It should be distinguished from osteopenia (age-related atrophy of bone tissue) and osteomalacia (impaired mineralization of the bone matrix).
Postmenopausal (type I) - the most common form among women, associated with the cessation of estrogen secretion.
Involutional (type II) - occurs with the same frequency in both sexes over the age of 75 years, is associated with a latent long-term imbalance between the rate of bone resorption and bone formation.
Mixed - a combination of I and II types (the most common).
Idiopathic - in women in the premenopausal period and in men younger than 75 years of age for unclear reasons.
Juvenile - in children in the prepubertal period for unclear reasons, disappears on its own.
Secondary - associated with the intake of GCs, the presence of rheumatic diseases, chronic diseases of the liver or kidneys, malabsorption syndrome, systemic mastocytosis, hyperparathyroidism, hyperthyroidism, etc.
Frequency. Postmenopausal, involutional, mixed - 30–40% of women, 5–15% of men. The prevalence of idiopathic and juvenile types is unknown. Secondary - 5–10% of the population. The predominant age: juvenile - 8–15 years, postmenopausal - 55–75 years, involutional - 70–85 years. The predominant gender is female.
Risk factors Belonging to Caucasoid or Mongoloid race Family predisposition Body weight less than 58 kg Smoking Alcoholism Low or excessive physical activity Early menopause, late onset of menstruation, infertility Coffee abuse, dietary calcium deficiency, long-term parenteral nutrition Concomitant diseases - Cushing's syndrome, thyrotoxicosis, type 1 diabetes, pathology of the gastrointestinal tract and hepatobiliary systems, mastocytosis, rheumatoid arthritis, prolactinoma, hemolytic anemia, hemochromatosis, thalassemia, ankylosing spondylitis, myeloma, hyperparathyroidism, etc. Drug therapy - GC, thyroid hormone replacement therapy, heparin, lithium salts, anticonvulsants, phenothiazine derivatives, antacids containing aluminum .
Pathomorphology Decrease in bone volume, more pronounced in the trabecular than in the cortical regions Loss of trabecular bridges The number of osteoclasts and osteoblasts varies Bone marrow is normal or atrophic.
Clinical picture Acute or chronic pain syndrome associated with a bone fracture (often thoracic vertebrae, femoral neck) Spinal kyphosis, leading to compression of the nerve roots, painful focal muscle hypertonicity.
Laboratory studies ALP activity may transiently increase after fractures Increased urinary excretion of hydroxyproline in fractures Markers of bone formation ALP Osteocalcin Bone resorption activity is determined by: the ratio of urine calcium to urine creatinine the ratio of urine hydroxyproline to urine creatinine.
Special studies X-ray examination Early changes - an increase in intervertebral spaces, intense shading of the cortical plates, vertical striation of the vertebrae Late changes - fractures, concavity or biconcavity of the vertebrae Densitometry CT - determination of the bone mass of the trabecular or cortical layer in the lumbar spine Quantitative histomorphometry - a method for assessing the rate of bone mineralization after administration of tetracycline.
General tactics Moderate restriction of dietary intake of protein and phosphorus (meat, fish, legumes should not be abused), as well as alcoholic beverages Inhibition of bone resorption and stimulation of its formation Ensuring sufficient intake of calcium from food or inhibition of its excretion.
With moderate postmenopausal osteoporosis. Ensuring the intake of 1-1.5 g / day of calcium (in the absence of hypercalciuria and calcium stones), for example, in the form of calcium carbonate 600 mg 4-6 r / day, and ergocalciferol 400 IU / day. Continuous hormone replacement therapy (estradiol + dienogest).
With severe or progressive postmenopausal osteoporosis Conjugated estrogens 0.625-1.25 mg / day, taking a 5-day break every month to prevent endometrial hyperplasia, or continuous hormone replacement therapy (estradiol + dienogest). During treatment, an annual gynecological examination is required, including Pap smears or endometrial biopsy, annual breast examination or mammography. BP should be determined 2 times a week If treatment is started within 3 years of last menstruation, no bone destruction occurs, but new bone formation occurs If treatment is started later than 3 years after last menstruation, then bone destruction does not occur, but does not occur and the formation of new bone tissue Calcitonin 100 IU / day s / c in combination with a calcium preparation and ergocalciferol - with estrogen intolerance or contraindications to them For fractures: 100 IU / m daily for a week, then 50 IU daily or every other day within 2-3 weeks Supportive therapy - 50 IU intramuscularly 3 days a week for 3 months, then a break for 3 months Ergocalciferol 600-1000 IU daily under the control of calcium in the urine (not higher than 250 mg / day) ; if exceeded, temporary discontinuation of the drug is necessary with further resumption at a half dose Bisphosphonates Etidronic acid 400 mg / day for 14 days every 3 months (with continuous use, inhibition of bone mineralization is possible) in combination with calcium preparations (500 mg / day) Alendronic acid according to 10 mg 1 r / day for a long time (years) in combination with calcium preparations (500 mg / day); after 3 years, the dose is reduced to 5 mg / day.
In men - calcium 1-1.5 g / day. Calcium malabsorption (calcium content in the urine<100 мг/сут) дозу кальция повышают до 3 г/сут и дополнительно назначают эргокальциферол в дозеМЕ; необходимо периодическое определение содержание кальция в сыворотке крови и моче.
With steroid-induced osteopenia With urinary calcium excretion of more than 4 mg / kg / day - hydrochlorothiazide (reduces calcium excretion) at 25–50 mg 2 r / day With calcium excretion less than 4 mg / day - ergocalciferol and calcium preparations.
Treatment of fractures according to the rules of traumatology and orthopedics.
Prophylaxis is indicated for individuals with osteopenia identified by one of the following special methods Exercise High calcium diet Calcium gluconate 1000–1500 mg/day Cholecalciferol 200–300 IU/day Estrogen replacement therapy Calcitonin for initial osteoporosis 50 IU IM every other day within 3 weeks A clear definition of indications for the appointment of HA.
ICD-10 M80 Osteoporosis with pathological fracture M81 Osteoporosis without pathological fracture M82* Osteoporosis in diseases classified elsewhere
ICD is an international classifier of the disease, because. it has been approved 10 times and is called ICD 10. This system is made for a convenient classification of human diseases. It can detect new diseases and include them in the list.
In this system, osteoporosis ICD 10 was identified as a subclass of diseases of the musculoskeletal system and connective tissue. This pathology is very well known to have complications and problems in the future.
Osteoporosis is a disease that affects the spine and limbs, as a result of which their density decreases and the integrity of the bone tissue is disturbed. And the chemical composition is the same. This disease is an international issue.
Osteoporosis code ICD can be as follows:
The complexity of the disease depends on the increased risk of various injuries, sprains and fractures due to a decrease in bone density. Usually, this disease affects older people after 40 years.
They actively experience a decrease in bone strength. More women suffer from this disease, because. after 40, hormonal disorders begin, menopause, which are accompanied by an initial small bone mass, but children are also susceptible to illness.
Osteoporosis ICD 10 can be of two types:
Juvenile - a type of pathology that has not yet been fully studied by doctors. This category includes infants and adolescents. Poor posture is a symptom of spinal osteoporosis.
Postmenopausal (postmenopausal). It begins with the appearance of menopause and functional disorders of the female ovaries. May begin in women approaching advanced age.
Senile osteoporosis appears in a category of people after 50 years. The biggest problem is that the effects of this form are irreversible, often leading to early death.
It is difficult to treat and the outcome is unfavorable. The second way of the course of this disease can occur with a decrease in bone mass. The human skeleton can take on a different shape. This pathology occurs due to a lack of collagen of the first type.
Ideopathic. It appears extremely rarely and, as a rule, in the elderly. The appearance of such osteoporosis is promoted by the use of alcohol, smoking.
Risk factors also include a lack of vitamins, due to malnutrition. If there is a lack of vitamins D, C, Ca and various proteins in the body, the skin becomes pale, dry, ceases to be elastic, and regeneration properties are impaired.
To prevent this from happening, you need to think over your diet and include foods that contain all the necessary vitamins and essential substances for the body. My patients use a proven remedy, thanks to which you can get rid of pain in 2 weeks without much effort.
Inflammation. When healthy cells become inflamed, a large release of cytokines occurs. They reduce bone mass, so the joints begin to suffer. The cells become less viable, small and weak, thereby creating a greater risk of fractures.
In order not to become a hostage of this disease, it is necessary to carry out prevention. From a young age, the body must contain all the necessary vitamins and minerals for the body.
It is necessary to make a diet with a high content of calcium. It is he who helps to strengthen the immune system of the body. It is also necessary to give up bad habits (alcohol and nicotine addiction, heavy coffee consumption). These addictions remove calcium from the body.
Many young mothers face such a problem when.
Diffuse osteoporosis is a common disease. .
Joints play a very important role in the structure.
One of the most common diseases in
The joints begin to disturb for a reason.
The well-being of any person will certainly be reflected in him.
Experience 18 years. Deputy chief physician, specialist in traumatology and arthrology.
In order to streamline and bring into one register the diagnoses of all diseases, there is an international classifier. ICD 10 is the 10th revision of the international classification of diseases. This classification encodes all signs and diagnoses of diseases, symptoms and their pathology. There is a code in the international classifier of diseases. System coding allows you to track new types of diseases and enter them into a common registry. The code is also assigned to subclasses that already have more than species. Each code is presented in a separate field, which systematizes and simplifies the work with ICD 10.
Osteoporosis is a skeletal pathology in which a decrease in bone density occurs with progressive dynamics, that is, the quantitative composition of bone substance per unit volume of bone increases. At the same time, the chemical composition of the bone tissue remains unchanged.
