What is destruction (destruction) of bones? Why osteoporosis develops and what is dangerous: signs, diagnosis and treatment of the disease

A common pathology of bone tissue is osteoporosis, the symptoms and treatment of which should be known to every person.

This condition is characterized by the destruction of bones, a decrease in their strength, an increase in fragility and a change in the structure of tissues, which causes frequent fractures. A feature of the disease is the absence of a vivid clinical picture.

The destruction of bone tissue is a physiological process, like mineralization. Normally, their balance is observed.

These processes are ensured by the coordinated work of osteoblasts and osteoclasts.

The development of osteoporosis is based on insufficient mineralization or increased tissue destruction.

The risk group includes women over 50 years of age. By the age of 70, the prevalence of this pathology in women reaches 50%, which is due to hormonal changes.

Men get sick much less frequently. Osteoporosis requires a comprehensive approach to treatment and, if symptoms are ignored, can lead to complications. The most common of these is a hip fracture.

Osteoporosis in women and men can be asymptomatic for years. After 50 years, complaints occur only in 30% of cases. This often results in delayed or misdiagnosis.

Many doctors mistake osteoporosis for arthritis or osteoarthritis. Often the diagnosis is made already with the development of complications in the form of pathological fractures.

Osteopenia and osteoporosis are synonyms. With this pathology, the following symptoms are possible:

• bone pain in various parts of the body;
• fast fatiguability;
• damage to the teeth;
• the presence of dental plaque;
• gray hair at an early age;
• cardiopalmus;
• frequent fractures;
• convulsions predominantly at night;
• decrease in growth.

The main manifestation of the disease is dull, aching pain. It can intensify with a sharp change in climatic conditions. The first signs of osteoporosis go unnoticed.

Along with symptoms of bone destruction, manifestations of the underlying disease may be present.

These can be: an increase in the thyroid gland, dyspepsia, symptoms of dysfunction of the kidneys, adrenal glands, manifestations of lupus erythematosus and rheumatism. In this case, we are talking about secondary osteoporosis.

Hands and feet

Upper and lower extremities are affected first. Osteoporosis of the foot often develops.

It is characterized by constant, mild or moderate pain in the leg. Often the nail plates change.

They may delaminate or become brittle, as with a fungal infection.

With a long course of the disease and the absence of treatment, deformity of the feet occurs. This makes movement and daily activities difficult.

The most dangerous osteopenia of the femoral neck. This is the narrowest part of the bone, which is located between its head and body. With osteoporosis, it often breaks.

A similar problem is faced by women of advanced age (over 65 years). Signs of a hip injury are:

• shortening of the limb on the side of the lesion;
• increased rotation of the sore leg outward;
• severe pain in the groin.

Pain in osteoporosis in the legs in the early stages may be absent. In case of damage to the vessels against the background of a fracture, aseptic necrosis of the bone head may develop.

In osteoporosis of the legs, it is most often caused by damage to the femoral neck. Along with the lower extremities, the upper ones are often affected. The bones of the hands, shoulder and forearm may be involved in the process. The symptoms are the same as for a foot injury.

Upper extremity involvement can be unilateral or bilateral. If osteoporosis of the fingers is not treated in a timely manner, then a fracture of the radius is possible.

Less often, the neck of the humerus is damaged. Such fractures heal slowly and require prolonged immobilization.

spine

Often there is a destruction of the bones of the spine. These people have the following symptoms:

1. Backache.
2. Slouch.
3. Growth decline.
4. Restriction of mobility.
5. The presence of a hump.
6. Creases on the sides of the abdomen.

The stoop is manifested by the protrusion of the head, protrusion of the abdomen, lowered shoulders, a round back, protruding shoulder blades and a sunken chest.

Sometimes patients complain of heaviness in the chest. Over time, these people develop osteoporotic spondylopathy.

A frequent complication of the disease is compression fractures of the vertebrae in various departments.

joints

Often there is destruction of the articular surfaces of the bones. This causes movement disorders.

In its clinical picture, this pathology resembles deforming osteoarthritis.

Severe osteoporosis of the hip joint. It is complicated by a fracture of the neck of the bone.

Common signs of this pathology are:

• pain;
• stiffness of movements;
• crunchy feeling;
• tissue swelling;
• decrease in range of motion;
• joint deformity.

Most often, with this form of the disease, the femur and knee are affected. Osteoporosis of the shoulder joint with similar symptoms is less commonly diagnosed.

Sometimes there are signs of osteoporosis of the elbow joint.

pathological fractures

Pathological fractures often develop as a result of bone loss. This is a violation of the integrity of the bone in the area of ​​\u200b\u200bmaximum fragility.

A distinctive feature of pathological fractures of the femoral neck from simple ones is that they occur with a slight force of the traumatic factor.

Bone damage occurs with a weak impact or a fall from a small height. This problem is more common in elderly and senile people.

Pathological fractures against the background of osteoporosis are dangerous because patients remain immobilized for a long time, which can cause complications (congestive pneumonia, bedsores).

Complete bone injury with displacement is rare. Most often, large cracks and transverse damage are observed.

The tubular bones of the extremities are predominantly involved in the process. With these fractures against the background of osteoporosis, there are no crepitus (a sound resembling a crunch) and pathological joint mobility.

Hemorrhages occur rarely or they are mild.

