According to the ICD, arthrosis of the interphalangeal joints of the hands. Osteoarthritis - description, causes, symptoms (signs), diagnosis, treatment

Note. In this block, the term “osteoarthritis” is used as a synonym for the term “arthrosis” or “osteoarthrosis”. The term “primary” is used in its usual clinical meaning.

Excludes: spinal osteoarthritis (M47.-)

Included: arthrosis of more than one joint

Excludes: bilateral involvement of the same joints (M16-M19)

[localization code see above (M00-M99)]

Excluded:

• arthrosis of the spine (M47.-)
• rigid big toe (M20.2)
• polyarthrosis (M15.-)

In Russia the 10th revision ( ICD-10

ICD-10

The release of the new revision (ICD-11) is planned by WHO in 2022.

Clinical picture and features of arthrosis of the wrist joint: symptoms, signs, treatment

Arthrosis of the wrist joint is not as common as arthrosis of the foot. In this case, the hands suffer, which become significantly deformed and gradually lose the ability to move.

Such a disease can completely deprive a person of the ability to take care of himself at home independently.

This is accomplished to the greatest extent due to the spherical structure of the department. When injury occurs, cartilage tissue is damaged.

This in turn affects its structure, making it rough. Due to this effect, surface friction occurs and tissues are further destroyed.

As the cartilage degrades, small osteophytes begin to appear. They somewhat reduce mobility and give significant pain during exercise or movement. Gradually, the radial ossicle becomes deformed, and as it progresses, it can shorten.

It is characteristic of arthrosis of the wrist joint that the deformation, if externally manifested, is at a late stage and is very insignificant. Severe deformities may occur if there has been a previous bone fracture. According to the ICD-10 code, the disease is classified as M.19.

But the pain syndrome significantly predominates in the clinical picture, and if at first it appears only during exercise, then as it develops it makes itself felt at rest. The following types of wrist arthrosis are distinguished:

• Purulent nonspecific ones manifest themselves due to infectious lesions of the articular cavity;
• Specific ones develop due to the pathogens of syphilis and gonorrhea;
• Infectious-allergic symptoms occur due to infectious diseases as a complication (for example, dysentery or measles);
• Metabolic diseases develop under the influence of metabolic disorders, such as gout.
• Systemic ones are usually provoked by systemic pathologies affecting connective tissues.

• Post-traumatic consequences after a fracture;
• Infectious diseases of general type and more specific ones;
• Arthritis;
• Violation of metabolic processes;
• Autoimmune reactions;
• Hormonal changes.

It is noted that the incidence of arthrosis localized in the wrist joint appears many times more often in women during periods of hormonal imbalances and age-related changes, for example, during menopause, pregnancy, and so on.

The symptoms of such arthrosis have some differences from other various localizations. So, first of all, the deformation of the joint is insignificant for the wrist joint, but the following are present:

• Pain syndrome;
• Swelling, swelling of the area;
• Decreased mobility of the department.

At the first stage, the pain is slight and temporary.

As a result, a person involuntarily begins to tense other muscles in order to reduce the load on this area.

• X-ray;
• Arthroscopy;
• Urine tests;
• Puncture in the affected area;
• Blood tests;

It is also important to identify the cause of the pathology. Therefore, the doctor can sometimes prescribe other research procedures.

Therapy for any type of arthrosis of the wrist joint consists of several directions. Orthopedic influence and exercise therapy play an important role in it. The influence of medications and physiotherapy is also included.

The photo shows changes in the hand with wrist arthrosis of 1st and 2nd degree

Treatment with medications is particularly effective in relieving symptoms and improving quality of life.

It is impossible to be cured completely with the help of drugs, but stopping degenerative processes with the right approach is quite possible. Therefore they use:

Drugs for arthrosis

Physiotherapy can mainly be represented in such areas as:

Physiotherapy for arthrosis

Surgical methods are mainly designed to eliminate the symptoms and consequences of the negative effects of degenerative processes. For these purposes the following may be carried out:

• Joint replacement if there is significant shortening of the radius;
• Puncture to diagnose the affected area;
• Arthroscopy to examine and remove fragments of cartilage tissue that may cause inflammation;
• Periarticular osteotomy corrects the position of the joint, reducing the load on it, as well as pain. It is used infrequently, as it is quite difficult to rehabilitate.

But doctors still give preference, whenever possible, to non-surgical types of therapy. If possible, the main recommendation is annual treatment in specialized sanatoriums.

Possible complications include:

• Intense pain syndrome;
• Muscle atrophy;
• Shortening of the radial joint;
• Attachment of arthritis;
• Reducing the range of motion to a minimum.

The prognosis for the disease is positive only if it is fully and comprehensively treated using a variety of techniques. It is important to carry out each type of influence at its own time. In this way, it is possible to stop the progression and put the disease into remission.

Thanks to this, the patient’s quality of life can be significantly improved. in the absence of treatment, arthritis and complications are most likely to develop.

