Joint diseases - Medical experts

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Joint diseases - especially degenerative joint diseases (wear and tear diseases) - are the most common impairments of the musculoskeletal system. Joint pain affects almost every second person over the age of 45. In medicine, joint diseases are also known as arthropathies.

Here you will find an overview of the different clinical pictures and specialists.

ICD codes for this diseases: M24

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Article overview

Joint diseases

Joint diseases are usually caused by joint wear and tear, which occurs in most people as they age. Overuse and/or incorrect loading during life often lead to increased joint wear.

Experts refer to such pathological changes to the knee, hip joints, shoulder or elbow as joint diseases.

What types of joint disease are there?

Doctors summarize joint diseases under the term arthropathies.

These are divided into two forms:

Joint diseases are often the result of metabolic disorders or infections that lead to inflammation.

The causes of joint diseases

As a rule, joint diseases have several causes and therefore cannot be traced back to a single trigger. They are therefore multifactorial. Nevertheless, there are factors that promote a disease, such as Joint misalignments.

Joint misalignments include, for example

In addition, advanced metabolic diseases often lead to joint disorders.

Risk factors are for example

Incorrect and excessive strain, as occurs when lifting loads, is another cause of degenerative joint diseases.

Gelenkfehlstellung: O-BeineMisalignments in the knee can manifest as knock knees or bowlegs @ Papcut design /AdobeStock

The development of degenerative joint diseases

The history of the development of degenerative joint damage is best studied. Incorrect loading over many years wears down the cartilaginous joint surfaces more and more .

The problem with this is that joint cartilage does not regenerate. It is therefore irreversibly lost. Uneven wear on the joint surfaces also causes unevenness. Small ridges form, which further accelerate the abrasion of the joint surfaces.

In the end, the articular cartilage layer is so thin that the joint surfaces of the bones rub against each other. This in turn leads to pain and promotes inflammatory processes that can further damage the cartilage and joint surfaces.

What symptoms do joint diseases cause?

Regardless of the cause and history, there are symptoms that can occur equally frequently in all joint diseases.

These include the cardinal symptoms of inflammation:

  • Pain (dolor)
  • Swelling (tumor)
  • Heat (calor)
  • Redness (rubor)

Depending on the degree of joint damage, this may lead to

  • Restricted movement
  • Muscle pain and
  • A typical scraping or cracking sound when bending, e.g. the knee joint.

In more advanced stages of the joint disease, there may be

occur. At this stage, the pain is already chronic, so that movement is no longer possible without pain. This condition is extremely stressful for the quality of life and psyche of those affected.

The diagnosis of joint disease

In the early stages, doctors usually diagnose joint disease on the basis of the clinical picture. Pain that occurs permanently or after walking a certain distance (fatigue pain) during exercise indicates possible joint disease.

Joint effusions, restricted movement and misalignments in the joint are also signs of joint disease.

The joint surfaces can be visualized very well in an X-ray. In particular, unevenness, spurs and abrasion particles in the joint space become apparent. The joint space is often also significantly reduced in size.

Inflammatory joint diseases can be detected by inflammation parameters or rheumatoid factors in the blood. One example is polyarthritis, which is one of the rheumatic diseases.

Stärkere Arthrose am HüftgelenkSevere osteoarthritis of the hip joint @ crevis /AdobeStock

Treatment options for joint diseases

As many joint diseases primarily cause pain, pain therapy is a top priority, especially at the beginning of the disease. Non-steroidal anti-inflammatory drugs (NSAIDs) are the drugs of choice here. These include ibuprofen or diclofenac, for example.

In some cases, doctors resort to chondroprotectants, cartilage-protecting substances . These include hyaluronic acids, green-lipped mussel extracts and others, which are primarily intended to inhibit the enzymes that promote the inflammatory breakdown of cartilage.

This slows down the progression of the disease. In the case of joint effusions and severe inflammation, doctors often inject cortisone directly into the affected joint to stop the inflammatory processes.

Doctors initially treat rheumatic joint diseases with immunotherapy to suppress the function of the immune system. Methotrexate, for example, is used for this purpose.

Physiotherapy or physiotherapy exercises are also frequently used to prevent incorrect loading and muscle breakdown.

Finally, invasive treatment methods are available for advanced joint disease or unbearable pain with restricted movement.

These include arthroscopy, or joint endoscopy. This involves the doctor making a micro incision and inserting a probe into the knee joint, for example. This allows him to view the joint space, clear it out and smooth the joint surface. This can improve movement and slow down joint wear and tear.

The last resort is surgery and the use of an artificial joint. However, this is only an option for patients with advanced joint disease who suffer from severe pain and restricted movement.

What is the prognosis for joint diseases?

Acute inflammatory joint diseases usually have a good prognosis, as the danger to the joints is averted after treatment.

However, the situation is different for joint diseases caused by wear and tear. These are irreversible, so it is particularly important to treat them as early as possible.

This can delay the course of the disease. Physiotherapy, osteopathy or chiropractic treatments can also help.

Which doctors treat joint diseases?

Joint diseases are treated by various specialists depending on the cause.

These include specialists for:

References

flexikon.doccheck.com/de/Arthropathie
medlexi.de/Gelenkerkrankungen
Michael JWP et al., Epidemiologie, Ätiologie, Diagnostik und Therapie der Gonarthrose. Dtsch Arztebl Int 2010; 107(9): 152-62. doi:10.3238/arztebl.2010.0152
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