Causes of osteoporosis

Senile (senile), postmenopausal or adolescent osteoporosis is a multifactorial disease.

The primary form is due to physiological changes occurring in the body.

Risk factors for the development of pathology are:

• burdened family history;
• elderly age;
• female;
• carriage of the gene responsible for the formation of pathological collagen;
• asthenic body type;
• a sharp decrease in body weight;
• low growth;
• late onset of the menstrual cycle;
• a history of a large number of pregnancies and childbirth;
• prolonged breastfeeding;
• infertility.

The development of secondary osteoporosis is based on hormonal disorders, somatic diseases and an unhealthy lifestyle. Risk factors are:

In older men, depletion of calcium from the bones contributes to a decrease in testicular function.

Osteopenia of the hip joint is caused by uncontrolled use of medications (systemic corticosteroids, diuretics, anticoagulants, immunosuppressants, tetracycline antibiotics).

Increases the risk of developing osteoporosis regular use of household chemicals.

The reason for the development of the disease may be insufficient mineralization of bone tissue. This is observed against the background of malnutrition. Risk factors are:

• abuse of carbonated drinks;
• lack in the menu of foods rich in calcium;
• drinking large amounts of coffee;
• addiction to salty and sweet foods;
• rigid diets;
• excess protein and fat in the diet.

Osteoporosis in men, women and children is often associated with insufficient intake of calcium and phosphorus in the body.

Vitamin D is responsible for the absorption of these elements. The daily intake of calcium for an adult varies from 800 to 1200 mg.

During pregnancy and breastfeeding, as well as during intensive sports, this figure is maximum.

The risk of developing this pathology increases with insufficient consumption of milk, cottage cheese, yogurt, kefir, sour cream, cheese, apricots, apples, oranges, nuts, vegetables and some berries.

Types and degrees of osteoporosis

Classification of osteoporosis distinguishes primary and secondary forms. The first is subdivided into idiopathic (unspecified etiology), postmenopausal (diagnosed only in women), adolescent and senile.

Postmenopausal form develops during the extinction of sexual function, when menstruation stops and the hormonal background changes. This causes the appearance of signs of osteoporosis in women after 50 years.

Senile (senile) form disease is diagnosed after 70 years. Most often, it is the result of the body's natural aging process.

Idiopathic form diagnosed when the cause of bone destruction cannot be identified. It can occur in people of any age.

Adolescent primary osteoporosis develops at 12-17 years of age. The reason is hormonal changes during puberty.

During this period, the production of testosterone increases, which can affect mineral metabolism.

In the event that a direct relationship is established between a decrease in bone strength and another pathology, secondary osteoporosis is diagnosed. It is regarded as a clinical syndrome.

Changes in bone structure during menopause during menopause occur in several ways.

Depending on the type of morphological tissue restructuring, the following types of osteoporosis are distinguished:

• with loss of spongy substance;
• with loss of the cortical (cortical) layer;
• mixed.

Bone changes can be uniform or patchy (focal). There is also a disease of the first, second, third or fourth degree.

For reference!

Osteoporosis 1 degree is characterized by the absence of external symptoms.

Changes are detected only in the process of instrumental examination (X-ray, CT or MRI).

Such people may have signs in the form of increased hair loss, their dullness, dry skin and mucous membranes.

For reference!

Osteoporosis grade 2 is characterized by a decrease in bone density.

Changes are diffuse (uniform). Most often, only 1 per bone is affected.

Signs of osteoporosis can be detected in the region of some 1 section of the spine. Such patients complain of constant pain in the lower back or shoulder blades. Often there are interruptions in the work of the heart.

Osteoporosis of the 3rd degree on the radiograph is distinguished by pronounced signs of damage to the spine. Areas of demineralization are found in the form of zones of enlightenment.

The shape of the vertebrae of a sick person changes. They become flatter. The vertebrae may become wedge-shaped. At this stage of the disease, several parts of the spine are affected.

In advanced cases, pronounced osteoporosis is detected. The picture shows extensive areas of enlightenment and a sharp deformation.

The growth of such people can decrease by 10 cm or more. Such changes lead to a sharp limitation of mobility. The process of self-care is difficult, so patients require outside help.

Methods for diagnosing osteoporosis

Diagnosis requires:

1. Questioning the patient.
2. Physical research.
3. Inspection.
4. Determination of bone density.
5. Radiography.
6. biochemical analyses.
7. General clinical blood and urine tests.
8. Computed or magnetic resonance imaging.

Additionally, specific tests for osteoporosis are performed. If necessary, the condition of the kidneys, adrenal glands, heart and thyroid gland is assessed.

If you suspect a secondary form of osteoporosis, you may need to evaluate the hormonal background. A biopsy is performed to rule out tumors.

Identification of risk factors

When making a preliminary diagnosis, the results of a patient survey are informative. During the history taking, the doctor identifies possible risk factors for osteoporosis. Defined:

• the nature of the diet;
• Lifestyle;
• motor mode;
• names of previously taken medications;
• presence and number of pregnancies;
• the presence of bad habits;
• the presence of harmful professional factors;
• the presence of chronic diseases;
• accommodations.

All this allows us to identify the causes of osteoporosis in men and women.

Instrumental Methods

The final diagnosis is made on the basis of instrumental studies. Plain radiography is not informative at an early stage of the disease.

