How best to determine the condition of the joint. Arthrosis and arthritis. How to find out? What can I offer? Functional testing of the posterior cruciate ligament

Dear friends, good day!

The topic of this conversation is the most common diseases of the joints. What are their reasons? How to find out what it is: arthritis or arthrosis? How are their treatment plans different? What to offer when asked for something for joint pain? What can not be offered so as not to harm? We will talk about all this now.

First, let's look at the anatomy.

How is the joint arranged?

The joint is formed by the articular surfaces of most often two bones, each of which is covered with articular cartilage.

The joint is surrounded by a joint capsule (capsule), the inner shell of which produces synovial fluid into the joint cavity. It is necessary for lubrication, to nourish the joint, so that our joints do not creak, crunch, click, or ache. By the way, it contains hyaluronic acid. Do you understand where I'm getting at?

Cartilage, covering the articular surfaces, performs two important functions:

Provides sliding of articulating bones relative to each other.
It is a shock absorber that the joint experiences when walking, running, jumping.

There is a certain warranty period for the operation of articular cartilage. It does not have a specific figure and depends on the person's lifestyle, weight, nutrition, past injuries and some other factors.

But most often it is 40-60 years.

With age, the amount of synovial fluid in the joint cavity decreases. The cartilage loses moisture, becomes thinner, “erased”, its depreciation capabilities decrease. Articular surfaces begin to rub against each other. Gradually, the process passes from cartilage to bone, causing deformation of the articular surfaces and the formation of bone outgrowths - osteophytes.

You can come across other names for arthrosis: "osteoarthritis", "osteoarthritis", "deforming arthrosis".

At the age of 60+, signs of arthrosis can be found in almost every joint.

But above all, it does not spare the most loaded joints: the knee and hip.

Arthrosis of the knee joint is called "gonarthrosis", arthrosis of the hip - "coxarthrosis".

How to recognize arthritis?

Symptoms of osteoarthritis depend on its stage.

At the beginning of the disease, after a long walk or playing sports, the joint begins to ache. Over time, the pain intensifies, there is a crunch when moving. In the morning after getting up or after sitting for a long time, stiffness of movements occurs, and it takes some time, about 10-15 minutes, to disperse. Inflammation develops in the joint, which is externally manifested by swelling.

In the future, pain when walking becomes constant, movements in the joint are painful, difficult.

If we are talking about the hip joint, then the thinning of the cartilage leads to the fact that the leg on the side of the lesion becomes shorter. There is a distortion of the pelvis, spine. There is a degeneration (destruction) of the mesvertebral discs, the formation of protrusions and hernias is possible. There are back pains.

To prevent this, it is necessary to put an orthopedic heel pad under the sore leg.

The saddest thing about all this is that the process cannot be reversed. You can only pause it.

A radical treatment for arthrosis is joint replacement - an expensive operation that not everyone can afford.

So, what do we have with arthrosis:

"Drying" and destruction of cartilage.
, inflammation, swelling.
Decreased range of motion.

Therefore, the complex treatment of arthrosis will be something like this:

What is assigned?	What for?
NSAIDs inside	Reduce pain and inflammation.
NSAIDs externally	Strengthen the action of NSAIDs for internal use.
	Stimulate the formation of collagen, stop the process of cartilage destruction.
Hormonal drugin the joint (appointed with the ineffectiveness of NSAIDs)	Relieve acute inflammation and pain.
Hyaluronic acid preparation	Moisturize cartilage, improve lubrication of articular surfaces, facilitate their sliding, reduce pain.
orthosis	Fix and unload the joint, which will reduce pain and speed up recovery.
Orthopedic	Reduce the shock load on the diseased joint to reduce the period of exacerbation.
Cane	Transfer the load to a healthy leg, unloading the patient. The cane makes walking easier and reduces pain.
Physiotherapy	Reduce inflammation, pain, improve joint blood circulation, speed up recovery.
exercise therapy	Improve blood circulation, strengthen the muscles of the joint, increase the range of motion.

Of this scheme, the most cruel is the introduction of the hormone into the joint, as it further destroys the cartilage. But sometimes it is urgent to remove the inflammation in order to start treatment with hyaluronic acid preparations. Or the pain is so severe that the person cannot walk.

For intra-articular administration, betamethasone, triamcinolone, hydrocortisone are used.

Hyaluronic acid preparations are otherwise known as synovial fluid prostheses. These are Ostenil, Fermatron, Suplazin, etc. As a rule, they are administered once a week. The course requires 3-5 injections.

Rheumatoid arthritis

The second most common joint disease after arthrosis is rheumatoid arthritis.

This is an autoimmune disease in which one's own immune system suddenly begins to attack native connective tissue and, first of all, joints and periarticular tissues. A huge amount of inflammatory mediators, autoantibodies (this is called the “rheumatoid factor”) is produced, the activity of macrophages and lymphocytes increases.

Chronic inflammation develops in the joints, which further leads to the destruction of cartilage and bone. There are terrible deformations. To spare the nerves of the especially impressionable, I will show the most harmless photos:

This disease is more common in women.

Rheumatoid arthritis can occur at any age after a viral infection, hypothermia.

Why it occurs, no one really knows. Maybe a lousy gene got mixed up, since patients with rheumatoid arthritis can be traced in different generations of the same family.

Unlike arthrosis, small joints are first affected here.

Typical symptoms of rheumatoid arthritis:

Swelling and soreness of the small joints of the hands, then of the feet. Moreover, this process is symmetrical.
The pain is worse at night and early in the morning. This is due to the fact that during the night an inflammatory exudate accumulates in the joint cavity, irritating the nerve endings of the synovial membrane.
Morning stiffness, which can last from 30 minutes to infinity (depending on the activity of the process). It feels like the joints are stiff. For comparison: with arthrosis, it does not exceed 15 minutes.
The appearance of rheumatoid nodules. These are soft formations ranging in size from 2 mm to 3 cm, located in the area of \u200b\u200bthe joints. It is believed that their cause is the deposition of immune complexes in the vessels - the result of the activity of an enraged immune system:

Weakness, fatigue, decreased appetite, weight loss, possibly body. This happens due to intoxication of the body caused by inflammation and destruction of its own tissues.
Joint deformities. They are so strong that a person cannot brush his teeth, comb, dress, light a burner.
Rheumatoid arthritis is usually accompanied by changes in other organs and systems: spine, heart, lungs, eyes, nervous system.

Principles of treatment of rheumatoid arthritis:

I'll explain a little.

In the treatment of rheumatoid arthritis, there is such a thing as basic therapy, which should begin as early as possible. It includes immunosuppressive agents and agents with a pronounced anti-inflammatory effect.

Suppress the activity of the immune system Methotrexate, Arava, Remicade, MabThera, glucocorticosteroids (prednisolone, methylprednisolone, dexamethasone), antimalarial drugs (Plaquenil, Delagil).

Arava, Sulfasalazine, Plaquenil, Delagil have an anti-inflammatory effect.

If basic therapy with one drug is ineffective, two or even three drugs from these groups are prescribed, for example, Methotrexate and Arava or Methotrexate and Sulfasalazine.

Non-steroidal anti-inflammatory drugs against the background of such a fire that burns in the joints with rheumatoid arthritis are ineffective. Therefore, they are prescribed, as a rule, in combination with one of the means of basic therapy.

And yet, if you are talking to a customer and understand that everything here is very similar to rheumatoid arthritis, of course, you can independently recommend an over-the-counter drug from the NSAID group and

The choice of product depends on the localization of the process. Most often, this is an orthosis for the wrist joint.

And be sure to consult a doctor.

Other arthritis

Very briefly about other arthritis.

Reactive arthritis occurs after an infectious disease. For example, after an intestinal or genitourinary infection. Mostly large joints of the legs are affected: knee, ankle, and the lesion is asymmetrical. Mostly young people are affected.

The basis of treatment is antibiotic therapy. To reduce pain, NSAIDs are used, in severe cases - hormones.

Rheumatic arthritis. Not to be confused with rheumatoid! This is a systemic disease with a primary lesion of the heart (rheumatism is the main cause of acquired heart defects). Occurs in young people, often in children.

The culprit is Streptococcus. There is even such an expression: "Streptococcus bites the heart and licks the joints."

Rheumatism begins 1-2 weeks after suffering a sore throat. The temperature rises, the pulse quickens, chills, sweating, chest pain are noted, large joints of the legs hurt and swell, and the inflammation wanders from one joint to another.

Treatment includes antibiotics to kill streptococcus, corticosteroids and NSAIDs to reduce inflammation and pain.

There are also psoriatic, gouty and other arthritis, but less often.

Summarize.

Differences between osteoarthritis and arthritis

	arthrosis	Arthritis
Age	Mostly in the elderly	Any
What comes first	cartilage destruction	Inflammation
Which joints are affected	Mostly large	Any
Pain at rest	Rarely	Often
The nature of the pain	Moderate, aching, aggravated by movement	Acute, persistent
Edema	Might not be	There is
Forecast	Healing Impossible	A cure is possible (depending on the type of arthritis)
Basis of treatment	NSAIDs, hyaluronic acid preparations, chondroprotectors	Antibiotics, anti-inflammatory drugs, in rheumatoid arthritis - immunosuppressants

What can you offer when asked for something for joint pain:

NSAIDs over-the-counter orally and externally.
Chondroprotector, if you see an elderly person in front of you, because you can’t go wrong here. Everyone over the age of 60 has arthrosis.
Orthopedic product for the joint.
Orthopedic insoles (for pain in the joints of the legs).
Cane (for pain in the joints of the legs).

Attention! What not to offer:

Warming ointment and warming knee pad in the first week after the onset of symptoms of the disease, because. as a result of vasodilation and improved blood circulation, the area of inflammation increases.

That's all for today.

A new riddle from buyers today will be like this:

See you on the blog for hard workers!

With love to you, Marina Kuznetsova

As a rule, this question is already asked when the pain is very strong. What is the name of the doctor who will help inflamed joints, everyone needs to know, because damage to the articular tissues can occur in any person, regardless of age, gender and social status.

People who suffer from joint diseases sometimes do not pay attention to the symptoms. This leads to the transition of diseases to the next stages, which are more difficult to deal with. So, if the hip joint is not treated, its prosthetics will be required, the pathology of the spine and knee joint will limit the human motor function. Inflammation can affect bones, ligaments, and muscles.