Osteoporosis is a medical problem of an international nature that the entire scientific community and practitioners of various specialties and directions have to face. According to ICD 10, osteoporosis is identified in the XIII subclass "Diseases of the musculoskeletal system and connective tissue."
Code according to the international classification of diseases of the 10th revision (ICD 10):
Due to the decrease in bone density, the proportion of fractures is increased. A large percentage of fractures occur in people after 45 years of age, which are caused by the consequences of osteoporosis. This type of disease often occurs mainly in the female part of the population. It is assumed that this is due to hormonal age-related changes in the female body. Throughout human life, bone tissue has the property of self-healing, this is when tissue renewal occurs. The old structure is destroyed, absorbed and overgrown with new tissue. The processes of synthesizing and destroying tissues lead to a quantitative decrease in bone mass.
The disease can be divided into 2 main types: primary and secondary. The first type includes:
The secondary form of osteoporosis is a consequence of other diseases. The etiology of the disease is very different. The cause may be endocrine system disorders, diabetes mellitus, inflammatory processes in the intestines.
As you can see, all age categories are subject to the risk factor.
Preventive actions will help to avoid or reduce the risk of disease. From early childhood and adolescence, a healthy skeletal system requires an adequate supply of minerals. The supply of calcium in the bone system will help maintain immunity in the future. Moderate alcohol consumption and smoking cessation increase the safety of calcium excretion from the body.
Take care of yourself and be always healthy!
Very detailed and good article. Thank you. Coxarthrosis is a terrible disease.
Yes, try to find out locally.
We cannot advise based on yours.
It's hard to say, you have to.
Take care of yourself, your lifestyle, do not allow the development of pathology
The International Classification of Diseases of the 10th revision is a single register in which codes are indicated. After the introduction of the protocol, it became easier for doctors to track degenerative conditions. Osteoporosis with and without a pathological fracture caused by various conditions is also included in the international classification of diseases. It is characterized by damage to the bone structure, a decrease in bone mineral density, a low calcium content, and is accompanied by vertebral fractures. With this disease, bone destruction occurs in the bone structure. Osteoporosis ICD 10 occupies sections M80, M81, M82.
Classification of diseases exists to simplify the work of doctors. It contains causes, signs and diagnoses. In the ICD of Diseases of the 10th revision, there is information about the development of a degenerative disease, how differential diagnosis is carried out. There is also information that describes patient education and clinical recommendations, the correct behavior during bone resorption. Osteoporosis according to ICD 10 is a degenerative condition in which there is a decrease in bone mass and bone density. They become porous and brittle. The destruction of the bones accompanies the pain syndrome, which increases as it progresses.
In diseases classified in the ICD, degenerative pathology is introduced into subclass 8. Osteoporosis ICD 10 - codes:
Due to a decrease in bone mineral density, the likelihood of a violation of the integrity of the skeleton increases. Pathogenetic treatment includes the appointment of drugs that relieve pain, serving as a prophylaxis of the disease to prevent the formation of new bone fractures. Patient education, clinical recommendations given by doctors allow the formation of new bone tissue. Ailments caused by various conditions respond well to treatment in the early stages. The processes of synthesizing and destroying a large amount of bone tissue are accompanied by fractures of the vertebrae and other skeletal structures.
A decrease in bone density occurs for various reasons. Doctors distinguish primary and secondary type. After the introduction of a protocol that divides the disease into certain categories, it became more convenient for doctors to diagnose and prescribe treatment. As part of this protocol, doctors also stimulate patients and encourage them to maintain a proper lifestyle to prevent the development of pathology, to prevent a decrease in bone mineral density. Conditions with a pathological fracture M80 includes nine sub-items. Osteoporosis m81 is the type without pathological fracture, but there is bone loss in the joints.
The primary disease is osteoporosis, ICD code 10:
Primary osteoporosis is also senile and juvenile. Secondary osteoporosis is formed due to other conditions. Codes according to ICD 10 (the first code is with pathological, the second is without it):
Pathogenetic treatment includes the appointment of drugs according to the type of disease. If the calcium content is low, but there is no fracture, the patient is prescribed Actonel, Ideos, Calcium Dz Nycomed, Alfadol-Sa. In the presence of a violation of the integrity of the skeleton, to restore the volume of bone tissue, patients are prescribed Natekal Dz, Aklasta, Ideos. If the disease is caused by endocrine disorders, the use of the drug "Osteogenon" is prescribed. In ICD 10, under each subparagraph, drugs are indicated that are used for a certain type of degenerative-dystrophic pathology. This makes it easier for doctors to work.
[localization code see above]
In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to contact medical institutions of all departments, and causes of death.
ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170
The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.
With amendments and additions by WHO.
Processing and translation of changes © mkb-10.com
[localization code see above]
Excludes: osteoporosis with pathological fracture (M80.-)
Osteoporosis after ovary removal
Post-surgical osteoporosis due to malabsorption
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International Statistical Classification of Diseases and Related Health Problems.
In order to classify all diseases and identify new ones, a special system has been created called ICD 10. The International Classification of Diseases 10 revision contains more codes for various ailments and their subspecies. Osteoporosis according to ICD 10 also has its own code.
Osteoporosis is a bone disease characterized by thinning and frequent fractures. This disease is characterized by a chronic course with increasing progression. Scientists and physicians from all over the world are working with this problem, because despite the developed modern medicine and pharmacy, the number of patients with osteoporosis is increasing.
This pathology is listed in the ICD in the 13th department, which contains codes for diseases of the musculoskeletal system and connective tissue.
Osteoporosis has several codes for microbial 10:
All types of osteoporosis can be divided into 2 subspecies:
The first type includes diseases:
The second type includes osteoporosis, which occurs against the background of other endocrine, inflammatory or oncological diseases. Very often, this lesion of bone tissue occurs against the background of diabetes mellitus, thyroiditis, pituitary adenoma. It is also possible the development of osteoporosis of a medical nature, in which the trigger is the long-term use of medications that leach calcium from the bones (antihypertensive drugs, diuretics, steroid anti-inflammatory drugs). In this case, treatment begins with an impact on the root cause of the disease, and only then proceed to the restoration of bone tissue.
The treatment of this pathology for each patient is prescribed individually, taking into account the characteristics of the patient's body, as well as the etiology of osteoporosis itself. But for all types of pathology, it is advisable to apply preventive measures:
When the first symptoms appear that indicate the development of the disease (stoop, pain in the spine, reduced growth, brittle nails), it is urgent to seek advice from a highly qualified specialist. Your health should be trusted only to experienced and knowledgeable hands of doctors.
All information on the site is provided for informational purposes and is not an instruction for action. For treatment of the disease, consult a doctor. © MedeOk.ru, 2018.
The use of materials is allowed only if there is an indexed link to the page with the material
Osteoarthritis deformans, 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 predominantly affecting the peripheral joints (limbs).
Osteoarthritis 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: deforming arthrosis, osteoarthritis, osteoarthritis.
Osteoarthritis is considered the most common disease of the human musculoskeletal system. More than 1/5 of the world's population is affected by this disease. It is noted that women suffer from this disease much more often than men, but this difference is smoothed out with age. After the age of 70, more than 70% of the population suffers from this disease.
The most “vulnerable” joint for DOA is the hip joint. According to statistics, it accounts for 42% of cases. The 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 an articulation of at least two bones. Such a joint is called simple. In the knee joint, which is complex, having 2 axes of movement, three bones articulate. The joint itself is covered by the articular capsule and forms the articular cavity. It has two shells: outer and inner. Functionally, the outer shell protects the articular cavity and serves as a place for attachment of the ligaments. The inner membrane, 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 (pineal glands). These endings have hyaline (articular) cartilage on their surface, which performs a dual function: friction reduction and shock absorption. The knee joint is characterized by the presence of additional cartilage (menisci), which perform the functions of stabilizing and attenuating shock effects.
The development of arthrosis begins with damage to the tissues of the articular cartilage (ICD-10:24.1 code). The process occurs imperceptibly and is diagnosed, usually, with significant destructive changes in the articular cartilage.
The main factors contributing to the development of arthrosis: increased physical stress on the articular cartilage, as well as the loss of functional resistance to normal stress. This leads to its pathological changes (transformation and destruction).
Factors contributing to the development of the disease determine the main prerequisites for its occurrence. So, the loss of resistance can be caused by the following circumstances:
Increased stress on articular cartilage occurs as a result of:
Articular cartilage pathogenesis
The destruction of articular cartilage is caused by prolonged microtrauma of the articulated bone surfaces or a one-stage injury. In addition, some developmental disorders, such as dysplasia, contribute to a change in the geometry of articulating bone surfaces and their compatibility. As a result, the articular cartilage loses its elasticity and integrity and ceases to perform its functions of cushioning and reducing friction.
This leads to the fact that strands begin to form 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 the 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. Osteo-cartilaginous osteophytes are formed (ICD-10 code: M25.7 Osteophyte). Further changes concern the surrounding muscle tissue, which atrophies and leads to a deterioration in blood circulation and an increase in pathological changes in the joints.
The main symptoms of DOA include:
Joint pain is the main reason for a visit to a specialist. Initially, it manifests itself irregularly, mainly when moving (running, walking), hypothermia of the body or with prolonged uncomfortable body position. Then the pain acquires a non-disappearing character and its intensity increases.
At an early stage, gonarthrosis is characterized by a feeling of "stiffness" that appears after a long rest (sleep, rest). The knee joint becomes less mobile, its sensitivity decreases and pains of varying intensity are felt. All these manifestations decrease or completely disappear during movement.
Another characteristic symptom is creaking, clicking and other extraneous sounds that occur during long walking or a sudden change in body position. In the future, these sounds become a constant accompaniment during movement.