It allows detecting a violation of mineralization only with a decrease in bone density by 25% or more. Osteoporosis is judged by the intensity of the color of the bone in the picture.

If there are enlightenments, then this indicates osteopenia. The most commonly performed x-rays of the bones of the skull, pelvis, extremities and spine.

If osteoporosis is suspected, osteodensitometry is mandatory. This method is highly accurate, informative and non-invasive. The radiation intensity is minimal.

When carrying out densitometry (determination of tissue density), X-ray and ultrasound techniques are used.

The advantage of the latter is the absence of radiation exposure. This procedure is best suited for examining pregnant women. Every doctor should be able to do densitometry.

In the past, absorptiometry was widely used in the diagnosis of osteoporosis. This study is based on the degree of absorption of radiation by the bone tissue. A detailed assessment of the degree of mineralization allows computed tomography.

Laboratory methods

In the blood of patients are determined:

• bone enzyme alkaline phosphatase;
• calcitonin;
• osteocalcin;
• vitamin D;
• parathormone;
• pyridinoline;
• deoxypyridinoline.

It is a hormone secreted by the thyroid gland and promotes the absorption of calcium by bone tissue. Laboratory research methods for osteoporosis include cytological analysis.

The doctor examines the cells of the bone tissue. This allows you to exclude a malignant tumor.

If necessary, an analysis is carried out for tuberculosis, because with this pathology, bones are also often affected. Laboratory diagnostics of osteoporosis in combination with instrumental examination makes it possible to identify osteoporosis.

Indicators of bone destruction

There are indicators that characterize the processes of bone destruction. These include C-terminal telopeptides and dioxypyridinoline. The last one is the most informative.

Dioxypyridinoline is a substance that is formed as a result of the destruction of bones. It enters the bloodstream and is excreted in the urine.

The stronger the bone decay, the higher the concentration of dioxypyridinoline will be. The material for the study is the urine of the patient.

These indicators are also determined to assess the effectiveness of the therapy. If the treatment is correct, then the concentration of these substances decreases.

Formation of new bone tissue

When examining patients, indicators of bone tissue metabolism are evaluated. These include:

• carboxyterminal propeptides of type I procollagen;
• alkaline phosphatase isoenzyme;
• osteocalcin.

These indicators allow:

• assess the risk of developing osteoporosis;
• assess the degree of bone mineralization;
• determine the need for treatment of patients.

Osteocalcin increases in osteoporosis. It is a protein that is found inside the bones and is released into the blood in small amounts.

Normally, its concentration in women after 50 years is 15-46 ng / ml, and in men - 15-46 ng / ml. These markers are informative at any stage of osteoporosis.

Indicators of calcium and phosphorus metabolism

When examining patients, calcium and phosphorus are necessarily evaluated.

The material for analysis is the venous blood of the patient. Parathyroid hormone is synthesized by the parathyroid glands.

With a decrease in the level of calcium in the blood, the activity of this hormone increases. It promotes the transfer of calcium from cells into the bloodstream.

In healthy people under 17 years of age, the content of parathyroid hormone is normally 1.3-10 pmol / l, and at an older age - 1.3-6.8 pmol / l.

An indirect sign of osteoporosis is a change in the levels of phosphorus and calcium in the blood. Their level is not an indicator of the state of bone tissue, since it can change under the influence of vitamins and other substances.

Normally, it is 2.2-2.75 mmol / l.

Medical treatment of osteoporosis

Treatment of osteoporosis in older women and men should be comprehensive. An important aspect of therapy is the use of drugs.

The main objectives of drug treatment are: reducing bone loss, tissue repair and stimulation of the mineralization process. Medications for osteoporosis in women and men include:

• drugs that affect phosphorus-calcium metabolism;
• estrogens;
• bisphosphonates;
• anabolic steroid;
• calcium preparations.

Modern methods of treating osteoporosis include the use of hormonal agents (estrogens, gestagens, androgens). When choosing a medicine, the following factors are taken into account:

• phase of the menopause;
• tolerance of drug components;
• age;
• risk factors;
• gender of the patient.

Hormonal drug therapy is not carried out in case of severe liver and kidney diseases, thrombophlebitis, uterine bleeding, neoplasms and severe diabetes mellitus.

The treatment regimen for osteoporosis necessarily includes drugs that regulate mineral metabolism in the bones. This group includes:

• Alostin;
• Boar;
• Osteogenon.

These medicines are available in the form of tablets, dragees, sprays and solutions. Additionally, vitamins (Ergocalciferol, Cholecalciferol) are prescribed for osteoporosis.

In order to enhance the deposition of calcium salts in bone tissue, protein synthesis and slow down the excretion of phosphorus from the body, anabolic steroids are prescribed.

This group includes Retabolil. The drug is contraindicated in case of intolerance, during pregnancy and lactation, with prostatitis, nephrotic syndrome, liver failure, breast or prostate cancer.

The treatment regimen includes calcium preparations (calcium gluconate, calcium chloride or calcium lactate).

Prevention of osteoporosis

To reduce the risk of developing osteoporosis, you must:

• eat well;
• stop smoking and alcoholic beverages;
• enough to move;
• take dietary supplements and vitamins;
• timely treat the pathology of the kidneys, liver, stomach, intestines and endocrine glands;
• observe the regime of work and rest;
• monitor the hormonal background;
• normalize weight;
• spend more time outdoors
• take medicines only as prescribed by a doctor.