Asking the question of how to check the health of the joints, you need to know the characteristic symptoms of their damage. If you find signs of the disease, you need to contact a specialist.

joint pain

It accompanies all lesions of the joints. It happens: aching, stabbing, constant or intermittent, dull and sharp, twitching, strong or mild. It appears in the affected joint, can radiate to the bones, muscles, tendons. Occurs with heavy loads on the legs – running, going up/down stairs. Sometimes the loads make the condition easier.

Note! Often the pain is especially disturbing after sleep, rest. Gradually, with walking and other physical exertion, it decreases. This phenomenon indicates the pathology of the joint and the need for a medical examination.

Crunch and limited movement

It can occur already at a young age with increased stress. In addition to the knees, it can appear in other joints:

Ankle joint.
Hip joint.

This indicates possible degenerative-dystrophic processes in the joint.

Restriction of mobility occurs due to insufficient synovial fluid and the formation of bone spikes.

Inflammation and blockade of the joints

Signs of inflammation:

Redness of the skin in the articular region.
Its temperature is higher than that of the rest of the skin.
Joint pain.
Deterioration of the general condition.

Jamming, or blockade, occurs in the later stages of the development of the disease. This condition is characterized by sudden immobilization of the joint. This provokes infringement and severe pain.

Note! Jamming can take place on its own, with active movements of the leg or arm (depending on its location).

Deformation

This is the advanced stage of the disease. It is difficult not to notice the deformation of the contours of the joint, it is striking. In addition to the aesthetic defect, there is severe pain, in some cases a person can become disabled, unable to take care of himself.

Joint doctor

Joint diseases are within the competence of physicians of several specialties. Who to contact depends on the degree of development of the pathology. The therapist is engaged in treatment at the primary stage. It is to him that they will be directed at the registry when treating with signs of the disease. After examining and making a primary diagnosis, he issues a referral to a specialist.

Family doctor

If family medicine is practiced in the clinic, then a referral will be issued to a doctor of this specialty. This doctor has a broader body of knowledge in medical science.

Note! Your family doctor can prescribe treatment based on your symptoms. A referral for examination to a narrow specialist will be issued if the treatment has not worked.

Who is a rheumatologist, the question may arise. This is a doctor who treats diseases of the joints and connective tissues. If you look at the statistics, then most of the cases are the treatment of inflammation of the articular tissues. Acute inflammation can be diagnosed by the following signs:

Changes in the general blood test.
Swelling and redness of the periarticular tissues.
Pain syndrome.

Diseases treated by a rheumatologist:

. First, the pain appears in the joints of the hands and feet, then spreads to the large joints of the limbs. Deformation of the articular tissues develops, which becomes noticeable. Manifested by morning stiffness.
reactive arthritis. This pathology affects one or more areas. Moreover, the cause of the development of lesions is a previously transferred infectious disease. The onset is acute with severe pain.
Autoimmune diseases affecting the joints. With this pathology, the protective function of the immune system is disrupted. The first characteristic manifestations: pain and swelling of the joints.
Inflammation associated with impaired metabolic processes. The most common disease in this group is gout. It starts like many other joint diseases, so the patient does not respond in time and does not go to the doctor. Big fingers or toes are affected. Men suffer from this disease more often.

Note! In a state polyclinic, it is almost impossible to get a direct appointment with a rheumatologist. To do this, you need an examination and referral of a general practitioner, a family doctor. As for private clinics, there you can immediately get to the target specialist.

An orthopedic traumatologist can check the condition of the joints and treat their diseases. He is given a referral for additional examination with such symptoms that appeared after the injury:

Pain and crunch.
Stiffness.

Physicians in this specialty treat:

He also specializes in post-traumatic conditions.

Note! The stage when prosthetics is needed is the responsibility of the surgeon .

Conclusion

In order for the treatment to be effective and timely, the patient needs to consult a doctor of the appropriate specialty. Now knowing which doctor treats joints, this is easy to do. It is worth remembering: the sooner you apply, the greater the likelihood of a complete cure.

The most complete answers to questions on the topic: "how to check the joints of the whole body in women?".

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Magnetic resonance imaging of the joints with contrast can be used if there are contraindications to x-rays.

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X-ray densitometry is aimed at studying the mineral density of bone tissue.

Where to get the service?

In modern commercial laboratories, medical services are tailored to the individual patient, and the results can be recorded on a CD.

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Joint diseases do not begin overnight - the pains that appear indicate that the disease has already reached a certain stage. How to monitor the condition of the joints in order to detect a deviation from the norm in time and immediately begin treatment? Let's figure this out.

Competent diagnosis of joint diseases is the key to effective treatment

Joint pain can be a signal of arthritis, including rheumatoid, arthrosis, osteoarthritis, bursitis, chondrocalcinosis, Bechterew's disease and other diseases. The following symptoms usually indicate the problems that have arisen.

The appearance of pain in the knees while climbing or descending stairs can signal osteoarthritis. This disease sometimes affects the fingers - in this case, the upper phalanges are compacted. Sudden sharp pain in the big toe is a typical sign of arthritis. This disease often affects the hip joints and makes itself felt with severe pain in the upper leg. Rheumatoid arthritis can manifest as a violation of fine motor skills of the hands, when it becomes difficult to insert a key into a lock or thread into a needle.

Unfortunately, today 30% of the world's population suffer from joint diseases, and not only people of respectable age are among them. Joint diseases develop rapidly, so it is very important to diagnose them in time and start treating them. This will help maintain mobility, ease of movement and relieve severe pain.

For reference
What are the functions of the joints?

Movement in space - it is the joints that allow us to walk, run, jump.
Mobility - with the help of the joints, we cross our legs, squat, raise and lower our hands, clench our fists.
Preservation of body position - the joints allow you to squat or on a chair, leaning forward, stand, leaning on something.

General examination and palpation method

The first visit to the doctor begins with a general examination, which allows you to see external deviations from the norm. This may be, for example, swelling in the joint area. During a general examination, the doctor may ask the patient to make certain movements in order to understand the nature of the pain and the area of \u200b\u200bits distribution. Posture and gait can also indicate joint diseases.

Another most common and easiest method of examination is palpation, or palpation. With the help of touch, the doctor detects external signs of joint diseases. So, for example, you can find rheumatic and rheumatoid nodules, find the place where discomfort occurs during movements, determine the state of the joint capsule, changes in temperature and humidity of the skin in the area of the joints.

General examination and palpation are the most accessible methods of examination, but they occur without the use of technical means, therefore they do not give a complete picture of the clinical picture of the disease.

Goniometry

This is a method of examination using a goniometer - a device that allows you to determine the amplitude of joint mobility. The goniometer resembles a protractor and allows you to determine the angle of mobility. The patient makes a number of necessary movements (flexion, extension, lifting and lowering of the limbs), and the doctor takes measurements, records the indicators and correlates them with the norm.

Laboratory diagnostic methods

More accurate information about the patient's condition and his disease can be obtained by learning the results of the tests.

Blood analysis

Many indicators of a blood test indicate joint disease. So, during a biochemical analysis, the doctor will definitely pay attention to the content of C-reactive protein in the blood serum, to the content of total protein, to the dephenylamine reaction and other indicators. An alarming signal should be considered an increase in ESR (erythrocyte sedimentation reaction), since this reflects the level of the inflammatory process. In rheumatic inflammatory pathologies, an immunological blood test shows antinuclear antibodies (ANA). With arthritis and other diseases of the joints in the blood serum, the level of uric acid rises sharply. In addition, in patients suffering from rheumatism, psoriatic arthritis, ankylosing spondylitis and other diseases of the joints, there is a change in the content of lysosomal enzymes (acid proteinase, acid phosphatase, deoxyribonuclease, cathepsins) in the blood serum and synovial fluid.

Analysis of urine

It should be noted that significant deviations from the norm in the analysis of urine are observed only in severe forms of joint diseases. However, it should be remembered that in healthy people protein and blood in the urine should not be present. Their appearance indicates the presence of diseases.

X-ray diagnostics of joints

To study in detail the state of the joints and their structure, methods of radiation diagnostics allow. These procedures do not require prior preparation.

X-ray examination. Indications for its implementation may be pain in the joints, difficult mobility, swelling and discoloration of the skin in the joints. During the examination, the image of the joints is projected onto a special film using x-rays. A special apparatus directs the beams to the examined area, for safety reasons all vital human organs are covered with a protective lead apron. The patient is either sitting or lying down. X-ray allows you to see the deformation of the joints and their pathology. The procedure takes no more than three minutes, the results can be presented in 15 minutes as a snapshot. Even when using the most modern equipment, minimal radiation occurs, so X-rays, like other radiation methods of research, are not recommended for pregnant women.

Arthrography- a more accurate method compared to conventional x-rays. It is used for damage to the meniscus, ligaments, suspected rupture of the joint capsule. Before arthrography, the joints are artificially contrasted. To do this, a special substance is injected into the joint cavity, then the patient is asked to make several movements and the image is fixed by targeted radiography. The result, depending on the equipment, can be obtained on a monitor or on film. The procedure lasts about 10 minutes and is not dangerous. However, if the patient has an allergic reaction to iodinated contrast agents, this is a contraindication for this examination.

Why the joints of the legs can hurt - it is this question that brings many people of different sex and age to the doctor's office. Without examinations, it is impossible to establish the cause of pain, since its occurrence can be provoked by a wide variety of pathologies and injuries.

Why do joints hurt?

There are many reasons for joint pain. The first thing to suspect is injury. Dislocations, fractures, sprains, cracks, bruises will certainly cause pain. And if there was no injury, but the joints hurt, then this may indicate the presence of the following diseases:

In some diseases, not directly the joints can hurt, but other organs, the pain from which radiates to the joint. An example of such diseases is vein thrombophlebitis, vascular atherosclerosis, venous stasis, pinched nerves in the spine, etc.

When to see a doctor?

Seek help immediately if you experience the following symptoms:

the leg became cold or hot;
lost sensation in the legs;
the color of the skin has changed - they turned blue, reddened or blackened;
against the background of pain in the joints, there is a deterioration in the general condition and fever;
swelling and impaired mobility of the joint.

In other cases, you should also not try to cure joint pain on your own and consult a doctor as soon as possible. After all, the transition of some diseases of the joints into a chronic form can make it difficult to move or completely immobilize the legs.