Exercises and gymnastics to restore the wrist joint in our video:

Primary arthrosis of the first carpometacarpal joint:

• unilateral

Post-traumatic arthrosis of the first carpometacarpal joint:

• unilateral

Secondary arthrosis of the first carpometacarpal joint:

• unilateral

In Russia International Classification of Diseases 10th revision ( ICD-10) was adopted as a single normative document for recording morbidity, reasons for the population’s visits to medical institutions of all departments, and causes of death.

ICD-10 introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

Causes and symptoms of deforming arthrosis of the wrist joint

Arthrosis of the wrist joint is always deforming in nature, since it leads to curvature of bone tissue, which is why it is called deforming.

Deforming arthrosis of the wrist joint is a serious disease that can occur after injuries or increased loads on the hand. Pathology can occur in builders, athletes and other categories of people who constantly strain this joint.

The wrist joint is a movable connection between the bone tissues of the forearm and hand. This structure is formed by the widened and concave surface of the radius and the distal surface of the cartilaginous disc. The anatomical structure of the joint is quite complex.

Osteoarthritis of this structure is a degenerative-dystrophic lesion of the joint. This condition can develop due to disruption of the structure of hyaline cartilage, decreased synthesis of synovial fluid and changes in the biomechanics of movement of the affected joint.

In the absence of adequate therapy, there is a risk of a significant decrease in motor activity. According to ICD-10, pathology is coded as follows: M19. Other arthrosis.

Arthrosis of the wrist joint is characterized by the following features:

• symptoms of arthrosis develop due to stress on the joint - this is the main difference from arthritis, which manifests itself at night;
• pain predominates in a specific area;
• heaviness, fever and weakness are absent.

There is arthrosis of 1, 2, 3 degrees. Each of them is characterized by certain features. First degree pathology is accompanied by the following manifestations:

• There are no obvious external manifestations, but there are signs of periodic pain that increases when moving the arm or as a result of physical activity;
• There may be slight swelling in the area of ​​the nail phalanges.

With arthrosis of the second degree, the following manifestations occur:

• the pain syndrome becomes constant - it has an aching character;
• the skin in the joint area turns red and becomes swollen;
• small Heberden nodes appear on the hands, which are symmetrical in nature;
• the nodes do not disappear even after the elimination of edema and hyperemia;
• motor activity in the hands decreases, this process is accompanied by a crunching sound;
• signs of muscle tissue atrophy appear.

The following signs are characteristic of pathology of the third degree:

• swelling and redness become permanent symptoms;
• curvature of the joints and the appearance of bone growths prevent the bending of the fingers or hand - as a result, their mobility is completely lost;
• in addition to the nodes, deformation of all structures of the hand appears;
• the affected limb becomes thinner and thinner.

The main causes of pathology include the following:

• traumatic injuries;
• old age;
• hereditary predisposition;
• excessive stress on the joint;
• inflammatory processes or autoimmune pathologies;
• lack of vitamins and microelements.

An orthopedic surgeon can identify the pathology. You should contact this specialist at the first signs of illness. Diagnosis begins with a visual examination. Based on its results, the following studies are prescribed:

1. X-ray – this method makes it possible to determine the width of the gap between the joints, identify bone processes and evaluate the structure. This procedure makes it possible to make an accurate diagnosis.
2. A general blood test and a rheumatic test - with their help it is possible to distinguish arthrosis from arthritis. These pathologies have a similar clinical picture, but the therapy is significantly different. With arthrosis, all parameters remain normal. Arthritis is accompanied by an increase in uric acid levels, erythrocyte sedimentation rate, etc.
3. Magnetic resonance imaging is a technique used when the doctor has doubts about the correctness of the diagnosis. This procedure is very informative and allows you to identify the disease in time.

After identifying the pathology, the doctor selects a treatment regimen. Treatment can be conservative or surgical. It must be comprehensive. Therapy should be aimed at eliminating the cause of the pathology. Therefore, it is necessary to perform the following actions:

• eliminate increased stress on the joint;
• avoid traumatic injuries to the wrist;
• engage in the prevention of metabolic disorders;
• eliminate nutritional deficiencies.

First of all, immobilization of the diseased joint is carried out. With the help of a bandage, it is given the least painful position. In addition, the specialist prescribes medications and prescribes physical therapy. During remission, therapeutic exercises are performed. In difficult cases, a person is indicated for surgical intervention.

Arthrosis of the wrist joint is not as common as arthrosis of the foot. In this case, the hands suffer, which become significantly deformed and gradually lose the ability to move.

Such a disease can completely deprive a person of the ability to take care of himself at home independently.

Features of the disease

The wrist joint is designed in such a way that, due to the connection of the ulna, carpal and radial bones, it has increased mobility.

This is accomplished to the greatest extent due to the spherical structure of the department. When injury occurs, cartilage tissue is damaged.

This in turn affects its structure, making it rough. Due to this effect, surface friction occurs and tissues are further destroyed.