Prevention should be carried out from a young age. The periods of puberty and postmenopause are critical.

Prevention of osteoporosis in women after 50 years of age comes down to good nutrition. You need to eat more foods rich in calcium.

Frequently asked Questions

When making a diagnosis, patients often ask their doctor the following questions:

• is it possible to completely cure the disease;
• how dangerous it is;
• whether physiotherapy, gymnastics and massage are useful during treatment;
• how to eat.

All this can be useful to patients during treatment.

What is the diet for osteoporosis?

There is no special diet for this pathology. The main tasks of clinical nutrition are:

• intake of a sufficient amount of calcium in the body;
• strengthening of bone tissue;
• increased absorption of calcium.

Minerals and vitamins play an important role in osteoporosis. They promote the absorption of calcium in the body. In the menu of patients with osteoporosis, it is necessary to include foods rich in magnesium, phosphorus, copper, ascorbic acid, vitamins K, A and D.

Proteins should not exceed 100-150 g. Patients should include in the menu:

• milk and dairy products;
• cabbage;
• cereals;
• dried fruits;
• nuts;
• meat;
• oily fish;
• wholemeal bread;
• bananas;
• seeds;
• egg white.

Raisins, cherries and cream are rich in copper. It is useful to consume foods containing boron. This element is involved in the absorption of vitamin D.

Boron is rich in peaches, grapes, legumes, pears and beets.

Zinc is actively involved in phosphorus-calcium metabolism. It is found in oatmeal, peanuts, wheat, pumpkin seeds, and seafood.

The following products impair the absorption of calcium by tissues:

• strong tea;
• black coffee;
• chocolate;
• beef;
• pork.

They need to be limited in use.

Which doctor should I contact?

People with osteoporosis can be treated by different specialists:

• orthopedists;
• endocrinologists;
• rheumatologists.

You can contact any of them. Often, consultation of other specialists (gastroenterologist, therapist, vertebrologist) is required.

Is it possible to exercise?

Doing gymnastics with osteoporosis is possible only with the permission of the attending physician. This takes into account physical fitness, concomitant pathology and the severity of the disease. A set of exercises is selected by a doctor for exercise therapy. The most common treatments for osteoporosis are:

• flexion and extension of the lower extremities;
• foot turns to the side;
• flexion and extension of the arms;
• pulling up to the chest bent knees;
• raising the shoulders above the floor in the supine position;
• alternately crossing the legs in the supine position;
• alternately raising straight legs in a standing position.

Each exercise is repeated at least 5 times.

Can osteoporosis be cured?

Proper and timely treatment can slow down the development of the disease or stop it.

Many patients have to change jobs due to decreased performance and movement disorders. The prognosis worsens with the development of complications (fracture of the femoral neck).

Can massage be done for osteoporosis?

Patients often turn to a massage therapist for osteoporosis. Such treatment is in addition to drug therapy and diet. Massage allows you to:

• improve blood circulation and mental activity;
• reduce pain syndrome;
• speed up metabolic processes;
• relieve muscle fatigue;
• reduce nervous tension.

Osteoporosis is a progressive bone disease in which bones lose calcium, and with it strength. Bones become brittle, which can lead to frequent fractures - even with minor injuries.

Why do bones break
The human bone is a living organism in which two types of cells live and fight: destroyers and builders. Destructive cells attach to the surface of the bone and secrete acids and enzymes that break down the bone. At the same time, calcium is released from the bones into the bloodstream in small portions, which is necessary for the functioning of many vital organs. As a result, depressions (lacunae) form on the surface of the bone, and the destroying cells die. Builder cells rush into these cavities and create a base from a special protein, where they then "immure" calcium, which is captured from the blood. The lacuna is filled with new bone substance. The process of building a new bone takes approximately 3 months. In a healthy person, bone destruction (resorption) and bone building (osteogenesis) are in perfect balance.

Osteoporosis dramatically increases the activity of cells-destroyers. Many sites of destruction are formed in the bone, and the builder cells do not have time to fill all the cavities with new bone substance. Deteriorating bone loses calcium, thins and becomes brittle. If you look at the bone through a microscope, it will seem that numerous holes - pores - are formed in the collapsing substance of the bone. Hence the name of the disease - osteoporosis (translated from ancient Greek - "porous bone").

When the bones break
The supply of calcium in the bones of the human skeleton after the age of 30 begins to decrease. At first, the loss of calcium from the bones is almost imperceptible. In the female body, the activity of destroying cells is controlled by the sex hormone estrogen, which monitors the presence of calcium in the bone and, ultimately, its safety. At the onset of menopause, estrogen ceases to form in the female body, and destroying cells begin to “uncontrollably” destroy bones. Bone destruction is especially enhanced in the first 3 years of menopause. At this time, about a kilogram (!) Of bone mass is lost every year (and on average, the skeleton of an adult weighs 20-25 kg). That is, after the cessation of menstruation, a woman annually loses about a kilogram of bone mass!
After 3-5 years of menopause, the loss of calcium from the bones decreases somewhat, but still remains quite significant.
There are risk factors leading to irreversible destructive processes in the skeleton even at a young age. These include low body weight, frail physique, low bone mineral density, fractures, certain diseases of the endocrine system, especially the thyroid gland, stomach and intestinal surgery, eating calcium-deficient foods, vitamin D deficiency, taking hormonal drugs, sedentary lifestyle life, prolonged (more than 2 months) bed rest.

dangers
Osteoporosis is insidious: for a long time, the disease is asymptomatic, without showing itself in any way. Sometimes the only manifestation is back pain when standing for a long time, which decreases when the person assumes a horizontal position.

