and computers. Negative consequences are only possible with repeated x-rays, since bones are capable of accumulating radiation. It should be noted that after conducting such a study, women should not plan to conceive within a month.
The radiation exposure per year should be no more than 5 mSv.
The following points are contraindications to the study in question:
If there are contraindications, an alternative to X-ray examination is digital radiography. In this case, the images are of better quality, and the patient is less exposed to radiation. You can also conduct magnetic resonance imaging or computed tomography, which are the most effective examination methods.
An x-ray is obtained by passing scattered x-rays through various tissues. The greater the density of the fabric, the more rays it will block and the better it will be visible on film. Bone tissue can be clearly distinguished on an x-ray; soft tissues are less visible. Tendons can only be seen if the required x-ray rigidity is provided. Changes in the thickness of cartilage tissue are judged by the distance between bone structures, as well as by the configuration of the endplates.
An interesting fact is that objects located close to the device produce smaller images than objects located further from it. This is due to the scattering of rays.
An X-ray of the knee joint area will help identify the following pathological changes:
Traumatologists also use X-rays to monitor the progress of regeneration processes when bone or joint structures are damaged.
Before taking a photo, it is often recommended to expose the knee area. But if there is a bandage, including a plaster cast, it does not need to be removed.
During the examination, the patient is prohibited from moving, as the image will be blurred and dynamic blur will appear. If the image is of poor quality, making a correct diagnosis will not be possible.
X-rays of the knee joint are performed in both two and one projection. It depends on the presumptive diagnosis. In case of a fracture, it is necessary to take x-rays in two projections. In addition, the doctor can conduct targeted radiography with the lower limb bent at the knee.
After receiving the image, the radiologist describes it and makes a conclusion about the suspected diagnosis. Based on the data obtained, the treating specialist prescribes the necessary treatment measures.
An X-ray of a healthy knee joint reveals the femur, tibia, patella and partly the fibula. They do not have any pathological neoplasms, the articular surfaces are smooth. There should be no cracks or splinters. The components that make up the joint correspond to each other. The joint gap is the same in width on both sides; there are no inclusions or other formations in its lumen.
What will the image show for various diseases? The following pathological changes are visible on an x-ray for knee diseases:
X-ray examination will help diagnose not only diseases that occur with high frequency, but rare diseases. These include cysts, foreign bodies that have entered the joint cavity during injury, osteomyelitis, various osteochondropathy, congenital deformities of the knee, and abnormal tuberosities of the tibia.
In these diseases, the x-ray picture has the following features:
An X-ray examination is mandatory to diagnose knee arthrosis. To further check the condition of the cartilage tissue and surrounding muscles, an ultrasound is often prescribed.
X-rays are still in demand in diagnosing various diseases of the knee joint. It is the most accessible and quite informative both when making a primary diagnosis and when monitoring the dynamics of a knee injury. An alternative to this study is its digital version, as well as an MRI study.
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X-rays of the hand are used to diagnose various types of fractures and dislocations. An X-ray of the limbs can reveal a large number of joint diseases. A photo created using an x-ray makes it possible to diagnose the presence of a disease such as arthrosis.
C-arched modern device with high sensitivity
Radiography is a diagnostic method that allows one to identify the structure and damage of the bone skeleton. X-rays are used to determine changes in the elbow joint and other joints, damage to bone tissue and muscles. The condition of the hand joints is of utmost importance for diagnosing the disease. Pathologies, their nature and location can clarify a lot both in the course of the disease and in determining its stage. Of great importance is which joints undergo changes during the development of the disease.
The joints of the hands are the first to respond to the development of rheumatic diseases. X-rays are required to assess the extent of damage to bone structures and soft tissues. This is especially important if calcification of joint tissue occurs.
This is what a healthy hand looks like in the photo
If the disease has not affected the soft tissues, then on an x-ray, changes in the joint will be noticeable in the form of thickening and compaction of tissue, but in such a situation it is difficult to reliably and convincingly say which structures have pathological changes.
The main pathologies in the joints of the hand with the development of rheumatic diseases in the shoulder joint area, determined using radiography, include:
A standard x-ray of the shoulder joint is performed in a direct projection. The fingers of the hand are placed together, and the hands themselves should lie flat on a special cassette. The hands should be positioned so that their axis coincides with the axis that passes through the forearms and wrists.
