Osteoarthritis of the ankle joint. Symptoms and treatment, remedies, exercises

The ankle joint is often injured because it withstands heavy loads. A doctor can diagnose ankle osteoarthritis based on the symptoms and prescribe treatment. The disease does not depend on age or gender: tissues become thin and destroyed, which can lead to disability.

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

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

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

The disease appears gradually. A healthy person has a smooth joint surface. In case of overload, it promotes easy gliding during physical activity.

With osteoarthritis, tissue nutrition and metabolism deteriorate. The outer surface of the joint changes, becomes rough, the cartilage touches and inflammation appears. When a person lifts heavy objects, the load falls on the bones, leading to degenerative disorders.

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

Types

There are several types of osteoarthritis according to different criteria:

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

Ranking criteria	Types of osteoarthritis
venue	Osteoarthritis of the knee, wrist, ankle, elbow, shoulder and cervix.
cause of the event	primary – develops on its own, without prerequisites; secondary – joint damage occurs due to the development of infectious diseases, mechanical damage, injuries, hypothermia and other factors.
location	local damage - symptoms cover a small area of the joint or its individual tissues; generalized - several joints are affected or one with complete coverage of all tissues.
progression of the disease	acute form - increased intensity of symptoms and their severity, severe pain, morphological changes occur more dynamically; chronic form - the course of the disease is slow, manifested by individual symptoms during exacerbations.

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

Stages and diplomas

Ankle osteoarthritis (symptoms and treatment directly depend on the patient's age) can occur in different ways. For some, many years pass between the appearance of the first symptoms and the critical stage, while for others the disease develops quickly.

It depends on age and concomitant diseases at the start of treatment. As ankle osteoarthritis progresses, symptoms become more pronounced.

There are 4 stages of the disease.

1. The first step is often ignored. Main symptoms: stiffness that occurs in the morning, characteristic crunching when walking. Pathogenic changes are not revealed in the picture, the destructive process has already begun.
2. Morning stiffness persists longer. It will take 20-30 minutes to develop the leg. Some patients suffer from lameness. On an x-ray, you can see stage 2 pathology by bone growths 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 necessary. The joint swells, changes, the muscles thin and decrease in volume. The joint space narrows, as can be seen on an x-ray, and osteophytes form.
4. The final stage develops in the absence of treatment. The cartilage is destroyed, the surfaces of the joints come together. The patient cannot walk.

There are several degrees of osteoarthritis:

1. First degree– The x-ray shows no changes or joints. There is a slight morning stiffness. At this stage it is necessary to start treatment.
2. In the second degreeactivity becomes difficult, a crunch is heard when walking, swelling is observed. The x-ray shows a reduction in the interarticular space. The person limps and morning stiffness lasts longer.

3. In the third degreeClearly pronounced 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. To the last degreeThere is practically no common space, activity is almost impossible. Radiography can diagnose a large number of osteophytes. Only surgical intervention is prescribed.

Ankle osteoarthritis appears gradually, so treatment should be started as soon as the first symptoms appear to prevent the condition from worsening and complications from occurring.

Symptoms

Ankle osteoarthritis is characterized by several symptoms (they affect the method of treatment):

• The pain is initially moderate and only occurs during physical activity. Over time, the pain becomes stronger and interferes with rest;
• in case of injuries and dislocations, swelling and inflammatory manifestations appear and an increase in temperature occurs in the area of injury;
• "dry" click accompanied by pain;
• dislocation, as the cartilage tissue thins and deteriorates, the joint loses its stability. The bones move and fall from the joint capsule;
• joint stiffness;

• when walking, a person quickly gets tired;
• in the final stages, the joint becomes deformed.

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

Reasons for the appearance

Ankle osteoarthritis (symptoms and treatment are often caused by age-related changes) affects the older generation. Recently, a pathology has been observed among young people.

The provoking factors are:

• injuries, dislocations and bruises;
• age-related disorders of joints and ligaments;
• inflammatory processes;
• Overweight;

• violation of metabolic processes;
• congenital foot deformity and flat feet occurring during life;
• hereditary predisposition;
• excessive physical activity;
• use uncomfortable shoes;
• diseases of the endocrine system;
• osteochondrosis.

Less synovial fluid is produced, making the cartilage less nourished. The joint space narrows, which can lead to bone fusion. Crusarthrosis appears, which cannot be reversed. Despite this, treatment must be prescribed immediately to prevent progression of the disease.

Diagnostic

Diagnosis of osteoarthritis involves studying existing symptoms and research data. Since there are no tests that can clearly determine the pathology, doctors recognize laboratory methods as insufficiently effective.

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

To confirm the diagnosis, instrumental methods are used:

1. Simplex-rayis the most reliable method. Muscles do not perceive X-rays in the same way: soft muscles transmit them, while hard muscles 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 structures relative to each other, the condition of the tissues and the size of the joint space. 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 displaced inward. If there are corresponding symptoms (narrowing of the joint space, osteophytes and other signs), osteoarthritis 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 explore areas of the body that contain water.