Characteristics of diseases that cause pain in the joints of the legs

Arthritis

Arthritis is an inflammatory disease of the joints. The knees and feet are most commonly affected. There are several types of arthritis, depending on the etiology, but for all the symptoms will be the same:

sore joints;
stiffness of movements in the joint;
possible swelling, hyperemia of the joint and adjacent tissues.

Psoriatic arthritis

This type of disease combines the appearance of arthritis and psoriasis. It is equally often exposed to men and women aged 25-45 years. Arthritis can develop both after the onset of psoriasis and before it. The most common causes of this disease are malfunctions of the nervous system, trauma, taking certain medications, infectious diseases, and heredity. Both large and small joints can be affected.

Symptoms:

In severe cases, the disease is possible fever, myocarditis, polyneuritis, inflammation of the kidneys.

Treatment of the disease should be carried out simultaneously by two doctors: a rheumatologist and a dermatologist. It is impossible to completely cure the disease, however, by starting timely therapy, you can slow down the rate of development of the disease, reduce the manifestations of symptoms and avoid the development of severe complications.

For treatment appoint:

NSAIDs (Diclofenac, Ibuprofen, Nimesulide, Ketoprofen, etc.);
glucocorticoids (Beclomethasone, Prednisolone, Dexamethasone);
anti-inflammatory drugs (Sulfasalazine, Leflunomide, Cyclosporine-A);
bio-agents (Humira, Remicade, Infliximab) are prescribed when therapy with other means is ineffective.

In addition to treatment with pharmaceuticals, courses of special physiotherapy exercises are prescribed.

Rheumatoid arthritis

This type of arthritis is the most severe. In its development lies a violation of the immune system, as a result of which immune cells begin to attack the cells of the joint, mistaking them for foreign agents. The knee and interphalangeal joints are most often affected. With advanced disease, almost all joints of the body can be affected. The exact cause of the disease has not yet been established.

The disease occurs more often in women than in men. Most of the patients are over 30 years of age.

Symptoms:

It is almost impossible to recover completely from the disease. All drugs used in therapy eliminate the symptoms of the disease and prevent its progression.

As part of complex therapy, the following are used:

NSAIDs (Diclofenac, Piroxicam, Movalis, etc.);
glucocorticoids (hydrocortisone, methylprednisolone, prednisolone);
gold preparations (Auranofin, Krizanol);
immunosuppressants (Kuprenil, Artamine);
the antimicrobial drug Sulfasalazine;
antimalarial drugs (Plaquenil and Delagil);
cytostatics (Azathioprine, Methotrexant, Leukeran, Chlorbutin).

Physiotherapeutic methods of treatment, laser and cryotherapy are also prescribed.

Post-traumatic arthritis

This type of arthritis occurs after a traumatic injury to the joint. Such arthritis is most characteristic of the ankle and knee joint. The disease is equally common in men and women, while the risk groups are athletes and people with constant heavy loads on the joints.

Symptoms:

The treatment of such arthritis depends on the degree of damage to the joint and includes the use of medications (NSAIDs, glucocorticoids), massages, physiotherapy and exercise therapy.

Gouty arthritis

This type of arthritis develops due to the deposition of uric acid salts in the joint cavities.

Gouty arthritis is more typical for men aged 35-50 years. Women are exposed to this disease in 55-70 years. The reasons can be metabolic disorders in the body, heredity, malnutrition, taking certain medications, etc. Small joints are affected primarily, in particular the joints of the toes.

Symptoms:

In complex therapy are used:

NSAIDs (Ibuprofen, Movalis, Revmoxicam, Celecoxib, Indomethacin, etc.);
specific drug Colchicine;
drugs to reduce the urea content: Allopurinol, Urikozyme, Probenecid.
compresses using Dimexide;
physiotherapy (paraffin wraps, laser therapy, massage, magnetic therapy);
obligatory diet;
physiotherapy.

arthrosis

Arthrosis is a disease of a dystrophic nature, in which the destruction of intra-articular cartilage occurs. This disease is the most common among all diseases of the joints. Both men and women suffer from arthrosis equally often, from about the age of 30. The older the age, the higher the chance of developing the disease.

There are several types of arthrosis:

gonarthrosis - damage to the knee joint;
coxarthrosis is a disease of the hip joint.

Osteoarthritis develops as a result of a violation of intra-articular metabolism, which causes a loss of cartilage elasticity. This can be facilitated by excessive stress on the joint, metabolic disorders, heredity, circulatory disorders of the joint, rheumatoid arthritis, gout, etc.

Symptoms:

joints hurt, especially during movement;
as the disease worsens, the intensity of pain increases, up to unbearable;
crunch in the joints;
impaired mobility of the joint, up to complete immobilization in severe arthrosis;
joint deformity.

The treatment of arthrosis should be comprehensive and include, in addition to taking medications, physiotherapy, physiotherapy exercises, as well as an orthopedic regimen.

Medical treatment includes:

NSAIDs (Diclofenac, Meloxicam, Indomethacin, Celecoxib, etc.);
corticosteroids (Diprospan, Hydrocortisone);
chondroprotectors (Chondroitin, Glucosamine, Dona, Teraflex, Artra, Structum);
Diacerein.

Osteoarthritis

This disease develops rather slowly due to the destruction of articular structures, cartilage damage and changes in the capsule. The knee and hip joints are more susceptible to this disease. The disease occurs with the same frequency in people of both sexes after 45-50 years.

The causes of osteoarthritis are age-related changes, genetic predisposition, excess weight, joint injuries.

Symptoms of osteoarthritis are mild. Sometimes, even when the diagnosis is confirmed by x-ray, no symptoms may be observed. The pains are not permanent: during the period of exacerbation, the pains are strong, during the period of stability, they are completely absent.

In more severe cases, there are:

severe aching pains;
stiffness of movements;
joint swelling;
the appearance of bone growths.

For treatment, drugs of the group of NSAIDs, glucocorticoids, chondroprotectors are used. A complex of therapeutic exercises, physiotherapy is also prescribed.

Meniscopathy

Although this disease is less known to a wide range of the population, it is no less common than arthritis and arthrosis. This disease is characterized by damage to the meniscus of the knee joint. The cause of its development can be injuries, sprains, excessive stress on the knees, gout, arthritis, etc. Depending on which of the menisci is damaged, there are medial and lateral meniscopathy.

Symptoms:

pain in the knee joint, aggravated during movements;
hyperemia of the knee joint;
violations of motor function;
effusion, hemarthrosis or cyst.

Treatment for meniscopathy can be conservative or surgical. Conservative includes taking NSAIDs, glucocorticoids, chondroprotectors. If such treatment fails, or if the cyst, effusion, or hemarthrosis is severe, then arthroscopy is performed. This operation allows you to remove the accumulated effusion and restore the meniscus.

A lot of various diseases can provoke pain in the joints of the legs. Therefore, with the appearance of even a not significant intermittent pain, it is necessary to consult a doctor. This will allow you to start treatment on time and prevent the development of complications.

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If a person is diagnosed with arthrosis, foot treatment at home is the main way to influence the disease. In the clinic, the patient can only undergo a course of physiotherapy. A sadder reason for a visit to the hospital is a surgical operation. But this happens only in the most advanced cases, when the joints of the legs have completely lost their mobility or the life of the patient is in danger. If you monitor your health and do not self-medicate, then the disease can be stopped in the early stages.

A feature of arthrosis is that it can even be detected independently, even at the time of formation. The disease makes itself felt with pain and unusual sounds made when walking. Do not wait for an exacerbation of arthrosis of the legs and subsequent disability. You need to see a doctor urgently. He will refer the patient to an orthopedist, who will give recommendations on treatment methods and the choice of drugs for arthrosis.

Medical method of treatment

A cure at home is possible only at the first and second stages of the disease, when there are no pathological processes associated with the destruction of cartilage tissue and the fusion of leg bones. Medication is the traditional treatment for all mild bone diseases. The basis of success is the correct selection of drugs and the implementation of all instructions of the attending physician. Treatment of arthrosis of the foot at home is regularly adjusted depending on the results achieved or lack thereof.

As a rule, the patient is prescribed such drugs:

Chondroprotectors. These are unique modern means that allow you to stop the destruction of cartilage tissue, cause its strengthening and regeneration. A full course of taking chondroprotectors in combination with proper nutrition allows you to completely restore the structure of the joint.
Anti-inflammatory. Medicines of this group relieve swelling from the legs and contribute to the destruction of foci of infection. The course of taking anti-inflammatory drugs continues until the foot takes on a natural configuration.
Painkillers. These medicines are taken in the first days of treatment to reduce the patient's suffering and restore his ability to move normally.
Antibiotics. They are prescribed if an infection in the joint bag is detected. The course of treatment lasts from 3 to 7 days, depending on the detected pathogen.

Medicines are taken in the form of tablets, ointments, tinctures and injections. In some cases, the patient is prescribed droppers with glucose, vitamins and saline.

Treatment of arthrosis of the foot with folk remedies

Treatment of pathologies of the joints of the legs with folk remedies can be successful if you strictly adhere to the prescribed recipe. You should tune in to the fact that the therapeutic effect will not come immediately. It can take months to stop the disease and return the feet to their natural shape. However, it's worth it.

Folk remedies do not give complications to the internal organs, they are completely harmless to the body. The substances contained in them strengthen the immune system and improve metabolism. Accumulating in the internal organs and blood, useful trace elements have a long-term therapeutic and preventive effect.

Regardless of the degree of leg damage, the following traditional medicine recipes are used:

Foot baths. There are no restrictions on the frequency of their adoption, since water procedures only bring benefits. The water temperature is selected depending on the condition of the foot. If there are inflammatory processes and infection, then the water must be heated to body temperature. In the absence of such pathologies, the temperature can be increased to 40 - 42 ° C. A decoction of juniper, wild rosemary, chamomile, thyme, string, oregano and tricolor violet flowers is added to the basin. As the water cools, boiling water is poured into it.
Compresses. You can treat the feet with compresses of various compositions. For example, from the grass that remained after straining for foot baths. It contains enough useful substances. Another recipe includes salt, honey and alcohol. The components are mixed so that a mass is obtained that does not spread. Therapeutic mixtures are applied to the leg, wrapped in cellophane and fixed with an elastic bandage. It is advisable to do compresses at night.
Rubbing. The most effective is a mixture of vodka (0.5 l) and eucalyptus tincture (100 ml). The ingredients are mixed and infused for 2-3 days. After that, the liquid is rubbed into the affected joints in the morning and evening. The treated area is wrapped with a warm cloth or elastic bandage.
Wraps. The basis is a burdock leaf, which relieves pain or plantain well. A mixture of vodka (alcohol), honey and crushed garlic is applied to the leaves of these plants. Such a composition causes severe and penetrating irritation of soft tissues. As a result, there is an increase in blood flow and an improvement in metabolism in the affected joints.
Applying leeches to the foot. These creatures secrete anticoagulants that prevent the formation of clots and blood clots in the blood vessels. Leeches should be taken only in pharmacies. Otherwise, unpleasant complications are possible.
Bee venom. Bee stings activate all metabolic processes at the local level. Before using this method, you should consult with an allergist.