As the cartilage degrades, small osteophytes begin to appear. They somewhat reduce mobility and give significant pain during exercise or movement. Gradually, the radial ossicle becomes deformed, and as it progresses, it can shorten.

It is characteristic of the wrist joint that the deformation, if externally manifested, is at a late stage and is very insignificant. Severe deformities may occur if there has been a previous bone fracture. According to the ICD-10 code, the disease is classified as M.19.

But the pain syndrome significantly predominates in the clinical picture, and if at first it appears only during exercise, then as it develops it makes itself felt at rest. The following types of wrist arthrosis are distinguished:

• Purulent nonspecific ones manifest themselves due to infectious lesions of the articular cavity;
• Specific ones develop due to the pathogens of syphilis and gonorrhea;
• Infectious-allergic symptoms occur due to infectious diseases as a complication (for example, dysentery or measles);
• Metabolic diseases develop under the influence of metabolic disorders, such as gout.
• Systemic ones are usually provoked by systemic pathologies affecting connective tissues.

Since this area is not so often affected by arthrosis, doctors were able to identify the main factors that influence the development and course of the pathology:

• Post-traumatic consequences after a fracture;
• Infectious diseases of general type and more specific ones;
• Arthritis;
• Violation of metabolic processes;
• Autoimmune reactions;
• Hormonal changes.

It is noted that the incidence of arthrosis localized in the wrist joint appears many times more often in women during periods of hormonal imbalances and age-related changes, for example, during menopause, pregnancy, and so on.

Also an important role is played by the type of activity in which the load or vibration impact is greater on this area.

Symptoms of the wrist joint

The symptoms of such arthrosis have some differences from other various localizations. So, first of all, the deformation of the joint is insignificant for the wrist joint, but the following are present:

• Swelling, swelling of the area;
• Decreased mobility of the department.

At the first stage, the pain is slight and temporary.

As a result, a person involuntarily begins to tense other muscles in order to reduce the load on this area.

As the pain progresses, it begins to increase until it becomes unbearable.

Unlike other types, arthrosis of the wrist joint cannot be diagnosed by visual or palpation examination. Therefore, it is often confused with arthritis due to the similarity of symptoms. To differentiate arthrosis, the following is carried out:

• Arthroscopy;
• Urine tests;
• Puncture in the affected area;
• Blood tests;

It is also important to identify the cause of the pathology. Therefore, the doctor can sometimes prescribe other research procedures.

Treatment

Therapy for any type of arthrosis of the wrist joint consists of several directions. Orthopedic influence and exercise therapy play an important role in it. The influence of medications and physiotherapy is also included.

The photo shows changes in the hand with wrist arthrosis of 1st and 2nd degree

Medication

It is especially effective in relieving symptoms and improving quality of life.

It is impossible to be cured completely with the help of drugs, but stopping degenerative processes with the right approach is quite possible. Therefore they use:

• Hormonal drugs;

In case of particularly severe pain, a novocaine blockade may be required, which can only be done by a doctor. After eliminating the acute pain syndrome, exercise therapy can begin. To reduce the load, special bandages and elastic bandages are used.

Drugs for arthrosis

Physiotherapy can mainly be represented in such areas as:

• Cryotherapy;
• Electrophoresis;
• Phonophoresis;
• Laser treatment.

Herbal treatment methods are also used. They border on, but at the same time are recognized as effective by official medicine. Compresses and herbal baths are usually used.

Physiotherapy for arthrosis

Surgical methods

Surgical methods are mainly designed to eliminate the symptoms and consequences of the negative effects of degenerative processes. For these purposes the following may be carried out:

• Joint replacement if there is significant shortening of the radius;
• Puncture to diagnose the affected area;
• Arthroscopy to examine and remove fragments of cartilage tissue that may cause inflammation;
• Periarticular osteotomy corrects the position of the joint, reducing the load on it, as well as pain. It is used infrequently, as it is quite difficult to rehabilitate.

But doctors still give preference, whenever possible, to non-surgical types of therapy. If possible, the main recommendation is annual treatment in specialized sanatoriums.

Possible complications

Possible complications include:

• Intense pain syndrome;
• Muscle atrophy;
• Shortening of the radial joint;
• Attachment of arthritis;
• Reducing the range of motion to a minimum.

As the condition progresses, it becomes so unbearable that the patient can no longer even sleep without painkillers. Therefore, it is better not to bring hand arthrosis to the last stage.

Forecast

The prognosis for the disease is positive only if it is fully and comprehensively treated using a variety of techniques. It is important to carry out each type of influence at its own time. In this way, it is possible to stop the progression and put the disease into remission.

Thanks to this, the patient’s quality of life can be significantly improved. in the absence of treatment, arthritis and complications are most likely to develop.

Exercises and gymnastics to restore the wrist joint in our video:

Exercise therapy.

