Causes and main manifestations of osteosclerosis. Physiological, hereditary, subchondral osteosclerosis of the spine

Osteosclerosis is a pathological condition characterized by thickening of the bone tissue. In this condition, there are no symptoms and changes in the size and geometric shapes of the bones do not occur.

Along with osteoporosis, osteosclerosis is one of the most common diseases in which bone tissue is broken. The treatment of osteosclerosis is complicated by the absence of signs at the initial stage of development, which can lead to serious complications - paralysis of the limbs, the development of a malignant tumor.

Reasons why osteosclerosis develops

The cause of the development of the disease may be genetic factors. As a rule, osteosclerosis of the spine develops in women suffering from congenital diseases of bone tissue and joints.

Also, intoxication of the body and chronic forms of inflammatory diseases, namely bone tuberculosis and tertiary syphilis, lead to a pathological change in bone tissue in the form of its thickening.

The disease can develop in the presence of excess weight, lack of estrogen in menopause, acquired diseases of the bone and joint tissue, excessive stress on the joints, injury to the joints, saturnism, Albers-Schoenberg's disease and fluorosis.

Varieties of the disease.

Types of disease depend on the cause:

In violation of the development of bone structures, which occurs with marble disease, meloreostosis and osteopoikilia, an idiopathic appearance develops.
The period of skeletal growth can cause the development of a physiological species.
The period of fracture healing can also cause pathological processes in bone tissue, this type is called post-traumatic.
Inflammation in the body, in which the structure of the spongy substance changes, causes an inflammatory form of the disease.
A reactive type is considered a reaction to tumors and the presence of dystrophic changes, in which compacted bone tissue is observed.
When exposed to toxic substances on the body, a toxic form of the disease occurs.

Separately, it is worth highlighting the deterministic hereditary species. Here, the pathological process can take on different forms depending on its combination with other signs: osteopetrosis, scleroostenosis, dysosteosclerosis and scleroostenosis.

Symptoms of osteosclerosis

Manifestations of symptoms of the disease occur depending on the area where it is localized and how it proceeds. The focus can be in the joints and bones, hence the development of certain symptoms.

Damage to the bone structure within the bone leads to enostoses and compact islands, which are manifested by bone resorption and destruction. In addition, there is the presence of periosteal changes, the formation of sequesters and cavities.

It is worth noting once again that the initial stages of the disease have practically no symptoms, which prevents its timely detection.

Basically, osteosclerosis is manifested by internal pain, aggravated by stress. Spotted forms of osteosclerosis can be expressed by fever and are also a sign of the inflammatory process.

The form of osteosclerosis, in which the disease affects the articular surfaces, is called subchondral, with it the cartilage tissue is affected.

This form manifests itself in a rather serious damage to the joints, which leads to immobilization if there is no proper treatment. The possibility of diagnosing is difficult, because the early stage has no noticeable symptoms.

Consider different areas of damage

hip joint

The neck of the femur is affected, osteosclerosis is manifested by constant pain while walking or after a long sitting, which affect the area of the sacrum. As a rule, this form of osteosclerosis affects people who, due to their professional activities, sit for a long time.

There is a strong compaction of the bone, which can lead to a serious fracture even with a slight load. For the treatment of this form of osteosclerosis, a specialist consultation is necessary to avoid complications.

shoulder joint

Lesions of this part occur more widely, which is explained by increased activity of the upper limbs. The main symptom is pain that is noted during movement in the shoulder joint, as well as when the arms are pulled back. The shoulder joint itself apparently does not change.

Knee-joint

Knee joint lesions are similar to those of the shoulder joint. At the same time, symptoms are also expressed little or not at all, which leads to a late visit to a medical institution when motor activity is impaired. With the localization of subchondral osteosclerosis in the knee joint, the patient notices rapid fatigue while walking, pain while sitting is insignificant.

Spine

The endplates of the vertebral bodies are affected, which is a serious pathology, diagnosed by MRI. The symptoms are as follows: aching pain, which does not allow lying and standing, in addition, deformation is noted in the spinal column and its structures. But these symptoms can show other diseases, so an accurate diagnostic study is necessary.

Damage to the spine can cause the appearance of kyphosis, osteochondrosis and intervertebral hernia. If the disease is advanced, the likelihood increases that the patient will develop an imbalance of bone structures at the cellular level, which, in turn, will cause seals and malignant neoplasms.

For treatment, various therapeutic methods are used. At the same time, an operation in which bone marrow is transplanted is performed only in the case of an advanced stage of the disease.

Osteosclerosis is treated with more than one method; combination therapy is used, which includes:

Medical treatment. The doctor prescribes drugs that include glucosamine and chondroitin. Usually, treatment is carried out for at least three to six months, finishing it after the appearance of visible changes.

Therapeutic gymnastics. For the greatest effect, you need to exercise on an exercise bike. But, if the patient has an inflammatory process, then the exercises are limited so that the joint is temporarily immobile.

Compliance with proper nutrition. Regardless of the form of the disease and the stage at which it is located, body weight is first normalized by organizing proper nutrition, for which it is necessary to exclude fried and fatty foods. The same applies to sweets.

Treatment does not guarantee that osteosclerosis and the pathological changes caused by it will completely disappear. But nevertheless, the patient should be prescribed preventive therapy, therapeutic exercises and proper nutrition.