When using various methods of treatment with folk remedies, it is necessary to monitor the appearance of side effects in the form of fever, rash or nasal discharge. If such facts are available, then the treatment should be stopped and consult a doctor.

Gymnastics for the feet

As for the treatment of arthrosis at home, gymnastics is an activity that can be done at any time, without being tied to the conditions of the situation. Many patients mistakenly believe that with the pathology of the lower extremities, it is necessary to observe complete rest, without loading the feet. This is a big mistake, since the immobility of the legs causes congestion, which aggravates the course of the disease. In addition, there is a weakening of the tendon structure and a weakening of the musculature.

In order to successfully cope with the disease, it is necessary to perform the following sets of exercises:

Walking on a massage mat. These are special products with a corrugated surface. The protrusions exert point pressure on soft tissues, which helps to improve blood circulation and metabolism in damaged joints. A good solution is to walk on grass, loose earth or sand around the house. All this helps to increase the tone of all tissues of the foot.
Rolling a pimply rubber ball with the foot. This exercise can be performed even while sitting. It is performed in the case when it is not possible to go outside, or in the phase of exacerbation of arthrosis. An analogue to balls is a foot massager made of wood or plastic in the form of a cylinder covered with spikes.
Active leg movements that mimic cycling. The exercise is performed lying on your back. You can do it on the floor or on the couch, at any time convenient for this. Such gymnastics helps to improve the mobility of the feet and the outflow of excess fluid.
Walking around the room on bent legs. A moderate load on the joints contributes to the activation of all metabolic processes and blood circulation. Stagnation disappears completely.

Physiotherapy exercises allow you to strengthen weakened toes, develop tendons and restore their mobility. The joints begin to bend as it was before the disease. active regeneration of cartilaginous tissues begins.

Manual therapy

With arthrosis of the lower extremities, blood circulation is disturbed. This process contributes to the progression of the disease and its transition to a more severe stage. It is possible to restore normal blood circulation even in the advanced phase of the disease. Stimulation of the joints causes the activation of all metabolic and regenerative processes.

Foot massage should be performed with little effort, without exceeding the average level of pain threshold. The impact is carried out with fingertips by soft strokes and pressure on the affected area. You need to start the massage from the tips of the toes, gradually moving towards the ankle joint. End the session with hand movements on the foot from the bottom up.

The effectiveness of manual therapy will be much higher if the legs are preheated. To do this, you can use a warm bath or wrapping the limb with ozocerite.

Passing a course of physiotherapy

The modern medical industry produces a wide range of portable physical therapy devices. To avoid wasting time and effort on trips to the clinic, it is advisable to have such devices at home. In terms of the effectiveness of the healing action, they do not differ from stationary analogues. At home, electrophoresis, UHF and electromagnetic radiation are used.

Physiotherapy allows you to achieve the following therapeutic effect:

activation of metabolic processes in the tissues of the joints of the foot;
improvement of blood circulation in the tissues of the lower limb;
elimination of stagnant processes in soft tissues;
stimulation of cartilage regeneration in the joint;
restoration of the natural structure of cells, the return of their resistance to infection.

After treatment, the acquired devices can be used for the prevention of arthrosis and the treatment of other diseases.

Diet

In the treatment of arthrosis, it is necessary to adhere to proper nutrition. Avoid sweet, spicy and fatty foods. All salinities are categorically contraindicated, since salt is deposited in the joints, aggravating the situation. Those who like sweets should switch to honey. Diet promotes weight loss, which reduces pressure on sore joints.

The diet should include foods high in calcium. This mineral is necessary for the restoration of bone and cartilage tissue. A good healing effect is given by broths, cottage cheese and other fermented milk products. Poultry and fish meat is useful. During each meal, you need to eat greens with a high content of vitamins - onions, garlic and dill.

Conclusion on the topic

Treatment of arthritis at home will only be successful if the patient wears soft and comfortable shoes with low heels. You need to constantly monitor your weight and give up bad habits. Loads on the injured limb and any sudden movements are not allowed. Hypothermia is strictly contraindicated.

What to do if the leg hurts in the hip joint?

In the human body, the hip joint plays an important role, since it is on this part that a huge and prolonged load is placed. In addition, he is able to maintain the balance of the body, and supports most of its weight. Moreover, the hip joint provides movement. That is why pain in it delivers severe discomfort and can even interfere with normal life. Such symptoms require careful examination and immediate treatment.

Characteristics of pain
Causes of pain in the hip joint
- Discomfort in the joint with arthritis
- Pain in the hip joint due to bursitis
- Unpleasant sensations in the leg due to deforming arthrosis (coxarthrosis)
- Infectious diseases
- Development of tendinitis
- hereditary diseases
- Neoplasms of soft tissues and bones
How to help if your leg hurts in the thigh?
How to treat an injured hip joint?

Characteristics of pain

When the hip begins to hurt badly, most likely, we are talking about damage to the joint. Quite often, the cause of discomfort is defects in nearby tissues or structures: bones, muscles, cartilage, tendons and fascia. Moreover, injuries in the region of the femoral joint can be accompanied not only by pain in it, but also spread up to the lower leg. Sometimes, on the contrary, no pain in the leg occurs, but they cover the lumbar segment of the vertebra.

In most cases, discomfort in this proximal joint occurs along with stiffness when walking or moving. With such an ailment, it is difficult to perform lateral movements and bend the hip.

Causes of pain in the hip joint

Conditionally, the causes of hip pain can be divided into the following categories:

Incorrect position of the head of the femoral joint in relation to the articular notch. Such a problem may be congenital or acquired, for example, physical overexertion and traumatic dislocations.
Diseases of the musculoskeletal joint or hip joint, namely inflammation, damage and degeneration.
Diseases of tissues and organs that are near the joint: innervation of nerve endings and inflammation, pathological processes in the womb, sacrum or buttocks.

But pain in the leg of the hip joint does not occur alone, as a rule, it goes to the thigh, spreading in some cases to the knee. There are many factors that cause discomfort in the hip joint, however, most often this occurs due to injuries.

The femoral neck is a rather vulnerable part of the joint, so it often breaks. Older people mostly suffer from this problem, as their bones become brittle and fragile due to osteoporosis. At a younger age, a similar fracture can be obtained after a traffic accident, sports or work injury.

Often, the femoral joint undergoes dislocation, which occurs when the acetabulum is underdeveloped. The head of the hip bone in such a situation falls out of its limits. Most often, such injuries occur during falls, work injuries or accidents. A key sign of dislocation is intense pain in the hip joint.

With subluxation, the causes and symptoms are the same as for dislocations, however, they are less pronounced. That is why such a problem is considered dangerous, because with it the leg begins to hurt only when walking, without giving a signal about the need for an urgent appeal to a specialist.

During pregnancy, the leg in the hip joint can also get sick, because the baby growing in the womb takes a huge amount of calcium from the mother's body. All this makes the bones very fragile. Moreover, with the increase in the weight of the child, the pressure on the hip joints of the woman increases, which are already experiencing a huge load.

Another pain in the leg causes dysplasia. With this pathology, a deviation of the joint occurs, in addition, it can lead to the formation of subluxations and dislocations. In most cases, this condition occurs in newborn babies when the joints are at the wrong angle, thereby limiting the range of motion of the legs.

Diseases that cause pain in the hip joint

When there are no external causes of pain in the hip joint, but there is constant discomfort, there is a high probability of developing a pathological process.

Discomfort in the joint with arthritis

This disease is widespread, according to statistics, its symptoms can be detected in every hundredth person in old age. Although today arthritis occurs even in thirty-year-old people. With such a problem, a person has severe pain in the leg on the affected side, and there are also unpleasant sensations in the groin area, sometimes spreading to the knee and thigh. The main symptoms of arthritis include an attack of acute pain when trying to get up.

Similar symptoms appear in those who suffer from rheumatoid arthritis. The transferred rheumatism provokes the development of this disease. A feature of this pathology is the symmetry of the lesion. Rheumatoid arthritis affects both the left and right hip joint.

Pain in the hip joint due to bursitis

Large joints in the body are surrounded by small sacs, in other words, bursae containing synovial fluid inside. They are needed to reduce the friction of the bones that form the joint. There are two main bursae between the thigh and pelvic bones. The first is located in the groin area on the outside of the thigh, and the other is located at the trochanter on the femur. Inflammatory processes, as a rule, appear in the trochanteric bag. This happens for various reasons.

There are several risk factors for developing bursitis:

Trochanteric bursitis makes itself felt with sharp pain sensations that are localized deep in the thigh, moving to the outer surface. After some time, pain may also occur in other parts of the pelvis and thigh, which becomes more intense at night, when sitting, walking for a long time, relying on an injured leg. It also increases in the supine position on the side.

Unpleasant sensations in the leg due to deforming arthrosis (coxarthrosis)

This disease is quite common. The risk group usually includes people of the middle age category. Coxarthrosis can be asymptomatic, however, the first signs of the disease appear at the earliest stages. With such an ailment, a person begins to be disturbed by pain in the femoral joint on the left or right side, and sometimes on both at once.

Pain worries as the pathology develops. In total there are three degrees of the disease. Severe discomfort occurs in the second stage. The patient begins to complain of pain during the rotation of the body and at the beginning of the movement, radiating to the groin and knee. The muscles in the affected area are tense all the time. Moreover, they do not weaken even in a dream, therefore, often unpleasant sensations in the hip joint with deforming arthrosis appear at night.

