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Subchondral sclerosis of the hip joint is a degenerative-dystrophic disease that affects the articular surfaces. The pathological process causes damage to healthy cartilage tissue, transforming it into a connective tissue that cannot cope with the necessary functions. A similar process can occur in the spinal column (affecting the endplates of the vertebral bodies), and in any other joint.

Etiology

HJ sclerosis of a subchondral nature in most cases occurs against the background of osteochondrosis and osteoarthritis. The following reasons lead to the development of pathology:

excessive or insufficient physical activity;
traumatic injuries of the joints;
genetic predisposition to growth, increased bone density;
disturbed metabolism;
infectious, inflammatory diseases localized in the area of TBS;
articular dysplasia;
endocrine pathologies.

The surface of the joint under consideration is covered by a subchondral tissue structure, connected simultaneously with bone and cartilage. The bone area is replete with blood vessels, nerve endings and provides the cartilage with the necessary minerals.

Violation of the processes of blood circulation affecting this tissue leads to its deformation and pathological growth. As a result, the nutrition of the cartilage is disturbed, which leads to its destruction. This is the etiology of the development of subchondral sclerosis affecting the hip joint.

Classification and types

Medical specialists subdivide subchondral articular surface sclerosis into 2 main forms:

Primary - the disease occurs against the background of excessive, increased load on the hip joint area.
Secondary - pathology can develop due to existing damage to cartilage tissue structures.

Doctors qualify subchondral sclerosis according to the following stages of the development of the pathological process:

The first stage is characterized by the growth of bone tissue by marginal osteophytes forming in the area of the joints.
On the second, the joint space narrows, specific growths form.
The third stage of sclerosis is characterized by a significant narrowing of the gap, an increase in bone growths, and a limitation of the motor activity of the joint.
At the fourth stage, there is a deformation of the roof of the acetabulum of the pelvic bone, the lack of the ability to fully flex and extend the joint.

The disease progresses quite quickly and can lead to complete immobilization of the hip joint affected by sclerosis.

Risk factors

Doctors identify the following disorders and conditions that greatly increase the likelihood of developing subchondral sclerosis:

large and frequent loads on the joint (typical for professional athletes);
overweight;
autoimmune disorders;
congenital vascular anomalies;
hormonal disorders.

Increased stress on the hip joint due to pregnancy, age-related changes, hard work and other similar factors can lead to the development of sclerosis.

Symptoms of subchondral sclerosis

Doctors distinguish the following clinical manifestations of pathology:

strong pain;
impaired motor function.

Pain syndrome can occur in one of the limbs when trying to lean on a sore leg after a long state of rest.

knee joints

Sclerosis of the knee is manifested by the presence of the following symptoms:

increased fatigue of the affected limb;
a specific crackling sound in the joint during walking;
uncomfortable, painful sensations when trying to bend the knee.

TBS

Sclerosis of this area is manifested by the following characteristic symptoms:

painful sensations of a aching nature, localized in the hip joint and lumbar spine;
there may be a pronounced pain syndrome, extending to the inguinal region;
crunch and clicks during movements in the joint;
limitation of joint mobility.

A sick person complains of severe pain in one or both limbs with a tendency to worsen at night, in cool, damp weather, as well as severe limitation of movement, impaired joint function.

Diagnostics

If a disease is suspected, patients are prescribed the following types of diagnostic studies:

radiographic examination;
computed and magnetic resonance imaging;
laboratory blood tests;
genetic test.

Comprehensive diagnostics makes it possible to determine the provoking factors, the stage of development and localization of subchondral sclerosis, and to develop the most effective therapeutic course for a particular clinical case.

Therapy Methods

Competent treatment should be complex systemic. Therapy of subchondral sclerosis is aimed at eliminating the provoking pathology, normalizing motor activity, and relieving painful symptoms.

Treatment of the underlying disease

Subchondral articular sclerosis, in fact, is an x-ray symptom of other pathologies. Therefore, in order to achieve positive, stable results, it is first necessary to treat the underlying disease. Depending on the diagnosis, the doctor prescribes to the patient a course of drug therapy, which includes anti-inflammatory, analgesic, antibiotic, antihistamine, hormonal drugs, chondroprotectors.

All medicines are taken strictly according to the prescription of the attending physician, subject to the recommended dosage and duration of the therapeutic course.

In the most difficult clinical cases, surgery is required to restore lost joint functions. Specialists may recommend arthroscopy, surgical removal of bone growths, partial or complete prosthetics of the affected joint.