Unfortunately, now many people know what kind of disease it is - osteoarthritis. And although the disease more often manifests itself in old age, it often occurs in young people. Osteoarthritis (ICD-10 code) is a joint disease that occurs in 80% of older people. This disease affects the articular cartilage, which first becomes deformed and then becomes thinner. But cartilage performs an important function - it acts as a shock absorber, protecting the surface of the bones. Special diagnostic criteria help determine the presence of the disease, after which the doctor prescribes treatment.

Degrees of osteoarthritis

There are 4 main degrees of osteoarthritis. Treatment of each of them requires a special approach from a doctor, so self-medication is not recommended. The main reason for the appearance of the disease is that the body does not get enough vitamins. In particular, this occurs due to a lack of calcium. But only a doctor can determine the cause and prescribe treatment. Diagnostic criteria will help him do this.

Initial stage

This disease practically does not manifest itself. In the morning, the patient feels a slight stiffness in the joints, but after walking it goes away. Sometimes pain appears when starting to walk after a long rest. If you make a sudden movement, you can hear a crunch, but there will be no pain. Pain syndrome usually occurs after long periods of exercise, but after rest it completely disappears.

Second degree

Osteoarthritis grade 2 is characterized by more severe symptoms. The pain becomes stronger, joint mobility decreases. Due to daily stress, the patient may feel constant fatigue, pressure in the joints, and partial destruction of cartilage begins. The patient's ability to work is reduced, so he cannot perform certain types of work. You can find out about the disease using x-rays. Other diagnostic criteria that the doctor recommends may also be useful in this regard.

Third degree

This degree is considered severe as several more symptoms are added. Bone overgrowth and fluid accumulation lead to significant deformation of the bone. Movements become limited and constrained. Inflammation of the joints begins, which is why pain is observed not only during movement, but also during rest. The muscles located around the affected joint atrophy.

Fourth degree

If grade 4 arthrosis is allowed to develop, the joint will completely cease to perform its functions. Any movement will cause severe pain, which is why “joint blockade” occurs. The patient will not be able to move independently. Only implantation of an artificial joint will help prevent disability.

Arthrosis of the foot

Arthrosis of the talonavicular joints of the foot (ICD-10 code) leads to severe swelling of the foot. During its movement, a crunching sound is heard, and unbearable pain is felt when bending and straightening the foot. The same thing happens during a long walk. Such pain makes it difficult for the patient to move, resulting in injury to the muscles located next to the talonavicular joint of the foot. Therefore, inflammation is transferred to other areas. As a result, the patient cannot move his leg freely.

Arthrosis of the talonavicular joint of the foot can be primary or secondary. The disease can appear at any age. The treatment will also depend on this. Immediately after the first signs of illness appear, it is imperative to go to the hospital. The doctor will order an x-ray and all the necessary tests to determine the presence of the disease.

Primary arthrosis of the wrist joint (ICD-10 code) is rare, as it appears as a complication after a fracture at any age. Moreover, arthrosis does not occur immediately, but several weeks or months after the injury.

With arthrosis of the wrist joint, there is a crunching sound when it moves and severe pain when trying to bend it. At rest, there is usually no pain. The mobility of the wrist joint also decreases by 30-50%. It is impossible to determine the disease externally, since the bone does not change in any way.

Arthrosis of the elbow joint

With arthrosis of the elbow joint (ICD-10 code), there is pain that appears during flexion and extension of the arm. At first, these symptoms are mild and become apparent only after prolonged exercise (weight lifting, intense gymnastics, fitness, etc.). As the disease progresses, pain in the elbow joint becomes stronger and is observed even during rest. Sometimes such pain even radiates to the cervical spine, so the disease is often mistaken for cervical osteoarthritis.

When the elbow joint moves, a rough crunching sound is heard, which is caused by the friction of the bones against each other. As the disease progresses, this crunch becomes more noticeable. Limitation of elbow joint mobility may also be observed. It is difficult to perform rotational movements with your hand. This becomes the result of muscle spasms.

Also, with arthrosis of the elbow joint (ICD-10 code), Thompson's symptom may appear. In this case, the patient cannot hold the hand bent and clenched into a fist. Vetla's symptom is also characteristic of arthrosis of the elbow joint. If the doctor asks the patient to bend and straighten his arms to the forearms at the level of the chin, he cannot do this.

In addition, in case of illness, modification of the affected elbow joint occurs. The reason for this is the proliferation of osteophytes and an increase in the amount of synovial fluid. Inflammation leads to swelling and the appearance of small bumps in the elbow joint. To make it easier for a doctor to determine the presence of a disease, diagnostic criteria help him.

Osteoarthritis of the knee

The disease can be of two types: primary and secondary gonarthrosis (ICD-10 code). The reasons for the development of primary knee arthrosis are unknown (the same applies to arthrosis of the elbow joint). As a rule, this disease is more common in old age. It often affects both joints at once.

Secondary gonarthrosis appears as a result of knee pathology that was previously suffered. It can occur at any age and usually affects only one knee.