Arthrosis of the knee joint. X-ray for osteoporosis Reflexology. Methods and means. When moving, under the influence of body weight, the articular cartilage of the knee joint is compressed like a sponge, and the unused tissue
In this case, the articular head and socket can significantly increase in size. With the progression of arthrosis of the knee joints (corresponds to 3–4
Gonarthrosis. Deforming arthrosis of the knee joint. It should be noted that this is a misnomer: although with arthrosis of the knee joint deposits are sometimes observed X-ray of the knee joint
What tests need to be taken for rheumatoid arthritis of the joints? How do doctors make this diagnosis? Laboratory diagnostics, x-ray
Examination of a patient with arthrosis of the knee joint - gonarthrosis. image: after all, x-rays show changes in the shape of the joint quite clearly
They took an x-ray and found arthrosis of the left knee. Constant pain With stage 1 arthrosis, there is rarely large swelling of the joints. Need to. How to determine whether there is a gap or not if the x-ray does not show?
X-ray of the knee, confirming extended wear of the joints. During knee replacement surgery for knee arthrosis, the following occurs.
Metabolic diseases of the knee joint in arthrosis (osteoarthrosis, gonarthrosis) are based on a variety of metabolic disorders.
Arthrosis is one of the most common causes of joint pain. It is believed that the consequences of arthrosis are injuries, the accumulation of microtraumas of the joint over many years, and there is also a hereditary form of the disease called primary arthrosis, which occurs mainly in middle-aged women.
For joint diseases, radiography is widely used to make a diagnosis. Using an x-ray, you can see the changes that have occurred in the joint and the extent to which the articular surface has been destroyed. However, x-rays do not show cartilage tissue and its thickness, so in the very early stages, when cartilage tissue just begins to deform and collapse, it is quite difficult to recognize arthrosis. The quality of an x-ray image largely depends on the professionalism of the doctor performing the image. To better identify various changes in the joint, I take pictures in several projections.
X-ray of the knee joint
The distinctive features of arthrosis on an x-ray are narrowing of the joint space and the formation of bone growths around the joint (osteophytes). If the narrowing and osteophytes are not visible on the image, then a more detailed diagnosis is necessary. Narrowing of the joint space is almost always present with arthrosis; changes are especially noticeable in the middle and late stages of the disease. However, narrowing can also occur with other types of joint disease. With arthrosis, the narrowing of the joint space is asymmetrical, that is, in one of the paired joints, for example, in the left knee joint. In inflammatory joint diseases, narrowing occurs symmetrically in both paired joints.
X-ray equipment
Often, a subchondral cyst is found in joints affected by arthrosis. It is a cystic formation, an accumulation of joint fluid.
Rheumatoid arthritis is a common rheumatic disease that affects joints, bursae, tendon sheaths, and the attachment of tendons and ligaments to bones. Possible involvement of periarticular soft tissues, bones and cartilaginous joints. Symmetrical polyarthritis is characteristic; The joints of the extremities are most often affected.
X-rays of the hands and wrists are performed in direct and oblique projections (in the latter case, the hand should be half supinated).
In the early stages of the disease, the following changes are detected on radiographs of the hands.
At advanced stages, the changes are already different.
80% of patients experience similar changes in the feet. The knee, hip, elbow and shoulder joints are slightly less likely to suffer.
The presented x-ray of the pelvis and hip joints in a direct projection in the area of the left hip joint (HJ) shows a slight narrowing of the joint space, signs of subchondral sclerosis.
In the area of the right hip joint, the head of the femur is deformed and structurally changed, the joint space is uniformly narrowed and amounts to less than ? from normal, the articular surfaces are sclerotic, there are marginal growths of bone tissue. The acetabulum has a cellular structure.
Conclusion: radiological signs of deforming osteoarthritis of the right hip joint, stage 3, of the left hip joint, stage 1 according to Kosinskaya. The probable outcome is aseptic necrosis of the femoral head (Calvé-Perthes disease).
With inadequate treatment or late diagnosis of this pathology, arthrosis of the hip joint may develop. In a particular case, arthrosis is secondary. The main risk factors for osteoarthritis are:
The main symptoms include:
This patient is indicated for surgical treatment.
All information presented on the site is for informational purposes only. Medicines, procedures and recommendations should be prescribed by an experienced specialist. When copying materials, there is an active link to the artroz-plus website. Apparently, the size of osteophytes can be influenced by both changes in adjacent areas of the joint and local ones, which can be mediated by biochemical or mechanical growth factors. The latter can most likely explain the connection between the size of osteophytes of the medial TFO and PFO with varus deformity.
