Calcification Sendi Knee
Rheumatology Division & nbsp; Department of Internal Medicine
FK Padjadjaran University / Hasan Sadikin Hospital
Bandung, West Java
Calcification of the joints & nbsp; often experienced by those over 50 years old. & nbsp; This disease is the most common rheumatic disease compared to other rheumatic diseases. The term joint calcification is often misinterpreted by patients or the general public so that this disease is associated with excessive calcium in the body. Some patients also think that this disease is due to too much calcium they consume, even though it is not related. & Nbsp; In medicine this disease is known as osteoarthritis, & nbsp; because the mechanism of this disease is not only due to calcification of the bones around the joints but also involves many other factors, therefore the term joint calcification will then be replaced by & nbsp; be osteoarthritis (OA) in this paper.
The most important thing to know about osteoarthritis is that it cannot be cured, but if detected early and treated properly it can be controlled and more severe joint damage can be avoided. Patients with OA are generally able to carry out daily activities well with the help of proper therapy, good habits, exercise and rest as well as joint aids and surgery (if needed). The joints most commonly affected are the knee joints.
What is osteoarthritis ?
Osteo means bone, artr means joint, and itis means inflammation. Inflammation causes pain, stiffness and swelling. & Nbsp; So osteoarthritis means inflammation of the joints and surrounding bones. At first, OA was thought to be purely due to a degenerative process (aging) and pain that occurs due to a mechanical process, but it turns out that there is also an inflammatory process that causes pain. & Nbsp; There are various kinds of rheumatoid arthritis that cause arthritis or inflammation in the joints, such as rheumatoid arthritis, gout and arthritis. In general, the inflammation that occurs in OA is milder than in other arthritis diseases. OA disease is a rheumatic disease that is most often found in the community, especially in those over 50 years of age.
Osteoarthritis occurs when the cartilage (cartilage) between two joints becomes worn. & nbsp; This cartilage serves to protect the ends of the bones and is also useful as a cushion so that the bones do not collide with other bones when the joint is moved, and joint movement becomes smooth.
Figure 1. Normal joints and osteoarthritic joints
In the condition of osteoarthritis, & nbsp; cartilage & nbsp; becomes erosive, thinner, and uneven, causing pain, stiffness, swelling and disturbances in joint movement. & nbsp; (see figure 1). & nbsp; Cartilage becomes worn & nbsp; causes the bones around the joint to collide with one another and there are small fractures in the bone, as a result the body will react to form new bone and create new pieces of bone (osteophytes) known as calcification. Furthermore, the bones around the joint & nbsp; undergoes a change in shape (deformity) and becomes bigger.
Osteoarthritis also causes stiffness in joints but generally only 15-20 minutes, especially in the morning. If the joint is used, it will feel even more painful. At rest the pain will be reduced, as a result the patient is often reluctant to move and more sitting still. This can lead to muscle atrophy or wasting due to underuse, which will further worsen the osteoarthritis.
If it is not anticipated, over time the cartilage will thin out and the bone meets the bone directly. In this situation the patient will feel even more sick.
Joints frequently affected by osteoarthritis
Not all joints in the body are affected by osteoarthritis, generally only certain joints that support the weight of the body such as the knee joint (most commonly affected), hip, spine. (see figure 2) & nbsp; Several other small joints can also be affected such as joints in the fingers, especially the tip (distal) accompanied by a lump in the bone known as Herbeden’s node. (see figure 3). The joints of the toes are also frequently affected.
Figure 2 joints of the body that are often affected by osteoarthritis.
Figure 3. Herbeden nodes on the finger
What are the symptoms of osteoarthritis ?
Symptoms of OA generally appear slowly and can be months or even years. & nbsp; Patients generally feel that their knees are:
- Pain that appears slowly, gradually becomes more frequent.
- Early in OA, pain is usually caused by strenuous physical activity such as after running, walking long distances, or after going up and down repetitive stairs.
- Further, pain is caused by everyday activities such as when getting up from squatting, or when prostrating, and standing for a long time.
- Pain usually gets worse when the joint is used and improves when rest.
- When moved it causes crepitus sounds
- May be accompanied by swelling and stiffness which lasts approximately 15-20 minutes.
Figure 4 Osteoarthritis pain in the knee joint
Diagnosis of Knee osteoarthritis
How do doctors make a diagnosis of OA? Actually there is no single blood test that can be used to detect OA. The doctor will do a question and answer and collect data about the complaints that the patient feels, then performs an examination of the joint and sometimes requires x-rays of the affected joint to determine that the disease experienced by the patient is osteoarthritis. Suppose a blood test is done is to rule out another disease or to assess whether it is safe to administer drugs.
Risk Factors for Osteoarthritis Knee
The risk factors for OA are
- Age: with increasing age, the tendency for OA to occur will be greater. It does not mean that everyone in their old age will experience this OA disease.
- Family history: there is a genetic role in OA, where the family has OA, the likelihood of experiencing OA is also greater.
- Excessive weight: If the weight is too much then the knee and hip joints have to work harder to support the weight, because it will wear out more easily than those of a normal weight. Lighter weight will mainly reduce the pressure on the joints and also reduce pain in the joints.
- Joint trauma: Trauma to the joints causes damage to the cartilage, which in turn causes changes to the joints, resulting in a history of trauma & nbsp; can cause OA.
- Complications from other arthritis diseases: OA can also be caused by other arthritis diseases, for example gout disease or rheumatoid arthritis. This disease can cause damage to the cartilage of the joints, leading to further OA.
How to treat osteoarthritis knee
It is important to early diagnose OA so that further damage is prevented and disability is avoided. The goals of osteoarthritis therapy are: to control pain, increase the ability of joint activity and function, and prevent further joint damage.
- Rest in severe pain:
If the pain in OA is accompanied by signs of inflammation such as swelling, redness, and warmth, it is necessary to rest the joint for a while. See a doctor for a good treatment for pain and inflammation.
Avoid or reduce activities that can cause pain in the joints, such as squatting, standing for a long time, going up and down stairs. & nbsp; & nbsp; As soon as the pain decreases & nbsp; & nbsp; it is important to resume activities so as to keep the muscles around the joints from becoming arthropic.
Do exercises / sports according to your ability and increase joint strength.
Figure 5. Exercises that can be performed on osteoarthritis
- Lose weight if excess: Losing weight can reduce the burden on joints that support body weight.
- Eating healthy foods: choose healthy foods, including many nutritious substances that the balance also includes green vegetables and nuts.
Figure 6. Eat a healthy diet, including green vegetables
- Using assistive devices: & nbsp; Assistive tools such as canes, deckers etc., can help reduce pain in the affected joint, discuss with your doctor which tool is appropriate to use.
Figure 7: Some tools that can be used in OA
- Use of drugs: should be under the supervision of a doctor, some anti-pain drugs have dangerous side effects in certain patients, so it is necessary to discuss with your doctor about the safety of these drugs.
Figure 8: Medications for osteoarthritis
- Operation: Operation is performed if both drug and non-pharmacological therapy has been performed but has not been successful. The operation can be done in the form of replacement of the joints affected by the OA.
Knee osteoarthritis is a disease that affects the joints, causing pain and can cause joint damage and impaired function and activity for the sufferer. Early recognition and prevention of joint damage can be done so that disability can be avoided in this disease.
- Indonesian rheumatology association website: https://reumatologi.or.id