Kellgren's disease

Generalized osteoarthritis is a disease that results in damage to several joints located symmetrically. The disease appears as a result of damage to hyaline cartilage. It thins out, changes and completely disappears.

Generalized osteoarthritis (ICD-10 code) can be early or late. In the first case, the cartilage becomes thinner and its structure changes. In the case of a late stage, bone destruction begins. The disease can appear in the area of ​​the elbow, hip, talonavicular, and knee joints.

Prevention

In old age, bone density decreases, so they become less strong. To avoid any arthrosis at any age, its prevention is necessary.

In women, the disease manifests itself much more often than in men, so they need to take care of themselves much more. It is necessary to include vitamins in your diet that are found in fresh vegetables and fruits.

It is better to give up smoking and alcohol, as these two bad habits often lead to arthrosis. It is better to replace these two components with healthy vitamins.

Diagnostics

Diagnostic criteria for arthrosis (ICD-10 code) allow the doctor to quickly determine the presence of the disease in the patient. But before making a diagnosis, the doctor must prescribe tests and x-rays to the patient.

The following diagnostic criteria are distinguished:

• pain in the talonavicular joint of the foot, which hinders movement;
• deformation of the joint, which causes thinning of the cartilage tissue;
• narrowing of the joint space;
• The urine test is not abnormal.

Diagnostic criteria may vary depending on the form and course of the disease. Of course, the patient must also help the physician make a diagnosis. After all, a doctor can only learn symptoms such as pain and joint stiffness from the patient.

Treatment

Treatment of talonavicular arthrosis of the foot (ICD-10 code) should be prescribed by a doctor. Therapy should be comprehensive, including several components: taking medications, wearing special restorative devices, gymnastics, and a proper diet. But if the disease in the area of ​​the talonavicular joint of the foot has become chronic, then it can only be treated surgically.

Medicines include tablets, ointments, and injections that relieve inflammation. But taking medications can lead to deterioration in the functioning of some internal organs. Therefore, along with medications, the doctor prescribes a special diet that contains the vitamins the body needs. You should take medications cyclically: for 10-15 days, and then take a short break. To prevent dystrophy of the muscles located next to the talonavicular joints of the foot, special physical therapy is necessary. If the treatment is to be performed by another doctor, he must be provided with a medical history.

When a patient comes to the hospital with joint pain, the doctor performs diagnostic tests to determine whether the disease is present. After this, the doctor prescribes treatment. It is necessary to ensure that the patient’s joints are saturated with chondroprotectors. The doctor also prescribes gymnastics, which should restore mobility to the articular bones. Among the treatment methods, compresses, massages, laser therapy, therapeutic mud, and the like are actively used.

Traditional treatment is also used effectively. But all prescriptions must also be agreed with the attending physician. Medical history may also affect the ability to use traditional methods.

Treatment of the wrist joint: diagnoses and methods

Quite often, the wrist joint begins to cause discomfort to a person. Moreover, it is significant, since hands are involved in all spheres of our lives, from everyday life and self-service to working capacity, which provides us with the means to subsist.

Many patients are interested in why the wrist joint is located on the forearm and not on the hand. The answer is simple: it connects both sections of the arm. Strictly speaking, this joint does not belong to either the hand or the forearm, since it is located at their junction. But it ensures the multifunctionality of the limb and the ability to make very precise movements, operate with small objects and at the same time be able to lift and hold significant weights. Naturally, the wrist joint alone cannot be used to solve all these problems. It must be accompanied by strong ligaments, developed muscles, reliable bones - and skills that are implanted in a person’s brain, instincts and subconscious from the moment of his birth.

Such a multifunctional part of the body cannot be simple in design. The wrist joint includes dozens of small “parts.” And the pathology of each of them leads to the loss of a certain proportion of the functionality of the hand as a whole.

At-risk groups

In principle, each of us may need treatment for the wrist joint - treatment that will return the hands to their former mobility, the ability to lift your own child, pet a dog, or easily perform professional duties. But for some people, the risk of becoming semi-disabled for a long time (and sometimes even without the prefix “semi”) is much higher than that of their fellow citizens. These include:

• those who are engaged in heavy physical labor, where the load falls mainly on the hands. For example, rowers, loaders, lumberjacks;
• office workers, from secretaries to programmers. Here the risks even increase, since many of these employees work in non-design conditions. For example, the ratio of the height of the table and the chair is not observed - and there is constantly excess pressure on the wrists;
• athletes who actively and constantly work their hands - badminton players, tennis players, boxers (the latter are at greatest risk in terms of injuries to the wrist joint);
• people whose profession requires the constant use of fine motor skills. These include seamstresses and lacemakers; signers of dishes, eggs, cups; musicians, especially those specializing in stringed instruments and dealing with the piano.

However, treatment of the wrist joint may also be required by ordinary people - those, for example, who cannot imagine life without playing online games. Spending a lot of time at the computer, such people have to make a huge number of monotonous movements with the hand, which seriously overload the radial joint. At a certain stage, this approach to one’s own hands results in acute illnesses, sometimes turning into chronic forms.

