Osteosclerosis: bones, joints, vertebral bodies,causes, treatment

Update: October 2018 Osteosclerosis is a condition called
a symptom of many diseases — consisting in condensing one or
several sections of the bones. As a result, the bone loses its elasticity, and
under normal loads, a fracture can occur precisely in foci
osteosclerosis.

Osteosclerosis of the bones does not show itself for a long time, while the process
goes deeper and can lead to immobilization of the limb,
development of tumors, pathological fractures. Detect
disease by radiography, and according to its results orthopedists
or traumatologists prescribe treatment: either conservative or
operational.

Causes of pathology

Pathology occurs when bone synthesis goes faster than its
destruction. This happens when:

  • hereditary diseases. This is osteopetrosis or
    marble disease, osteopoikilia, meleoreostosis, pycnidisostosis,
    dysosteosclerosis, scleroosteosis, Paget’s disease;
  • frequent bone injuries;
  • poisoning of the body with various substances, mainly
    heavy metals (lead, strontium, fluorine);
  • frequent and prolonged loads on the limbs or spine,
    when microtraumas are constantly appearing in the bones
    restore bone synthesizing cells;
  • osteosclerosis of the joints occurs with a sedentary lifestyle,
    which is due to the fact that the nutrition of the articular parts of the bone
    comes from joint fluid – while moving;
  • chronic bone diseases like chronic
    osteomyelitis, bone tuberculosis;
  • insufficient nutrient intake – with
    malnutrition or some metabolic
    diseases;
  • obesity, which in itself represents an increased load
    on the bone;
  • tumors or bone metastases. Bone metastases are characteristic.
    for many types of cancer, especially for lung, prostate, lactic
    glands;
  • osteochondrosis, for example, of the cervical spine;
  • transferred vascular diseases when the diet was broken
    bones;
  • weak (untrained or affected) muscles that
    separate joints are set in motion;
  • blood diseases: leukemia, myelofibrosis;
  • transferred operations on the bones.

Types of osteosclerosis

The focus of osteosclerosis can be:

  1. Physiological (normal) when it appears in the growth zone
    bones in a teenager.
  2. Pathological. It arises as a result of various reasons about
    which we talk below.

If osteosclerosis foci are numerous, and they are located
�“Out of tune” (this can be seen on the radiograph), the disease is called
spotty. It can be large-focal and small focal. Can
be with rare or multiple tricks.

If it is clear that one large area of ​​osteosclerosis consists of
many small foci, it is called uniform.

There is also a classification that takes into account the quantity and volume.
compacted bones. Proceeding from it, osteosclerosis happens:

  • limited (local, focal): is within one
    bones. It is observed mainly in the outcome of inflammatory bone.
    diseases;
  • diffuse: uniformly affects the tubular bones, mainly in
    areas of their diaphysis (for example, in chronic osteomyelitis);
  • common: hit a few bones or a patch
    bone system (for example, lower limbs and pelvis, bones
    shoulder girdle and so on);
  • systemic (generalized): foci of bone
    substances are found in the bones of the entire skeleton. It develops with
    systemic diseases (leukemia, marble disease).

Depending on the underlying causes, osteosclerosis can be:

  • functional: the same as physiological – arises in
    areas of growth zones when bone growth stops;
  • идиопатическим – связанным с пороками развития bones;
  • post-traumatic – resulting from bone healing
    after her fracture;
  • воспалительным: развившимся в результате воспаления bones;
  • reactive – arising in response to a tumor or malnutrition
    bones. It occurs on the border between normal and affected
    bone tissue;
  • toxic – developed as a result of poisoning of the body
    heavy metals or other toxic substances.

In addition, bone osteosclerosis is isolated, when lesions are affected.
are located in different parts of the diaphysis, and subchondral
osteosclerosis. In the latter case, the bone is compacted only in the area
under the articular cartilage (“sub” – “under”, “chondros” – cartilage) –
the structure in contact with the other bone in the joint.
The latter type of disease is also called osteosclerosis.
switching plates or articular osteosclerosis. Main
The causes of this type of osteosclerosis are an excessive load on
joints, degenerative diseases (deforming osteoarthrosis),
swelling, inflammation. If at the same time a person has vascular
diseases, metabolic disorders, chronic infections –
areas of compaction in the bones under the greatest stress
he is guaranteed.

Symptoms of this condition

The disease does not manifest itself for a long time: a person suffers
degenerative or inflammatory disease of the bone or joint, and
has no idea that smaller or larger portions of it steel bones
to remind glass – dense, but fragile.

Only when the sealing areas become quite large, and
нарушают характер движения, появляются признаки osteosclerosis. They
slightly different, depending on the location of the lesion.

Ilium compaction

Osteosclerosis of the ileum for a long time is asymptomatic.
You can suspect it by the appearance of pain in the sacrum,
arising from long walking or after a long sitting.

