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One of the most basic tests in the diagnosis of bone and joint diseases is radiography, which is the popular X-ray image. In the descriptions of the results of X-ray examinations, we often come across the term: subchondral sclerotization. What is behind these words, what conditions is this symptom associated with, and how does it affect the patient?
What is subchondral sclerosis?
Subchondral sclerotization is an increase in bone density in the place where the bone tissue is subjected to the greatest stress. It is the result of the degeneration of articular cartilage, which no longer properly absorbs the frictional forces generated during joint movement. The bone then compensates for the lack of the cartilage sheath by hardening in the area closest to the cartilage. Since this process is the fastest in the places that are most exposed to loads, we usually refer to sclerotization in the knee joint, tibia epiphysis or around the sacroiliac joints. Although sclerotization itself is not harmful or painful, in any case it is a disturbing symptom of lesions within the joints and absolutely requires further diagnosis. If the X-ray image shows sclerosis, it is most likely osteoarthritis or rheumatic changes.
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Sclerotization in osteoarthritis
Subchondral sclerosis is a typical symptom of osteoarthritis. It consists in the progressive deterioration of both the quantity and condition of cartilage within the joints. The disease is chronic and most often affects the elderly, although sometimes it affects people over 35 years of age. As the cartilage degenerates, bone sclerosis occurs, the joint capsule is damaged, and, finally, the tendons and muscles. Osteoarthritis often affects the hips and spine, although the most common form of osteoarthritis is gonarthrosis, which is an osteoarthritis of the knee. However, it is worth remembering that the disease can potentially affect any joint in the human body.
The characteristic symptoms of osteoarthritis are:
- joint pain, which increases with physical activity
- characteristic stiffness of the joint that disappears after moving,
- joint crackling,
- tenderness around the joint, especially when it becomes inflamed.
If left alone, osteoarthritis can lead to a significant reduction in the mobility of the joint and, consequently, to disability. Unfortunately, this happens so often that the disease takes on the proportions of a social problem.
Sclerotization and rheumatic diseases
Few people realize that “rheumatism” is not the name of any disease. Rather, we can talk about a group of diseases characterized by chronic autoimmune inflammation of connective tissue. It turns out that medicine knows as many as 200 diseases with such characteristics! The most common, however, are rheumatoid arthritis (RA for short) and ankylosing spondylitis (AS).
Since rheumatic diseases also cause cartilage degeneration, bone sclerosis is also a common symptom. In addition, common symptoms of rheumatic diseases include:
- joint pain and swelling
- stiffness of the joints after waking up,
- increased tissue temperature around the joint,
- reduced joint efficiency,
- joint deformities,
- characteristic rheumatoid nodules palpable under the skin.
However, the X-ray image of the joint is of the greatest importance for the diagnosis of rheumatic diseases. It is here that the doctor can observe changes typical of rheumatism, such as joint deformities, osteophytes, bone erosions and sclerotization.
Check what biological treatment looks like in rheumatic diseases
Treatment of diseases associated with bone sclerosis
Unfortunately, subchondral sclerotization is irreversible. The chances of curing the disease, the sclerosis of which is a symptom, depends largely on the individual situation and the type of disease itself. Diseases of the joints in which sclerosis occurs are usually treated in a comprehensive manner, i.e. combining various methods of therapy. The progress of many of these conditions cannot be reversed or even stopped. In such cases, the efforts of doctors are aimed at alleviating the ailments caused by the progression of the disease in such a way as to make it as difficult as possible for the patient to function normally. It is worth realizing that in many cases limitation of mobility is not only a matter of physical fitness – people suffering from such diseases may face serious difficulties in participating in social life, which also affects mental health.
Therefore, medicine has a wide range of methods to alleviate joint diseases. Pharmacological agents include painkillers, anti-inflammatory drugs, steroids and biological drugs. Rehabilitation and physiotherapy are equally important. In cases of very severe damage, when the joint becomes completely immobilized, surgical intervention in the form of joint prosthesis implantation is also used.