Infectious diseases

If an infection has entered the body, then the nature of pain changes. They become more acute and are accompanied by fever, hyperemia of the skin and swelling in the femoral zone. Sometimes, because of the pain, it is even impossible to touch the joint. Treatment in this case is carried out only in the infectious diseases hospital. After the suppression of the pathological process, discomfort disappears on its own.

Development of tendinitis

Inflammation of the tendons most often occurs in people who are constantly exposed to physical exertion, athletes are especially susceptible to the disease. During tendonitis, severe pain in the leg appears with heavy loads or active movements. And they may not be at low loads.

hereditary diseases

Pathologies of the hip joint often carry a hereditary factor. In this situation, we are talking about Legg Calve-Perthes disease. It occurs mainly in children, mostly boys. Such an ailment is one-sided, in other words, unpleasant sensations appear in the left or right hip joint. Often this pathology is manifested by pain in the knee, and not in the hip.

Neoplasms of soft tissues and bones

Aching pain may not be associated with problems in the joint. Sometimes they are caused by tumors in the bone or muscle tissue. The nature of the pain depends on the type of neoplasm (malignant or benign) and its location.

How to help if your leg hurts in the thigh?

If you experience discomfort in the hip joint, you need to take some measures. You can put an ice pack on the affected area. The cold will help soothe the pain in the joint. First, a towel should be placed on the thigh, and then ice should be placed on the affected area. It must be held for at least 15 minutes. When pain sensations arose as a result of an injury, they are also acute in nature, cold cubes will have to be placed on the thigh every hour. True, if the pain is chronic, as during arthritis, twice a day is enough.

After two days of ice treatment, you can proceed to warming procedures. For this, a conventional electric heating pad is suitable. It is better to set it to medium heat, the main thing is not to fall asleep with it. A warm bath also helps to get rid of pain in the femoral joint. The water in it should be above 32 degrees.

Then the affected area must be rubbed with ointment. When it is rubbed, the tense muscles of the thigh are relaxed. You should try Fastum-gel and similar products. But you can not use ointments in which menthol is present, along with the use of a heating pad, as you can get severe burns.

After that, you need to take painkillers:

Paracetamol;
ibuprofen;
Acetaminophen.

If the dosage indicated on the package does not help get rid of pain in the hip joint, it is better not to risk it and consult a specialist.

How to treat an injured hip joint?

The doctor first of all sends the patient with such pain in the hip joint for an x-ray examination. It is his result that will help determine the exact cause of their appearance. Only after that the specialist can prescribe complex therapy. As a rule, various methods of treatment are used to get rid of pain in the thigh. The patient must first of all observe bed rest. With such an ailment, nothing can be done. The state of rest will soothe the pain, and recovery will come faster.

Still, when the leg hurts in the femoral joint, you can use an elastic bandage. True, it is worth wearing it only if the symptoms of the disease begin to disappear. It is advisable to spend as much time as possible motionless in order to save the joint from various loads.

An equally effective way is drug treatment. Ointments with analgesic action will help relieve pain: Diclofenac, Ibuprofen and others. The doctor also prescribes anti-inflammatory drugs to the patient, which must be taken orally.

An excellent method of restoring the affected hip is massage. This procedure has become an integral part of complex therapy. Massaging movements should not cause discomfort and pain. People with similar problems are recommended to undergo about 10 massage sessions.

During the rehabilitation period, it is necessary to perform therapeutic exercises. But exercises with damage to the hip joint should be performed only under the supervision of a specialist. By the way, for most joint pathologies, swimming is the most suitable sport.

It should be remembered that the leg in the hip joint can hurt not only due to the development of diseases. In many cases, they become the consequences of bad weather conditions, improper and malnutrition. That is why it is necessary to lead a healthy lifestyle, and is always in a good mood. In addition, do not forget to regularly perform physiotherapy exercises.

Why do joints hurt?

When to see a doctor?

Seek help immediately if you experience the following symptoms:

the leg became cold or hot;
lost sensation in the legs;
the color of the skin has changed - they turned blue, reddened or blackened;
against the background of pain in the joints, there is a deterioration in the general condition and fever;
swelling and impaired mobility of the joint.

Characteristics of diseases that cause pain in the joints of the legs

Arthritis

sore joints;
stiffness of movements in the joint;
possible swelling, hyperemia of the joint and adjacent tissues.

Psoriatic arthritis

Symptoms:

In severe cases, the disease is possible fever, myocarditis, polyneuritis, inflammation of the kidneys.

For treatment appoint:

NSAIDs (Diclofenac, Ibuprofen, Nimesulide, Ketoprofen, etc.);
glucocorticoids (Beclomethasone, Prednisolone, Dexamethasone);
anti-inflammatory drugs (Sulfasalazine, Leflunomide, Cyclosporine-A);
bio-agents (Humira, Remicade, Infliximab) are prescribed when therapy with other means is ineffective.

In addition to treatment with pharmaceuticals, courses of special physiotherapy exercises are prescribed.

Rheumatoid arthritis

The disease occurs more often in women than in men. Most of the patients are over 30 years of age.

Symptoms:

It is almost impossible to recover completely from the disease. All drugs used in therapy eliminate the symptoms of the disease and prevent its progression.

As part of complex therapy, the following are used:

NSAIDs (Diclofenac, Piroxicam, Movalis, etc.);
glucocorticoids (hydrocortisone, methylprednisolone, prednisolone);
gold preparations (Auranofin, Krizanol);
immunosuppressants (Kuprenil, Artamine);
the antimicrobial drug Sulfasalazine;
antimalarial drugs (Plaquenil and Delagil);
cytostatics (Azathioprine, Methotrexant, Leukeran, Chlorbutin).

Physiotherapeutic methods of treatment, laser and cryotherapy are also prescribed.

Post-traumatic arthritis

Symptoms:

The treatment of such arthritis depends on the degree of damage to the joint and includes the use of medications (NSAIDs, glucocorticoids), massages, physiotherapy and exercise therapy.

Gouty arthritis

This type of arthritis develops due to the deposition of uric acid salts in the joint cavities.

Symptoms:

In complex therapy are used:

NSAIDs (Ibuprofen, Movalis, Revmoxicam, Celecoxib, Indomethacin, etc.);
specific drug Colchicine;
drugs to reduce the urea content: Allopurinol, Urikozyme, Probenecid.
compresses using Dimexide;
physiotherapy (paraffin wraps, laser therapy, massage, magnetic therapy);
obligatory diet;
physiotherapy.

arthrosis

There are several types of arthrosis:

gonarthrosis - damage to the knee joint;
coxarthrosis is a disease of the hip joint.

Symptoms:

joints hurt, especially during movement;
as the disease worsens, the intensity of pain increases, up to unbearable;
crunch in the joints;
impaired mobility of the joint, up to complete immobilization in severe arthrosis;
joint deformity.

The treatment of arthrosis should be comprehensive and include, in addition to taking medications, physiotherapy, physiotherapy exercises, as well as an orthopedic regimen.

Medical treatment includes:

NSAIDs (Diclofenac, Meloxicam, Indomethacin, Celecoxib, etc.);
corticosteroids (Diprospan, Hydrocortisone);
chondroprotectors (Chondroitin, Glucosamine, Dona, Teraflex, Artra, Structum);
Diacerein.

Osteoarthritis

The causes of osteoarthritis are age-related changes, genetic predisposition, excess weight, joint injuries.

Symptoms of osteoarthritis are mild. Sometimes, even when the diagnosis is confirmed by x-ray, no symptoms may be observed. The pains are not permanent: during the period of exacerbation, the pains are strong, during the period of stability, they are completely absent.

In more severe cases, there are:

severe aching pains;
stiffness of movements;
joint swelling;
the appearance of bone growths.

For treatment, drugs of the group of NSAIDs, glucocorticoids, chondroprotectors are used. A complex of therapeutic exercises, physiotherapy is also prescribed.

Meniscopathy

Symptoms:

pain in the knee joint, aggravated during movements;
hyperemia of the knee joint;
violations of motor function;
effusion, hemarthrosis or cyst.

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Competent diagnosis of joint diseases is the key to effective treatment

General examination and palpation method

Goniometry

Laboratory diagnostic methods

More accurate information about the patient's condition and his disease can be obtained by learning the results of the tests.

Blood analysis

Analysis of urine

X-ray diagnostics of joints

To study in detail the state of the joints and their structure, methods of radiation diagnostics allow. These procedures do not require prior preparation.

X-ray examination . Indications for its implementation may be pain in the joints, difficult mobility, swelling and discoloration of the skin in the joints. During the examination, the image of the joints is projected onto a special film using x-rays. A special apparatus directs the beams to the examined area, for safety reasons all vital human organs are covered with a protective lead apron. The patient is either sitting or lying down. X-ray allows you to see the deformation of the joints and their pathology. The procedure takes no more than three minutes, the results can be presented in 15 minutes as a snapshot. Even when using the most modern equipment, minimal radiation occurs, so X-rays, like other radiation methods of research, are not recommended for pregnant women.

Arthrography - a more accurate method compared to conventional x-rays. It is used for damage to the meniscus, ligaments, suspected rupture of the joint capsule. Before arthrography, the joints are artificially contrasted. To do this, a special substance is injected into the joint cavity, then the patient is asked to make several movements and the image is fixed by targeted radiography. The result, depending on the equipment, can be obtained on a monitor or on film. The procedure lasts about 10 minutes and is not dangerous. However, if the patient has an allergic reaction to iodinated contrast agents, this is a contraindication for this examination.

Computed tomography (CT) - the most modern and most informative method of radiology. CT allows you to assess the structure of articular tissues with an accuracy of up to a millimeter and make a "slice" in any plane. This makes it much easier for the attending physician to make a diagnosis. CT may show tissue changes, osteophytes, and cartilage growths. During the procedure, the patient lies on the couch, which begins to move during the examination, and a special tube transmits and captures x-rays in a certain sequence. This lasts 2-3 minutes. The degree of exposure is minimal. The result can be obtained both in digital format and in the picture.

Radionuclide methods researches allow to recognize pathologies with the help of radiopharmaceuticals. The most popular method of radionuclide diagnostics is scintigraphy. Radioactive isotopes are introduced into the body, and obtaining a high-quality image is achieved due to the radiation emitted by them. The procedure is performed using a single photon emission computed tomography scanner. Visualization is carried out at the cellular level and does not duplicate the results of other radiation studies. This allows you to see the functional changes that occur in the body before the anatomical ones. The procedure is safe, since gamma-emitting radionuclides with a short half-life are used, the radiation exposure is not higher than with conventional x-rays. Contraindications for examination: pregnancy and lactation. The patient can find out the results immediately after its completion.

