The ankle joint is often injured due to the heavy load it is subjected to. A diagnosis such as osteoarthritis of the ankle is not uncommon. It is placed regardless of the age and gender of the patient. What is osteoarthritis of the ankle and how can it be treated?
What's this?
There is a tremendous load on the ankle. Its function is to keep the body upright. Thanks to him, a person walks and runs. With a violation of the ankle system, it is extremely difficult to lead a family lifestyle. What interrupts the work of the ankle?
Osteoarthritis of the ankle, what is it? This is a chronic joint disease, characterized by a degenerative course. In the cartilage of the joint, irreversible processes are triggered, which lead to formidable complications.
Osteoarthritis of the ankle develops gradually. Healthy joint surfaces are elastic and smooth. They provide cushioning under heavy loads and smoothness while driving. With pathology, tissue trophism and metabolism are disturbed. The joint surface becomes inelastic and rough. During movement, the cartilages come into contact with each other, which leads to inflammation. When lifting weights, the main load falls on the bone, which threatens with degenerative ailments.
Lack of treatment leads to more serious ailments. At 3-4 stages, cartilage and tissue damage is observed. The synovium becomes inflamed. The joint becomes unstable. The helper function is violated. All these violations on the whole lead to the fact that movement becomes impossible.
Osteoarthritis (osteoarthritis) is one of the most common joint diseases that affects quite a large number of people.
Causes and risk factors
What is arthrosis of the ankle joint, we have solved. Now let's find out what its main cause is. Osteoarthritis of the ankle is considered a pathology of old age. This is due to age-related changes in the body. Cartilage thins, bones become unstable and brittle. However, over the past decade, the diagnosis of osteoarthritis of the ankle has become much younger. Such statistics are disappointing, as many patients ignore the early signs of the disease. Late diagnosis always threatens the development of serious complications.
Provoking factors include:
- dislocations;
- bruises;
- inflammatory diseases;
- wound;
- excess weight;
- impaired metabolism;
- unbearable physical activity;
- wearing uncomfortable shoes;
- autoimmune and endocrine diseases;
- osteochondrosis.
Clinical symptoms
Arthrosis of the ankle is recognized by the following characteristics:
- Ache. It is mild at first and appears after walking or physical exertion. Sometimes when a person is in an uncomfortable position. With the progression of the pathological process, the pain syndrome intensifies and worries already at rest.
- Swelling and inflammation. These signs appear against the background of injuries and dislocations. The body temperature in the affected area rises.
- Click. When the ankle is affected, the click is "dry" and causes a pain attack.
- Dislocation or subluxation. Due to the thinning and degradation of cartilage tissue, the joint becomes unstable. Bones can move and fall out of the joint capsule. These changes cause acute pain attacks.
- Joint stiffness. When cartilage tissue is replaced, the bone joint ceases to function normally, which adversely affects its mobility.
- Joint deformity. The symptom appears at 3-4 stages of arthrosis. Osteophytes also lead to curvature of the ankle.
If any of the symptoms appear, it is advisable to consult a doctor immediately. Prompt treatment initiated is a step towards recovery.
Osteoarthritis of the foot and ankle joints is characterized by a slow progression with a gradual development of clinical manifestations over several years.
Classification and phases
The disease develops in different ways. In some patients, several years pass from the first signs to the final stage, in others the rapid development of the disease is observed. The speed depends on the age and state of health of the patient, from the moment of the start of therapy. Symptoms of osteoarthritis of the ankle joint become brighter as the disease progresses.
There are four stages of osteoarthritis:
- The first stage is often unnoticed. Sometimes morning stiffness and ankle pain appear after intense exertion. When the foot moves, a characteristic creak is heard. Pathological changes are not yet visible on X-rays, but the destructive process of cartilage has already begun.
- Morning stiffness becomes prolonged. It takes 20-30 minutes to develop a leg. Sometimes lameness occurs. Arthrosis of the 2nd degree of the ankle joint is recognized on the radiogram by the growth of bone tissue, the displacement of the bones.
- The 3-stage symptoms are pronounced. Pain worries no longer only after a heavy load, but also at rest. It is difficult for a patient to do without painkillers. Lameness increases. Crutches may be needed. The affected joint is swollen and deformed. The ankle muscles atrophy. X-ray shows a narrowing of the joint space, the formation of osteophytes, subluxation.