Often, arthrosis of the knee joint leads to its pathologically hypertrophied mobility. According to the ICD code 10: M25.2, this is defined as a "dangling joint". This is manifested in a linear or horizontal mobility unusual for him. A decrease in the sensitivity of the terminal sections of the limbs was noted.
The main functions of the knee joint are to move (motor function) and maintain body position (support function). Arthrosis leads to functional disorders. 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.
With the development of the disease, the motor function of the diarthrotic joint degrades, 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 is manifested in lameness and stiffness of movements, unstable work of the musculoskeletal system. Irreversible processes of deformation of the limb begin, which ultimately leads to disability and disability.
These non-primary symptoms include:
The problem of diagnosing arthrosis is that the appearance of the main symptoms with which the patient comes to the specialist already indicate 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, 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 the pain, the presence of excess joint fluid. It seems possible to determine the amplitude of movement of the affected area, to understand the degree of limitation of motor function. In some cases, characteristic deformities of the limbs are noticeable. This happens with a long course of the disease.
Instrumental examination methods
The main methods of instrumental diagnosis of DOA include:
In 90% of cases, an x-ray is enough to diagnose arthrosis. In cases that are difficult or unclear for diagnosing, other methods of instrumental diagnostics are in demand.
The main signs that allow diagnosing DOA by X-ray:
In some cases, radiography reveals a number of additional signs of arthrosis: articular cysts, joint erosion, dislocations.
Rheumatoid arthritis according to clinical guidelines is a rheumatic autoimmune pathology of unknown etiology, which is manifested by chronic inflammation of the bone joints and systemic lesions of systems and organs. Most often, the disease begins with the defeat of one or more joints with a predominance of pain of varying intensity, stiffness, and general symptoms of intoxication.
According to clinical recommendations, the diagnosis of arthritis should be carried out in a complex manner. Before making a diagnosis, it is necessary to analyze the general condition of the patient, collect an anamnesis, conduct laboratory and instrumental tests, refer the patient to a consultation with narrow specialists (if necessary). To make a diagnosis of rheumatoid arthritis, the following criteria must be met:
The obligatory diagnostics of the pathological process, according to clinical recommendations, includes survey radiographs of the feet and hands. This method is carried out both at the initial stage of the disease, and for chronic patients annually in order to dynamically monitor the course of the pathological process. Typical signs of the development of rheumatoid lesions are: narrowing of the joint space, signs of osteoporosis, bone thinning, etc. MRI is the most sensitive and indicative method in rheumatology. On the basis of it, one can say about the stage, neglect of the process, the presence of erosions, contractures, etc. Most often, ultrasound of the hands or feet and ultrasound of large joints are performed. This method provides information about the presence of fluid and inflammation in the joint capsule, the condition of the joints and the presence of additional formations on them.
The use of the above diagnostic methods, according to clinical recommendations, provides valuable information about the degree and stage, as well as the exacerbation of the process. Thanks to additional methods, even the most initial signs of the disease can be determined. Based on the data obtained, the rheumatologist makes a diagnosis of the disease and prescribes a specific treatment. Here is an example of the correct formulation of the diagnosis (data from clinical recommendations):
Rheumatoid arthritis seropositive (M05.8), early stage, activity II, non-erosive (X-ray stage I), without systemic manifestations, ACCP (+), FC II.
According to clinical recommendations, the main goal of drug treatment of rheumatoid arthritis is to reduce the activity of the inflammatory process and achieve remission of the disease. A rheumatologist should conduct and prescribe treatment, who, in turn, can refer the patient for consultations to other narrow specialists: orthopedic traumatologists, neurologists, psychologists, cardiologists, etc.
Also, a rheumatologist should conduct a conversation with each patient about the timing of prolonging the remission of the disease. The prevention of relapses includes: giving up bad habits, normalizing body weight, constant physical activity of low intensity, warm clothes in winter, caution when engaging in traumatic sports.
According to clinical recommendations, the appointment of additional therapy: multivitamins, muscle relaxants, proton pump blockers, antihistamines, can significantly reduce the risk of side effects from basic therapy medications, as well as improve the general condition of the patient and the prognosis of the disease.
Rheumatoid arthritis is a severe pathological condition that occurs with periods of exacerbation and remission. The acute phase, according to clinical recommendations, is always accompanied by severe pain and inflammation, which significantly impair the performance and general condition of patients. Periods of subsiding exacerbation are characterized by the absence or slight severity of symptoms of inflammation. The prevalence of rheumatoid arthritis disease, according to the latest clinical guidelines, among the general population of people is about 1-2%. The disease often begins in middle age (after 40 years), but all age groups can be affected (eg, juvenile rheumatoid arthritis). Women are 1.5-2 times more likely to get sick than men.
When contacting a specialist at the initial stage of the disease, competent diagnosis and timely treatment, as well as following all the doctor's recommendations, it is possible to maintain remission of the disease for several years and delay the loss of working capacity and physical activity for many years.
Despite the development of medicine and rheumatology, in particular, in the modern scientific community there are still disputes about the origin, development and treatment of rheumatoid arthritis. This ailment has no specific prevention, and it is almost impossible to predict its onset. However, there are measures that will help reduce the risk of developing this disease. These measures include: strengthening one's own immunity, timely treatment of infectious diseases, rehabilitation of foci of inflammation, giving up bad habits, observing the basics of proper nutrition, controlling body weight, adequate consumption of vegetables and fruits, as well as undergoing preventive examinations by a therapist and pediatrician (in case of juvenile rheumatoid arthritis).
In modern medicine, the term "lumbalgia" is increasingly common. But the concept does not give a clear answer about what kind of disease it is. The diagnosis of lumbodynia means a collective term that speaks of all diseases accompanied by pain in the lower back. Based on this principle, pathology has its own code according to ICD 10 - M54.5. So any back disease is coded, which is accompanied by symptoms associated with pain in the lumbar region. However, the formulation of the diagnosis implies this ICD code 10 only as a preliminary opinion of the doctor. In the final conclusion, after the results of the examination, the main cause of lumbodynia is recorded in the first place under a different code, and the term itself is used only as a complication.
What kind of disease underlies this pathological syndrome? The reasons leading to the patient's pain may have a variety of origins. Most often, the disease occurs due to osteochondrosis of the spine, but the problem also develops due to tumors, injuries, autoimmune conditions. Therefore, the prognosis and treatment in each case will be individual, depending on the root cause of the pain syndrome. Each patient suffering from lumbalgia needs a thorough diagnosis of the problem, as well as etiological therapy, which is prescribed by a specialist in the underlying pathology.
The main cause of back pain is a degenerative-dystrophic process in the spine. Therefore, any pathology of the intervertebral discs, leading to compression of the spinal roots and accompanied by characteristic symptoms, is called vertebrogenic lumbalgia. The disease has an ICD 10 code - M51, reflecting structural changes in bone tissue as a result of osteochondrosis. The diagnosis implies bringing to the fore directly the degenerative-dystrophic process leading to the pain syndrome.
The main symptoms of vertebrogenic lumbalgia are similar to the manifestations of local dorsopathy. They can be represented like this:
The main difference between vertebrogenic lumbodynia is the presence of constant irradiation, the absence of general intoxication and temperature reaction, even with a significant pain syndrome.
Pain can be acute or chronic, unilateral or symmetrical, and in severity - mild, moderate or severe. It always decreases at rest or when taking a comfortable posture and increases with movement. Unilateral lumbodynia - right-sided or left-sided occurs with a local degenerative-dystrophic process with compression of the corresponding nerve root.
Acute vertebrogenic lumbalgia is characterized by the following features:
Acute pain is always combined with musculo-tonic syndrome, which is characterized by a sharp limitation of active movements in the lower back and limbs. The essence of the syndrome lies in the tension of the muscle fibers innervated by the damaged spinal root. As a result, their tone increases, which makes it difficult for the normal function of the limbs. The problem occurs more often on the right or left, but it can also be bilateral.
Chronic vertebrogenic lumbalgia lasts for years and decades, periodically reminding of itself with painful sensations. Its typical symptoms are as follows:
The diagnosis of chronic lumbalgia is easily confirmed by magnetic resonance or computed tomography, where specific bone and cartilage changes are clearly visible, up to herniation. Treatment of the disease takes a long period of time, but the main task is to quickly relieve pain. For this, non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, muscle relaxants and anxiolytics are used. Supplement the therapeutic complex of physical. exercise and physiotherapy. How to treat vertebrogenic lumbodynia with persistent pain syndrome? Usually this situation occurs in the presence of organic stenosis of the spinal canal, which is associated with hernial protrusions. Therefore, with persistent persistent pain, surgical approaches to treatment are used - ranging from local anesthetic blockades to surgical assistance in the form of laminectomy.
When a pain syndrome occurs in the lower parts of the spine, several reasons play a role at once. Lumbodynia can be associated with the following pathological conditions:
Since the main cause of lumbalgia is osteochondrosis of the spine, the main symptoms are associated with it. Typical manifestations include:
With lesions of the spine associated with tumors, the pain is persistent and pronounced. They do not pass under the influence of conventional NSAIDs, and the use of narcotic analgesics is required for removal. In addition, there is a distinct intoxication, which is characterized by a decrease in appetite, pale skin and weight loss. In the lumbar region, especially against the background of weight loss, it is easy to notice a neoplasm that does not move on palpation and is dense to the touch.
In chronic lesions of the spine, the symptoms are not too pronounced if the process is in remission. However, it is steadily progressing, which, against the background of cooling or intense exercise, leads to an exacerbation. Chronic lumbalgia during this period differs little from an acute pain attack. But due to the fact that the disease proceeds for a long time, the treatment process is delayed, and sometimes requires surgical correction. Lumbodynia often occurs during pregnancy, due to the increased load on the spine. However, due to the negative impact of many medications on the fetus, treatment has its own nuances and difficulties.