Similar independent development is observed in the lateral PFO and medial TFO, with osteophyte size being associated more with lateral patellar subluxation and varus deformity than with local joint space narrowing. Perhaps there are individual differences in the severity of the response to the action of certain factors, for example TGF-beta, or bone morphogenic proteine, which is involved in the growth of osteophytes. An interesting observation is the connection between chondrocalcinosis and the number of osteophytes: TGF-beta, in addition to stimulating the growth of osteophytes, increases production of extracellular pyrophosphate by chondrocytes, and mechanical stimulation of chondrocytes increases the production of ATP, a powerful source of extracellular pyrophosphate, thereby predisposing to the formation of crystals of the latter. Our data suggest the participation of a number of factors in the pathogenesis of osteoarthritis, including local biomechanical, constitutional and others, which determine the size and direction of growth of osteophytes formed during the progression of the disease. Kyiv National Medical University named after. Bogomolets, specialty - “General Medicine”. Although MRI is the leading method for detecting coxarthrosis, ultrasound has advantages in detecting small effusions in the hip joint, even less than 1 ml, as well as disorders of the periarticular soft tissues in the early stages of development. Skip to main content. X-ray diagnosis of osteoarthritis of the knee joints, gonarthrosis.
The lateral image is especially important for studying the PFD of the joint. Stages of osteoarthritis according to Kellgren I. Criteria for osteoarthritis Larsen A. Quite often, osteoarthritis of the knee joints manifests itself in the form of arthrosis of the PFO, almost always external, sometimes external and internal, rarely only internal. X-ray signs of osteoarthritis of the knee joint in the lateral and axial projections include: To neutralize radiation, after the X-ray examination it is recommended to drink more fluids: Before the procedure, it is recommended to eat onions and parsley.
It should be noted that in obese people, the image is blurred due to excess fat and muscle mass. Pregnancy is generally a contraindication for x-rays. In addition, the doctor can conduct targeted radiography with the lower limb bent at the knee. After receiving the image, the radiologist describes it and makes a conclusion about the suspected diagnosis.
Based on the data obtained, the treating specialist prescribes the necessary treatment measures. An X-ray of a healthy knee joint reveals the femur, tibia, patella and partly the fibula. They do not have any pathological neoplasms, the articular surfaces are smooth. The procedure is not considered easy. After it, an allergic reaction may develop. In addition, some patients report a crunch in the knee. It is carried out using the same or improved devices, but the image is transferred to the display. In this case, the quality of the image can be improved and transmitted via a local network to the attending physician. The digital method allows you to quickly obtain an image, which is important in traumatology. A regular X-ray reveals bone pathology, but damage to cartilage and soft tissue is inaccessible to this method. Based on these records, examination and other diagnostic methods, the attending physician makes a diagnosis and prescribes treatment. Not all children easily remain still during the examination, which is why the pediatric radiography room is equipped with clamps. When used correctly, they do not cause any harm or pain to the child and are necessary to immediately obtain a high-quality image, thereby saving the child’s young body from repeated irradiation. Since a child’s body is smaller than an adult’s body, during an X-ray examination, nearby organs may also be irradiated. Therefore, personal protection is used. For example, a newborn baby is completely covered with protection, leaving only the knee joint for X-rays. I would like to add that according to N.
It is customary for Kossinskaya to evaluate knee joints. Thank you very much for the site. Well, just a storehouse of necessary information. I’ve only been working for 3 months after PP, I’ve discovered so many useful things for myself! Skip to main content.
X-ray diagnosis of arthrosis Zharkov P. Dystrophic changes in the musculoskeletal system.
Local Regional Common and systemic 1. Polyarthrosis a of the spine hyperostosis of the spine 2. Widespread hyperostosis b joint Forestier arthrosis 3. Pathological and functional balance of bones in hemophilia 5. Kosinsky classification of arthrosis, includes 3 stages. Thus, the main signs of arthrosis in the stage of osteochondrosis are: In all stages, smooth, clear contours of the articulating bones are preserved. Arthrosis of the right shoulder joint in a miner. Arthrosis in the stage of osteochondrosis of the right elbow joint.