With this approach, it is possible to eliminate the unpleasant symptoms of the disease, as well as inhibition of pathological changes, so that the disease will not develop and bring complications to the patient.

Predictions for osteosclerosis

Osteosclerosis does not interfere with life, but only if appropriate treatment has been undertaken.

Otherwise, the patient may experience complications, quite serious. This can manifest itself in paresis of the facial nerve and anemic changes in the composition of the blood, as well as skeletal deformities.

Osteosclerosis cannot be cured unless a bone marrow transplant is performed. To prevent its development in case of a predisposition, preventive measures are used to avoid complications.

Prevention is carried out through the following measures:

Maintaining correct posture;
For sleep use a mattress of moderate hardness;
Leading an active lifestyle;
Proper nutrition;
To give up smoking;
Keeping alcohol consumption to a minimum.

But the most effective prevention is daily exercise. When doing light gymnastics, the blood circulation process is restored, due to which diseases of the joints and bones do not develop, which avoids long-term treatment.

Gymnastics will be useful for a person at any age, the most important thing is not to overwork the body, not to allow a large amplitude of inclinations or turns during execution, not to make sudden movements and not to lift weights that are not commensurate with one's own strength.

The subchondral bone is that part of the human skeleton that performs two important functions. In its cavity, the brain is enclosed by the back, regenerating white and red blood cells. And also its expanded part is a solid foundation for articular cartilage, and, thanks to its rich blood flow, maintains its structure and normal trophism. Subchondral osteosclerosis is a pathological condition of the bone in which excessive bone formation occurs, increasing its density, and leading to a decrease in the brain canal.

What is osteosclerosis and how is the formation of excess bone substance. The processes of its destruction and renewal are constantly going on in the skeletal tissue. Responsible for this are special cells - osteoblasts and osteoclasts. Under the influence of osteoblasts, new bone tissue is formed, and they also help calcium salts to be deposited in the intercellular substance. Osteoclasts, in turn, remove tissue cells by dissolving calcium and collagen.

In the body, these responsible cells work together under the influence of complex hormonal regulation, so that the bone tissue remains unchanged. But there comes a moment, and the action of osteoclasts, that is, cells that destroy bone tissue, becomes less pronounced than osteoblasts, and the bone tissue begins to grow and thicken.

Note!

Here a paradox arises - despite the fact that the bone tissue becomes denser, it becomes more fragile. This can be compared to cast iron and steel. The density of cast iron is much greater than steel, but it can crack on impact. In people suffering from osteosclerosis, one of the signs of the disease is frequent fractures.

This pathology is also dangerous because the bone tissue, growing inward, replaces the bone marrow, and does not allow it to function normally. Therefore, quite often the disease is accompanied by anemia.

Subchondral osteosclerosis is not an independent disease. It occurs either as a result of age-related changes in bones, or is a manifestation of the underlying pathology, most often osteoarthritis.

This medical term defines a group of diseases that are similar in their morphological and clinical manifestations.

In the process of pathology in the event of a disease, the following are involved:

subchondral bone;
articular cartilage;
capsule;
ligaments;
muscles;
synovial membrane.

The main clinical manifestations of osteoarthritis are bone deformity and pain on movement. The essence of the pathology is in the change in cartilage, accompanied by an inflammatory process. In the course of the disease, both one joint can be affected, and there may be a generalized lesion of all major joints (polyostearthrosis).

Most often, the disease affects:

the first joint of the foot;
hand joints;
spine;
hip and knee joints.

The most severe forms are the defeat of the cervical, lumbar spine, knees, and the hip part of the skeleton.

The most common types of pathology, depending on the location, received separate definitions:

gonarthrosis (other Greek “knee”) - arthrosis of the knee joint;
coxarthrosis (lat. "thigh") - arthrosis of the femoral joint;
osteochondrosis (dr. Greek "cartilage") - dystrophic pathologies in the cartilage, most often affect the intervertebral discs.

Sclerotic changes in the bone can only be determined with the help of radiography. When diagnosing in the pictures, the affected areas are visible as a blackout.

Osteoarthritis is a multifactorial disease, but there are three main causes:

dysplasia;
injury;
inflammation.

In the primary form of the disease, the main risk factors are hereditary mutations and disorders. A person's gender and race can play a role.

Non-hereditary causes include:

overweight;
age;
specific type of activity;
hypothermia;
trauma, or frequent microtrauma;
action of toxins;
surgical intervention.

Also, osteoarthritis can cause various disorders of the body:

endocrine disorders;
deficiency of trace elements in the body;
metabolic disorders;
neurodystrophic manifestations in the spine.

A fairly common cause is dysplasia, or a violation of the bone development process, as well as various acquired diseases of the joints and bones.

In addition to pain, subchondral osteosclerosis of the articular surfaces is accompanied by a characteristic crunch during movement and stiffness.

With gonarthrosis, degenerative-dystrophic changes occur in the knee joint, and the ending "oz" indicates that in this case there is no inflammation. In an inflammatory process, the condition of the knee joint would be defined as gonarthritis.

The load, which is reported to a person by the gravity of the earth, is extinguished precisely by the joints. The knee is one of the largest and most complex joints, which consists of two subchondral bones - the femur and tibia. Inside it are cartilaginous layers - menisci, which play the role of shock absorbers during movement.