- Phase 4 is the most difficult. It develops due to lack of treatment. Cartilage is destroyed, the surfaces of the joints are fused. Walking is no longer possible.
With the development of osteoarthritis of the ankle, there is a gradual change in the cartilage and bone tissue of the joint surfaces.
Diagnostics
Diagnosis of osteoarthritis of the ankle is based on clinical symptoms and information obtained during examinations. Laboratory studies are considered ineffective, since there are no special tests capable of detecting pathology. During the period of remission, all indicators are within normal limits, with an exacerbation of the disease, a clinical blood test will show a high level of C-reactive protein and ESR. These indicators indicate that the pathological process has already begun.
To confirm the diagnosis, instrumental methods are used:
- radiography;
- Magnetic resonance;
- Ultrasound;
- bone scan;
- joint puncture diagnosis.
Simple radiography
Simple radiography is the most reliable and effective method of diagnosing diseases that occur in the musculoskeletal system. The principle of manipulation is the different absorption of X-rays by the muscle tissues. Soft tissues allow X-rays to pass, but hard tissues absorb. An x-ray allows you to diagnose both the disease itself and its consequences.
Conventional radiography is a method of examination in which a small amount of X-rays are transmitted through the person's body or part of the body.
The snapshot allows you to see:
- The condition of the bone surfaces in the joint.
- The shape, size and arrangement of the structures in the joint are relative to each other.
- The state of the fabric.
- The size of the joint space.
These indicators help the doctor determine the type and extent of joint damage. If the data is not enough, doctors prescribe other studies.
With osteoarthritis of the ankle, an x-ray is performed in three projections:
- side;
- Back;
- back with one foot shifted inward.
The disease is characterized by the following changes:
- reduction of the joint space;
- the presence of osteophytes;
- replacement of bone cartilage (subchondral sclerosis);
- minor voids in the periarticular part.
Nuclear magnetic resonance
Nuclear magnetic resonance imaging (MRI) as a diagnostic method allows you to study those parts of the body where there is water. The image shows the bones in dark color, because they contain less water, but the muscle tissue, discs and nerves are displayed lighter. MRI allows you to detect the slightest changes in the structure of bone tissue and joints. The study is also prescribed to patients before joint replacements. YMG has one drawback - a high price.
On nuclear magnetic resonance, a change in the properties of hydrogen molecules is recorded under the influence of a strong magnetic field.
Magnetic resonance
Magnetic resonance imaging (MRI) is an alternative diagnostic method that allows you to carefully examine the ligament structure of joint, muscle and cartilage tissue. With the help of an MRI, the doctor assesses the condition of the joints in the leg. Based on the survey data, the pathology is revealed at an early stage of development.
The diagnostic principle is based on exposure to radio waves and strong magnetic radiation. The magnetic field used is not dangerous and does not represent a danger to health.
MRI is contraindicated in cases of mental disorders, during pregnancy and in the presence of metal objects in the human body.
When diagnosing osteoarthritis of the ankle, classic (closed-type) MRI machines are used, as they have better image quality. An MRI machine is a large cylindrical tube with a magnet around it. The patient lies down on a special table. The ankle is fixed with a special coil. The procedure takes 30-40 minutes. The study is absolutely painless. Patients may feel heat in the lower leg area.
Ultrasound
Ultrasound examination has been widely used in medicine since the 90s of the 20th century. This technique has proven effective in making accurate diagnoses. An ultrasound is also done for osteoarthritis of the ankle joint.
Today, ultrasound examination is not of particular importance in the diagnosis of osteoarthritis, since it does not allow a sufficiently good study of damaged joints.
The device with which the study is carried out produces ultra-frequency waves. The waves are reflected by the tissues and recorded on the monitor. Based on the resulting image, the doctor determines the type of pathology. To make the image on the monitor clear, a special gel is used. Eliminates air gaps and gives the sensor a better smoothness.
Ultrasound examination does not harm the patient, so the procedure can be repeated several times. The advantages of ultrasound also include low cost and high accuracy.
The following indicators are a clear sign of osteoarthritis:
- thinning of the cartilage;
- the presence of bone growths;
- accumulation of effusion in the joint cavity (synovitis);
- loss of cartilage space.