Major diseases

It would be quite a long process to list all the ailments that can affect the wrist joint. Let us dwell on those that doctors encounter especially often.

Carpal Tunnel Syndrome

The disease is caused by compression of the mentioned canal, the nerves passing through it are under pressure from the swollen tissues. Swelling can be caused by inflammation or stress - monotonous and monotonous, or short but excessive.

A typical manifestation of the syndrome is an increase in pain intensity during night rest. Many patients complain of persistent numbness, which in most cases affects the middle, index and thumb. Weakness and clumsiness of the entire hand or part of it are also common.

Osteoarthritis

It develops due to wear and tear of the cartilage tissue that covers the surface of the joint. In later stages, bone damage also develops. The wrist joint becomes deformed and loses mobility. The process is slow and is accompanied by pain that gradually increases in intensity.

Typical symptoms include:

• decreased hand mobility, especially noticeable in the morning;
• swelling in the joint area;
• pain not only during movement, but also at rest;
• crunching in the joint;
• rise in temperature in the affected area;
• pain on palpation of the joint.

Osteoarthritis develops as a result of injury, prolonged poor hand position, or age-related tissue degradation.

Tenosynovitis

With this disease, the tendons and tendon sheaths become inflamed. The reasons for its development are still the same: tension in the hand, excessive one-time or chronic, from monotonous movements, or microtrauma.

Signs of tenosynovitis include: pain when palpating the muscles and tendons, thickening at the site of the lesion, local increase in temperature, pain with even slight tension (for example, when clenching your palm into a fist).

Lack of timely diagnosis and proper treatment can lead to unpleasant consequences. Tenosynovitis, of course, does not threaten death, but partial loss of working capacity does. In this regard, it is enough to recall Robert Schumann, a composer and music critic who began as a pianist, but lost the opportunity to play music precisely because of chronic tendovaginitis.

Arthritis of reactive and rheumatic nature

They are a consequence of prolonged inflammation in the patient’s body, the presence of chronic pathologies, primarily tonsillitis, myocarditis and pyelonephritis.

More details

The same consequences can be caused by systemic diseases that affect the connective tissue or epidermis - gout, psoriasis, ankylosing spondylitis or lupus erythematosus. But it is worth noting that in these cases the pain is not localized exclusively in the wrist joint. It also affects the ankle, knees and spine. In the morning hours, a feeling of stiffness covers the whole body, and the pain syndrome, especially intense at this time, gradually subsides and disappears completely by the evening.

Arthrosis of the wrist joint

It occurs as a result of inflammation, injury, stress caused by occupational specifics, and age-related changes. It is difficult to diagnose arthrosis of the radial joint in the early stages - the pain is mild, and the patient usually does not pay attention to it. As well as the crunch that appears when moving. The patient goes to the doctor only when the pain becomes constant and causes discomfort. Swelling with arthrosis is almost never observed, nor is there a rise in temperature, even local. The pain is especially noticeable with maximum flexion of the hand, lifting something heavy, or leaning on the palm.

Hygroma

This is the name of a cyst on the wrist that looks like a lump. It forms gradually, at first it does not cause painful sensations and does not limit movements, so the patient simply does not notice the hygroma. As it grows, tissues and nerve endings are compressed; At first there is discomfort, later it gives way to pain. Failure to take measures at this stage leads to protrusion of the formation by 2-5 centimeters and significant limitation in the mobility of the hand.

Most often, hygroma occurs in those who are at risk. However, it can also appear as a result of a hereditary predisposition, as well as physical damage: an unsuccessful fall with emphasis on the wrist, sprain of one of the ligaments, dislocation or fracture. But sometimes such a lump can form without any reason (at least visible) or prerequisites. Moreover, hygroma develops in people of any age, from small children to very old people.

Injuries

They can be easily diagnosed by the victim himself - the pain is very vivid, sometimes reaching the level of unbearable. Of course, only a physician can determine what exactly is injured in the wrist joint, since the head of the bone may shift, the tendon may rupture, or the wrist itself may break. The last injury is considered the most difficult.

With a traumatic injury to the wrist joint, acute pain, rapid swelling of the soft tissues, limited mobility of the hand or a complete inability to move it are observed. Sometimes there is deformation of the forearm.

Principles of treatment

Therapy directly depends on the diagnosed disease and the nature of its course. But most often, the first step recommended by the doctor is to ensure immobility of the affected joint. A plaster cast or orthosis may be applied for immobilization.

Acute pain is relieved with painkillers; Quite often and for many diseases, novocaine blockades are used. To relieve swelling and, again, reduce pain, cold is applied to the affected area. In some cases, the doctor prescribes antiseptic drugs.

The inflammatory process is stopped with non-steroidal drugs, and chondoprotectors are prescribed to restore cartilage tissue.

Treatment of joints Read more >>

In some cases, the course of treatment includes antibiotics; if the nature of the disease of the wrist joint is rheumatoid in nature, their course will be quite long.

