Osteoarthritis of the ankle joint. Symptoms and Treatment, Medicines, Exercises

The ankle joint is often injured because it withstands great loads. A doctor can diagnose ankle osteoarthritis based on symptoms and prescribe treatment. The disease does not depend on age and gender, tissues thin and break down, which can lead to disability.

Arthrosis affects 12% of residents, and the disease more often affects women of retirement age.

As mentioned, the ankle can withstand a huge load. It keeps the body upright and allows one to move. Its violation changes the usual way of life.

Osteoarthritis of the ankle joint (symptoms and treatment may be different) is a chronic disease in which irreversible processes occur in the cartilage.

The disease occurs gradually. A healthy person has a smooth joint surface. When overloaded, it promotes easy sliding during physical activity.

In arthrosis, tissue nutrition and metabolism deteriorate. The outer surface of the joint changes, becomes rough, the cartilage touches and inflammation occurs. When a person lifts heavy objects, the load falls on the bone, which leads to degenerative disorders.

If treatment is not started, severe pathologies develop. In the later stages, the cartilage and tissue are affected, the synovial membrane is irritated and the joint loses stability. In this case, the supporting function suffers, movements become difficult.

Kinds

There are several types of arthrosis depending on different criteria:

• causes of occurrence (primary, secondary);
• stages of arthrosis;
• localization of the pathology;
• forms of localization (generalized and local);
• course of the disease (acute and chronic).

Classification criteria	Types of arthrosis
place of manifestation	knee, wrist, ankle, elbow, shoulder and cervical arthrosis.
cause of occurrence	primary – develops independently, without prerequisites; secondary - joint damage occurs due to the development of infectious diseases, mechanical damage, injuries, hypothermia and other factors.
localization	local damage - symptoms cover a small area of the joint or its individual tissues; generalized – several joints are affected or one with complete involvement of all tissues.
course of the disease	acute form - increased intensity of symptoms and their severity, severe pain, morphological changes appear more dynamically; chronic form - the course of the disease is slow, it manifests itself with separate symptoms during exacerbations.

Ankle arthrosis is divided into primary (degenerative processes begin in healthy cartilage due to excessive physical activity) and secondary (destructions are diagnosed, dystrophic changes in the cartilage tissue appear).

Stages and degrees

Osteoarthritis of the ankle joint (symptoms and treatment directly depend on the age of the patient) can appear in different ways. In some, many years pass from the appearance of the first symptoms to the critical stage, while in others the disease develops rapidly.

It depends on the age and co-morbidities when the therapy was started. As ankle arthrosis progresses, the symptoms become more pronounced.

There are 4 stages of the disease.

1. The first stage is often overlooked. Main symptoms: stiffness that appears in the morning, a characteristic crisis when walking. Pathogenic changes are not revealed on the image, the destructive process has already begun.
2. Stiffness in the morning lasts longer. Developing the leg will take 20-30 minutes. Some patients experience lameness. On an X-ray, you can see stage 2 pathology through bone spurs and bone displacement.
3. In stage 3, symptoms become more pronounced. Painful sensations appear in a calm state, the patient cannot do without painkillers. Lameness becomes noticeable and crutches are sometimes required. The joint swells, changes, the muscles thin and decrease in volume. The joint space narrows, as seen on an X-ray, and osteophytes form.
4. The last stage develops in the absence of treatment. The cartilage is destroyed, the surfaces of the joints fuse together. The patient cannot walk.

There are several degrees of arthrosis:

1. First degree– X-ray shows no changes and joints. He has mild morning stiffness. At this stage, it is necessary to start treatment.
2. In the second degreeactivity becomes difficult, crunch is heard when walking, swelling is observed. An X-ray shows a reduction in the inter-articular space. The person limps and the morning stiffness lasts longer.

3. In the third degreepronounced crusarthrosis, deformation of the joints. Muscles atrophy even more, movements become limited. Constant rest is necessary. The pain does not go away even in this state.
4. On the last degreeThere is practically no joint space, activity is almost impossible. X-ray examination allows you to diagnose a large number of osteophytes. Only surgical intervention is prescribed.

Ankle arthrosis appears gradually, so treatment should be started at the first symptoms to prevent worsening of the condition and occurrence of complications.

Symptoms

Osteoarthritis of the ankle joint is characterized by several symptoms (they affect the method of treatment):

• The pain is initially moderate and occurs only with physical activity. Over time, the pain becomes stronger and bothers you at rest;
• with injuries and dislocations, swelling and inflammatory manifestations appear and the temperature in the area of injury increases;
• "dry" clicking, accompanied by pain;
• dislocation, as the cartilage tissue thins and breaks down, the joint loses stability. Bones are displaced and fall out of the joint capsule;
• joint stiffness;

• when walking one gets tired quickly;
• in the last stages the joint is deformed.

If at least one symptom appears, you should immediately consult a doctor.