   The dark shade in the image represents bones, because their water content is much lower and muscles, nerves and discs appear lighter. The diagnosis reveals even minor disorders of bone tissue and joints. The procedure is indicated before arthroplasty. The only negative point is the high cost of diagnosis.

3. Magnetic resonance imagingvery precisely examines the ligamentous structure of the joint, muscle tissue and cartilage. Thanks to the study, a specialist can assess the condition of the joints of the lower leg, which makes it possible to identify pathology at the very beginning of its development. The procedure is painless and lasts approximately 30 minutes.

   During the procedure, radio waves and strong magnetic radiation affect the person. It must be remembered that the magnetic field is dangerous for the physiological state. MRI is prohibited in cases of neuropsychological disorders, pregnancy and the presence of metal objects in the body.

4. Ultrasoundallows a precise diagnosis. The device produces waves which are reflected by the tissues and recorded on the screen. The doctor examines the image and makes a diagnosis. For image clarity, a gel is used that removes air and ensures easy movement on the surface.

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


5. Bone scan– a study which makes it possible to determine pathological bone disorders using isotopes. A special substance containing labeled atoms is injected into the patient's body. Pathological zones are divided into cold and warm zones.

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

   This study makes it possible to distinguish osteoarthritis 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 medications 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, and based on the results, the specialist determines the characteristic features of the disease and at what stage of development it is. For osteoarthritis of the ankle, a puncture is made in the anterior part between the external ankle and the tendon of the extensor digitorum longus.

When to consult a doctor

If treatment for osteoarthritis is not started on time, incapacity for work and sometimes disability arise. Some patients are in no hurry to seek help because they do not know which doctor to make an appointment with. At the first symptoms, you should consult a rheumatologist who diagnoses dystrophic and inflammatory changes in the joint.

You must contact him if:

• there is discomfort and pain in the joints after excessive load, 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 turns red;
• there is a sharp pain, it is difficult to move;
• crackles and clicks appear;
• the joints are deformed.

Thanks to 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 avoided.

In order to prevent osteoarthritis, experts recommend following certain rules:

• wear comfortable, well-fitting shoes without heels;
• maintain proper nutrition, drink enough clean water;
• choose a suitable vitamin and mineral complex;
• exercise;

• take walks in the fresh air more often;
• avoid excessive stress on the legs;
• avoid hypothermia;
• be regularly observed by doctors;
• give up bad habits;
• do a series 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 food 4 hours before bedtime.
5. Steam, bake, boil food.

Fasting and a strict diet for osteoarthritis are strictly prohibited in order to avoid leaching of calcium necessary for the restoration of bones and cartilage.

Treatment methods

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

Drugs

Different medications are used to treat osteoarthritis:

1. Anti-inflammatoryand painkillers eliminate the source of inflammation and relieve pain. Tablets and ointments are used. The sooner anti-inflammatory medications 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 as an injectable solution and injected into the joint.
3. Chondroprotectorsnecessary to slow down the process of cartilage destruction.

The treatment regimen and dosage of drugs are established by the doctor depending on the severity of symptoms, concomitant diseases and other factors. It is strictly forbidden to self-medicate so as not to aggravate the situation.

Traditional methods

Regarding traditional methods of treating osteoarthritis, doctors recognize their beneficial properties and positive effects. Traditional medicine is also used to prevent diseases.

The main recipes for the treatment of ankle osteoarthritis are as follows:

1. Burdock leaves are thoroughly washed 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 it into a linen cloth and apply to the sore spot. Hold until the salt becomes cold. It is an effective way to relieve pain.
3. Pour triple cologne over lilac, leave in a dark place for 2 weeks, rub the sore spot twice a day.
4. Grind eggshells into powder, take 0. 5 tbsp. before meals.

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

Other methods

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

Generally, the indications for surgery are:

• repeated and primary osteoarthritis of 3-4 degrees;
• complications;
• intense, prolonged pain radiating to the knee;
• obvious lameness;
• paralysis of leg muscles;
• deterioration of the flexion-extension properties of the joint and the weight-bearing capacity of the foot.

For osteoarthritis of the foot, the following surgical interventions are used:

1. Arthrodesis– surgical intervention to immobilize the joint. Its task is to restore the lost ability to support the limb. The main disadvantage is the likelihood of bones fusing, which leads to immobility, therefore it is used very rarely.
2. Arthroscopyis a minimally invasive procedure in which the doctor cuts the joint and inserts an arthroscope. The surgeon conducts a visual examination and assesses the condition of intra-articular structures and, if necessary, removes synovial fluid from damaged parts of the joint or blood clots. With this operation, the risk of relapse is too high.
3. Endoprosthesescarried out in particularly serious cases. Allows you to replace a damaged seal in a certain part or completely. Prosthetics with modernized mechanics are used and last up to 20 years.

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

Possible complications

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

• disability;
• deformation that cannot be restored;

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

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

To make gymnastics, medications and traditional treatments more effective, it is recommended to use special orthopedic devices that reduce the load on the joint. This includes an orthosis and a fixation bandage.

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

Ankle osteoarthritis is a serious disease which, if completely untreated, leads to serious consequences and total immobility of the joint. Diagnosis at the initial stage, careful attention to symptoms and competent therapy help to avoid surgical intervention.