MRI of the joints

Magnetic resonance imaging of the joints (MRI) is performed using radio waves and strong magnetic radiation, which make it possible to obtain a clear image of the tissue. The patient lies down inside the “tube” of the MRI machine. The examination area is designated by the attending physician. The main requirement for the patient is to lie still, as the quality of the images depends on this.

MRI allows you to see in all details the clinical picture in injuries and degenerative diseases of the joints, for example, in chronic arthritis. MRI also makes it possible to diagnose osteoarthritis, septic arthritis, osteomyelitis and other diseases. The procedure lasts 10-20 minutes, and the patient can receive a conclusion in the form of an examination protocol and images in 20-30 minutes.

This examination of the joints is not dangerous, since the magnetic field used does not pose a threat to the human body, so there are practically no restrictions here. However, MRI is contraindicated in people with a pacemaker, hemostatic vascular clips, electronic or ferromagnetic middle ear implants.

Ultrasound examination of the joints

This method of diagnosing joints is based on the use of ultrasonic waves. A special device emits waves of a certain frequency, they interact with soft tissues and penetrate into the study area. Ultrasound of the joints is prescribed for injuries, rheumatological pathologies accompanied by inflammatory processes.

Acoustic vibrations are captured by a special scanner, the image immediately appears on the monitor, if necessary, it can be printed, that is, the patient will know the result almost immediately. During the procedure, so that there is no air between the scanner and the examination area, the surface of the body is lubricated with a special gel. The doctor guides the body with a sensor, which does not cause the patient the slightest discomfort. Ultrasound is the safest procedure possible even during pregnancy.

What research method to choose?

The most optimal method for diagnosing joints in each case is selected by the attending physician, taking into account the patient's complaints, the state of his body and the need to detail the area under study. Sometimes, for the diagnosis of uncomplicated arthrosis of the hip joint at the initial stage, a conventional x-ray is sufficient. With complaints of periodic moderate pain, as a rule, this examination is practiced, and it is enough. But, for example, with an advanced form of Bechterew's disease, it is better to resort to computed tomography.

Of course, in order to get the most accurate result, it is better to use modern methods of joint diagnostics: CT, MRI, ultrasound. You can contact the clinic where such examinations are carried out without prior consultation. The diagnostic specialist will voice your clinical picture and give an appropriate recommendation, advise which doctor to contact: an osteopath, an orthopedist or a traumatologist.

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Diagnosis of diseases of the joints

The classic definition of the term "joint" is a movable connection of bones. This description of the term can be called exhaustive: indeed, it is only thanks to the joints that we make any movements: from the simplest to those requiring a serious load.

The joints are formed by the articular surfaces of the epiphyses (end sections) of the bones, covered with cartilage. If there were no cartilage, then the bones would touch, which would wear them out and make movement difficult. Joints are strengthened by ligaments, as well as by the joint capsule. This is a kind of bag of connective tissue, its outer layer is dense, fibrous. The inner shell of the capsule produces a special synovial fluid - joint lubrication.

The greatest variety of movements is characteristic of the shoulder joint. It has a spherical shape, so we can not only raise, lower our hand and move it to the side, but also rotate it. Not all joints in the body have this amplitude. The knee joint is considered the most complex joint: it is formed by three bones (including the patella), strengthened by ligaments, and there are also two menisci in the joint.

The main diseases of the joints are divided into the following groups:

Degenerative-dystrophic (approximately 15% of the total number of joint diseases)

The cause of these diseases are metabolic disorders in the tissues that form the joint. As a result, the structure of the articular cartilage changes, as well as the bones, including in those areas to which the ligaments are attached. Degenerative-dystrophic diseases include osteochondropathy and one of the most common pathologies - arthrosis. In everyday life, these diseases are often called "salt deposition".

Inflammatory diseases are the most common joint diseases.

These include arthritis, synovitis (inflammation of the periarticular sac), bursitis, tendinitis (inflammation of the soft tissues surrounding the joint), Bechterew's disease, which affects the spine. The most common cause of inflammation of the joints is a bacterial infection, it can also be physical factors, chemical effects, etc. The patient feels pain, notes swelling of the joint, limited mobility. The disease is dangerous because as it develops, cartilage is destroyed.

Injuries (joint injuries account for more than half of all musculoskeletal injuries)

These are dislocations, bruises, damage to the ligaments of the joints, various disorders in the bones and soft tissues, and intra-articular fractures. The patient complains of pain, swelling, hemorrhage may occur in the joint cavity. With some injuries, the joint becomes hypermobile.

Tumor diseases

Tumors of the joints, according to experts, are less common than tumors of nearby tissues: for example, blood vessels, fatty tissue, ligaments. Most joint tumors are benign and are accompanied by pain. In malignant tumors, patients complain of weakness, fever, weight loss.

Congenital joint defects

Most often, these are dislocations and dysplasia of the joints. Newborn children are checked for the presence of pathology of the hip joints: babies suffer more often than others. Treatment is carried out in the first months of life.

Joint diseases are treated by two specialists: a rheumatologist or an arthrologist. The first specializes not only in joint diseases, but also in connective tissue pathologies in general. An arthrologist is more often treated with a specific disease - arthritis.

In diseases of the joints, early and accurate diagnosis is very important. Doctor's recommendations are necessary to maintain joint performance and to avoid deterioration of the patient's condition. The doctor forms conclusions on the basis of laboratory tests, instrumental diagnostics and data obtained during the examination of the patient.

Clinical Analysis

Communication between the doctor and the patient begins with an external examination. In the case of joint disease, this is an important stage, since many pathologies have bright external manifestations. For example, with rheumatoid arthritis, Bechterew's disease, osteoarthritis, patients notice morning stiffness of movements, a feeling that the joints are "filled with liquid." Damage to small joints is characteristic of rheumatoid arthritis, and large - to osteoarthritis. If the thoracic spine suffers, then the doctor may suggest intervertebral osteochondrosis. Acute inflammation of the big toe is an almost unmistakable sign of gout.

If patients, in addition to stiffness of movements, note fever, weakness, general malaise, then most likely there is an inflammatory disease in an acute form. At the same time, patients initially complain about crunching and creaking of the joints not very often: as a rule, “noise” effects are characteristic of a later stage of the disease.

After a general examination, the doctor proceeds to palpation. This method allows you to make a preliminary diagnosis, assess the condition of the patient's skin, which is important for diagnosis, as well as the condition of the muscles in the area of the affected joint.

First of all, the doctor examines the skin around the affected joint and evaluates its elasticity and temperature. With inflammation, the skin may turn red, the temperature rises. With joint disease, the skin fold after tingling is smoothed out slowly. By pressing on the skin in the area of the affected joint, the doctor can identify nodules, areas of swelling, areas of pain. In inflammatory diseases, touch can be painful for the patient. With degenerative cartilage diseases, the doctor will hear the crunch of the joint.

Laboratory methods for the study of joints

Assuming a particular disease based on the results of the examination, the doctor usually sends the patient to a laboratory examination. The most important role in the differential diagnosis of diseases is played by a blood test.

First of all, the doctor evaluates such a parameter as the erythrocyte sedimentation rate (ESR). This indicator is markedly increased in inflammatory diseases of the joints, but in arthrosis there are no significant changes in it. If at the same time the number of leukocytes is increased, then it can be assumed that an inflammatory process is going on in the body, which negatively affects the joints. In infectious and autoimmune diseases, the so-called C-reactive protein appears in the blood: a component that reacts faster than others to the destruction of body tissues.

Synovial fluid can also be taken for analysis. Its puncture is performed under local anesthesia, the patient experiences minimal discomfort. The consistency of the joint fluid, its color, viscosity is assessed. Normally, the liquid has a straw color, but with injuries or a bacterial infection, it can acquire a reddish, even brown tint. Transparent is normal, synovial fluid becomes cloudy with arthritis.

For a more detailed analysis, the number of cells in the synovial fluid is counted. An increase in their number may indicate arthritis.

Thus, laboratory tests allow not only to determine the nature of the disease of the joint, but also to draw a conclusion about its nature. However, radiation diagnostic methods, MRI and ultrasound help to get the most clear picture of the state of the joint.

Ultrasound diagnostics

Ultrasound of the joints is one of the most widely used diagnostic methods. It is well tolerated by patients, does not give radiation exposure to the body, and due to the characteristics of ultrasonic waves, it allows good visualization of all structures of the joint, which is not always possible with x-rays.

Indications for ultrasound of the joints are injuries, ruptures of tendons, ligaments, inflammatory, chronic, acute diseases, detection of various formations in the joint during palpation, control over the course of treatment, etc. The method has no contraindications, the procedure can be performed as many times as necessary for diagnosis. Ultrasound is performed even on newborn babies (ultrasound of the hip joints). Difficulties can be caused only by the diagnosis of the hip joint in overweight patients.

The doctor usually examines not only the diseased joint, but also a healthy one symmetrical to it. This allows you to assess the degree of damage to the tissues and structures of the diseased joint, as well as to identify the initial signs of a disease of a symmetrical joint. Pressure with the transducer helps the doctor to identify areas of pain, which is also important for diagnosing joints and bones.

Ultrasound shows the condition of the cartilage, cracks, and other lesions. The presence of inflammation can be judged by the amount of synovial fluid. You can also see inflammation of the muscles and ligaments, joint cysts, cartilage and meniscus lesions. All structures are well visualized on ultrasound.

The cost of ultrasound of the joints in Moscow is from 1000 rubles, depending on the joint.

MRI

Magnetic resonance imaging is a non-invasive diagnostic method, the main advantages of which are accuracy and safety. A serious obstacle to its use can be the price, which is higher compared to other types of examinations, as well as the need to remain still during the procedure: some patients find it difficult to comply with this requirement.

MRI is usually prescribed in case of injury, if the patient complains of prolonged pain in the joint, if there is a suspicion of an inflammatory, degenerative, tumor disease. At the same time, magnetic resonance imaging makes it possible to identify both recent and long-standing pathologies of the joints.