Reasons for the appearance

Osteoarthritis of the ankle joint (symptoms and treatment are often caused by age-related changes) affects the older generation. Recently, pathology has been observed among young people.

Provocative factors are:

• injuries, sprains and bruises;
• age-related disorders in joints and ligaments;
• inflammatory processes;
• Overweight;

• disturbance of metabolic processes;
• congenital deformity of the foot and flat feet that occurred during life;
• hereditary predisposition;
• excessive physical activity;
• using uncomfortable shoes;
• diseases of the endocrine system;
• osteochondrosis.

Less synovial fluid is produced, resulting in less nutrition for the cartilage. The joint space narrows, which can cause the bones to fuse. Cruciarthrosis occurs, which cannot be reversed. However, treatment should be prescribed immediately to prevent the progression of the disease.

Diagnosis

The diagnosis of arthrosis consists of studying the existing symptoms and data obtained from the research. Since there are no tests that clearly determine the pathology, doctors recognize laboratory methods as insufficiently effective.

During remission, the indicators are normal, during relapse, the blood test shows an increased level of ESR and c-reactive protein. This means that the pathology has already begun.

Instrumental methods are used to confirm the diagnosis:

1. justradiographyis the most reliable method. Muscles do not perceive X-rays equally: soft ones transmit them, while hard ones absorb them. The study reveals the disease itself and its consequences.

   The image allows you to analyze the condition of the bone surfaces in the joint, the shape, size and location of the structures relative to each other, the condition of the tissue and the size of the joint gap. Thanks to these data, the degree of pathology can be determined.

   

   If the ankle is affected, the diagnosis is made in the lateral, posterior, and posterior projections with the foot moved inwards. If there are corresponding symptoms (narrowing of the joint space, osteophytes and other signs), arthrosis is diagnosed.

2. Nuclear magnetic resonancedetermines the disruption of the functioning of hydrogen molecules under the influence of a strong magnetic field. Allows you to examine areas of the body that contain water.

   The dark shade of the image represents the bones, as their water content is much less, while the muscles, nerves and discs appear lighter. Diagnostics reveals even minor disorders in bone tissue and joints. The procedure is indicated before joint replacement. The only downside is the high cost of diagnostics.

3. Magnetic resonancevery accurately examines the ligament structure of the joint, muscle tissue and cartilage. Thanks to the examination, the specialist can assess the condition of the joints of the lower leg, which makes it possible to identify the pathology at the very beginning of its development. The procedure is painless and lasts about 30 minutes.

   During the procedure, the person is exposed to radio waves and strong magnetic radiation. It should be remembered that the magnetic field is dangerous for the physiological state. MRI is prohibited in case of neuropsychiatric disorders, pregnancy and the presence of metal objects in the body.

4. Ultrasoundenables an accurate diagnosis. The device produces waves that are reflected by the tissues and recorded on the screen. The doctor examines the image and makes a diagnosis. For clarity of the image, a gel is used that removes air and provides easy movement on the surface.

   The advantages of this procedure are safety for health, affordable price and high accuracy.


5. Bone scintigraphy- a study that makes it possible to determine pathological disorders in the bones using isotopes. A special substance containing labeled atoms is injected into the patient's body. Pathological zones are divided into cold and hot.

   In the first, there are no isotopes, the blood flow to them is weaker and they are not detected by scanning. This includes places where malignant tumors have appeared. In hot areas, isotopes are collected more actively and are clearly detected during scanning. These areas indicate the onset of inflammatory processes.

   This research allows to separate arthrosis from similar diseases with similar clinical signs, based on the results the doctor makes a prognosis and prescribes treatment.

   The main contraindications for the study are carrying a child, breastfeeding and taking drugs containing barium.

6. Joint punctureis a procedure in which the doctor inserts a needle into the joint cavity to collect synovial fluid for analysis.

   This biomaterial continues to be studied in the future, based on the results, the specialist determines the characteristic features of the disease and at what stage of its development it is. In ankle arthrosis, a puncture is made in the front part between the outer ankle and the tendon of the long extensor of the fingers.

When to see a doctor

If the treatment of arthrosis is not started on time, incapacity and sometimes disability occurs. Some patients do not rush to seek help because they do not know which doctor to make an appointment with. At the first symptoms, you should visit a rheumatologist who diagnoses dystrophic and inflammatory changes in the joint.

You should contact him if:

• there is discomfort and pain in the joints after excessive exertion, at the end of the working day;
• it is difficult to find a comfortable position for your legs at night;
• the joints swell, the skin becomes red;
• there is sharp pain, it is difficult to move;
• crunching and clicking sounds appear;
• joints are deformed.

With the help of modern diagnostic and therapeutic techniques, it is possible to avoid surgical intervention and preserve the functioning of the joint.

Prevention

Osteoarthritis of the ankle joint (symptoms and treatment can be checked with a doctor) can be prevented.