Treatment with folk remedies is allowed, but only as a constituent element of complex therapy after prior consultation with the doctor.

exercise therapy

Remedial gymnastics for joint sclerosis is an important element of treatment that contributes to the achievement of such results:

restoration of lost functionality;
normalization of blood circulation processes;
stopping the processes of further articular deformity.

Exercises are selected by an exercise therapy specialist on an individual basis for each patient.

Manual therapy and physiotherapy

To improve the general condition, eliminate painful symptoms, patients suffering from subchondral joint sclerosis are shown the following physiotherapy:

acupuncture;
thermal effect;
radiation and radio wave therapy;
electrophoresis with the use of drugs;
mud treatment that replenishes the deficiency of minerals in the joints.

Massages and manual therapy methods give a good therapeutic effect. They allow you to normalize the processes of blood circulation and microcirculation, eliminate pain and signs of inflammation, and even restore the affected cartilage tissue.

Complications

Joint sclerosis is a progressive pathology that, in the absence of timely medical intervention, leads to the formation of bone growths, severe pain, and impaired motor functions.

In advanced stages, pathology is fraught with the development of serious consequences:

inflammatory processes;
purulent complications;
damage to blood vessels, tendons, muscles, subcutaneous tissue;
necrosis.

A serious danger to the health and life of the patient is the development of purulent processes, in which pus, entering the bloodstream, penetrates into the region of other organs, causing serious illnesses, up to blood poisoning.

With incorrect treatment or lack thereof, the disease leads to limited movement and complete disability of the patient.

Prevention

Measures to prevent sclerosis of the hip and knee joints are the correction of lifestyle, reasonable physical activity, proper, balanced nutrition. To reduce the potential risk, you need to monitor your posture, fight excess weight in a timely manner.

To avoid the adverse effects of subchondral sclerosis, it is recommended to consult a doctor in a timely manner. Complex therapy will eliminate painful symptoms, restore joint functions and avoid further development of the pathological process.

Pathologies of the musculoskeletal system are distinguished by a variety of symptomatic complexes. Subchondral sclerosis of the articular surfaces is one of these syndromes that develops not as an independent disease, but against the background of other serious pathologies.

More often than others on radiographic images, subchondral sclerosis of the articular surfaces of the hip joints is determined, which is a typical clinical sign of a violation of the process of blood supply to the periosteum of the acetabulum and the head of the femur. In this case, the patient may experience pain in the thigh, radiating to the groin, buttocks and knee.

In second place in terms of prevalence is subchondral sclerosis of the articular surfaces of the knee joint, it is often associated with deforming osteoarthritis, improper positioning of the foot and cicatricial deformity of the ankle joint ligaments.

Pathology develops with constant compression exerted by cartilage tissue on the endplate. It is located directly between the head of the bone and the cartilaginous fibers of the synovial tissue. if the synovial cartilage tissue has a sufficient level of hygroscopicity, then it protects the endplates from excessive cushioning pressure when performing various movements.

If, against the background of a violation of diffuse nutrition, dehydration of the cartilaginous tissue occurs and it loses its depreciation properties, then a gradual compression destruction of the endplate begins. As a result of this, tissue degeneration occurs, its replacement with scar cells and fibrous fibers. This is how sclerosis develops. The term subchondral refers to the localization directly under the layer of cartilage (chondral tissue).

Treatment of this syndrome is possible only in combination with the treatment of the underlying disease. if efforts are directed only at stopping the clinical symptoms of subchondral sclerosis, then no positive results can be obtained.

If subchondral sclerosis of the articular surfaces was found during an x-ray examination, then begin treatment immediately. This condition quickly leads to the fact that the secondary destruction of bone tissue begins. This entails the formation of bone growths, cracks on the surface of the bone head.

You can contact our manual therapy clinic. Here, each patient is given the opportunity to receive a completely free consultation with an orthopedist. This doctor will conduct an examination, get acquainted with medical records, make a diagnosis and tell you about the possibilities and prospects for treatment using manual therapy methods.

Causes of subchondral sclerosis

In principle, subchondral sclerosis is an age-related degenerative change in the structural tissues of the body. Over the age of 50 years, this condition is detected in almost half of patients. But at a younger age, subchondral sclerosis is a clinical sign of tissue degeneration and dystrophy, as a result of which osteoarthritis or deforming arthrosis may soon develop.