Contraindications for the examination are the first trimester of pregnancy, the patient's agitated state or diseases in which he cannot remain still. Also, MRI cannot be performed if there are metal or metal-containing implants and various devices in the body (pacemakers, inner ear prostheses, etc.) . The magnetic waves that are used during the examination can cause malfunctions in their operation.

The examination does not give any radiation exposure to the body, it is harmless, but due to the high cost, many patients do not have the opportunity to undergo it often.

Tomography makes it possible to obtain clear images of all soft tissues of the joint. At the same time, the doctor sees a three-dimensional image on the screen, which can be rotated in any plane, as well as look at the “section”. Thus, we can say that MRI shows the state of the joint most fully and clearly.

The cost of MRI of the joints is about 4.5-5 thousand rubles per joint.

X-ray diagnostics of joints

X-ray examinations (X-ray and computed tomography) are carried out mainly in case of bone injuries, joint dislocations, sprains, etc. In other cases, it is preferable to do an ultrasound, which gives a more complete "picture" of the state of the soft tissues.

X-rays are the best way to examine when it comes to bones. On an x-ray or tomogram of the joint, displacements of the bones relative to each other are clearly visible, which lead to misalignment of the articular surfaces and dislocation. According to the width of the joint space, one can judge the presence of arthritis (the joint space is expanded), arthrosis (the thickness of the cartilage is reduced). Cysts appear as light patches on x-rays.

X-rays are contraindicated during pregnancy, as well as children under 14 years of age, unless there are vital indications for this.

Special preparation for X-ray examinations of the joints is not required. The doctor takes a picture in at least two projections, to determine the amplitude of movement of the joint, a picture with a load can be taken.

If a patient complains of joint pain, but the doctor cannot identify its reliable cause, a radionuclide study is sometimes prescribed. To do this, special chemical compounds are introduced into the body, and by the nature of their accumulation in the bones and joints, a conclusion is made about pathological processes.

The share of exposure in x-rays of the joint is small: for example, x-rays of the knee give a dose of 0.001 mSv. This is quite comparable to the dose of natural radiation per day. For the price of an X-ray of the joint, it is comparable to the cost of an ultrasound.

What is the best research method?

To answer the question which of the methods of examining the joints is better, probably only a doctor can. After all, it is he who directs the patient to one or another type of diagnosis. CT and X-ray are the most revealing methods for examining bones, ultrasound effectively detects inflammation, shows the condition of the cartilage and does not give any radiation exposure to the body. MRI detects most joint pathologies with high accuracy, but magnetic resonance imaging is the most expensive type of diagnosis. Thus, if you need to undergo an examination of the joints yourself and you are interested in the most accurate results in all respects, we recommend that you do an MRI.

Where can I get a bone and joint test?

X-ray, CT, MRI and ultrasound of the joints can be done in both public and commercial medical centers. When servicing in a public clinic, you will save significant money (according to indications, the examination can be done free of charge), but you can spend a lot of time: the queue for an MRI or X-ray can reach several weeks.

In the network of medical offices "INVITRO" you can do any of the listed examinations. A preliminary consultation with a specialist will help you choose the best diagnostic method for a particular patient, but if necessary, you can go through an additional examination here. Also in "INVITRO" you can make the necessary laboratory tests, which often help to clarify the diagnosis.

License of the Ministry of Health of the Moscow Region No. LO-50-01-006731 dated June 17, 2015

www.sovsport.ru

Joint examination methods

The first- this is a survey, in the language of the Aesculapius, the collection of anamnesis. The main symptom in diseases of the joints of the upper and lower extremities is pain. The joint, along with mechanical functions, performs the function of a receptor field, that is, it contains receptors that perceive and transmit “distress signals” to our brain.

Therefore, joint pain has a reflex nature, which means that joint pain should be considered not only on the basis of the biomechanical features of the musculoskeletal system, but also from the standpoint of the reflex nature of pain. Pain receptors are located in the fibrous and synovial layers of the capsule, their irritation can be caused by a functional overload of the joint or a reaction of the synovial membrane to inflammation, trauma.

The nature of the pain syndrome- one of the differential diagnostic signs - helps to distinguish one disease from another. For rheumatoid arthritis or an inflammatory process in the joint, the "inflammatory" nature of pain is characteristic - it occurs or increases at rest, at night, subsides with movements in the joint.

Osteoarthritis is characterized by "mechanical pain", that is, it occurs or increases during the load on the joint and subsides at rest. Pain usually appears after some time (minutes or hours) after the load, and continues for several hours or days even after the end of the load.

Pain at the first manifestation of osteoarthritis is not as pronounced as with arthritis, although it becomes persistent with the progression of the disease. Therefore, an experienced doctor, to a certain extent, even by the nature of the pain, its persistence can determine the severity of the disease as a whole.

Due to the occurrence of pain, a protective tension of the periarticular muscles is formed, which limits mobility in the joint.

Feeling of stiffness in the joints - frequent complaint of patients with joint diseases.

Stiffness is usually characterized by difficulty in the first movements - the phenomenon of a "frozen" joint after a period of rest, limitation of range of motion in the affected joint. Stiffness, as a rule, occurs only in the affected joint and lasts for several minutes, due to the thickening of the joint capsule.

Prolonged morning stiffness is seen in rheumatoid arthritis, development of synovitis(effusion in the joint) or reactive arthritis. Thus, the duration and severity of morning joint stiffness reflects the degree of local inflammation.

Joint pain are a frequent symptom not only of joint diseases, but also of other pathologies with a different etiology. So, for example, the constant, exhausting " bone pain» characteristic of tumor metastases in the bone. Any acute and chronic infection, intoxication, neuroendocrine disorders (diabetes mellitus, thyrotoxicosis) can cause joint pain of varying duration and intensity.

On examination, the following signs of joint disease can be detected. Swelling and smoothness of the contours of the joint are noted in the presence of effusion (synovitis) in the joint, with swelling of the joint capsule or periarticular tissues.

Joint deformity

Joint deformity- violation of its shape or the axis of the limb with the formation of an angle in the joint, open inward (varus deformity) or outward (valgus deformity), is a sign of joint destruction (violation of the shape caused by the destruction of joint structures).

Shortening of the lower limb is noted in the late stages of degenerative-dystrophic diseases of the joint ( osteoarthritis of the hip joint) and attracts attention when examining the patient. On closer examination, one can also note atrophy (reduction in volume) of a muscle or group of muscles responsible for the function of movement in a diseased joint.

Palpation

Palpation is a digital examination of the joint and allows you to identify dense thickening along the edge of the joint space, sealing of the joint capsule, crepitus (an audible crunch in the joint) with active movement, synovitis (effusion in the joint), as well as a local increase in the temperature of the skin in the joint area.

The next examination method- study of movements in the affected joint. It is necessary to evaluate the volume of active movements, that is, the movements that a person performs himself, due to muscle traction, and the volume of passive movements that are performed with the help of a doctor, with complete relaxation of his own muscles. When the joints are affected, the volume of passive movements is somewhat greater than active, which indicates damage to muscles, tendons and nerves. The nature of the pain that occurs during movement is also of diagnostic importance. The volume of movements depends on the sex, age and physical condition of the person. In the study of movements, the stability of the joint, the tone of the ligamentous apparatus are noted.

The function of the joint is determined by the combination of signs responsible for the active, painless and comfortable performance of the joint in the daily life of a person.

Additional and special examination methods

Despite the emergence and development of modern diagnostic methods, X-ray examination remains the most common method in the clinical practice of an orthopedist. This method is quite informative, affordable, safe and economical. Radiography reveals the following changes in the joint:

narrowing and uneven joint space;
subchondral osteosclerosis (hardening of bone areas adjacent to cartilage);
the presence of osteophytes (marginal bone growths in the joint area - what is called salt deposition);
areas of ossification of the joint capsule and ligaments (deposition of calcium salts in the periarticular tissues);
periarticular marginal defects of bone tissue;
subchondral cysts (cystic cavities in areas near the joint).

Arthroscopy- direct visual examination of the joint cavity. A video camera, a light source and manipulator instruments are introduced into the joint cavity under anesthesia. Arthroscopy allows you to examine the structure of the joint and the surface structure of the cartilage, to conduct a targeted biopsy (take a piece of joint tissue for examination), as well as low-traumatic therapeutic surgical procedures.

Radioisotope scintigraphy. The study of the joints is carried out using osteotropic radiopharmaceuticals (pyrophosphate) labeled with a radioactive substance 99m Tc. These drugs accumulate in places of active metabolism in bone and connective tissue, especially intensively in inflamed joints, which can be seen on joint scintigrams.

Thermography (thermal imaging)- a method for studying the intensity of infrared radiation by tissues. Using this method, the temperature of the skin in the area of the joints is remotely measured, which is recorded on photographic paper in the form of a contour shadow of the joint. The method allows to judge the activity and dynamics of inflammatory joint damage.

Magnetic resonance imaging (MRI). The method is based on the study of the magnetic field of the patient's joint tissues. The main advantages of the method include: non-invasiveness, harmlessness (no radiation exposure), three-dimensional nature of the image, no overlap on the image of bone tissue, the highest image accuracy of various joint formations.

Sonography (ultrasound). The method is used to assess the pathology of soft tissues, identify fluid in the joint, visualize cartilage and superficial bone structures.

Computed tomography (CT). The method is the most informative for assessing the bone structure of the articular ends of the bones in various parts of the joint.

Additional and special research methods for each patient are determined by the attending physician individually, based on the principle of maximum informativeness and minimum invasiveness.

Examination of joint (synovial) fluid

Joint fluid is obtained by puncture (puncture) of the joint, followed by aspiration (extraction with a syringe) of the contents from the joint cavity. Synovial fluid must be sent for bacteriological examination, even if it is clear, light and does not show signs of inflammation. Periodically, in a visually obviously not infected joint fluid, the growth of microorganisms is detected with a special seeding.

Normal joint fluid is light, clear and viscous. Infected joint fluid resembles pus and can often have an unpleasant odor. The inflammatory fluid is turbid, thick and relatively non-viscous.

The joint fluid is collected in a transparent syringe or poured into a test tube. It is necessary to shake the syringe or test tube to form some air bubbles. Normally, the bubbles rise slowly because the liquid has a certain density. A similar test can be performed as follows: a drop of liquid must be allowed to fall from the end of the syringe. If the viscosity of the liquid is high, the drop takes the form of a long viscous thread. The degree of turbidity of a liquid can be assessed by holding it in a clear syringe or vial in front of the printed page.