To prevent arthrosis, experts recommend following certain rules:

• wear comfortable shoes that fit properly and without heels;
• maintain proper nutrition, drink enough clean water;
• choose a suitable vitamin and mineral complex;
• exercise;

• walk in the fresh air more often;
• avoid excessive load on the legs;
• avoid hypothermia;
• to be regularly monitored by doctors;
• give up bad habits;
• do a set of exercises to warm up the ankle joint.

It is especially important to adjust your diet. Nutritionists have agreed on a menu that will prevent exacerbation of the disease and saturate the body with the necessary substances.

1. You should eat often and in small portions.
2. Drink at least 2 liters of clean water.
3. Avoid sweet and salty foods.
4. Do not eat 4 hours before going to bed.
5. Steam, bake, boil food.

Fasting and a strict diet in arthrosis are strictly prohibited in order to prevent the washing away of calcium, which is necessary for the restoration of bones and cartilage.

Methods of treatment

Once the diagnosis is confirmed, treatment should begin immediately. It is impossible to completely get rid of arthrosis, the main thing is to slow down the destructive processes and increase the period of remission. Various techniques are used for this purpose.

medicines

Different drugs are used to treat arthrosis:

1. Anti-inflammatoryand pain relievers eliminate the source of inflammation and relieve pain. Tablets and ointments are used. The sooner anti-inflammatory drugs are taken, the greater the chance of saving the joint.
2. Glucocorticoidsare used if the above drugs do not bring the desired result. They are produced in the form of an injectable solution and are injected into the joint.
3. Chondroprotectorsnecessary to slow down the process of cartilage destruction.

The treatment regimen and the dosage of the drugs are prepared by the doctor based on the severity of the symptoms, concomitant diseases and other factors. Self-medication is strictly prohibited in order not to worsen the situation.

Traditional methods

As for the traditional methods of treating arthrosis, doctors recognize their beneficial properties and positive effect. Traditional medicine is also used as disease prevention.

The main prescriptions for the treatment of arthrosis of the ankle are the following:

1. Burdock leaves are washed thoroughly and applied with the soft side to the skin. The plant is fixed with a bandage or cling film and left overnight.
2. Heat sea salt (buckwheat, sand) in a pan, pour into a linen cloth and apply to the sore spot. Keep until the salt cools down. This is an effective way to relieve pain.
3. Pour over the lilac with triple cologne, leave in a dark place for 2 weeks, rub the sore spot twice a day.
4. Grind eggshells into powder, take 0. 5 tsp before eating.

The use of traditional methods of treatment must be agreed with the attending physician. This is not the only measure, but an addition to the main therapy.

Other methods

When conservative therapy does not bring a positive effect, they resort to radical measures - surgery.

As a rule, indications for surgery are:

• repeated and primary arthrosis of 3-4 degrees;
• complications;
• severe and prolonged pain radiating to the knee;
• obvious lameness;
• paralysis of leg muscles;
• deterioration of the flexion-extension properties of the joint and the support ability of the foot.

The following surgical interventions are used for arthrosis of the foot:

1. Arthrodesis– surgery to immobilize the joint. Its task is to restore the lost ability to support the limb. The main disadvantage is the likelihood of bone fusion, which leads to immobility, so it is used very rarely.
2. Arthroscopyis a minimally invasive procedure in which the doctor cuts open the joint and inserts an arthroscope. The surgeon performs a visual examination and assesses the condition of the intra-articular structures and, if necessary, removes parts of the damaged joint or blood clots from the synovial fluid. With this operation, the risk of recurrence is too high.
3. Endoprosthesisperformed in particularly severe cases. Makes it possible to replace a damaged connection in a certain part or completely. Prostheses with modernized mechanics are used and last up to 20 years.

The main contraindications for surgery are age under 12 years, fistulas in the joint, diabetes mellitus, cardiac dysfunction and infectious diseases.

Possible complications

If treatment is delayed or absent, the following complications may occur:

• impairment;
• deformation that cannot be restored;

• inactivity and immobility of the joint;
• decline in quality and standard of living.

In addition to these complications, the chronic course of the disease is accompanied by pain, discomfort and inability to lead an active lifestyle.

In order to make gymnastics, medication and folk treatment more effective, it is recommended to use special orthopedic devices that reduce the load on the joint. This includes a brace and a fixation bandage.

The orthosis completely follows the contours of the ankle, increases the range of motion, relieves swelling and pain. The fixation bandage has the same effect as the orthosis. It is made of soft elastic material that allows you to fix the joint well. The bandage is used only in periods of remission, when the exacerbation passes.

Osteoarthritis of the ankle joint is a serious disease, which, if not treated, leads to severe consequences and complete immobility of the joint. Diagnosis in the initial stage, careful attention to symptoms and competent therapy allow to avoid surgical intervention.