Seal in the region of the Ilium, if it is located on
the border of her connection with the sacrum, says that a person
most likely, there is ankylosing spondylitis. It manifests pain
in the lower back and sacrum, which appear alone, mostly –
closer to the morning. Gradually, the whole spine begins to hurt. is he
becomes less mobile; slouch appears. May be amazed
large – knee, ankle, elbow – joints. Develop
also complications from the eyes, heart and kidneys.

In osteosclerosis of the articular surfaces of the Ilium and
sacrum need to do an MRI of the lumbar spine, area
connections of the sternum and ribs, donate blood for rheumatoid factor,
X-ray to examine other joints for arthritis.
If the joints are not evenly affected, inflammation is noticeable and
osteosclerosis in the small joints of the spine, as well as in
sterno-rib joints, negative rheumatoid factor,
most likely, this is Bechterew’s disease.

Seal in the hip joint

Osteosclerosis of the hip joint is very similar to compaction
подвздошной bones. This is a pain in the joint or lower back,
appearing during long walking or sitting. Progression
lesion is manifested by limp, decreased range of motion in
bone joints. This disease is very dangerous because
such scanty symptomatology, which, it seems, does not foreshadow trouble,
A femoral neck fracture may develop – a pathology that
can cause prolonged immobilization and serious
complications.

Consolidation of the subchondral zone of the shoulder joint

Osteosclerosis of the humerus appears quite early, since
upper limbs are very active and constantly moving, even
sedentary people. is he характеризуется появлением в области
shoulder joints pain that increases with the movement of the arms,
especially when they are raised and set back. With this shoulder joint
painless when feeling, it is not enlarged and not red.

Subchondral compaction of the knee joint

Osteosclerosis of the knee joint does not appear immediately after
уплотнения участка bones. is he характеризуется быстрым утомлением
legs, knee pain when sitting. These symptoms are observed.
for a long time, not really amplified. Meantime
the cartilage tissue of the joint is sclerosed and it becomes
sedentary. Such an advanced process is very curable.
complicated.

Spinal compaction

Osteosclerosis of the switching plates – structures that are on top
and from below they are in contact with adjacent vertebrae
intervertebral disc) – develops quite often. is he не имеет
any specific, pronounced symptoms, but may
lead to the development of kyphosis (curvature curvature
back), osteochondrosis, intervertebral hernia, compression
a change occurring as a result of a jump from a small height or
lightly hit.

Affection is characterized by the appearance of aching pain in the area of ​​the body.
vertebrae. The pain syndrome increases with standing and lying,
relieved by sitting.

Seals in the bones of the foot

Osteosclerosis in the area of ​​the foot bones (including, in the heel
bones) leads to fatigue of the legs, pain in the foot,
decrease in its range of motion. With a far advanced process
flatfoot is formed, phalanxes of fingers are deformed.

How to understand if osteosclerosis occurred as a result of congenital
reasons

Not all genetically determined diseases manifest in
early childhood. There are those who already manifest in a teenager
or an adult. We list their main features to
it was possible to suspect this or that pathology.

Osteopetrosis

is he может проявляться с рождения (такая форма передается
in an autosomal dominant manner) or late manifest
(autosomal recessive mode of inheritance).

Autosomal dominant type of disease is already visible at birth
the child’s head is large and the length of the body is less than 49 cm.
ultrasound of the brain (neurosonography) is diagnosed
hydrocephalus, and as it progresses, squeezing is observed
cranial nerves responsible for vision and hearing. Child
pale, as his bone marrow volume decreases,
synthesizing blood cells.

X-ray shows that the medullary canal is not pronounced,
bones of a skull are condensed, the size of pneumatic sinuses is reduced
the skull.

Autosomal recessive type of pathology appears at the age of 5
up to 10 years. Its symptoms are similar, but osteosclerosis is not so pronounced.

Dysosteosclerosis

This is an autosomal recessive illness. in the way
manifested in early childhood in the form of:

  • lag in growth;
  • very frequent caries caused by a decrease in the number of dental
    enamel;
  • visual impairment due to compression of the visual
    nerve in the cranial cavity;
  • nasal voices;
  • gagging.

Foci of osteosclerosis are found in the bones of the pelvis, skull, in
ribs and clavicle. Также отмечается osteosclerosis vertebrae.

Picodisostosis

This disease is transmitted in an autosomal recessive manner.
It is characterized by the appearance in early childhood. Kid
lags behind in growth, his face is deformed:

  • increased distance between the eyes;
  • large frontal bumps;
  • nose – beak-shaped;
  • jaw – wide;
  • teeth appear late, they grow not all. Celebrated
    change their shape and position.

In addition, there is a shortening of the hands and distal
phalanxes of fingers.

Sclerosteosis

This is another autosomal recessive disorder that manifests itself in
раннем детстве и поражающее почти все bones. Externally, it manifests itself
flattening of the face, protrusion of the lower jaw, skin accretion
fingers, underdevelopment of nails on the fingers.

Radiographically determined compaction of the clavicle, the outer layer
всех трубчатых костей, нижней челюсти и основания the skull.