Classification of deforming arthrosis according to N. Mandatory signs of deforming arthrosis are narrowing of the joint space, marginal bone growths, and subchondral osteosclerosis. Having seen it in one image, we will determine its exact location in another. Any photograph of the knee joint is targeted, that is, it depicts only a small area of the skeleton. It is known that any human joint consists of a section of bone that is covered with cartilage tissue. Since the rays easily pass through the cartilage, we do not see it on the x-ray. Therefore, the joint space seems so wide, as if there is nothing between the bones. An X-ray of the knee joint allows you to evaluate the thickness and structure of the bones that form the joint. We do not see the cartilage, but the underlying bone plate will react to its damage - in the form of areas of thinning or thickening, as well as unevenness of its contour. When assessing the articular cavity, one can see a change in its normal shape and structure, as well as the presence of protruding bone growths of osteophytes. Today we will talk to you about what osteoarthritis of the knee joints is, gonarthrosis, what causes it, what are the symptoms of its manifestation, and also how x-rays can help in diagnosing this disease. Comparison of a normal knee joint on the left with gonarthrosis on the right. Causes of gonarthrosis Gonarthrosis occurs in every fifth person on Earth. The causes of gonarthrosis include: It occurs against the background of prolonged nervous tension and protracted experiences. Leg fractures, knee dislocations, meniscus damage. With rheumatoid, reactive, psoriatic arthritis, rheumatism, gout, and ankylosing spondylitis, inflammation of the knee joints occurs.
In order, if necessary, to examine a person’s musculoskeletal system and diagnose pathological disorders, an X-ray of the hip joint (HJ) is prescribed. The examination is considered non-invasive, so it is painless and practically does not require the patient to follow any preparatory procedures. X-ray examination of joints and the spine does not cause harm to humans, because the effect of rays on the body is strictly dosed.
X-ray of the pelvic bones and hip joints is considered a mandatory diagnostic measure, which is prescribed primarily if pathological changes or disorders of bone structures are suspected. The main advantage of radiography is its simplicity, accessibility and low cost.
An x-ray can be taken at any hospital, and based on the image on the x-ray, the doctor will make a preliminary conclusion, which is important for determining further diagnostic methods.
Not all patients are allowed to take x-rays, because the body is still exposed to radiation. In some categories of patients, even minimal doses provoke severe complications. Also, the disadvantages of the procedure include:
X-rays of the hip joint are performed as prescribed by a doctor and are considered the main method for studying pathologies of the musculoskeletal system. The reasons why the procedure is prescribed are:
Pelvic x-rays are prohibited during all stages of pregnancy. In newborns and children under 16 years of age, radiography is prescribed only in extreme cases when other diagnostic procedures cannot provide the necessary results. If the hip joint is examined using contrast, the list of contraindications increases. The following violations are taken into account:
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X-ray of the femur does not require the patient to follow strict preparatory procedures. But in order for the results to be as accurate as possible, it is worth paying attention to important points. Since the location of the left or right thigh is located near the rectum, before the study it is worth clearing it of feces using a laxative or enema. It is important to eliminate excess gases; for this purpose, special medications are prescribed, for example, Espumisan. If contrast is used, it is important to pre-test for an allergic response. If the reaction is negative, the procedure can be carried out.
In order for the x-ray anatomy of the hip joint to show the extent of the damage, a lateral photograph is taken in a direct projection, capturing the lumbar and thoracic spine. To get a more accurate picture, images are taken in two projections. To obtain a direct image, the patient is placed on his back with his legs in a straight line with his feet turned inward. If it is necessary to obtain an image of a flexor joint, radiography is performed in a sitting position, the bending line is determined by the doctor. If it is necessary to administer contrast, 3-5 minutes before. Before the procedure, an injection is given, then the doctor takes pictures.
If it is indicated to take an x-ray of the hip joint in an infant, the baby is laid down with the legs straightened along a straight line. It is important that the limbs do not bend, because in this case the study does not always show the full picture of the disorders. So that the child does not have fear, and body movements do not distort the data, it is recommended to administer a sleeping pill before the examination.
If the preparation for the study was correct, based on the images obtained, the doctor will be able to make a preliminary diagnosis. Normally, the resulting images should not show any pathological shadows if the person is healthy and the outlines of the bones are clear. Each pathology is different, as can be seen in the picture:
Decoding an X-ray for a baby has its own peculiarities. The results are interpreted by a pediatric orthopedist or traumatologist. Due to the cartilaginous structure of the head of the hip bone, which is poorly visible on the resulting image, the doctor will not be able to determine the pathology, so the Hilgenreiner technique is used. The inclination of the roof of the acetabulum is assessed, the angle of which is different for each age. If the roof slopes at a large angle, this indicates dysplasia of varying severity.
If the pathology of the hip joint in a child is congenital, and urgent diagnosis is required, and radiography is contraindicated, an alternative method of examination is ultrasound diagnostics. This is a frequently prescribed and gentle examination method that can be performed at any age, as it has no contraindications.