If these pieces of cartilage wear out, or are damaged by trauma, new ones do not grow back. The amount of interarticular fluid decreases, so the bones simply begin to rub against each other, inflammation occurs, which ultimately leads to the formation of excess bone tissue and their deformation.

Hip injury

Osteoarthritis of the hip joint occupies a leading position among diseases of the musculoskeletal system, as the most important connection of human bones is affected. The mechanism of damage is the same as in the knee joints - cartilage is damaged and synovial fluid disappears. When the limb moves, there is a strong pain syndrome. Often the disease occurs in people who are actively involved in sports, or are on their feet all the time.

Often, sclerotic changes in the femur are preceded by a disease such as aseptic necrosis of the femoral head, which is asymptomatic. Signs appear when the head of the bone has already been destroyed. Therefore, osteosclerosis of the hip joint is best treated in the early stages, when conservative treatment is still indicated. At stages 3-4, treatment can only be surgical.

Subchondral osteosclerosis of the articular surfaces can lead to a complete loss of limb function, and, consequently, loss of human performance.

The existing osteosclerosis of the spine is expressed by pain when turning the head to the sides. This is explained by the infringement of the nerves between the vertebrae.

The spine has three main functions:

support;
protective, as it protects the spinal cord;
depreciation.

Depreciation occurs due to ligaments of intervertebral discs, which, when walking and moving, do not allow the vertebrae to touch. When defibration and microtears occur, the vertebrae themselves change - spondylosis, in which the growing edges of the vertebrae reduce the openings through which the spinal nerves pass. The overgrown vertebrae themselves begin to irritate the nerve, and hence pain arises.

Osteosclerosis of the spine is also dangerous because it increases the risk of developing an intervertebral hernia. This is, in fact, a protrusion of a softened intervertebral disc outward between the vertebrae. This also leads to pinching of the nerve, but if we are talking about the cervical spine, then the pain rushes to the arm.

Interesting! Depending on which finger hurts and becomes numb, the neurologist can determine in which vertebra changes occur.

Cervical vertebrae altered by osteosclerosis can be the cause of vertebrobasilar disease, in which the paired bone artery is irritated. It is responsible for the blood circulation of the brain, respectively, for blood pressure, the rhythm of heart contractions, and vestibular stability.

Treatment of osteosclerosis

Treatment of bone changes in some cases is difficult due to the patient's untimely request for help. Since at the initial stage of the disease there are no pronounced symptoms, a doctor is consulted when the joints or the spine can no longer function normally. In severe cases, surgery is indicated, the replacement of interarticular fluid and interarticular cartilage with implants.

If we talk about the treatment of atherosclerosis itself, then it is necessary to treat a disease, the manifestation of which is a change in bone tissue.

Osteosclerosis is difficult to treat when the cavity of the subchondral bone becomes overgrown with bone tissue. Immunity deficiency occurs, as the bone marrow overgrows, where white blood cells are born. Often against this background, inflammatory processes occur, therefore, anti-inflammatory and immune-supporting drugs are prescribed during treatment. In especially severe cases, one even has to resort to bone marrow transplantation.

Among the methods of general therapy, physiotherapy, massage and therapeutic exercises are prescribed, which is carried out under the supervision of a specialist. With a strong pain syndrome, painkillers and drugs to relieve muscle spasm may be prescribed.

In order not to start the process of bone changes, it is important to listen to your own body, because pain is its defensive reaction, which does not happen without a reason. And most importantly, remember that the best cure for any disease is prevention.

Osteosclerosis can be a variant of the norm, as well as a serious pathology. In what cases does it occur and what threatens the patient? To do this, you should delve into the features of this state.

What is osteosclerosis?

The bone consists of a number of structural elements - osteons, which fold into trabeculae (bone crossbars). They are visible on the radiograph or cut with the naked eye.

According to the position of the trabeculae, two types of bone substance are distinguished - spongy (bone beams are laid loosely, absorbs the load) and compact (dense structure, withstands heavy weight).

Osteosclerosis is called the growth of a dense, compact substance, while there is a thickening and compaction of the areas where it is located physiologically, and the displacement of the spongy substance. At the same time, the bone becomes denser and less elastic, resists loads worse, and is prone to pathological fractures.

Development of osteosclerosis

Osteosclerosis of the articular surfaces can also be physiological - it accompanies the growth and ossification of the skeleton in childhood and recovery from injuries.

Types of osteosclerosis

There are several types of osteosclerosis, depending on the causes and features of the lesion:

physiological(ossification of growth zones in children);
pathological(all other cases);
congenital(increased bone density, osteopetrosis - premature closure of growth zones);
acquired(the result of injury, inflammation or tumor).

Also by type of localization and prevalence:

uniform(affects the whole bone or a large area);
spotted(affects several small areas);
local or local(occupies a section of bone tissue, may be associated with loads in a certain area);
limited(occupies the whole area of the bone);
common(the process affects several bones);
systemic- Lesions are marked far apart throughout the skeleton.

Some types of pathology deserve special attention. Subchondral osteosclerosis develops with osteoarthritis - a disease of the joints, which is accompanied by degradation of cartilage tissue.

Such osteosclerosis is considered a characteristic diagnostic feature. The defeat of the endplates of the spine is a diagnostic sign.