If the liquid is thick, opaque, it will be impossible to see individual words on the page through it. The presence of blood in the synovial fluid suggests trauma, malignancy, hemophilia. Sometimes during the puncture of the joint there is a slight bleeding from the puncture site of the synovial membrane.

In such cases, the blood is always unevenly mixed with a clear liquid. In the liquid left in the test tube overnight, sometimes there are drops of fat that have entered the liquid from the bone marrow during an intra-articular fracture. In addition to such physical parameters of the synovial fluid as color, viscosity, transparency, depending on the pathological condition, the nature of its mucin clot and cytological (cellular) composition changes.

Changes in the main parameters of the synovial fluid allows to differentiate degenerative-dystrophic and inflammatory diseases of the joints. However, these indicators depend on the duration of joint damage and previous therapy, which in practice significantly reduces the diagnostic significance of the study itself.

For example, for rheumatoid arthritis, characteristic, although not specific, is the presence in the synovial fluid of rhagocytes - neutrophils, the cytoplasm of which contains inclusions consisting of various immunoglobulins, including rheumatoid factor.

The presence of crystals in the joint fluid can be examined using a polarizing microscope. Urate crystals are shaped like sticks or needles. Calcium pyrophosphate crystals may have a similar or rhomboid shape. Sometimes crystals of anti-inflammatory glucocorticosteroid drugs introduced into the joint earlier are found. The shape of the crystals, varying in shape and size, cannot be a reliable criterion in the diagnosis of arthritis.

The diagnostic value of the study of synovial fluid is significantly increased by determining the total protein in it, immunological parameters (rheumatoid factor, compliment, beta-2-microglobulin). With the simultaneous study of immunological and some other parameters (free radical oxidation activity, fatty acid spectrum of lipids) in the blood flowing to the limb (arterial) and flowing from it (venous) blood, additional information can be obtained about the activity and severity of the pathological process in the joint.

Based on materials: health-medicine.info

health-medicine.info

Why does knee pain occur?

The knee, hip and ankle joints are among the most complex in structure. The knee connects the femur and tibia, with the help of menisci, tendons and ligaments. Since the knee joints are located on the lower extremities, they experience the load of the weight of the entire human body.

If the knee joints are in satisfactory condition, moderate loads on them are not only harmless, but also useful, and besides, they do not cause pain. For effective treatment of pain in the knee joint, it is necessary to know exactly the causes that provoked this condition.

The complexity of diagnosing pathology lies in the fact that there are many diseases of the knee joint. Therefore, a complete examination of the knee joint is required to clarify the diagnosis. In each individual case, an individual approach is necessary, since the symptoms of various joint diseases are very similar.

Only a comprehensive examination can guarantee the correct definition of the disease and the appointment of adequate treatment.

Diagnostic methods

To correctly diagnose the disease and identify the causes that led to it, the doctor directs the patient to undergo a comprehensive examination. Treatment can be prescribed only after confirmation of the diagnosis.

Modern diagnostic measures include the following procedures:

x-ray examination;
computed tomography of the knee joint, thanks to which doctors have the opportunity to thoroughly examine human organs;
magnetic resonance imaging (MRI);
Arthroscopy of the knee joint - this procedure is akin to surgery, but when it is performed, minimal traumatization occurs. The method is carried out using an arthroscope, with which the doctor can examine the articular cavity from the inside;
general blood analysis;
a biochemical blood test is an additional research method for suspected joint diseases;
rheumatic tests.

A person must be aware that a neglected disease is much more difficult to treat than its primary form. Often, with complications, conservative therapeutic measures do not bring the desired result, and the patient needs surgery.

Most people trust the effectiveness of modern pharmaceuticals, which are widely advertised on television and on the Internet. Many medicines are really capable of providing recovery, however, it must be remembered that the reaction to certain medicines is individual for each person, so only a doctor can prescribe them.

Therefore, suspecting a disease of the joints, a person should not go to the pharmacy, but to see a doctor. Self-medication can not only delay the healing process, but also complicate the course of the pathology.

It is likely that self-medication can lead to temporary relief, but this does not mean that the disease has completely receded. In the future, the patient is likely to face arthritis, contracture and loss of motor function of the knee joint.

When a tendon or meniscus is torn, only surgery can save the patient from pain.

Test one:

the patient lies on his back;
the limb is 30 bent at the knee joint;
the doctor holds the patient's thigh with one hand, and moves the lower leg forward with the other;
knee flexors and quadriceps should be completely relaxed.

Evaluation: If there is movement of the lower leg relative to the thigh, then the anterior cruciate ligament is damaged. In this case, the end point of the displacement should not be clear and have a hard stop. If the stopping point is clear, this is evidence of the stability of the anterior cruciate ligament.

A tight stop at 3 mm displacement indicates absolute stability of the anterior cruciate ligament. A displacement of 5 mm or more confirms only the relative stability of the anterior cruciate ligament, a condition typical of sprains.

Suspicion of damage to the anterior cruciate ligament occurs when the end point of the displacement is completely absent or weakly expressed. If the range of motion of the drawer is greater than 5 mm, congenital laxity of the knee ligaments is suspected. To exclude such a pathology, a comparison with another knee joint should be made.

Non-contact Lachman test - if it is positive, dysfunction of the anterior cruciate ligament is confirmed. Test Method:

the patient lies on his back and with both hands holds the thigh (near the knee joint) of the injured leg, bent at the knee.
the patient should try to raise the lower leg above the table, while bending the leg at the knee should be maintained;
when the patient performs this test, the doctor observes the tuberosity of the tibia.

With a healthy ligament, no change in the contour of the tuberosity is observed. Perhaps a slight displacement of the tuberosity forward. If there is an acute injury to the ligamentous apparatus, in which the medial collateral and anterior cruciate ligaments are damaged, there is a significant displacement of the tibial tuberosity forward (articular subluxation).

This test allows the doctor to exclude a complex limb injury in a non-contact way.

Functional testing of the posterior cruciate ligament

Posterior Lachman test (drawer test at 90 knee flexion). This test is performed with flexion and approximate extension of the knee joint. Its performance is similar to the front drawer test, but in this case, the posterior displacement in the position of internal, external and neutral rotation is evaluated.

Grade. Maximum posterior displacement when the knee joint is close to extension indicates isolated posteromedial instability. Minimal posterior drawer and maximal posterolateral rotation are observed at 90 knee flexion.

If there is an isolated rupture of the posterior cruciate ligament, maximum posterior displacement occurs during flexion. Posterolateral displacement is not observed in any of these positions.

With combined damage to the posterolateral structures and the posterior cruciate ligament, in any degree of flexion, a lateral opening of the joint space and an increase in posterior displacement are observed.

Houston test to determine recurvation (excessive extension) of the knee joint and external rotation.

Methodology:

the patient lies on his back, both of his quadriceps muscles of the lower extremities are relaxed;
the doctor alternately lifts each leg by the foot.

If posterolateral instability is present, this action can lead to recurvation of the knee joint in varus position with parallel external rotation of the tibia.

To clearly demonstrate recurvation and external rotation of the knee joint, the test should be performed alternately on both limbs. This is done as follows: the leg from a state of slight flexion at the knee is transferred to a position of full extension. The doctor places one hand on the posterior surface of the knee joint to allow palpation of the posterior sagging and external rotation of the proximal tibia.

Meniscus testing

Grinding test (determination of Apley distraction and compression):

the patient lies on his stomach, the test leg is bent at the knee at an angle of 90;
the doctor fixes the patient's thigh with his knee;
in this position, the doctor rotates the limb with alternate use of axial compression and distraction of the leg.

If the patient experiences pain during rotation, this indicates a ligament injury (positive distraction test). Pain on compression is indicative of a meniscal injury (positive torsion test).

With a meniscus cyst or discoid meniscus, a characteristic click may occur. Pain during internal rotation is typical of damage to the lateral capsule or lateral meniscus.

Pain during external rotation confirms damage to the ligaments, medial capsule, or medial meniscus.

If the posterior horns of the outer menisci are damaged and the ligaments of the capsule are stretched, this symptom does not appear.

Fouche Sign (McMurray Test)

Methodology:

the patient lies on his back, the injured leg is maximally bent at the hip and knee joint;
with one hand, the doctor grabs the knee joint, and with the other hand, the foot;
first, in the position of extreme external, then internal rotation, the doctor performs passive extension of the patient's knee joint up to 90

Assessment of the situation:

If the patient has pain during extension in the state of external rotation and abduction of the leg, it is evidence of damage to the internal meniscus.
An injury to the external meniscus is indicated by pain during internal rotation.
A click in the position of maximum flexion is characteristic of a rupture of the posterior horn, in which the torn piece is infringed.
The crepitus that occurs on 90 flexion is typical of a medial meniscus injury.

Glide test performed to diagnose patellar instability.

Methodology:

the patient is in the supine position;
the doctor stands on the side opposite to the diseased joint;
with the first and second fingers of the hand, the doctor grasps the proximal part of the patella, and with the other hand, its distal part;
then, with the first fingers, the doctor tries to move the patella outward above the femoral condyle, at the same time, with the second fingers, he supports the kneecap - this is how the lateral test is performed;
when performing a medial test, the doctor tries to move the kneecap in the opposite direction with the second fingers.

If there is a suspicion of excessive lateral displacement of the patella, stability can be achieved with this test. In this case, the test should be performed with a contracted quadriceps muscle. The patient should raise the straightened leg above the table, while the doctor evaluates the movement of the patella.

The lateral and medial slip tests allow physicians to assess the degree of tension in the lateral and medial retinaculum. For comparison, such testing is carried out simultaneously on both knees. The doctor, without changing the position of the hands, can assess the degree of anterior displacement of the patella.

If the state of the knee joint is normal, the patellas move symmetrically without a characteristic crunch and a tendency to dislocation. An increase in lateral or medial displacement indicates weakness of the ligamentous apparatus of the knee joint, congenital subluxation or dislocation of the patella.

Crepitus or crunch during movement of the patella indicates the presence of chondropathy or retropatellar osteoarthritis. The clinician can extend this test without changing hand position by moving the patella distally. Decreased distal mobility indicates high standing of the patella or pathological shortening of the rectus femoris.