Melorestosis

This hereditary disease affects the limbs, sometimes –
spine or lower jaw. The bones of the skull are not compacted.

There is a disease of pain in the limbs, deformity
limbs, limiting their mobility and deterioration of their external
species (blanching, reducing the amount of hair). Suffers more
one limb. On the radiograph, the seals are arranged in the form
bands, because of which the bone becomes like a candle, with which
wax flows down.

How to recognize some acquired diseases that cause
osteosclerosis

Навести на мысль, что могло вызвать osteosclerosis, может
a combination of the various symptoms characteristic of the following
diseases:

  1. With Paget’s disease, people after 40 years of age suffer mostly
    men is heа характеризуется постепенным возникновением
    joint stiffness, in the absence of any other
    symptoms. Some people may have small joints.
    the pains. If the compressed bone tissue is pressed nerves
    roots, tingling, muscle weakness, loss
    sensitivity in this area. Affection of limb bones may
    lead to paralysis, and ostesclerosis of the bones of the skull – to the head
    pain, hearing loss.
  2. In chronic osteomyelitis, Garre suffers a shoulder, hip, or
    radius. In the area of ​​inflammation appears dense swelling, over
    he can see a network of dilated venous capillaries. Infiltrate not
    softens, in the form of a fistula is not opened. Over time pain
    it is enhanced, especially at night, given to the shin and foot (with
    lesions in the thigh) or hand (for lesions of the shoulder or
    forearm).
  3. With a Brodie abscess, a cavity appears in the bone, filled
    serous fluid or pus. There is pain in this area when
    its surface location – swelling and redness of the skin. Fistula not
    arises.

How is the diagnosis made?

Увидеть очаги osteosclerosisа позволяет любая рентгенограмма
bones. Here it can be seen that the spongy substance becomes
coarse necrotic and petty leaf, bone shadow begins
protrude within the surrounding soft tissue. Cortical layer
thickens, and its internal contour becomes uneven; tapers off
or disappears completely bone marrow channel. Confirm the diagnosis
possible using scintigraphy (radionuclide examination),
computed or magnetic resonance imaging, as well as
special study – densitometry, which involves
bone density measurement.

Чтобы лечение osteosclerosisа было назначено верно, нужно не
only “see” the areas of bone consolidation on the radiograph, but also
identify the disease that caused such changes. For this you need
examine the entire skeleton for other hotbeds, and
carefully consider their structure: for many diseases
certain radiological signs are characteristic:

  • �”Flowing wax” – with melodiostosis;
  • thickening of the diaphysis of the bone in the form of a spindle or half-spindle
    combination with a significant increase in bone shadow – with osteomyelitis
    Garre;
  • round hearth with smooth contours, on the periphery of which –
    умеренный osteosclerosis – при абсцессе Броди;
  • hotbed with fuzzy and jagged edges, surrounded by
    osteosclerosisом – при первично-хроническом остеомиелите;
  • hearth bone softening, surrounded on the periphery pronounced
    участком osteosclerosisа – при сифилисе.

Treatment

Если это субхондральный osteosclerosis, лечение обычно проводится
only conservative. Appointed:

  • chondroprotectors: Dona, Mukosat, Artra;
  • with signs of inflammation – antibiotics and
    nonsteroidal anti-inflammatory drugs;
  • preparations that improve the work of vessels in the affected
    areas;
  • at the tumor nature of the disease – antitumor
    drugs (cytostatics);
  • Massages in the affected areas – if there are no signs
    inflammations;
  • Exercise therapy with metered load on the affected limbs – in
    cases where there is no acute inflammations;
  • physiotherapy: magnetic therapy, UHF, electrophoresis,
    mud therapy;
  • a daily calorie diet up to 1800 kcal / day – if
    required to reduce body weight.

Surgical treatment is carried out in cases of:

  • stenosis of the bone marrow canals (then
    bone marrow transplantation);
  • if necessary, remove lesions containing necrotic
    fabrics;
  • if most bone or sclerotic bone is affected
    the tissue makes movement in the joint impossible (held
    joint or vertebral prosthetics).

Forecasts

The course of the disease and its outcome depend on the cause of the disease.
osteosclerosis. So, hereditary diseases such as osteopetrosis,
dysosteosclerosis, pycnidysostosis not cured, but to maintain
Adequate quality of life is possible, provided timely
treatment of anemia and skeletal deformities.

Melarestosis has a relatively benign course and
favorable prognosis, but it is only possible to eliminate skeletal defects
with the help of surgery. Well treatable
subchondral osteosclerosis resulting from
degenerative and inflammatory lesions.

Prevention

All that can be done to prevent osteosclerosis –
this:

  • avoid hypodynamia;
  • sleep on an orthopedic mattress;
  • maintain body weight in the normal range;
  • perform at least simple exercises;
  • eat well;
  • time to treat inflammatory and neoplastic diseases;
  • to refuse from bad habits.

Автор: Кривега Мария Салаватовна врач-реаниматолог

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