Foci of osteosclerosis in the bones

Pathological foci are visible on the radiograph in the form of lighter areas (blackout on the x-ray) of denser bone tissue in the patient's body without clear boundaries. Their shape and size may vary depending on the form of the disease.

Foci of osteosclerosis on x-ray

Diagnostics

Which doctor should I contact for osteosclerosis? If there are complaints, it is worth starting with a therapist. Most likely, he will write out a referral to a surgeon or traumatologist. The disease is treated by an orthopedic doctor who can request consultations from a surgeon, an infectious disease specialist, a traumatologist and an oncologist, if necessary.

Radiography plays an important role in the diagnosis of osteosclerosis. The appearance of moderate foci of denser tissue on x-ray is sufficient reason to start treatment.

If necessary, a sample can be taken for a biopsy (for oncological examination). Densitometry helps to determine the mineral density of bone tissue.

X-ray of osteosclerosis

Stories from our readers!
I want to tell my story about how I cured osteochondrosis and hernia. Finally, I was able to overcome this unbearable pain in my lower back. I lead an active lifestyle, live and enjoy every moment! A few months ago, I was twisted in the country, a sharp pain in the lower back did not allow me to move, I could not even walk. The doctor at the hospital diagnosed osteochondrosis of the lumbar spine, herniated discs L3-L4. He prescribed some medicines, but they did not help, it was unbearable to endure this pain. They called an ambulance, they put up a blockade and hinted at an operation, all the time I thought about it, that I would be a burden for the family ... Everything changed when my daughter gave me one article to read on the Internet. You have no idea how grateful I am to her. This article literally pulled me out of my wheelchair. In recent months, I began to move more, in spring and summer I go to the dacha every day. Who wants to live a long and energetic life without osteochondrosis,

Osteosclerosis can occur for several reasons, most often they are acquired:

trauma and recovery period after it;
inflammation (osteomyelitis,);
tumor process;
intoxication.

Causes of osteosclerosis of bones

Congenital anomalies include phosphate metabolism disorders, as well as genetic disorders that predispose to such diseases. Systemic diseases of the connective tissue are possible, which lead to the development of foci of osteosclerosis.

Symptoms of osteosclerosis

By itself, the change in bone structure does not cause any characteristic symptoms. However, the patient notices reduced mobility in the joints, pain in the limbs or back.

But most often osteosclerosis is diagnosed with pathological fractures. This is the name of injuries that occur during normal, not extreme loads for a given patient - walking, running, lifting light weights, morning exercises.

Localization	Pain syndrome	Mobility disorder	Other
	Lumbar, rarely sacral, cervical and thoracic, positions in which there is no discomfort, it is impossible to find	Decreased flexibility, pain when bending over and sudden movements	Increased risk of pinching in the vertebrae, spinal injuries
	Absent for a long time, occurs only with prolonged exertion, relieved after rest	Increased fatigue of the joint, rather weakly expressed, the condition is relieved after rest	Sluggish course, symptoms erased
Upper limb joints	Occurs in the early stages, provoked by movement. A characteristic symptom of a lesion of the shoulder joint is pain when the arm is abducted.	Mobility is preserved, but painful. It is especially pronounced in relation to the fingers.	Symmetrical lesion
	Strong when standing in the pelvis, especially while walking in the femur	Often there is lameness on the affected limb	A common complication is a hip fracture.
	Permanent, migratory, increase at rest and during intense exercise, weaken during exercise of moderate intensity	not expressed	A disease of professional athletes, most often a symmetrical lesion of the calcaneus or foot
Ilium	In the groin, sacrum, lower back, sternum, sides. May be constant or come and go	not expressed	During pregnancy - a high risk of rupture of the pubic joint
Edge	Severe, on breathing, mistaken for heart pain	not expressed	Risk of deformation, injury
acetabulum	Standing, sitting, walking	Significantly pronounced, leading to lameness	Rare pathology, high risk of hip dislocations

Treatment

Currently, osteosclerosis of any localization is preferably treated conservatively (that is, using medications and methods of physical therapy). The use of surgical methods is required only in severe severe course of the disease, when other means have been ineffective.

It is mandatory to prescribe a treatment regimen and diet - this increases the effectiveness of procedures and drug treatment. After the operation, a rather long recovery period is recommended. Physical activity should be strictly dosed.

Medical treatment of osteosclerosis

Drug treatment of osteosclerosis is carried out strictly according to the doctor's prescription:

Among the medications for the treatment of osteosclerosis, chondroitin and glucosamine preparations (Chondrogard and others) are of the greatest importance. They allow you to effectively restore bone and cartilage tissue, support the growth of normal osteons and trabeculae.
With osteosclerosis of the knee joint means are prescribed in the form of tablets or intra-articular injections. The course of treatment is up to six months.
In case of damage to other joints, injections are not used. from the risk of damaging the ligaments.
Additionally, general restorative treatment, phosphorus and calcium preparations, vitamin D, that improve the metabolism of minerals in the bones. Perhaps the appointment of hormones that regulate bone mineralization.

Therapeutic exercise and exercises

Physical activity is extremely important for the normal formation of trabeculae. is selected taking into account the localization of pathological changes and the nature of bone lesions.

With osteosclerosis of the lower extremities, the most effective exercise is an exercise bike, walking, running and squats. If the shoulder joints are affected - rotation, raising and lowering the arms.