The causes of subchondral sclerosis may be the following aspects of the negative impact:

problems of blood supply at the capillary level (for example, in violation of the tone of the vascular wall);
endocrine disorders (for example, diabetes mellitus, leading to the appearance of angiopathy and neuropathy, weakening of the blood supply);
disruption of the immune system with the development of reactive inflammatory processes;
rheumatoid disorders;
systemic lupus erythematosus, scleroderma and psoriasis;
pathologies of metabolic processes, for example, uric acid with the development of gout;
traumatic compression effect (for example, complex soft tissue injuries from the charter with the formation of an extensive internal hematoma);
contractures and other complications after fractures and cracks of the articular surfaces.

The following factors can lead to the development of subchondral sclerosis:

excess body weight, the higher it is, the greater the depreciation load is on the articular surfaces in terms of their compression (squeezing);
incorrect positioning of the foot (clubfoot or flat feet negatively affects the condition of the ankle, knee and hip joints);
tunnel syndromes, leading to impaired innervation in large joints;
increased physical activity;
engaging in active sports without the use of special equipment, including orthoses and protective bandages.

Hereditary predisposition can lead to the fact that subchondral sclerosis of the articular surfaces begins to develop at a fairly young age. Therefore, it is difficult to exclude the negative impact of the genetic factor. The development of this factor is facilitated by a sedentary lifestyle, the wrong choice of shoes and clothes, pregnancy and chronic intoxication of the body. Smoking and drinking alcohol accelerate the process of destruction of articular surfaces and the development of subchondral sclerosis.

Subchondral sclerosis of the acetabulum of the hip joint

When diagnosing a condition such as subchondral sclerosis of the joints, most often pathological changes are observed in the area of \u200b\u200bthe largest articulation of bones in the human body.

Subchondral sclerosis of the hip joint is the initial stage of development of deforming osteoarthritis. With the development of subchondral sclerosis of the acetabulum at the initial stage, patients do not experience any discomfort. However, after some time there is pain in the upper thigh. It is associated with physical exertion, prolonged standing.

With prolonged development, subchondral sclerosis of the acetabulum of the hip joint gives the following clinical symptoms:

stiffness of movements in the morning, immediately after waking up;
sharp pain in the head of the femur;
constant pulling pain in the sacrum, radiating to the groin and thigh;
during a long walk, cramps in the calf muscles associated with insufficient blood supply may occur;
with a total narrowing of the joint space, a tunnel syndrome occurs, clinical signs of neuropathy appear;
restless legs syndrome, which manifests itself in the fact that when trying to fall asleep at night, the patient cannot find a comfortable position for his legs;
dysfunction of the large intestine, expressed in the form of persistent atonic constipation, followed by long periods of diarrhea;
urinary retention or overactive bladder;
lameness, change in gait, gradual loss of the ability to move independently in space.

Diagnosis of subchondral syndrome begins with a thorough physical examination and diagnostic functional tests. Then the doctor prescribes radiographic images, as necessary - an MRI and CT examination.

Subchondral sclerosis of the knee and ankle

Primary subchondral sclerosis of the knee can develop due to improper foot placement and deformation of the ligamentous apparatus. Often the syndrome is associated with inflammation of the menisci and their proliferation. Approximately half of the cases of primary subchondral sclerosis are associated with inflammation of the joint capsule (bursitis).

The signs are very similar to the clinical symptoms of destruction of the articular surfaces in the area of the acetabulum of the hip joint. Soreness, fatigue of the calf muscles, lameness and gait disturbance are the main manifestations.

Subchondral sclerosis of the ankle joint can be diagnosed in young people who lead an active lifestyle and are fond of outdoor sports. As a result of increased physical activity, they often develop various soft tissue injuries, such as sprains and ruptures of ligaments and tendons. As a result of their improper treatment, fibrous scar tissue develops. It interferes with normal blood supply at the capillary level. Lack of arterial blood supply to the articular surfaces leads to deformity and development of subchondral sclerosis.

Subchondral sclerosis of the joint spaces of the foot

One of the most severe types of pathology is subchondral sclerosis of the foot - a condition in which there is an increased risk of deforming osteoarthritis of small joints between the phalanges, metatarsal bones, etc. Subchondral sclerosis of the joint spaces in the foot area develops for the following reasons:

wearing improperly selected shoes (high heels, with a deformed shoe, after a person with an incorrect foot position);
clubfoot and flat feet, as a result of which the small bones of the foot are displaced, wedge-shaped and metatarsus are more affected;
squeezing the leg;
rheumatoid processes;
diabetic foot;
violation of blood microcirculation against the background of increased platelet aggregation.

Diagnosis of this syndrome is carried out using an x-ray image. it can detect the narrowing of the joint spaces, the displacement of the small bones of the foot relative to each other.