The table below shows the treatment options for back pain in various clinical situations.
The spondylogenic nature of spinal lesions is associated with autoimmune diseases. Most often, the question concerns Bechterew's disease, less often dermatomyositis or rheumatoid arthritis. Treatment is usually conservative, and the pain syndrome can be relieved with the help of the complex effect of NSAIDs and cytostatics. With the maintenance intake of immunosuppressants, the disease proceeds stably with steady progression, but with long-term ability to work. Treatment with folk remedies gives only a temporary effect associated with the irritating effect of plant materials. However, such therapy is not capable of affecting the bone and cartilage tissue. Therefore, the passion for folk remedies is detrimental, especially with autoimmune or malignant lesions of the spine.
A good effect for relieving pain and speedy recovery of movements is given by exercises for lumbalgia. Their action is most pronounced in the degenerative-dystrophic process, as well as during recovery after surgical correction. The most relevant exercises used for vertebrogenic lumbalgia are listed below.
Physical exercise cannot be the only alternative to treating a patient. They are effective only in combination with medical support or surgical correction.
Although acute back pain is quite common, the basis of vertebrogenic lumbalgia is chronic degenerative-dystrophic processes. A protracted course of the disease takes with autoimmune damage, as well as in the presence of unoperated intervertebral hernias. The main signs of chronic lumbalgia can be represented as follows:
The pain is more often unilateral, rarely bilateral, which is associated with asymmetric compression of the spinal roots. If the symptoms spread to both parts of the back and lower limbs, then we are talking about a tumor or autoimmune process. In this case, the prognosis is always serious, a thorough detailed examination using magnetic resonance or computed tomography is required. Right-sided lumbodynia is somewhat more common, since the load force is distributed unevenly. People who are right-handed, and most of them in nature, tend to load this half of the body with physical effort. As a result, the muscle corset sags, and the degenerative-dystrophic process progresses, which inevitably leads to right-sided pain syndrome.
One of the varieties of chronic lesions of the spine is post-traumatic lumbodynia. In the anamnesis, there is necessarily an indication of trauma, usually in the form of a compression fracture or surgical correction. Clinical remission is difficult to achieve, since the organic nature of osteoarticular changes prevents effective therapy with conservative agents. Such patients are assisted by a neuropathologist together with a neurosurgeon, since it is often necessary to resort to surgical treatment tactics.
Chronic or acute process is most often associated with degenerative-dystrophic changes in bone and cartilage tissue. This is how vertebral lumbalgia occurs against the background of osteochondrosis of the spine. It has characteristic features:
The prognosis for vertebral lumbodynia is usually favorable. This is due to slow progression, successful use of NSAIDs, and rare serious complications in the form of limb paresis. Many patients up to a very old age use periodic medication, which stabilizes the quality of life at an acceptable level. When performing regular complexes of physical gymnastics, the muscle corset is strengthened, which helps prevent further progression of the disease. The main task of a specialist is to support dynamic monitoring in order to timely diagnose autoimmune or tumor processes. In their absence, the patient can be treated for life with maintenance medications.
Damage to the intervertebral joints and processes of the vertebrae is the basis of spondylogenic lumbodynia. It is most often of an autoimmune nature, as it is associated with a systemic lesion of bone and cartilage tissue. Discogenic lumbodynia is caused by a change in the intervertebral space due to deformation of the joints. This leads to damage to the spinal roots, and later the sciatic nerve is involved in the process. Pain in the spine radiating to the leg and buttock with damage to the sciatic nerve is called sciatica. The typical pain syndrome is felt more in the leg, which makes even simple movements of the limb difficult.
Typical signs of spondylogenic lumbodynia of an autoimmune nature with sciatica can be represented as follows:
The vertical posture of the patient is especially difficult, but what is it? This means that the patient cannot be in a standing position even for a few seconds due to the sharp pains in the leg. The problem disappears after drug stabilization of the patient's condition.
There are two periods in therapeutic measures for lumbodynia. With severe pain, bed rest for several days is required, as well as the intensive use of drugs to alleviate the suffering of a person. In the acute period, the following treatment is used:
For those patients who have suffered an attack of lumbodynia, it will forever remain in their memory what acute pain is and how to treat it at home. However, the treatment of lumbodynia does not end with the relief of pain syndrome. It is important to take drugs that stabilize cartilage tissue - chondroprotectors. In the presence of a hernia, operative correction is indicated. Of those patients who have cured lumbalgia, there are many patients who have undergone laminectomy. This is a radical way to get rid of an intervertebral hernia.
Therapeutic exercise is an integral part of the treatment of the disease. However, before starting training, it is important to establish the causes of lumbodynia. If there is a compression fracture, then bed rest with sparing exercises is indicated. Often helps and novocaine blockade with severe pain.
The full set of exercises can be viewed here:
Physical activity should be combined with other non-pharmacological methods of assistance. Massage is especially effective in chronic pathology. It is desirable to conduct its sessions no more than 2 times a year. Can there be a temperature with lumbodynia? This question cannot be answered unambiguously. There should not be a high temperature reaction, but a slight low-grade fever with an autoimmune process or excessive emotional outbursts is quite possible. Hormones, cytostatics and psychocorrectors will help to alleviate the condition. But what antidepressants can be taken in combination with physical activity? According to neurologists, there are no serious restrictions on taking these drugs. Modern antidepressants can be used long-term in many patients.
There are several conditions that are typical for vertebrogenic lumbodynia. These should include:
Signs of lumbodynia with radicular syndrome always increase the pain of the patient, since the manifestations of the disease spread to the lower extremities.
Young boys, as well as their girlfriends during pregnancy, are acutely concerned about the issue of military service. The answer to it cannot be unambiguous, since different clinical forms of lumbalgia are interpreted differently by doctors of military registration and enlistment offices. Young men are not fit for service in the following situations:
With minor pain or rare exacerbations of chronic lumbodynia without changes on CT or MRI, young people are subject to military service with few restrictions. Each specific case of a patient with a lesion of the spine is treated individually, depending on the severity of changes in the bone and cartilage tissue.
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Osteoporosis is a syndrome that is characteristic of many diseases, characterized by a generalized loss of bone tissue volume that exceeds age and gender norms and leads to a decrease in bone strength, which leads to susceptibility to fractures (spontaneous or with minimal trauma).
It should be distinguished from osteopenia (age-related atrophy of bone tissue) and osteomalacia (impaired mineralization of the bone matrix).
Classification of diseases exists to simplify the work of doctors. It contains causes, signs and diagnoses.
In the ICD of Diseases of the 10th revision, there is information about the development of a degenerative disease, how differential diagnosis is carried out. There is also information that describes patient education and clinical recommendations, the correct behavior during bone resorption.
Osteoporosis according to ICD 10 is a degenerative condition in which there is a decrease in bone mass and bone density. They become porous and brittle.
The destruction of the bones accompanies the pain syndrome, which increases as it progresses.
A decrease in bone density occurs for various reasons. Doctors distinguish primary and secondary type.
After the introduction of a protocol that divides the disease into certain categories, it became more convenient for doctors to diagnose and prescribe treatment. As part of this protocol, doctors also stimulate patients and encourage them to maintain a proper lifestyle to prevent the development of pathology, to prevent a decrease in bone mineral density.
Conditions with a pathological fracture M80 includes nine sub-items. Osteoporosis m81 is the type without pathological fracture, but there is bone loss in the joints.
The primary disease is osteoporosis, ICD code 10:
Primary osteoporosis is also senile and juvenile. Secondary osteoporosis is formed due to other conditions. Codes according to ICD 10 (the first code is with pathological, the second is without it):
Osteoporosis is a medical problem of an international nature that the entire scientific community and practitioners of various specialties and directions have to face. According to ICD 10, osteoporosis is identified in the XIII subclass "Diseases of the musculoskeletal system and connective tissue."
Code according to the international classification of diseases of the 10th revision (ICD 10):
Physical exercises with a predominance of static loads and isometric contractions of the back muscles (for example, swimming) Falls should be avoided.
Moderate restriction of dietary intake of protein and phosphorus (meat, fish, legumes should not be abused), as well as alcoholic beverages Inhibition of bone resorption and stimulation of its formation Ensuring sufficient intake of calcium from food or inhibition of its excretion.
With moderate postmenopausal
osteoporosis
Ensuring the intake of 1-1.5 g / day of calcium (in the absence of hypercalciuria and calcium stones), for example, in the form of calcium carbonate 600 mg 4-6 r / day, and ergocalciferol 400 IU / day. Continuous hormone replacement therapy (estradiol dienogest).
With severe or progressive postmenopausal
As you can see, all age categories are subject to the risk factor.
Preventive actions will help to avoid or reduce the risk of disease. From early childhood and adolescence, a healthy skeletal system requires an adequate supply of minerals. The supply of calcium in the bone system will help maintain immunity in the future. Moderate alcohol consumption and smoking cessation increase the safety of calcium excretion from the body.
Take care of yourself and be always healthy!
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ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170
The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.
With amendments and additions by WHO.
Processing and translation of changes © mkb-10.com
Frequency. Postmenopausal, involutional, mixed - 30–40% of women, 5–15% of men. The prevalence of idiopathic and juvenile types is unknown. Secondary - 5–10% of the population. The predominant age: juvenile - 8–15 years, postmenopausal - 55–75 years, involutional - 70–85 years. The predominant gender is female.