Not recommended - pull-ups and push-ups. The defeat of the elbows and joints of the hand require flexion-extension and rotation. It is required to put on a special limiter (knee pad, elbow pad) on the affected joint, which limits mobility.

An approximate set of exercises for patients with osteosclerosis of the knee joint:

Warm up- lifting on toes - 20 times, rotation in the knee joint - 10 times in each direction.
Squats- 20-30 times, with good physical shape, you can do more.
exercise bike 30 minutes or run 30 minutes.
Stretching- bends with straight knees.
Completion– slow walking 2-3 minutes.

You should clarify the set of exercises with your doctor - the same methods are not suitable for all patients. If the spine is affected, you can perform part of the exercises sitting or lying down.

Among the physiotherapy of osteosclerosis, preference should be given to massage with warming oils and ointments. You can also use gels. This procedure should be carried out by a professional massage therapist to avoid the risk of accidental injury.

This is especially important when it comes to osteosclerosis of the spine - an insufficiently qualified massage therapist can provoke or.

In addition to massage, other types of physiotherapy are shown:

Warming procedures are also needed, which enhance blood circulation, improve tissue nutrition - infrared irradiation,.
Assign electrophoresis with chondroprotectors and painkillers means, less often - anti-inflammatory drugs.
UHF and ultraviolet irradiation possible to enhance blood circulation in diseased bones.

Physiotherapy methods are used as additional to the main treatment regimen.

Surgical intervention

Considered a last resort. It is prescribed in cases where other methods have been ineffective, as well as in deformities and fractures of bones. Operations for osteosclerosis can be divided into two types - therapeutic and restorative.

X-ray after surgery

Restorative trauma surgeries are prescribed for severe spinal deformities and vertebral osteosclerosis that cannot be restored in other ways, as well as for fractures and dislocations of bones and joints. In this case, the fragments are repositioned, the normal structure is restored and it is fixed with the help of traumatological structures.

Therapeutic operations for osteosclerosis - transplantation of healthy bone tissue into the affected area. The method is effective, but is associated with a risk for the patient, like any operation.

Folk remedies at home

Folk remedies are not effective enough, however, many patients prefer to use them.

Among the most popular are:

cinquefoil (it is part of many ointments for joints and bones);
propolis tincture;
bee subpestilence, infused with alcohol;
snake poison;
a mixture of Vishnevsky ointment and heparin ointment.

Ointment Vishnevsky Heparin ointment Propolis tincture

The effectiveness of such funds is questionable. However, cinquefoil and snake venom are used as components of medicinal ointments.

Below are some recipes:

250g insist in 3 liters of cold water and add to the bath.
Alcohol-based honey ointment- applied under a compress for 10-15 minutes.
A mixture of lingonberry leaves, sweet clover grass, St. John's wort and flax seeds in equal proportions insist on water for 2 hours, treat diseased areas three times a day. The same mixture can be infused with alcohol and used as compresses for 10-15 minutes daily.
An elegant solution for cat owners - animal warmth sitting on the diseased area, comparable to physiotherapy. In addition, the purring of a cat increases the production of endorphins.

Sanatorium treatment of osteosclerosis involves walking and exercising in the fresh air, proper nutrition, and a therapeutic regimen. It is advisable to go to sea and mud sanatoriums, where there are unique natural factors that improve the condition of bones and joints.

Sanatorium treatment of osteosclerosis

Patients with chronic bone disease are advised to go to sanatoriums 2 times a year, preferably in spring and autumn. If the patient does not have such an opportunity, it is necessary to find it at least once a year.

A ticket to the sanatorium is issued by the attending physician, if necessary, a certificate of incapacity for work can be issued for this time.

If your back, neck or lower back hurts, do not delay treatment if you do not want to end up in a wheelchair! Chronic aching pain in the back, neck or lower back is the main sign of osteochondrosis, hernia or other serious disease. Treatment needs to start right now.

Nutrition and diet

Diet is not the main treatment. However, some dietary modification is required. First of all, you should think about the amount of food - you should not overeat, food should fully cover the energy needs of a person, but not exceed them.

With damage to the bones of the lower extremities and the spine, it is very important to normalize the weight, if there is an excess of it.

Required and allowed products:

milk and dairy products, preferably low-fat;
dietary meat and offal - liver, heart;
fresh fruits - apples, grapes, pears, bananas;
cereals, primarily buckwheat and barley.

These products contain calcium, which is necessary for building normal bone tissue, supporting healthy regeneration processes and trabecular formation. Foods that should be limited are bread and pastries, especially white ones, sweets, alcohol and fatty foods.

Consequences and prognosis

Speaking about the consequences, the cause of the pathology should be taken into account. If we are talking about physiological osteosclerosis, then there is nothing to be afraid of - this process must end in a timely manner, in accordance with the age norm. If this does not happen, treatment and diet are prescribed.

Post-traumatic osteosclerosis is part of the recovery process. This is normal. After fractures, trabeculae form chaotically, and in order to give them the right direction, a dosed load is required. With timely exercise, the prognosis is favorable.

If we are talking about pathological osteosclerosis, then the following complications are possible:

pathological bone fractures;
inflammatory process in cartilage and joints;
destruction of bone tissue;
osteomyelitis.

In severe stages of the disease, a deferment or complete exemption from conscription into the army is given. Disability is granted for complications of the disease.