The most serious and typical consequence of osteoporosis is hip fracture, which often occurs in the elderly. After such an injury, every second person remains disabled for life, every fourth person dies within three years after the fracture, and only in 25% of cases do patients return to normal life.

Symptoms
It is difficult to recognize osteoporosis in its early stages. An alarm signal is night cramps in the legs and feet, bone pain, back pain, fractures of the femoral neck, spine, wrists or other parts of the skeleton, widow's hump - curvature of the spine forward, decrease in height (by 2-3 cm per year), fragility or softening of nails, premature graying.

Diagnostics
To diagnose the disease, modern methods of examination are used - densitometry and radiography. Densitometry allows you to determine the mineral density of bone tissue and thus predict the risk of fractures and detect the disease at an early stage. X-ray allows you to make a diagnosis already at a later date in the presence of fractures.

Prevention and treatment
Prevention of osteoporosis should begin as early as 25-30 years of age. You should stop drinking excessive alcohol and coffee, smoking, exercise regularly, walk more, move more. It is much more effective to treat osteoporosis at an early stage, without waiting for it to manifest itself as a fracture. When a disease is detected, it is necessary to take calcium and vitamin D, as well as drugs that stop the destruction of bones.
When taking calcium supplements, the concentration of calcium in the blood increases. The concentration of calcium is a constant and important value for the body. He does not have “extra” calcium: he stores some of it, placing it in the bones, and removes some with the help of the kidneys. If vitamin D3 is included in the composition of the calcium-rich preparation, this improves the transport of calcium to the bones.
However, with massive bone loss due to osteoporosis, the bones do not receive enough calcium. Builder cells do not have time to fill all the cavities with it. Therefore, taking conventional calcium preparations, even with vitamin D3, is not able to stop the destruction of the bone.
The most powerful protection against bone destruction is provided by special medicinal substances - bisphosphonates. In their structure, they are similar to the mineral in the composition of the bone - hydroxyapatite. Therefore, when taken orally, these substances quickly enter the bone - precisely in those areas where destruction occurs, and form a protective film there. As a result, the destroyer cell dies, while the builder cells continue to work. The balance between the destruction of the bone and the formation of a new one is restored. The supply of calcium in the body is stabilized and even replenished.
The most modern bisphosphonates are effective in a regimen of just one tablet per month. The previous generation of bisphosphonates was taken daily or weekly.
To restore bone strength, you need to take bisphosphonates regularly, over a long period of 3-5 years. In this case, the bones will reach a sufficient degree of mineralization and get rid of numerous pores.

In order to improve the situation related to the incidence of osteoporosis in Russia, a hotline was created, as well as the Internet site www.osteoporosu.net.

Hot line “No to osteoporosis!” 8-800-200-05-78(phone for Moscow 785-05-78) has been operating since October last year. Any Russian can apply to her - the call is free for all regions of the country. Hotline experts - leading Russian rheumatologists, traumatologists, nutritionists - advise on the prevention, diagnosis and treatment of osteoporosis, and also provide telephone numbers for recording to the country's leading medical centers dealing with the problems of this disease: Endocrinological Research Center of the Russian Academy of Medical Sciences (ESC RAMS), Central Institute Traumatology and Orthopedics (CITO), Moscow Regional Scientific Research Clinical Institute (MONIKI), Institute of Rheumatology RAMS.

Diseases of the bones and joints are not as simple as they seem at first glance - they are distinguished by a wide variety of causes. These diseases occur at absolutely any age, only the forms of manifestation differ. In young people, inflammatory diseases usually predominate: osteomyelitis and arthritis, which affect the bones and joints, respectively. Their course is fast - the processes of tissue destruction occur in a short time.

In contrast, adults and the elderly develop diseases associated with many years of "exploitation" of the skeleton. At the same time, bone and cartilage tissue loses its former strength and flexibility, which leads to their gradual destruction under the influence of a load. The result of this process is the loss of compact bone substance, or arthrosis - a violation of the normal structure of the joint.

There are also congenital and neoplastic diseases that can be found in a person at any period of life. If the symptoms slightly limit daily activity, then there is absolutely no need to consult a doctor. But any pathology always has a progressive course, so you need to be able to suspect it and cure it in time.

Bone diseases

The basis of any disease is a violation of the main qualities of bone tissue - strength and flexibility. It seems to many that the bone consists only of durable minerals, while having a "stony" density. In fact, most of it is occupied by connective tissue, which includes minerals of calcium and phosphorus compounds. They are balanced in such a way that excessive fragility is not created, which would contribute to the development of many fractures. Bone diseases lead to a violation of this stability, developing in two ways:

• Inflammation disrupts metabolic processes - immune cells enter the bone with blood flow, causing the development of edema. A large number of aggressive substances begin to destroy the connective tissue, which immediately begins to transform into purulent masses.
• In the absence of inflammation, the mineral composition changes due to the activation of the processes of "self-destruction" of the bone. It contains special cells that perform the opposite work - formation or destruction. When the latter begin to predominate, signs of illness appear.