Risk factors Belonging to Caucasian or Mongoloid race Familial predisposition Body weight less than 58 kg Smoking Alcoholism Low or excessive physical activity Early menopause, late onset of menstruation, infertility Coffee abuse, dietary calcium deficiency, prolonged parenteral nutrition Concomitant diseases - Cushing's syndrome, thyrotoxicosis, Type 1 diabetes, pathology of the gastrointestinal tract and hepatobiliary system, mastocytosis, rheumatoid arthritis, prolactinoma, hemolytic anemia, hemochromatosis, thalassemia, ankylosing spondylitis, myeloma, hyperparathyroidism, etc. Drug therapy - GC, thyroid hormone replacement therapy, heparin, lithium salts, anticonvulsants , phenothiazine derivatives, antacids containing aluminum.
Pathomorphology Decrease in bone volume, more pronounced in the trabecular than in the cortical regions Loss of trabecular bridges The number of osteoclasts and osteoblasts varies Bone marrow is normal or atrophic.
Clinical picture Acute or chronic pain syndrome associated with a bone fracture (often thoracic vertebrae, femoral neck) Spinal kyphosis, leading to compression of the nerve roots, painful focal muscle hypertonicity.
Laboratory studies ALP activity may transiently increase after fractures Increased urinary excretion of hydroxyproline in fractures Markers of bone formation ALP Osteocalcin Bone resorption activity is determined by: the ratio of urine calcium to urine creatinine the ratio of urine hydroxyproline to urine creatinine.
General tactics Moderate restriction of dietary intake of protein and phosphorus (meat, fish, legumes should not be abused), as well as alcoholic beverages Inhibition of bone resorption and stimulation of its formation Ensuring sufficient intake of calcium from food or inhibition of its excretion.
With moderate postmenopausal osteoporosis. Ensuring the intake of 1-1.5 g / day of calcium (in the absence of hypercalciuria and calcium stones), for example, in the form of calcium carbonate 600 mg 4-6 r / day, and ergocalciferol 400 IU / day. Continuous hormone replacement therapy (estradiol + dienogest).
With severe or progressive postmenopausal osteoporosis Conjugated estrogens 0.625-1.25 mg / day, taking a 5-day break every month to prevent endometrial hyperplasia, or continuous hormone replacement therapy (estradiol + dienogest). During treatment, an annual gynecological examination is required, including Pap smears or endometrial biopsy, annual breast examination or mammography. BP should be determined 2 times a week If treatment is started within 3 years of last menstruation, no bone destruction occurs, but new bone formation occurs If treatment is started later than 3 years after last menstruation, then bone destruction does not occur, but does not occur and the formation of new bone tissue Calcitonin 100 IU / day s / c in combination with a calcium preparation and ergocalciferol - with estrogen intolerance or contraindications to them For fractures: 100 IU / m daily for a week, then 50 IU daily or every other day within 2-3 weeks Supportive therapy - 50 IU intramuscularly 3 days a week for 3 months, then a break for 3 months Ergocalciferol 600-1000 IU daily under the control of calcium in the urine (not higher than 250 mg / day) ; if exceeded, temporary discontinuation of the drug is necessary with further resumption at a half dose Bisphosphonates Etidronic acid 400 mg / day for 14 days every 3 months (with continuous use, inhibition of bone mineralization is possible) in combination with calcium preparations (500 mg / day) Alendronic acid according to 10 mg 1 r / day for a long time (years) in combination with calcium preparations (500 mg / day); after 3 years, the dose is reduced to 5 mg / day.
In men - calcium 1-1.5 g / day. Calcium malabsorption (calcium content in the urine<100 мг/сут) дозу кальция повышают до 3 г/сут и дополнительно назначают эргокальциферол в дозеМЕ; необходимо периодическое определение содержание кальция в сыворотке крови и моче.
With steroid-induced osteopenia With urinary calcium excretion of more than 4 mg / kg / day - hydrochlorothiazide (reduces calcium excretion) at 25–50 mg 2 r / day With calcium excretion less than 4 mg / day - ergocalciferol and calcium preparations.
Treatment of fractures according to the rules of traumatology and orthopedics.
Prophylaxis is indicated for individuals with osteopenia identified by one of the following special methods Exercise High calcium diet Calcium gluconate 1000–1500 mg/day Cholecalciferol 200–300 IU/day Estrogen replacement therapy Calcitonin for initial osteoporosis 50 IU IM every other day within 3 weeks A clear definition of indications for the appointment of HA.
ICD-10 M80 Osteoporosis with pathological fracture M81 M82* Osteoporosis in diseases classified elsewhere
[localization code see above]
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Take care of yourself, your lifestyle, do not allow the development of pathology
The International Classification of Diseases of the 10th revision is a single register in which codes are indicated. After the introduction of the protocol, it became easier for doctors to track degenerative conditions. Osteoporosis with and without a pathological fracture caused by various conditions is also included in the international classification of diseases. It is characterized by damage to the bone structure, a decrease in bone mineral density, a low calcium content, and is accompanied by vertebral fractures. With this disease, bone destruction occurs in the bone structure. Osteoporosis ICD 10 occupies sections M80, M81, M82.
Classification of diseases exists to simplify the work of doctors. It contains causes, signs and diagnoses. In the ICD of Diseases of the 10th revision, there is information about the development of a degenerative disease, how differential diagnosis is carried out. There is also information that describes patient education and clinical recommendations, the correct behavior during bone resorption. Osteoporosis according to ICD 10 is a degenerative condition in which there is a decrease in bone mass and bone density. They become porous and brittle. The destruction of the bones accompanies the pain syndrome, which increases as it progresses.
In diseases classified in the ICD, degenerative pathology is introduced into subclass 8. Osteoporosis ICD 10 - codes:
Due to a decrease in bone mineral density, the likelihood of a violation of the integrity of the skeleton increases. Pathogenetic treatment includes the appointment of drugs that relieve pain, serving as a prophylaxis of the disease to prevent the formation of new bone fractures. Patient education, clinical recommendations given by doctors allow the formation of new bone tissue. Ailments caused by various conditions respond well to treatment in the early stages. The processes of synthesizing and destroying a large amount of bone tissue are accompanied by fractures of the vertebrae and other skeletal structures.
A decrease in bone density occurs for various reasons. Doctors distinguish primary and secondary type. After the introduction of a protocol that divides the disease into certain categories, it became more convenient for doctors to diagnose and prescribe treatment. As part of this protocol, doctors also stimulate patients and encourage them to maintain a proper lifestyle to prevent the development of pathology, to prevent a decrease in bone mineral density. Conditions with a pathological fracture M80 includes nine sub-items. Osteoporosis m81 is the type without pathological fracture, but there is bone loss in the joints.
The primary disease is osteoporosis, ICD code 10:
Primary osteoporosis is also senile and juvenile. Secondary osteoporosis is formed due to other conditions. Codes according to ICD 10 (the first code is with pathological, the second is without it):
Pathogenetic treatment includes the appointment of drugs according to the type of disease. If the calcium content is low, but there is no fracture, the patient is prescribed Actonel, Ideos, Calcium Dz Nycomed, Alfadol-Sa. In the presence of a violation of the integrity of the skeleton, to restore the volume of bone tissue, patients are prescribed Natekal Dz, Aklasta, Ideos. If the disease is caused by endocrine disorders, the use of the drug "Osteogenon" is prescribed. In ICD 10, under each subparagraph, drugs are indicated that are used for a certain type of degenerative-dystrophic pathology. This makes it easier for doctors to work.
In order to streamline and bring into one register the diagnoses of all diseases, there is an international classifier. ICD 10 is the 10th revision of the international classification of diseases. This classification encodes all signs and diagnoses of diseases, symptoms and their pathology. There is a code in the international classifier of diseases. System coding allows you to track new types of diseases and enter them into a common registry. The code is also assigned to subclasses that already have more than species. Each code is presented in a separate field, which systematizes and simplifies the work with ICD 10.
Osteoporosis is a skeletal pathology in which a decrease in bone density occurs with progressive dynamics, that is, the quantitative composition of bone substance per unit volume of bone increases. At the same time, the chemical composition of the bone tissue remains unchanged.
Osteoporosis is a medical problem of an international nature that the entire scientific community and practitioners of various specialties and directions have to face. According to ICD 10, osteoporosis is identified in the XIII subclass "Diseases of the musculoskeletal system and connective tissue."
Code according to the international classification of diseases of the 10th revision (ICD 10):
Due to the decrease in bone density, the proportion of fractures is increased. A large percentage of fractures occur in people after 45 years of age, which are caused by the consequences of osteoporosis. This type of disease often occurs mainly in the female part of the population. It is assumed that this is due to hormonal age-related changes in the female body. Throughout human life, bone tissue has the property of self-healing, this is when tissue renewal occurs. The old structure is destroyed, absorbed and overgrown with new tissue. The processes of synthesizing and destroying tissues lead to a quantitative decrease in bone mass.
The disease can be divided into 2 main types: primary and secondary. The first type includes:
The secondary form of osteoporosis is a consequence of other diseases. The etiology of the disease is very different. The cause may be endocrine system disorders, diabetes mellitus, inflammatory processes in the intestines.
As you can see, all age categories are subject to the risk factor.
Preventive actions will help to avoid or reduce the risk of disease. From early childhood and adolescence, a healthy skeletal system requires an adequate supply of minerals. The supply of calcium in the bone system will help maintain immunity in the future. Moderate alcohol consumption and smoking cessation increase the safety of calcium excretion from the body.
In order to classify all diseases and identify new ones, a special system has been created called ICD 10. The International Classification of Diseases 10 revision contains more codes for various ailments and their subspecies. Osteoporosis according to ICD 10 also has its own code.
Osteoporosis is a bone disease characterized by thinning and frequent fractures. This disease is characterized by a chronic course with increasing progression. Scientists and physicians from all over the world are working with this problem, because despite the developed modern medicine and pharmacy, the number of patients with osteoporosis is increasing.