Prevention of osteosclerosis

It is impossible to completely avoid osteosclerosis, so we can only talk about maintaining a sufficiently high quality of life:

You should strictly follow the doctor's recommendations regarding treatment, diet and exercise. You can also reduce the rate of progression of the disease in a chronic course.
It is necessary to eat foods containing calcium and phosphorus compounds, primarily dairy products and fruits.
If necessary, take vitamin complexes, containing the specified substances in the required volume.
To avoid post-traumatic osteosclerosis, it is required to perform a set of exercises aimed at developing the limb.

Osteosclerosis is a pathological condition in which there is a thickening of bone tissue in the absence of severe symptoms. The affected bone tissue is clearly visible on the x-ray. The dimensions and geometric shapes of the bones do not change.

ICD-10	M85.8, Q77.4
ICD-9	756.52
DiseasesDB	15823
MeSH	D010026

Osteosclerosis is the second most common disease after osteoporosis, which is accompanied by a violation of bone structures. Treatment of changes in bone and cartilage is carried out under the supervision of a traumatologist and.

At the initial stages, the disease practically does not manifest itself in any way, which is the reason for the lack of timely treatment. Complications of the disease are quite serious and consist in paralysis of the limbs and the development of malignant tumors.

Foci of osteosclerosis

Foci of osteosclerosis are pathological changes in bone and cartilage tissue that have a different size, shape, and fine-loop structure. They arise due to an imbalance between the internal processes responsible for the formation and destruction of bone, in favor of the first.

Foci of osteosclerosis on the radiograph have:

the presence of a coarse trabecular fine-loop structure of the spongy substance;
protrusion of the bone shadow against the background of soft surrounding tissues;
thickening of the cortical bone layer, which has an uneven internal contour;
narrowing of the lumen, and sometimes complete closure of the medullary canal.

Foci of osteosclerosis in the bones on the X-ray image appear in a uniform and spotted form. The spotted form of the disease (piebald) is distinguished by the presence of multiple light defects against the general background of the transparency of the bone pattern. At the same time, the cortical layer does not become thinner, but the inner one becomes loose and turns into a spongy-type tissue.

Uniform foci have the correct diffuse transparency of a homogeneous appearance. Focal enlightenments in this case are absent, and the spongy substance has rare trabeculae. Treatment of patchy and even osteosclerosis is aimed at eliminating the causes and reducing the symptoms of the disease.

Reasons for development

The reasons for the development of osteosclerosis may lie in genetic factors. This disease mainly affects women with congenital diseases of the joints and bone tissue. Pathological thickening of bone tissue often develops with intoxication of the body and the presence of chronic forms of inflammatory diseases, such as bone tuberculosis and tertiary syphilis.

There are acquired and environmental causes of osteosclerosis:

overweight;
lack of estrogen in menopause;
acquired diseases of bone and joint tissue;
joint injury.

The development of osteosclerosis occurs with intoxication and diseases such as saturnism, Albers-Schoenberg's disease and fluorosis. The defeat of individual bones is observed in the presence of metastases of cancer of the breast, prostate and bronchi.

Varieties of the disease

Depending on the cause of development, the following types of disease are distinguished:

Idiopathic - violations of the development of bone structures in diseases such as marble disease, osteopoikilia and meloreostosis.
Physiological - develops during the growth of the skeleton.
Post-traumatic - characterized by pathological processes that occur during the healing period of fractures.
Inflammatory - occurs when there is inflammation in the body that changes the structure of the spongy substance.
Reactive - is a reaction to tumors and dystrophic changes, and is manifested by the appearance of compacted bone tissue.
Toxic - occurs due to the toxic effects on the body of metals and other substances.
Deterministic hereditary. The diverse nature of the disease and its combination with other signs made it possible to identify the following forms of this pathological process: dysosteosclerosis, scleroostenosis, pincodysostosis and osteopetrosis.

Symptoms

Symptoms of osteosclerosis are quite versatile and depend on the area of localization of the disease and the form of its course. There are foci of osteosclerosis in the bones and joints, which leads to the development of certain symptoms.

When bone structures are damaged, enostoses and compact islands appear inside the bone, which manifest themselves in the form of bone resorption and destruction. Periosteal changes are also present, sequesters and cavities are formed. With damage to the articular tissue, symptoms in the initial stages of the disease are practically absent, so it is quite difficult to identify it, which prevents timely treatment.

The main manifestations of osteosclerosis is internal pain, which increases with stress. With patchy forms of osteosclerosis, an increase in body temperature is possible, which also indicates the presence of inflammatory processes. External signs of pathological changes are completely absent. Osteosclerosis of the articular surfaces is called subchondral and is characterized by damage not to bone, but to cartilage tissue.

Subchondral osteosclerosis is a serious damage to the joints, which leads to their immobilization if not treated in time. This type of disease is practically not diagnosed in the early stages of development, since it does not have pronounced signs.

Hip injury

In the presence of a focus of osteosclerosis in the neck of the femur, constant pain is observed, which is localized in the region of the sacrum when walking or sitting for a long time. Osteosclerosis of the hip joint develops in people whose professional activities involve prolonged sitting (drivers, office workers, etc.).

When the hip joint is affected, the bone is so compacted that even with minor loads, a serious fracture can occur. Treatment of osteosclerosis of the hip joint should be carried out only after consultation with a specialist, since there is a high probability of complications.