Osteoporosis is the dominant pathology of the musculoskeletal system, becoming a real threat to elderly and senile patients.

Osteoporosis

The name of this pathology literally from Greek means the formation of holes in the bone. But in fact, no “pores” appear there - all changes occur at a microscopic level:

• The bone tissue is not continuous, but has the form of beams or crossbars along which two specific types of cells move.
• Some are synthesizers, they continuously connect mineral salts and connective tissue to each other, forming strong complexes.
• Others are destroyers, their task is to destroy old or improperly built beams. This process is carried out by them continuously, so they can "accidentally" destroy a normal beam that gets in the way.
• Normally, the first cells always work harder, which does not allow the "destroyers" to thin the bone tissue.
• With age, this ratio begins to gradually decrease, and the second cells do not lose activity, continuing to work intensively.
• As a result, the loss of the basic substance of the bones develops, which sharply reduces their resistance to stress and damage.

Since the pathology develops over the years, its first sign will be a fracture that develops with minimal trauma. Therefore, for the elderly, even a banal fall can be deadly. The disease is detected by comparing bone density with a standard on an x-ray.

The treatment of this disease is long and ineffective, so the main emphasis is on prevention - good nutrition and an active lifestyle.

Osteomyelitis

Inflammation of bone tissue is accompanied by vivid symptoms - fever occurs, the limb becomes painful and hot to the touch. If the focus is located close to the joint, then swelling, redness and impaired mobility in the joint can be observed. Inflammation of the bone occurs as a result of the following reasons:

1. With closed fractures, fragments can form, which, if the plaster is not applied correctly, become inflamed. The process develops without the participation of microbes - by this measure, the immune system tries to destroy dead tissues.
2. Everything happens differently with open fractures, when various bacteria can enter through the wound. Once in closed and warm conditions, they begin to multiply intensively, causing the formation of an abscess.
3. In traumatology, operations are now widely used using pins or rods that fix fragments. In case of violation of sterility or care techniques after surgery, microbes also penetrate through the wounds on the skin.
4. can form without damage to the bone - while the bacteria are introduced with the blood stream. With abscesses of a different location or infection of the blood, it is possible for microbes to enter the bone tissue, where ideal conditions are created for them.

The disease often proceeds latently, when there are no local symptoms in the form of redness, pain and swelling in the area of ​​​​the abscess. The patient can only observe fever and sweating, which slightly limit his activity. And the abscess, meanwhile, does a “dirty deed”, destroying bone tissue.

Treatment of inflammation is always surgical - the abscess is opened and pathological secretions are removed, after which a course of antibiotics is carried out.

Tumors

Development combines both pathological processes, combining inflammation and "self-destruction". Tumors have different aggressiveness and growth rates, which determines the rate of onset of symptoms. Therefore, the disease is divided into two groups depending on the source:

• In the first case, the neoplasm comes from its own tissues - bone, cartilage or connective. This form is considered benign, and also has a slow growth. The only unpleasant symptom is that the tumor quickly leads to a change in the shape of the bone.
• In the second case, the neoplasm has the character of metastases, the source of which is in another organ. This complication is typical for cancer of the genital organs (prostate, ovaries and uterus), as well as for leukemia. Since metastases grow very quickly, another clinic comes out on top - unbearable pain.

To identify lesions, x-ray methods are used to assess the location and size of lesions. Then they choose the optimal tactics: surgical removal, if it is impossible - chemotherapy.

Joint diseases

Unlike bone pathology, with an element of inflammation is always present. This feature is associated with their structure - shells and cartilage are tissues that the immune system responds well to. Therefore, even with their slight damage, antibodies are released that provoke an inflammatory process there:

• Normally, this does not occur, since there are no blood vessels inside the joint.
• Its nutrition is carried out by diffusion - this is the name of the exchange between tissue and intra-articular fluid.
• The activity of the process depends entirely on the adjacent sections of the bone - if they are healthy, then the joint receives enough oxygen and nutrients.
• The entire exchange is carried out through a special barrier of cells, which prevents the penetration of blood elements through the membranes of the joint.
• Diseases of the surrounding tissues lead to a change in its permeability, which is manifested by an inflammatory process.

Arthritis is more often observed - an acute inflammation of the joint cavity, which is accompanied by vivid signs - pain, swelling, impaired mobility.

Arthritis

When the cause that violates the permeability of the joint capsule is sudden, the inflammatory process develops immediately after exposure. Therefore, not only local, but also general causes are observed, which are associated with changes in the circulatory and immune systems:

1. More often, traumatic arthritis develops in response to damage or excessive load on the joint. It is based on the "true" mechanism - in response to damage to the tissues of the joint, an immune reaction occurs.
2. After an infection, the development of reactive arthritis is possible, when the microbes themselves or their metabolic products enter the joint cavity.
3. With various allergic diseases, the basis is a change in the activity of the immune system - it begins to react inadequately to its own tissues, it develops. This produces a huge amount of antibodies that provoke the development of the inflammatory process in any part of the body.
4. Separately, there are rheumatological diseases, the causes of which are still not clearly defined. At the same time, the reaction resembles an allergy - immunity begins to attack its own tissues through unknown mechanisms.

The question of origin is very important - further successful treatment depends on it. In any case, all efforts are aimed at eliminating inflammation in order to prevent further progression of the disease.