This pathology is listed in the ICD in the 13th department, which contains codes for diseases of the musculoskeletal system and connective tissue.
Osteoporosis has several codes for microbial 10:
All types of osteoporosis can be divided into 2 subspecies:
The first type includes diseases:
The second type includes osteoporosis, which occurs against the background of other endocrine, inflammatory or oncological diseases. Very often, this lesion of bone tissue occurs against the background of diabetes mellitus, thyroiditis, pituitary adenoma. It is also possible the development of osteoporosis of a medical nature, in which the trigger is the long-term use of medications that leach calcium from the bones (antihypertensive drugs, diuretics, steroid anti-inflammatory drugs). In this case, treatment begins with an impact on the root cause of the disease, and only then proceed to the restoration of bone tissue.
The treatment of this pathology for each patient is prescribed individually, taking into account the characteristics of the patient's body, as well as the etiology of osteoporosis itself. But for all types of pathology, it is advisable to apply preventive measures:
When the first symptoms appear that indicate the development of the disease (stoop, pain in the spine, reduced growth, brittle nails), it is urgent to seek advice from a highly qualified specialist. Your health should be trusted only to experienced and knowledgeable hands of doctors.
[localization code see above]
Excludes: osteoporosis with pathological fracture (M80.-)
Osteoporosis after ovary removal
Post-surgical osteoporosis due to malabsorption
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International Statistical Classification of Diseases and Related Health Problems.
Osteoporosis is a syndrome that is characteristic of many diseases, characterized by a generalized loss of bone tissue volume that exceeds age and gender norms and leads to a decrease in bone strength, which causes susceptibility to fractures (spontaneous or with minimal trauma). It should be distinguished from osteopenia (age-related atrophy of bone tissue) and osteomalacia (impaired mineralization of the bone matrix).
Postmenopausal (type I) - the most common form among women, associated with the cessation of estrogen secretion.
Involutional (type II) - occurs with the same frequency in both sexes over the age of 75 years, is associated with a latent long-term imbalance between the rate of bone resorption and bone formation.
Mixed - a combination of I and II types (the most common).
Idiopathic - in women in the premenopausal period and in men younger than 75 years of age for unclear reasons.
Juvenile - in children in the prepubertal period for unclear reasons, disappears on its own.
Secondary - associated with the intake of GCs, the presence of rheumatic diseases, chronic diseases of the liver or kidneys, malabsorption syndrome, systemic mastocytosis, hyperparathyroidism, hyperthyroidism, etc.
Special studies X-ray examination Early changes - an increase in intervertebral spaces, intense shading of the cortical plates, vertical striation of the vertebrae Late changes - fractures, concavity or biconcavity of the vertebrae Densitometry CT - determination of the bone mass of the trabecular or cortical layer in the lumbar spine Quantitative histomorphometry - a method for assessing the rate of bone mineralization after administration of tetracycline.
With moderate postmenopausal osteoporosis. Ensuring the intake of 1-1.5 g / day of calcium (in the absence of hypercalciuria and calcium stones), for example, in the form of calcium carbonate 600 mg 4-6 r / day, and ergocalciferol 400 IU / day. Continuous hormone replacement therapy (estradiol + dienogest).
In severe or progressive postmenopausal osteoporosis Conjugated estrogens 0.625-1.25 mg/day daily, taking a 5-day break every month to prevent endometrial hyperplasia, or continuous hormone replacement therapy (estradiol + dienogest). During treatment, an annual gynecological examination is required, including Pap smears or endometrial biopsy, annual breast examination or mammography. BP should be determined 2 times a week If treatment is started within 3 years of last menstruation, no bone destruction occurs, but new bone formation occurs If treatment is started later than 3 years after last menstruation, then bone destruction does not occur, but does not occur and the formation of new bone tissue Calcitonin 100 IU / day s / c in combination with a calcium preparation and ergocalciferol - with estrogen intolerance or contraindications to them For fractures: 100 IU / m daily for a week, then 50 IU daily or every other day for 2–3 weeks Maintenance therapy - 50 IU intramuscularly 3 days a week for 3 months, then a break for 3 months Ergocalciferol 600–1000 IU daily under the control of calcium in the urine (not higher than 250 mg / day) ; if exceeded, temporary discontinuation of the drug is necessary with further resumption at a half dose Bisphosphonates Etidronic acid 400 mg / day for 14 days every 3 months (with continuous use, inhibition of bone mineralization is possible) in combination with calcium preparations (500 mg / day) Alendronic acid according to 10 mg 1 r / day for a long time (years) in combination with calcium preparations (500 mg / day); after 3 years, the dose is reduced to 5 mg / day.
In men - calcium 1–1.5 g / day. Calcium malabsorption (calcium content in the urine< 100 мг/сут) дозу кальция повышают до 3 г/сут и дополнительно назначают эргокальциферол в дозеМЕ; необходимо периодическое определение содержание кальция в сыворотке крови и моче.
With steroid-induced osteopenia With urinary calcium excretion of more than 4 mg / kg / day - hydrochlorothiazide (reduces calcium excretion) at 25–50 mg 2 r / day With calcium excretion less than 4 mg / day - ergocalciferol and calcium preparations.
Most often, fractures of the radius, a fracture of the femoral neck, and a compression fracture of the spine occur. Also, the symptoms of this disease include pain in the muscle tissue surrounding the spine, since an increased load is formed in this area due to the weakening of the skeleton. Osteoporosis leads to a feeling of pain in the shoulder blades, deformation of the skeleton and bones.
The “risk group” of people who are likely to get a disease such as osteoporosis includes the following categories of the population:
The disease affects women more than men. This is especially true for women after the onset of menopause, especially if it occurred at an early age or as a result of surgery.
Persons leading a sedentary lifestyle.
Persons suffering from chronic diseases of the gastrointestinal tract.
Patients with chronic renal failure.
People with a hereditary predisposition to osteoporosis.
Smoking, alcohol abuse, coffee consumption also increase the likelihood of a disease such as osteoporosis.
In addition to medical therapy after spinal fractures, doctors recommend the use of corsets that support the back. The therapeutic effect when taking medication comes very slowly, while the corset supports the spine immediately after putting it on. However, such corsets in the upper part press belts or other structural elements on the skin in the area of the shoulders and armpits, and in the lower part they clamp the stomach with a wide belt. In addition, very rarely the corset is able to provide ventilation, and the skin under it sweats and rubs in places.
Reactive arthritis has an ICD 10 code - M02. Joint damage is associated with the development of infection, however, the reaction from the immune system is of great importance, which allows the infection to develop. The duration of the incubation period is 2-4 weeks. Identification of the disease is complicated by the fact that rheumatoid and reactive arthritis can develop simultaneously.
In most cases, joint damage occurs in older people. Pathology is more often formed in males, occurring after a genitourinary infection. In women, the disease appears after the development of an intestinal infection. However, in children, reactive arthritis is also formed, often appearing at the age of 9-14 years.
The causes of arthritis are associated with the presence of an abnormal antigen in the DNA, so the development of a urogenital or gastrointestinal infection leads to the activation of immune T-lymphocytes. As a result of this process, the tissues of the patient are damaged.
The causes of enretoarthritis are associated with poisoning, which is caused by the following bacteria and conditions:
Reactive arthritis also occurs when the genitourinary system is affected by the following infections:
The development of the disease occurs not only during the acute stage of infection. Long stay of the pathogen also has a negative effect. In most cases, the cause of joint damage is associated with the activity of chlamydia. In some cases, pathology is formed after immunization. There are the following ways of spreading urogenital diseases:
Intestinal pathologies penetrate in the following way:
Depending on the cause of the development of reactive arthritis, the following types are distinguished:
The stages of development differ in duration and signs of the disease:
Symptoms of reactive arthritis may appear immediately or after some time. The localization of signs is associated with large articulations of the joints:
In most cases, there is a unilateral nature of inflammation of the joints. The disease affects one or more joints, but inflammation can cover several groups at once:
The main symptoms of reactive arthritis are as follows:
Reactive arthritis is also represented by systemic symptoms:
Against the background of reactive arthritis, there are manifestations of an infection that led to the formation of an ailment. For this reason, rashes may occur on the patient's skin, and the mucous membranes will be irritated. The condition is dangerous, as it can lead to complications. In childhood, there is a threat of developing juvenile-type spondyloarthritis. Dangerous complications are glomerulonephritis and myocarditis.
Diagnosis is an important step, so when signs appear, it is imperative to consult a doctor. Diagnostics includes the following methods:
The diagnosis of reactive arthritis is also based on criteria that can confirm the presence of the disease:
Primary diagnostic data are also important, as primary manifestations can be detected. With the help of radiography, even the smallest changes are determined. Thanks to hardware diagnostics, calcifications located on bone tissues are detected. Radiography is also needed for a long course of pathology in the joints.
The presence of an inflammatory process in the eyes requires a visit to an ophthalmologist. For differential diagnosis, it is necessary to compare the presented form of arthritis with other diseases and types of arthritis:
How to treat reactive arthritis? The basis of therapy is drug tactics aimed at eliminating the signs of the disease and manifestations of infection. Means and methods are selected only by a specialist. Of great importance are antibiotic drugs, which are used taking into account the nature of the infection. Antibiotic treatment is carried out within a week, and after 3 weeks, a diagnosis is made.
The following drugs are used for chlamydial infection:
With an intestinal infection, their own medicines are used. A feature of therapy is the appointment of the presented group after therapy with immunosuppressants. The following medicines are used for treatment:
Additionally, complexes with vitamins and enterosorbents are used. For oral administration, non-steroidal anti-inflammatory drugs are used:
Elimination of pain syndrome is an important task during therapy, therefore, injections of glucocorticosteroids are injected into the area of diseased joints:
Treatment of reactive arthritis with rapid development or the presence of complications requires the appointment of immunosuppressants:
If immunosuppressants do not bring the desired result, then resort to the help of monoclonal antibodies. Infliximab is a representative of this group. They resort to the help of local therapy, for which they prescribe ointments with NSAIDs. Dimexide has good efficiency, which can be used simultaneously with NSAIDs.