Shoulder injury

The subchondral form of osteosclerosis in the shoulder joint occurs quite often, since the upper limbs are the most active part of the musculoskeletal system. In this case, the main symptomatology is the appearance of pain during the activity of the shoulder joint and when the arms are pulled back. Visible changes in the joint itself, such as swelling, deformation and redness of the skin, are completely absent.

Damage to the knee joint

Subchondral osteosclerosis of the articular surfaces also extends to the knees. The symptoms of the disease in such a case may not be sufficiently pronounced, so patients with this disease are often unaware of its existence. An appeal to a doctor occurs at a time when an injury that has arisen due to pathological changes in cartilage tissue leads to a violation of motor activity. In this case, the treatment of osteosclerosis of the knee joint is much more complicated. The defeat of the articular surfaces of the knee region is accompanied by rapid fatigue when walking and minor pain while sitting.

Spinal injury

Subchondral osteosclerosis of the spine, namely the endplates of the vertebral bodies, is a serious pathology that can only be diagnosed using MRI. Symptoms of pathological changes in this area are manifested by aching pain, which does not allow you to fully stand and lie down, as well as deformation of the spinal column and structures. Similar signs are also typical for other diseases, so treatment is not prescribed without an accurate diagnostic study.

Subchondral osteosclerosis of the endplates is a provocateur of the development of such diseases of the spine as kyphosis, osteochondrosis and intervertebral hernia. In the advanced stages of the disease, there is a high probability of developing an imbalance of bone structures at the cellular level, which leads to the appearance of seals and malignant neoplasms.

Treatment

Treatment of osteosclerosis today is carried out using various therapeutic methods. Surgical intervention (bone marrow transplantation) is required only at advanced stages of the disease.

Treatment of subchondral osteosclerosis involves the use of combination therapy:

Medical treatment. Preparations with glucosamine and chondroitin are prescribed. The duration of treatment is from 3 to 6 months and ends with visible changes.
Physiotherapy. With osteosclerosis, exercises on an exercise bike are most effective. In the presence of an inflammatory process, they should be limited and the joint should be temporarily immobilized.
Proper nutrition. In any form and stage of the disease, first of all, body weight should be normalized with the help of proper nutrition, which implies the rejection of fried and fatty foods. Sweets should also be limited.

Treatment of osteosclerosis of the spine and joints does not lead to the complete elimination of pathological changes. Despite this, each patient is recommended to undergo maintenance therapy, exercise therapy and adhere to proper nutrition. This approach will eliminate the unpleasant symptoms of the disease in the form of aching pain and stop pathological changes, preventing the development of complications of osteosclerosis.

Forecasts and prevention

With osteosclerosis, the prognosis for life is favorable, but only if therapeutic measures are taken in a timely manner. If left untreated, there is a high probability of developing serious complications, such as skeletal deformities, facial nerve paresis, and anemic changes in the composition of the blood. Anemia in this case is treated with a splenectomy or a red blood cell transfusion. Osteosclerosis without bone marrow transplantation is not completely curable, therefore, if there is a predisposition to this disease, preventive measures should be taken to prevent its development.

Prevention of osteosclerosis:

monitor posture;
sleep on a mattress of moderate hardness;
to live an active lifestyle;
Healthy food;
stop smoking;
do not abuse alcohol.

The most important preventive measure is exercise, which should be carried out daily. Light physical exercise restores blood circulation, which helps prevent the development of diseases of the joints and bones.

Osteosclerosis and the army

In the initial forms of osteosclerosis, a deferment from the army is given only if a sufficient number of signs of the disease are determined. At the initial stages of development, this disease is not dangerous, so the maximum that can be achieved is a delay for a year. Only after the diagnosis is made, the unfitness for the draft is recognized, but this, as a rule, indicates the presence of a serious stage of the disease, the signs of which are clearly visible on the x-ray.

- a pathological condition accompanied by bone compaction, an increase and thickening of the compact substance and bone trabeculae. It develops with inflammatory diseases of the bones, some tumors, intoxications, arthrosis, a number of genetically determined diseases and during the recovery period after a skeletal injury. Physiological osteosclerosis is also distinguished, which occurs in the area of growth zones in the process of bone growth in children and adolescents. The diagnosis is made on the basis of clinical signs and x-ray data. Treatment of osteosclerosis can be either conservative or surgical.

ICD-10

M85.8 Other specified disorders of bone density and structure

General information

Osteosclerosis (from lat. osteon bone + sclerosis hardening) is an increase in bone density, accompanied by a decrease in the interbeam marrowy space, thickening and increase in bone beams. In this case, the size of the bone does not increase. The reason for the development of osteosclerosis is an imbalance between the activity of osteoclasts and osteoblasts. Osteosclerosis leads to a decrease in bone elasticity and can cause pathological fractures. It is the second most common pathological process, accompanied by a violation of the structure of bones, after osteoporosis.

Most often, this pathology is detected in chronic inflammatory diseases and intoxications. In addition, osteosclerosis occurs with some genetically determined diseases, lead and strontium poisoning, chronic inflammatory processes in the bones (bone tuberculosis, tertiary syphilis, Brodie's abscess, Garre's osteomyelitis), metastasis of bronchial cancer, prostate cancer and breast cancer. Osteosclerosis of the subchondral zones is one of the radiographic signs of arthrosis. Osteosclerosis is treated by orthopedists and traumatologists.