Concomitant treatment is also being carried out. The patient may need to restore immunity, he may need to maintain and restore the functioning of the heart muscle, kidney therapy, or eliminate a gout attack. For hygroma, if it is not advanced, puncture can be used as treatment. During the procedure, a needle is inserted into the formation, and the liquid accumulated in its capsule is pumped out with a syringe. However, modern medicine rarely uses this technique. After the puncture, the membrane of the hygroma remains in place. Therefore, after some time it may arise again. But for analysis and predicting the course of the disease, the puncture remains invaluable.

When the acute phase of the disease is leveled, other methods of its recovery can be introduced. They support and consolidate the effect that the primary treatment of the wrist joint was able to achieve. Treatment in the second stage again depends on the diagnosis. So, with tendovaginitis, the emphasis is on laser therapy, shock wave exposure and UHF; for arthrosis and arthritis, more attention is paid to manual practices; During the treatment of carpal tunnel syndrome, contrast baths in combination with massage have a good effect.

With hygroma, it makes sense to apply all physiotherapeutic procedures only at the earliest stage of the disease. In advanced cases (which is what doctors usually have to deal with), only radical methods will be effective.

In a hopeless situation

In case of purulent inflammation of the wrist joint, drainage is placed, and in most cases this is enough for a complete cure. However, in some cases this technique does not produce results. And under other circumstances, with different diagnoses, conservative treatment may be ineffective. If remission is incomplete, and relapses are too frequent, if joint degradation progresses, surgical intervention is required. During the operation, excision of the tendon sheaths that are subject to inflammation is performed; in the case of hygroma, the capsule of the neoplasm is excised or it is burned out with a laser. Treatment is carried out under local anesthesia. After surgery, a tight bandage is mandatory, and in some cases, immobilization of the hand. Sutures are removed between the fifth and seventh day after the intervention. Typically, the postoperative period requires injection of antibiotics.

For the final rehabilitation of the wrist joint, physiotherapeutic procedures will be required, which may include mud applications, paraffin therapy, electrophoresis, ozokerite and laser exposure. Exercises aimed at restoring full mobility of the hand and developing the joint itself will be prescribed. Limiting the load on the affected arm can last for quite a long time.

Take care of your hands, and you will never need treatment for your wrist joint. But if you already feel discomfort from your hands, please go for an examination so as not to lose the ability to self-care and not be left without work.

Gonarthrosis of the knee joint, ICD-10 code: M15-M19 Arthrosis

Deforming osteoarthritis, abbreviated as DOA, refers to chronic joint diseases. It leads to the gradual destruction of articular (hyaline) cartilage and further degenerative-dystrophic transformation of the joint itself.

ICD-10 code: M15-M19 Arthrosis. These include lesions caused by non-rheumatic diseases and affecting predominantly peripheral joints (extremities).

• Spread of the disease
• Development of DOA
• Symptoms
• Diagnostics

Arthrosis of the knee joint in the international classification of diseases is called gonarthrosis and has the code M17.

In practice, there are other names for this disease, which are synonyms according to the ICD10 code: arthrosis deformans, osteoarthrosis, osteoarthritis.

Spread of the disease

Osteoarthritis is considered the most common disease of the human musculoskeletal system. More than 1/5 of the population of our planet faces this disease. It has been noted that women suffer from this disease much more often than men, but with age this difference smooths out. After the age of 70, more than 70% of the population suffers from this disease.

The most “vulnerable” joint for DOA is the hip. According to statistics, it accounts for 42% of cases of the disease. Second and third places were shared by the knee (34% of cases) and shoulder joints (11%). For reference: there are more than 360 joints in the human body. However, the remaining 357 account for only 13% of all diseases.

A joint is the articulation of at least two bones. Such a joint is called simple. The knee joint, a complex joint with two axes of motion, articulates three bones. The joint itself is covered with an articular capsule and forms an articular cavity. It has two shells: outer and inner. Functionally, the outer shell protects the articular cavity and serves as an attachment point for ligaments. The inner lining, also called synovial, produces a special fluid that serves as a kind of lubricant for rubbing bone surfaces.

A joint is formed by the articular surfaces of its constituent bones (epiphyses). These endings have hyaline (articular) cartilage on their surface, which performs a dual function: reducing friction and shock absorption. The knee joint is characterized by the presence of additional cartilage (menisci), which perform the functions of stabilization and attenuation of impact impacts.

Development of DOA

The development of arthrosis begins with damage to the tissues of the articular cartilage (ICD-10 code: 24.1). The process occurs unnoticed and is usually diagnosed with significant destructive changes in the articular cartilage.

Etiology

The main factors contributing to the development of arthrosis: increased physical load on the articular cartilage, as well as its loss of functional resistance to normal loads. This leads to its pathological changes (transformation and destruction).