Non-drug tactics are associated with providing rest for sore spots. It is useful to use complexes of physiotherapy exercises. The selection of exercises is carried out only by a specialist. To improve well-being and ensure the best result, physiotherapeutic methods are prescribed:
Reactive arthritis requires the use of gymnastics. This treatment allows you to improve blood flow and get rid of the symptoms. During the event, you need to perform movements smoothly. Classes are held every day, the duration is equal to minutes. Use the following exercises:
Reactive arthritis can be treated with traditional medicine, which successfully complements the official treatment. For the first recipe, you will need the following ingredients:
Each ingredient is taken in an amount of 10 g. The mixture of the components is brewed in a glass of boiling water. To prepare the composition, you need 1 spoon of the collection. After 3 hours of infusion, take 1 glass during the day, so the product is divided into equal portions.
In a similar way, a composition is made from the following ingredients:
If reactive arthritis is characterized by severe pain in the joints, then a horseradish and radish recipe will do. The components must be taken in equal proportions, chopped, and then add a small amount of baby cream. The mixture is applied to sore joints. After 1-2 hours, the product must be washed off.
Comfrey ointment will help get rid of pain. The leaves of the plant are crushed, then poured with the same amount of vegetable oil. The agent is boiled for 20 minutes over low heat. A spoonful of Dimexide and 5 ml of vitamin E are added to the composition. For use, the medicine is applied to a compress and applied to the affected areas. The compress is applied for half an hour.
You can prevent the development of reactive arthritis. To do this, it is important to follow the rules of prevention:
If reactive arthritis has appeared, then the patient should undergo a massage course. During the procedure, ointments with anti-inflammatory components are used, which increases the effectiveness of the technique. It is recommended to follow a diet that will help the body cope with infections or other diseases. The patient should avoid eating fried foods and foods with animal fats. Smoked meats and spices are also prohibited. It is recommended to drink a decoction of wild rose. It is useful to include fresh vegetables and fruits in the diet.
If a woman has postmenopausal osteoporosis, treatment should begin without delay. This disease does not pose a threat to the life of the patient. But if urgent measures are not taken, then serious health problems can arise, up to limiting the ability to move around.
Osteoporosis is a disease that is characterized by a decrease in bone mass and a violation of the structure of the tissue of which it consists. The disease leads to fragility and fragility of bones. For many women, it begins to develop after menopause, either naturally or after surgery.
According to the latest global revision of the classification of diseases, the ICD-10 code for this disease is M81.0, which means "Postmenopausal osteoporosis." In terms of frequency of diagnosis, osteoporosis is second only to diseases of the heart, lungs and oncology. It affects at least a third of the world's population over the age of fifty.
The occurrence of the disease can be provoked by such factors:
The risk group includes athletes, elderly ladies and representatives of the Caucasian race.
This disease is not characterized by a pronounced manifestation and rate of development. The disease progresses gradually, declaring itself with new meager and barely noticeable symptoms.
The following signs may indicate the appearance of postmenopausal osteoporosis:
Sometimes fractures occur without any mechanical impact from the outside. This is evidence that the bone tissue of the musculoskeletal system has reached a state of extreme exhaustion.
Since the primary symptoms of osteoporosis are characteristic of many diseases of the musculoskeletal system, an accurate diagnosis requires complex diagnostics. Without this, it is impossible to prescribe an effective course of treatment.
The examination of the patient is carried out in the clinic by the following methods:
Radiography helps to get a picture of the disease only in cases where bone loss is more than a third of the original.
In addition to identifying osteoporosis itself, the patient is assigned to undergo a differential diagnosis. It is necessary in order to determine the causes of the disease and factors that may interfere with its effective treatment. After consultations with specialized specialists, a woman is prescribed a course of medications, recommendations are given on diet and exercise therapy.
The main goals of the treatment of the disease are blockade of the processes of bone tissue resorption and activation of the processes of bone remodeling (formation).
To achieve a successful result, the patient must fulfill the following conditions:
The mainstay of treatment for postmenopausal osteoporosis is systemic hormone replacement therapy.
Depending on the age, the degree of damage to the bone tissue and the characteristics of the body, the patient is prescribed the following drugs:
These drugs strengthen the skeleton, reducing the risk of fractures. Medicines have practically no side effects, having an estrogen-like effect on bone tissue.
During treatment, the patient must adhere to a strict diet. Foods containing magnesium, calcium and minerals should be constantly present in the diet. A good restorative effect is given by jelly, cottage cheese, sea fish and cereals. It is better to refuse coffee, as this drink removes calcium from the body.
To reduce the risk of fractures during physical exertion, the patient is recommended to wear an orthopedic supporting corset. It should be used in everyday life and when performing gymnastic exercises. The goal of the course of physiotherapy exercises is to create muscle mass on the back and limbs. This will help relieve pressure on the bones and prevent fractures. The load is selected for each patient individually.
Thoracalgia (ICD code 10 - M54.6.) is a disease of peripheral nerves, accompanied by severe pain.
Violation of thoracalgia, like pain in the sternum, is sometimes associated with the manifestation of other disorders: heart attack, angina pectoris, etc.
Most often, the disease indicates problems with the spine.
Causes of pain:
When exposed to such processes and disorders, the nerve is compressed by adjacent tissues.
The affected nerve does not perform its normal functions, which may cause pain in the affected part.
Chest pain at a young age is often associated with a Scheuermann-May disorder, due to which there is an increase in kyphosis and deformation of the vertebrae. The cause of pain in the lower part of the sternum of the elderly may be osteoporosis with the presence of a compression fracture of the vertebrae.
Girdle pain in the sternum may appear due to herpes zoster, nerve damage in diabetes, vasculitis.
The risk of thoracalgia is increased by low physical activity, bad habits, heavy lifting, prolonged monotonous work, etc.
There are 4 clinical variants of the disorder:
With osteochondrosis, the occurrence of pain occurs in this way. At the initial stage, there are violations of the structure of the vertebral disc, the core tissues lose moisture and the disc, accordingly, loses its elasticity.
At the next stage, disc protrusion is observed.
The part of the disc protruding into the cavity of the canal presses on the posterior longitudinal vertebral ligament, innervated by the spinal nerves. Irritation of the nerves of this ligament causes back pain, which is called thoracalgia.
In the future, the integrity of the disc capsule is violated and the destroyed nucleus enters the spinal canal - an intervertebral hernia appears.
Basically, a hernial protrusion is observed in the lateral sections of the disc, where the nerve roots pass. At this stage, irritation of these nerves is added, which also causes pain.
Pain syndrome vertebrogenic bilateral lumboischialgia provoke problems in the lumbosacral region. What should you be aware of in this case?
The main manifestations include:
Sometimes pains of this nature are confused with heart problems. Pain in heart disease is of a permanent nature, and the attack is relieved by taking nitroglycerin.
If the pain does not disappear when taking the drug, then this is a manifestation of osteochondrosis.
Intercostal neuralgia, unlike thoracalgia, is characterized by superficial pain along the spaces between the ribs.
For pain in the sternum, it is necessary to exclude another origin of pain associated with the need for medical care. If there is suspicion of an acute illness, then the patient must be urgently placed in the hospital.
Applied research methods for diagnosis:
If the symptoms indicate that the patient has thoracalgia, it is better to start treatment immediately.
For different variants of the syndrome, their treatment is used:
Treatment of deviation with drugs is ineffective without physiotherapy, massage and therapeutic exercises.
The neurologist prescribes the following drugs:
All these activities improve tissue microcirculation, their recovery, and reduce inflammation.
Massage is carried out only after physiotherapy. During massage, the doctor acts on the scapular muscles and the paravertebral zone of the chest.
If acute pain occurs, massage should be stopped for a while.
Moderate exercise is the main way to treat chest pain. Exercise therapy makes it possible to restore the biomechanics of movements, which allows you to stop the development of pathological processes.
Folk methods of treatment:
Folk remedies temporarily neutralize the pain, but do not cure the disease completely.
Gentle manual therapy is performed to mobilize motor segments, remove muscle blocks, eliminate subluxation of the facet joints, reducing pain, restoring range of motion in the spine.
Acupuncture allows you to restore the conductivity of nerve fibers and relieve pain.
For prevention, it is necessary to take care of the spine, carefully handle weights, observe the temperature regime, relax on comfortable furniture, a mattress, and eat well.
It is very important to go in for sports, which will allow you to keep your muscles in good shape, “develop” the spine, and in case of injuries or other disorders of the spine, consult a doctor.
Be aware that infections and other illnesses can also cause pain.
Combined treatment allows you to achieve a positive result in a fairly short time, slow down the development of the disorder for a long time.
Thoracalgia is a complex problem for both diagnosis and treatment, requiring the efforts of a large number of competent specialists.
Osteoarthritis deformans, 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 predominantly affecting the peripheral joints (limbs).
Osteoarthritis 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: deforming arthrosis, osteoarthritis, osteoarthritis.
Osteoarthritis is considered the most common disease of the human musculoskeletal system. More than 1/5 of the world's population is affected by this disease. It is noted that women suffer from this disease much more often than men, but this difference is smoothed out with age. After the age of 70, more than 70% of the population suffers from this disease.