Classification

On radiographs, osteosclerosis and hyperostosis are determined. Seals of bone tissue have the form of longitudinal intermittent or continuous stripes, which creates a characteristic pattern of "wax on the candle". In the adjacent parts of the limb, mild osteoporosis is sometimes detected. Treatment is symptomatic. Prevention of contractures is carried out, with significant deformities, surgical correction is performed. The prognosis is favorable.

Osteosclerosis in Paget's disease

Paget's disease or deforming osteodystrophy is a disease accompanied by a violation of the structure and pathological growth of individual bones of the skeleton. It most often develops in men over 40 years of age. Often it is asymptomatic. Perhaps a slow, gradual formation of joint stiffness, some patients experience pain and bone deformity. Other symptoms depend on the localization of pathological changes. When the skull is damaged, the forehead and superciliary arches increase, headaches occur, and damage to the inner ear is sometimes observed. When the vertebrae are damaged, their height decreases, which leads to a decrease in growth. Possible compression of the nerve roots, manifested by weakness, tingling and numbness of the extremities. Occasionally, paralysis develops. When the bones of the lower extremities are affected, gait instability, deformation of the affected segment, and pathological fractures are observed.

When studying radiographs, a certain staging of the process is revealed. In the osteolytic phase, bone resorption processes predominate; in the mixed phase, resorption is combined with osteoblastic bone formation. Osteosclerosis develops in the osteoblastic phase. Deformities, incomplete and complete pathological fractures can be detected. On radiographs of the skull, a thickening of the arch and heterogeneous foci of osteosclerosis are determined. To clarify the diagnosis and assess the degree of dystrophic processes, the level of alkaline phosphatase, phosphorus, magnesium and calcium in the blood is determined. Also prescribed scintigraphy. Treatment is usually conservative - taking biphosphates and NSAIDs. If necessary, perform joint arthroplasty. Hearing aids are used for hearing loss.

Osteosclerosis in Osteomyelitis Garre

Chronic sclerosing osteomyelitis of Garre is caused by staphylococcus aureus and is more often detected in men 20-30 years old. The hip, shoulder, or radius are usually affected. The pathological focus occurs in the middle third of the diaphysis or in the diaphyseal zone closer to the metaphysis. Perhaps acute, subacute and primarily chronic onset. In the surrounding tissues, there is a pronounced dense edema, often there is an expansion of the subcutaneous venous network. Hyperemia and other signs of inflammation may be absent. Subsequently, unlike other forms of osteomyelitis, softening does not occur, a fistula does not form. On the contrary, the infiltrate is even more compacted and palpable in the form of a dense tumor-like formation associated with the bone. The pains become more and more severe, intensify at night, often radiate, simulating sciatica, neuritis and sciatica.

The clinical picture in Garre's chronic osteomyelitis often resembles a sarcoma. However, X-rays of the femur, lower leg, or X-ray of the forearm reveal that the "bone tumor" is actually composed of soft tissue. At the same time, characteristic pathological changes are revealed on the radiograph: correct spindle-shaped thickening of the diaphysis, less often - thickening in the form of a semi-spindle, narrowing or fusion of the medullary canal, pronounced osteosclerosis, increased bone shadow to the degree of eburnation. Cavities, sequesters and foci of destruction are usually absent. The final confirmation of the diagnosis often allows sowing, in which a culture of staphylococcus is found. Treatment includes antibiotic therapy in combination with radiotherapy. If necessary, surgical interventions are performed. The prognosis is favorable for life, however, in the outcome of patients, disability is often observed.

Osteosclerosis in other bone diseases

Brodie's abscess is an inflammatory disease caused by Staphylococcus aureus. It occurs more often in young men. It is localized in the periarticular region of the long tubular bone (more often the tibia). It proceeds chronically, with rare exacerbations. Perhaps almost asymptomatic course. Brodie's abscess is a bony cavity filled with granulations and serous or purulent fluid. Around the cavity is a focus of osteosclerosis.

It is manifested by vague pains, sometimes by slight swelling and hyperemia. Due to proximity to the joint, synovitis may develop. Fistulas are absent. An x-ray of the lower leg reveals a rounded rarefaction center with smooth contours, surrounded by a zone of moderate osteosclerosis. Brody's abscess is differentiated from primary chronic osteomyelitis, extra-articular tuberculous focus and isolated syphilitic gumma. With osteomyelitis, the contours of the focus are uneven and indistinct, more pronounced periosteal overlays are revealed. With syphilis, a more extensive focus of osteosclerosis is found in the gumma area. Treatment is conservative - antibiotic therapy in combination with radiotherapy.

Limited osteosclerosis can also be seen in early congenital syphilis, late congenital and tertiary syphilis. With ossifying osteitis and periostitis, the focus of osteosclerosis occurs at the end of the inflammatory infiltration. Subsequently, hyperostosis develops, the bone thickens, the medullary canal closes. The phenomena of osteosclerosis are especially pronounced in syphilitic gums. Gummas are localized intracortically, subperiosteally or in the bone marrow and represent a focus of inflammation with decay in the center. A wide zone of reactive osteosclerosis appears around the gummous node, which is clearly visible on x-rays. In some cases, gummas suppurate with the formation of sequesters, also surrounded by foci of osteosclerosis.