Subchondral sclerosis of the shoulder

Subchondral sclerosis of the shoulder joint is a condition that can accompany osteoarthritis, habitual dislocation of the shoulder, stretching of the ligamentous apparatus, osteochondrosis of the cervical spine, humeroscapular periarteritis and a number of other pathologies.

Subchondral sclerosis of the shoulder joint manifests itself in the form of the following clinical symptoms:

pulling unpleasant pain in the shoulder and forearm;
inability to fully extend the arm in the elbow joint;
difficulty when trying to raise the upper limb in the lateral plane;
decreased muscle strength on the affected side;
feeling cold, pale skin.

If these symptoms appear, you should consult a doctor and take a series of x-rays. If it is difficult to make a correct diagnosis, the doctor may recommend an MRI examination.

Treatment of subchondral sclerosis

For the treatment of subchondral sclerosis of the articular surfaces, it is important to restore blood microcirculation and improve the condition of the cartilage tissue. Of the modern pharmacological preparations, not a single agent is able to perform such a task.

Treatment with manual therapy can achieve a positive result. Our manual therapy clinic uses the following techniques:

osteopathy and massage restore microcirculation of blood and lymphatic fluid in the area of the affected joint;
reflexology will start the process of natural regeneration of damaged tissues;
therapeutic exercises and kinesiotherapy improve the condition of muscle tissue, which provides complete diffuse nutrition of all cartilage fibers of the joint;
laser exposure accelerates the healing process and prevents the development of deforming osteoarthritis;
physiotherapy can improve joint mobility and prevent the appearance of fibrous scar tissue.

If you need treatment for subchondral sclerosis of the articular surfaces, you can make an appointment with an orthopedist at our chiropractic clinic. The doctor will conduct an examination, make a diagnosis and talk about how to conduct a comprehensive effective treatment. The first consultation is free of charge for all patients.

Subchondral sclerosis is a degenerative lesion of the cartilage that covers the inner surfaces of the joints, in which normal functional tissue is replaced by connective tissue that is unable to perform the required functions. At the same time, the bone tissue of the joints also begins to thicken and grow, forming growths.

This pathological process is not distinguished as a separate disease, but is one of the manifestations of osteoarthritis of the joints and osteochondrosis of the spinal column. It does not develop immediately, but as the underlying disease progresses with the non-elimination of causative factors, improper treatment. Subchondral sclerosis is more susceptible to older people, but recently it has also been observed in young people.

Stages of subchondral sclerosis

The development of the disease takes place in stages:

Initial subchondral sclerosis - bone growth occurs only along the edges of the joint.
Moderate subchondral sclerosis - osteophytes are visible on the x-ray, the joint space is narrowed, and the articular part of the bone is characterized by a lighter color.
Subchondral sclerosis stage III - there is a significant narrowing of the joint space, large bone growths, the motor activity of the joint is significantly impaired.
Subchondral sclerosis stage IV - very large osteophytes, the articular surfaces of the bones are significantly deformed, there is an inability of the joint to full extension and flexion.

Subchondral sclerosis of the knee - what is it?

The knee joint is very often affected by subchondral sclerosis, because. it is constantly subjected to high loads. Risk factors for the development of pathological processes in this joint are:

overweight;
hormonal disruptions;
professional hazards.

Pathology is detected in patients with deforming osteoarthritis of the knee joints, manifested by such symptoms as pain during exercise and at rest, crunching during movements, difficulty in flexion-extension of the knee. When this occurs, cracking, thinning of the cartilage tissue, loss of strength and elasticity. A frequent consequence of subchondral sclerosis of the knee joint is the development of varus or valgus deformity of the legs.

Subchondral sclerosis of the spine - what is it?

Subchondral sclerosis of the endplates of the vertebral bodies of the spine is more often observed in the cervical region, less often in the thoracic and lumbar. In this case, patients complain of chronic pain in the corresponding affected area, neurological complications (numbness of the limbs, dizziness, etc.), spinal deformities are also possible.

The main danger of the pathology of this localization is the increased risk of spontaneous compression fractures, which can occur even with minimal physical exertion. In the most advanced cases, partial or complete paralysis is noted.

Subchondral sclerosis of the hip joint

This localization of the pathology almost always complicates the course of arthrosis of the hip joint. The main manifestations in this case are: chronic pain in the thigh (in motion and at rest), limitation of the range of motion in the joint, development of lameness.

Subchondral sclerosis of the hip joint is dangerous with an increased risk of fracture of the femoral neck and aseptic necrosis of its head. Therefore, when a pathological process is detected, it is necessary to immediately deal with the prevention of possible serious consequences. If treatment is not started on time, you can completely lose the function of the limb.