Arthrosis

This disease is “age-related”, as it mainly affects people of older age groups. The main problem is that there is no adequate treatment, which requires timely prevention from patients and doctors aimed at slowing down the destruction processes. It is based on the following pathological mechanisms:

1. Gradual wear of the joints - when they stop working normally, then there is a sluggish inflammation, leading to a violation of mobility in them.
2. Immunity at this age acts without selectivity, destroying the destroyed areas of cartilage and ligaments.
3. The joint is no longer able to create adequate repair and nutrition of the cartilage, which leads to the growth of bone tissue at the site of defects.
4. This further exacerbates the impairment of mobility - as it decreases, the body "does not want" to support life in the joint anymore.
5. In an attempt to eliminate instability, he gradually reduces the articulation cavity, making it eventually closed. This completes the final stage, when mobility completely disappears.

The main help for such patients is a change in lifestyle, since good nutrition and physical activity slow down the age-related destruction of the joints.

congenital anomalies

The last type of pathology that affects the joints are violations of its structure, which are congenital in nature. In this case, diseases can be divided into two groups:

• In the first case, something is missing in the joint, or underdevelopment of its main components is noted. In such patients, problems begin in childhood, when the defective joint begins to lose its functions - supporting and functional.
• In another case, there is an additional formation - an outgrowth or protrusion of the forming tissues. They are an obstacle that will be damaged when the load increases, provoking the development of arthritis.

Detection of these diseases is difficult, as they themselves do not have clear symptoms. People seek help already with signs of a complication, which makes it difficult to find the cause - but with the advent of modern diagnostic methods, this is not a problem.

Bone is a solid formation in the human body, which is an integral part of the skeleton. Bone disease can occur in both adults and children. Bones need a constant supply of vitamins and minerals. If this process is disturbed, the development of diseases of bone structures or their complete destruction is possible.

The reasons

Bones play an important role in the body. They protect the internal organs and soft tissues from damage, are an integral part of the musculoskeletal system. These are the strongest structural elements of the skeleton, they can withstand the weight of the whole body, but even they are subject to disease.

The reasons:

• congenital malformations of the musculoskeletal system;
• age-related degenerative changes;
• excess weight;
• trauma;
• excessive overload;
• endocrine disorders;
• unbalanced nutrition, deficiency of vitamins and microelements, in particular, calcium and phosphorus;
• infectious diseases;
• inflammatory diseases of the joints or musculoskeletal apparatus;
• a sedentary lifestyle, as a result of which nutrition and blood circulation are disturbed, muscles atrophy;
• frequent hypothermia;
• hereditary predisposition;
• malignant or benign tumor.

Infectious heart diseases, such as endocarditis, are a common cause of human bone disease.

Bone diseases are often accompanied by joint damage. In most cases, illnesses are caused by injuries.

Symptoms

Symptoms depend on the type of disease. Inflammatory infectious diseases are accompanied by severe local and general symptoms. Body temperature may rise, chills, fever, headache, nausea, pain in the affected area, swelling, swelling may occur.

Also, bone diseases are manifested by stiffness and limited mobility. Bones are deformed, posture and gait may change, lameness appears.

Pain sensations at the initial stage are moderate, intensify after physical exertion. As the pathology develops, the pain does not leave the patient even at rest.

With degenerative-destructive lesions, for example, such symptoms appear as a result - a decrease in height, different lengths of limbs, spontaneous fractures.

Major diseases

All bone diseases can be grouped into the following groups:

• inflammatory and infectious nature;
• post-traumatic;
• congenital;
• metabolic.

The first two groups are the most common.

Inflammatory diseases are caused by infection. It can enter the bone structure through the blood or directly during an injury. The most severe disease from this group is.

Post-traumatic diseases often occur due to fractures and fractures of bones. The probability of damage to the bone structure increases with a lack of nutrients, as a result of which it becomes thinner and less durable.

Open injuries can become a gateway for infections, while closed ones lead to metabolic disorders and inflammation.

Metabolic diseases are caused by deficiency of vitamin D and calcium. Osteoporosis and osteomalacia are common. Bone tissue necrosis occurs due to malnutrition of bone tissue and microcirculation disorders.

There are such bone diseases:

• Osteochondrosis - degeneration of bone and cartilage tissues.
• Kyphosis, scoliosis or lordosis is a curvature of the spinal column.
• - inflammation of the joints, which leads to the destruction of bone tissue.
• - destruction of articular joints and bones.
• Osteoarthritis is a degenerative-dystrophic change that often affects the femur, hip, and lower legs.
• - rheumatic affection.
• (acute dystrophy) - This disease develops when there is a violation of the restoration of bone tissue, as a result of which small and large bones are deformed. Another name is osteitis deformans.
• Bone tuberculosis is an inflammatory and dystrophic process after pulmonary tuberculosis.
• Osteomyelitis is a purulent-necrotic disease. It is the most dangerous, accompanied by a large number of complications, leading to disability and even death of the patient. Osteomyelitis is caused by an infection that penetrates the bone structures from distant infected foci through the blood, as a result of trauma or surgery.
• Osteoporosis is a decrease in bone density and an increase in bone fragility. This is a chronic metabolic disease that occurs against the background of other pathological processes.
• - this is the fusion of several bones with each other. It is physiological and pathological.