The most “vulnerable” joint for DOA is the hip joint. According to statistics, it accounts for 42% of cases. The 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 an articulation of at least two bones. Such a joint is called simple. In the knee joint, which is complex, having 2 axes of movement, three bones articulate. The joint itself is covered by the articular capsule and forms the articular cavity. It has two shells: outer and inner. Functionally, the outer shell protects the articular cavity and serves as a place for attachment of the ligaments. The inner membrane, 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 (pineal glands). These endings have hyaline (articular) cartilage on their surface, which performs a dual function: friction reduction and shock absorption. The knee joint is characterized by the presence of additional cartilage (menisci), which perform the functions of stabilizing and attenuating shock effects.
The development of arthrosis begins with damage to the tissues of the articular cartilage (ICD-10:24.1 code). The process occurs imperceptibly and is diagnosed, usually, with significant destructive changes in the articular cartilage.
Etiology
The main factors contributing to the development of arthrosis: increased physical stress on the articular cartilage, as well as the loss of functional resistance to normal stress. This leads to its pathological changes (transformation and destruction).
Factors contributing to the development of the disease determine the main prerequisites for its occurrence. So, the loss of resistance can be caused by the following circumstances:
Increased stress on articular cartilage occurs as a result of:
Articular cartilage pathogenesis
The destruction of articular cartilage is caused by prolonged microtrauma of the articulated bone surfaces or a one-stage injury. In addition, some developmental disorders, such as dysplasia, contribute to a change in the geometry of articulating bone surfaces and their compatibility. As a result, the articular cartilage loses its elasticity and integrity and ceases to perform its functions of cushioning and reducing friction.
This leads to the fact that strands begin to form 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 the 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. Osteo-cartilaginous osteophytes are formed (ICD-10 code: M25.7 Osteophyte). Further changes concern the surrounding muscle tissue, which atrophies and leads to a deterioration in blood circulation and an increase in pathological changes in the joints.
The main symptoms of DOA include:
Pain
Joint pain is the main reason for a visit to a specialist. Initially, it manifests itself irregularly, mainly during movement (running, walking), hypothermia, or prolonged uncomfortable body position. Then the pain acquires a non-disappearing character and its intensity increases.
Difficulty in movement
At an early stage, gonarthrosis is characterized by a feeling of "stiffness" that appears after a long rest (sleep, rest). The knee joint becomes less mobile, its sensitivity decreases and pains of varying intensity are felt. All these manifestations decrease or completely disappear during movement.
Another characteristic symptom is creaking, clicking and other extraneous sounds that occur during long walking or a sudden change in body position. In the future, these sounds become a constant accompaniment during movement.
dangling joint
Often, arthrosis of the knee joint leads to its pathologically hypertrophied mobility. According to the ICD code 10: M25.2, this is defined as a "dangling joint". This is manifested in a linear or horizontal mobility unusual for him. A decrease in the sensitivity of the terminal sections of the limbs was noted.
The main functions of the knee joint are to move (motor function) and maintain body position (support function). Arthrosis leads to functional disorders. 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.
With the development of the disease, the motor function of the diarthrotic joint degrades, 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 is manifested in lameness and stiffness of movements, unstable work of the musculoskeletal system. Irreversible processes of deformation of the limb begin, which ultimately leads to disability and disability.
Other symptoms
These non-primary symptoms include:
The problem of diagnosing arthrosis is that the appearance of the main symptoms with which the patient comes to the specialist already indicate 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, 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 the pain, the presence of excess joint fluid. It seems possible to determine the amplitude of movement of the affected area, to understand the degree of limitation of motor function. In some cases, characteristic deformities of the limbs are noticeable. This happens with a long course of the disease.
Instrumental examination methods
The main methods of instrumental diagnosis of DOA include:
In 90% of cases, an x-ray is enough to diagnose arthrosis. In cases that are difficult or unclear for diagnosing, other methods of instrumental diagnostics are in demand.
The main signs that allow diagnosing DOA by X-ray:
In some cases, radiography reveals a number of additional signs of arthrosis: articular cysts, joint erosion, dislocations.
Senile osteoporosis is a pathology of bone tissue, characterized by a change in its density. The result of the disease is a gradual degeneration of the bone tissue of the skeleton, leading to bone fragility. The consequences of the disease are frequent fractures.
Since calcium is washed out of the body gradually, without causing pain or any discomfort, patients turn to the osteoporosis center already at advanced stages of the disease.
The word "senile" is a synonym for the word "senile", which explains the specifics of this form of the disease. The disease is diagnosed only in elderly patients, mainly at the age of 65-70 years. Pathology is characterized by slow progression, damage to the bone tissue of the trunk and extremities. Like other types of diseases of the musculoskeletal system, senile osteoporosis is more typical for women than for men. More than 75% of cases of this disease occur in women in the postmenopausal period.
The international classification of diseases ICD-10 designates senile osteoporosis with the code M81.8.0.
The main feature of the disease is an equal lesion of the bone tissue of the trunk and limbs. This distinguishes the pathology from other types of the disease, since most often with osteoporosis, the bone structures of the spinal column and large joints (knee, hip) suffer.
The main reason for the development of the disease is the changes that occur in the body as it ages.
Bone tissue gets stronger up to 30 years. The maximum density of the skeleton remains on average up to 40-45 years, then the aging process begins, as a result of which the bones become more fragile. Each person is different, osteoporosis does not appear in everyone. Conditions associated with aging play an important role in the development of this disease, including:
Hormonal changes, against which senile osteoporosis can develop, primarily affect women. A sharp decrease in estrogen levels is potentially dangerous for the development of skeletal disorders. This happens after menopause. Despite the fact that the average age of menopause is 50 years, osteoporosis develops slowly, so the first symptoms may appear after 10-15 years. In men, hormonal levels also change with age, but these processes occur gradually, and not abruptly, as in women, so men suffer from osteoporosis much less often.
The development of the disease contributes to a violation of the absorption of vitamins and minerals. As a rule, this occurs against the background of severe pathologies of the gastrointestinal tract or the intake of certain groups of drugs. The lack of calcium in the body is one of the main factors in the occurrence of bone diseases. Deficiency of this element develops due to a violation of the production of certain gastric enzymes that help absorb calcium from food, or against the background of taking diuretics that stimulate active leaching of calcium from the body.
A poor diet or an unbalanced diet is another reason for the development of osteoporosis. A person absorbs the main part of calcium from food, so the lack of dairy products, fish, greens and nuts in the diet leads to a lack of this element and negatively affects the condition of the bone tissue.
Osteoporosis as a secondary disease develops against the background of endocrine disorders.
Thyroid disorders, metabolic disorders, diabetes mellitus and gout are all diseases that can lead to a decrease in bone density.
Senile osteoporosis is a pathology with slow progression. Symptoms become noticeable only when bone density decreases by more than 35%. These include:
The first symptom is a sudden increase in stoop. Long walks or work associated with physical labor are the cause of aching pains in the bones of the lower extremities. A person is tormented by back pain, aggravated in the morning and with a long stay in an upright position.
As a rule, loss of bone density is manifested by a decrease in height. With osteoporosis, a person loses from 5 to 15 cm of height, depending on the severity of the pathological process.
With this disease, the bones become brittle, so any injury or fall is potentially dangerous with a fracture.
Senile osteoporosis is diagnosed using X-ray, densitometry, and other clinical and laboratory tests.
Ultrasound can detect senile osteoporosis at an early stage. This method of examination detects even minor changes in the structure of bones, when their density decreases by 5-10%. Radiography can diagnose osteoporosis with a decrease in bone density by 25% or more.
As a rule, the diagnosis is made with a significant decrease in the volume of bone tissue, when pronounced symptoms of osteoporosis appear. Early diagnosis is usually done by chance when the patient goes to the doctor with other complaints.
Timely diagnosis is an important condition for effective treatment. Persons over 50 years of age who are at risk of developing osteoporosis are recommended to undergo an annual examination for early detection of the pathological process.
Due to the peculiarities of the development of senile osteoporosis in elderly patients, a fracture of the femoral neck is often diagnosed. A decrease in bone density leads to a slowdown in regeneration processes, so recovery after a fracture is very difficult. In the vast majority of cases, such an injury leads to disability or even death.
Another complication of senile osteoporosis is marked changes in posture. The curvature of the spine against the background of this disease negatively affects the functioning of internal organs, which can worsen the course of existing chronic diseases.
With senile osteoporosis, treatment is aimed at filling the lack of calcium in the body. This allows you to slow down the pathological process and improve the condition of the bones. For this purpose, preparations based on calcium and vitamin D are used.
To reduce the rate of progression of the pathology, hormonal drugs can be used: Calcitonin and Somatotropin. To improve the regeneration of bone and cartilage tissue, chondroprotectors (Chondroitin and analogues) are used.
To improve bone regeneration, physiotherapy is prescribed: radon baths, magnetic field treatment, laser exposure. Be sure to prescribe gentle gymnastics. Walking and swimming are recommended for elderly patients.
From folk remedies, decoctions of such medicinal plants are used, such as:
Decoctions will not relieve osteoporosis, but they will improve the absorption of calcium from food. Folk remedies can be used as an auxiliary method. Herbal decoctions will increase the effectiveness of a special diet that includes foods high in calcium.
Moderate exercise can restore bone mass by 2-3% in 3-4 months, and bed rest, on the contrary, will lead to a loss of bone volume up to 15%
It is necessary to treat senile (or senile) osteoporosis comprehensively, treatment is most effective at the initial stage of the disease. The prognosis is unfavorable, since it is impossible to completely restore bone tissue. Taking medications will improve the patient's quality of life, but the diagnosis of osteoporosis will remain with the person forever.
Prevention of senile osteoporosis should begin at a young age. It comes down to proper nutrition. It is important to avoid deficiency of calcium and other minerals, lead an active lifestyle and be attentive to your own health.