Factors contributing to the development of the disease determine the main prerequisites for its occurrence. Thus, loss of resistance can be caused by the following circumstances:

• Hereditary predisposition;
• Endocrine and metabolic disorders;
• Age-related changes (especially after 50 years of age);
• Diseases of the musculoskeletal system with a different etiology.

Increased stress on articular cartilage occurs as a result of:

• Chronic microtraumatization. This may be due to professional activities, sports activities or household reasons;
• Overweight, obesity;
• Joint injuries of various origins.

Pathogenesis of articular cartilage

Destruction of articular cartilage is caused by long-term microtraumas of articulated bone surfaces or simultaneous trauma. In addition, some developmental disorders, for example, dysplasia, contribute to changes in the geometry of articulated bone surfaces and their compatibility. As a result, the articular cartilage loses its elasticity and integrity and ceases to perform its functions of shock absorption and friction reduction.

This leads to the formation of cords from the connective tissue, designed to compensate for changes in the kinematics of the joint. The consequence is an increase in the amount of synovial fluid in the joint cavity, which also changes its composition. The thinning and destruction of articular cartilage leads to the fact that the bone endings begin to grow under the influence of loads in order to distribute them more evenly. Osteochondral osteophytes are formed (ICD-10 code: M25.7 Osteophyte). Further changes affect the surrounding muscle tissue, which atrophies and leads to deterioration of blood circulation and an increase in pathological changes in the joints.

Symptoms

The main symptoms of the development of DOA include:

Painful sensations

Joint pain is the main reason for a visit to a specialist. Initially, it appears irregularly, mainly during movement (running, walking), hypothermia of the body, or during a prolonged uncomfortable position of the body. Then the pain becomes non-disappearing and its intensity increases.

Difficulty moving

At an early stage, gonarthrosis is characterized by a feeling of “stiffness” that appears after a long period of rest (sleep, rest). The knee joint becomes less mobile, its sensitivity decreases and pain of varying intensity is felt. All these manifestations decrease or completely disappear with movement.

Another characteristic symptom is creaking, clicking and other extraneous sounds that occur during prolonged walking or a sudden change in body position. In the future, these sounds become a constant accompaniment when moving.

Loose joint

Often arthrosis of the knee joint leads to its pathologically hypertrophied mobility. According to ICD 10 code: M25.2, this is defined as a “loose joint.” This manifests itself in linear or horizontal mobility that is unusual for it. A decrease in the sensitivity of the end parts of the limbs was noted.

The main functions of the knee joint are movement (motor function) and maintaining body position (support function). Arthrosis leads to functional impairment. This can be expressed both in the limited amplitude of its movement, and in excessive mobility, “looseness” of the joint. The latter is a consequence of damage to the capsular-ligamentous apparatus or hypertrophied muscle development.

As the disease progresses, the motor function of the diarthrosis joint degrades, and passive contractures begin to appear, characterized by limited passive movements in the joint (ICD code 10: M25.6 Stiffness in the joint).

Musculoskeletal dysfunction

Occurring degenerative-dystrophic changes over time develop into dysfunction (motor and support) of the entire lower limb. This manifests itself in lameness and stiffness of movement, unstable functioning of the musculoskeletal system. Irreversible processes of limb deformation begin, which ultimately leads to loss of ability to work and disability.

Other symptoms

These non-main types of symptoms include:

1. Change in the size of the limb, its deformation;
2. Joint swelling;
3. Excessive presence of joint fluid (to the touch);
4. Visible changes in the skin of the extremities: increased pigmentation, characteristic capillary network, etc.

Diagnostics

The problem with diagnosing arthrosis is that the appearance of the main symptoms with which the patient comes to a specialist already indicates certain serious changes in the joint. In some cases, these changes are pathological.

Preliminary diagnosis is made on the basis of a detailed medical history of the patient, taking into account his age, gender, profession, lifestyle, presence of injuries and heredity.

A visual examination allows you to see those characteristic symptoms of arthrosis that were discussed: swelling, increased local skin temperature. Palpation allows you to determine pain and the presence of excess joint fluid. It is possible to determine the amplitude of movement of the affected area and understand the degree of limitation of motor function. In some cases, characteristic deformities of the limbs are noticeable. This occurs with a long course of the disease.

Instrumental examination methods

The main methods of instrumental diagnosis of DOA include:

1. Radiography;
2. Magnetic resonance and computed tomography (MRI/CT);
3. Scintigraphy (injection of radioactive isotopes to obtain a two-dimensional image of the joint);
4. Arthroscopy (microsurgical examination of the joint cavity).

In 90% of cases, radiography is sufficient to diagnose arthrosis. In cases that are difficult or unclear for diagnosis, other instrumental diagnostic methods are in demand.

The main signs that allow diagnosing DOA using radiography:

• Pathological growths in the form of osteochondral osteophytes;
• Moderate and significant narrowing of the joint space;
• Hardening of bone tissue, which is classified as subchondral sclerosis.

In some cases, radiography can reveal a number of additional signs of arthrosis: articular cysts, joint erosions, dislocations.