Bone scan
Scintigraphy is a high-precision study that, using isotopes, is able to detect pathological changes in the bones. Doctors divide pathogenic outbreaks into "cold" and "hot". In the first case, these are areas in which there are no isotopes. These areas are poorly supplied with blood and are not visible during the scan. "Cold" areas are places affected by malignant tumors. In "hot" areas, isotopes accumulate rapidly and appear very bright when scanned. Such areas indicate the presence of inflammatory processes.
The role of scintigraphy in osteoarthritis is significant. The study helps distinguish osteoarthritis from a number of other diseases when the clinical symptoms are extremely similar.
During the bone scan, a special preparation containing special labeled atoms is injected into the body.
Based on the results of the scintigraphy, the doctor makes a clinical prognosis and determines the treatment regimen. The only drawback of the studio is its high cost. Scintigraphy is performed using special equipment and, unfortunately, not all medical institutions can afford to purchase it.
Although radioactive scanning is a safe procedure, it still has a number of contraindications:
- pregnancy;
- lactation period;
- taking drugs containing barium.
When a radioactive substance is injected, some patients experience an allergic reaction in the form of itching and rash. These side effects do not cause any dangers and disappear on their own in a short time.
joint puncture
Joint puncture is a diagnostic procedure in which a needle is inserted into the joint cavity to collect synovial fluid. This liquid is then sent for further research. Based on the data obtained, the doctor draws a conclusion about the nature of the disease and the stage of its development.
At first glance, a puncture is a simple procedure, but it isn't. The withdrawal of fluid from the joint capsule requires exceptional precision of the movements of the doctor. The synovium is very thin and an awkward movement traumatizes it. As a result, an inflammatory process develops. Potential risks also include infection. It is not difficult to get the infection into the joint capsule through poorly sterilized instruments.
The manipulation technique is different for each joint. When the joint exudate is collected from the ankle, the puncture is performed in front, between the outer ankle and the extensor longus tendon of the fingers.
Diagnostic intra-articular fluid sampling allows for laboratory analysis and excludes inflammatory arthritis.
Basic principles of treatment
After confirming the diagnosis of osteoarthritis of the ankle joint, the symptoms will not be long in coming. The treatment is started immediately. Further prognosis depends on a well-chosen treatment regimen and the timeliness of initiation.
Osteoarthritis is an insidious disease. It cannot be completely healed. The goal of therapy is to stop degenerative processes and prolong the period of remission. For this purpose, doctors prescribe drugs, physiotherapy, massage, remedial gymnastics and folk remedies. If all conditions are met, it is possible to count on positive dynamics, otherwise the disease progresses.
Drug therapy for osteoarthritis
Depending on the therapeutic effect, drugs are divided into several groups:
- Anti-inflammatory or pain reliever. This group of drugs is aimed at eliminating the focus of inflammation and relieving pain. The earlier anti-inflammatory therapy is started, the better the chances of saving the joint. Drugs of this group can be produced in the form of tablets and ointments.
- Glucocorticoids. These drugs are prescribed when the above funds are ineffective. They are produced in the form of a solution for injection. The medicine is injected directly into the joint.
- Chondroprotector. Designed to slow down the destruction of cartilage.
The treatment regimen and dosage are selected by the doctor, based on the severity of symptoms, the age of the patient, the presence of concomitant diseases and other factors. Self-medication is dangerous and often aggravates the situation, since many of the drugs have a number of side effects and have their own contraindications.
Features of radical treatment
If conservative therapy has failed, doctors are forced to resort to a radical method of treatment (surgical intervention). The operation is also shown when:
- secondary (post-traumatic) and primary arthrosis of 3-4 degrees;
- osteoarthritis with complications;
- constant and severe pain in the ankle, radiating to the knee;
- severe lameness;
- paresis and paralysis of the leg muscles;
- violation of the flexion-extensor function of the joint;
- violation of the supporting ability of the foot.
Surgery is contraindicated if:
- the patient is less than 12 years old;
- fistulas are located in the joint;
- the patient has a history of diabetes mellitus, heart failure;
- Infectious diseases were found in the area of the proposed intervention.
Traditional treatment
Doctors believe that the treatment of arthrosis should be carried out exclusively under the supervision of a specialist, but they do not deny the positive effect of folk remedies. Alternative medicine acts as an effective prophylaxis that helps eliminate symptoms and maintain remission.
Folk remedies are a rather symptomatic treatment for osteoarthritis of the foot.
Home treatment must be coordinated with the doctor to avoid side effects and complications.