Myeloma is the most dangerous. Cancer cells penetrate the bone structures with the blood stream. The disease is more common in people over the age of 40.

Any bone disease can cause complications. For example, osteochondrosis without treatment leads to sciatica, myositis, scoliosis and spondylosis.

Which doctor treats bone diseases?

A traumatologist, orthopedist, rheumatologist, vertebrologist and surgeon can treat bone diseases. The choice of a specialist depends on the specifics of the disease.

General principles of treatment

Any disease of the bone structure can lead to quite serious consequences. Whether the patient loses his ability to work or the ability to move independently depends on timely diagnosis and high-quality treatment.

Treatment depends on the etiology of the origin of the disease and its severity. In most cases, therapy takes place in a hospital. The affected part of the body needs complete rest, it is important to completely unload the diseased bone. For this, special orthopedic devices are used.

The treatment is complex, the following conservative methods are used:

1. Medical treatment:

• antibacterial agents (if the inflammatory process is caused by an infection);
• analgesics to reduce pain;
• non-steroidal anti-inflammatory drugs and hormonal drugs (in severe cases);
• antiplatelet agents and anticoagulants to normalize blood circulation;
• chondprotectors for the restoration of cartilage tissue;
• vitamin therapy (taking drugs containing calcium and vitamin D).

1. Physiotherapy procedures. Mud therapy, laser therapy, magnetotherapy, paraffin applications and others.
2. Massage and manual therapy. Acupuncture is especially effective.
3. exercise therapy. Helps to normalize blood circulation, strengthen muscles and reduce pain.
4. Dieting. It is important to choose a balanced diet. It is useful to eat foods high in gelatin and calcium. Salt and sugar intake should be limited.

Surgical treatment is used in the destruction of the bone. The most common type of surgery is arthroplasty.

Drug treatment is aimed only at eliminating symptoms and inhibiting further destruction, but therapy will not be effective if the cause of the pathology is not eliminated. During the period of therapy, it is important to adhere to preventive measures. Do not lift more than 5 kg and do not overwork physically.

The age of the patient plays an important role in the treatment of bone diseases. The older the person, the slower the recovery process.

Osteoporosis is a systemic disease with damage to the bone tissue, which is characterized by progression, a decrease in bone density and violations of their structure. With this pathology, the bones become brittle and break with minor loads.

There are the following types of osteoporosis:

• postmenopausal - associated with insufficient production of female hormones after menopause;
• senile - associated with age-related changes in the skeleton, a decrease in the mass and strength of bones, which is observed after 65 years;
• glucocorticosteroid - develops against the background of long-term hormone therapy, when patients take high doses of glucocorticoids;
• secondary osteoporosis - occurs in the presence of concomitant diabetes mellitus, with cancer, chronic renal failure, thyroid lesions, lung diseases, hepatitis, as well as insufficient intake of calcium or chronic aluminum intoxication.

Main Causes of Osteoporosis

Osteoporosis develops when there is a violation in the process of bone fiber remodeling. So, two types of cells are involved in bone renewal - osteoclasts and osteoblasts. Osteoclasts are responsible for the destruction of bone tissue, and osteoblasts - for its restoration. When osteoclasts are overactive, bones break down faster than they can be repaired, causing them to become brittle, which leads to frequent fractures in this disease.

Among the risk factors that provoke the development of this pathology, the following can be distinguished:

• female;
• hereditary predisposition;
• hypodynamia;
• violation of the menstrual cycle;
• short stature and low body weight;
• long-term use of corticosteroids, heparin, drugs that reduce the acidity of the stomach (antacids), which include aluminum;

Other factors, such as smoking and alcohol consumption, coffee abuse, excessive meat consumption, and insufficient vitamin D, can also affect the development of the disease.

Calcium also plays an important role in osteoporosis - with insufficient intake of calcium, the bones become less strong, so you need to include dairy products in your daily diet, which are a valuable source of this trace element.

Symptoms of osteoporosis

Often this disease is disguised as osteochondrosis or arthrosis. Osteoporosis of the bones is dangerous because it can occur for a long time without any clinical symptoms.. So, this pathology can be diagnosed already with frequent fractures that occur with minimal trauma.

How to identify osteoporosis in the early stages of its development?

Patients should be alerted to changes in posture, bone pain that occurs when the weather changes, tooth decay, brittle nails. Often with a latent form of osteoporosis, there are signs of periodontal disease, growth decreases due to a decrease in the height of the vertebrae. may present with primary symptoms such as leg cramps, which in most cases occur at night. There is also pain in the legs and lower back with prolonged static postures, for example, during prolonged sedentary work.

Osteoporosis of bones: treatment

In the treatment of this lesion, it is important to consider the cause of its development. So, if osteoporosis is associated with endocrine disorders, effective treatment is possible only if the hormonal background is corrected. If this disease occurs against the background of a lack of vitamins and calcium, an appropriate diet with a high content of dairy products, green vegetables, legumes, and fish is prescribed.

Calcium and vitamin D preparations are indicated. In the presence of osteomalacia, patients should take high doses of these drugs. If the cause of osteoporosis is chronic renal failure, dihydrotachysterol and calcitriol are prescribed.

A good therapeutic effect in the treatment of osteoporosis is shown by bisphosphonates - agents that prevent bone destruction and contribute to a gradual increase in bone mass. It should be noted that these drugs are used to treat severe forms of osteoporosis.