Traditional healers suggest treating osteoarthritis of the ankle with:
- Burdock. Wash the burdock leaves with soap and running water. Apply the leaves with the soft side to the skin. Secure the top with a bandage or cling film. It is best to keep the compress overnight.
- Sea salt. Chop the salt in a pan. Pour it into a linen bag and attach it to the ankle. Keep the bag until the salt has cooled. Heat relieves pain. Instead of salt, sand, lentils, buckwheat are also used.
- lilac. Pour the triple cologne over the lilac flowers. Let the tincture sit in a cool dark place for 10-14 days. Rub the affected area in the morning and evening.
- Eggshell. Grind the shells in a coffee grinder. Take the resulting powder for ½ tsp. before eating.
Do not forget that treatment with folk remedies should not be the only measure. Complex treatment includes taking medications, physical therapy, massages, physiotherapy, spa treatments. In advanced cases, doctors resort to radical measures - surgical intervention.
Surgery
For osteoarthritis of the foot, the following types of operations are used in medicine:
- joint arthrodesis;
- joint arthroscopy;
- endoprosthesis.
Arthrodesis is an operation to immobilize a joint. It is performed to return the limb of lost support capacity. The only drawback of surgery is that the bones (tibia and talus) grow together, which leads to immobility. Arthrodesis is rarely used in medical practice.
Arthroscopy is a minimally invasive procedure. During the operation, the doctor makes small incisions in the joint area and through them inserts an arthroscope (a special tube at the end of which a camera is installed). With the help of it, the surgeon carefully examines and evaluates the condition of the intra-articular structures. If necessary, pieces of the damaged joint or blood clots are removed from the synovial fluid. This manipulation is less traumatic. The only drawback of arthroscopy is that the risk of recurrence is too high.
Endoprosthesis is a last resort treatment. It is performed with advanced osteoarthritis. The endoprosthesis allows you to partially or completely replace the affected joint. Innovative prostheses with modernized mechanics are used as a prosthetic product. An artificial joint lasts 10 to 20 years.
Power functionality
In order to achieve a favorable result, drug treatment is supplemented with diet therapy. Nutritionists have developed a special diet to avoid exacerbation of the disease and at the same time provide the body with all the necessary vitamins and nutrients. Diet for overweight patients plays a special role. Since obesity is one of the reasons for the development of osteoarthritis, weight correction is an integral part of the treatment.
The patient needs to reconsider some of his habits in daily life, which contribute to and cause the progression of osteoarthritis of the foot.
Nutritionists recommend sticking to the following nutritional conditions:
- Eat often and in small portions.
- Drink at least 2 liters of fluids per day.
- Give up sweets and salt.
- The last meal is no later than 18. 00.
- Dishes can be steamed, boiled or baked.
The main task of the osteoarthritis diet is a balanced and fortified diet. Fasting is out of the question. Harsh diets and body cleansing do more harm than good. Calcium is excreted from the body, which is necessary for the restoration of cartilage. A nutritionist will help you compose a daily diet.
With osteoarthritis, it is allowed to eat cereals, pasta, dairy products, cheese, legumes, vegetables, fruits, rye bread, dried fruits, nuts, fish, poultry meat. Heavy and fatty side dishes, foods containing dyes and flavorings, as well as pickles, marinades, smoked meats, fatty broths, baked goods, spices, sauces, chocolate, ice cream, coffee and alcohol are prohibited.
Prevention of arthrosis
To avoid the development of arthrosis of the ankle joint, doctors recommend taking preventive measures:
- wear comfortable shoes without heels;
- stick to a diet and drink enough fluids;
- take vitamin and mineral complexes seasonally;
- I swim;
- walk more in the fresh air;
- eliminate excessive stress on the legs;
- avoid hypothermia;
- be seen by a doctor in a timely manner.
With existing osteoarthritis, it is recommended to correct the lifestyle:
- Refuse bad habits. It has been shown that they cause the stagnation of blood in the tissues and accelerate the destruction of cartilage.
- Do a series of exercises to warm up your ankle.
Forecast
Osteoarthritis is a progressive disease. Without treatment, it leads to irreversible consequences and complete immobility of the joint. Early diagnosis of pathology allows you to do without radical measures. Drugs are able to suspend the pathological process and alleviate the patient's condition. The fight against the disease in the early stages is uncomplicated.