The metaphyses expand, and the epiphyses sink into them. The epiphyses are deformed, flattened, enlarged in diameter and protrude to the sides in the form of flat bowls. The articular surfaces of methotrexate are straightened and sclerosed in the subchondral regions.
The timing of the appearance of ossification nuclei is disturbed due to the accelerated maturation of the skeletal system. The vertebrae are relatively rarely affected. The bones of the brain skull can be affected in isolation in the neurovisceral form of the disease: the presence of multiple lacunar-cystic enlightenments in the spongy substance is characteristic.
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Periodontal disease is often observed in the form of marginal rarefaction along the alveolar processes of the jaws. Articular and intervertebral spaces narrow, but the degree of Methotrexate pills depends on the nature of the changes in the bone and the duration of the disease. As the disease progresses, shortening and curvature of the tubular bones occurs.
Characterized by early synostosis of the epiphyses with metaphyses and premature cessation of skeletal growth. In the future, deforming arthrosis develops with the formation of intra-articular bodies and an increase in the relief of the bones at the places of attachment of the ligamentous bursal apparatus.
Kashin-Beck disease is characterized by: the onset and development during the growth period, more often at the age of 6-14 years, the confinement of the disease to living in a certain area, the symmetry of the damage to the joints of the extremities, short stature, short-fingeredness, fever-free course, the absence of an inflammatory shift in ESR.
In the initial period and with an erased form, the anamnesis and Methotrexate online of the hands are leading in the diagnosis. When differentiating with rheumatoid arthritis, it should be borne in mind that for it, unlike Kashin-Beck disease, the presence of osteoporosis and ankylosis in the joints is typical and shortening and curvature of the axis of tubular bones is not typical.
These main symptoms, along with radiographic data, make it possible to make a diagnosis and make a differential diagnosis with rheumatoid arthritis, chondrodystrophy, and osteochondropathy.
There is much in common with chondrodystrophy: low growth of patients, shortening of tubular bones, premature synostosis of the epiphyses, deformation of the epiphyses and metaphyses. However, with chondrodystrophy, the bones that form the hip, knee, and shoulder joints are most often affected, and are rarely involved in the process of the phalanx of the hands and feet. It is more difficult to differentiate Kashin-Beck disease from epiphyseal dysplasia, and therefore the endemic history is given the dominant value.
The main role belongs to balneological, physiotherapeutic methods, physiotherapy exercises and massage. Especially effective are repeated (3-6 courses) treatment with radon baths, applications of paraffin, ozocerite or mud. Diathermy, ultrasound, UHF, light and brine baths are also used.
The treatment is aimed at improving the function of the joints, combating contractures, pain, and increasing efficiency.
Treatment must be carried out persistently, repeated courses. According to the indications, surgical treatment is carried out. The goal is possibleThe most important surgical intervention is the elimination of methotrexate contractures in the joints and the restoration of movements in them. Operations are indicated for patients with stages 2 and 3 of the disease, as well as at a young age with gross changes in the joints and in the presence of contractures. According to the indications, arthrotomy with the removal of intraarticular bodies and joint arthroplasty can be performed.
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Of the medicines, calcium and phosphorus preparations, vitamins B 1, B 12, C, aloe, vitreous, fibs are widely used, according to indications - painkillers. Arthrotomy is most indicated on the knee joint. It is made from a parapatellar incision, which makes it possible to revise the joint and remove free chondromic bodies, altered cartilage and menisci in case of their disfigurement and fragmentation. At the same time, if there is a contracture of the joint, redressing is performed.
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In cases of disfigurement of the joints with a gross deformity of the limb, joint arthroplasty is indicated. The recovery period after surgery for Kashin-Beck disease includes a set of measures aimed at restoring the function of the operated limb: early therapeutic exercises from 5-7 days, massage, physiotherapy, spa treatment, restorative treatment with the use of calcium preparations, multivitamins.
The prognosis for life is favorable. Treatment undertaken in the initial period of Rheumatrex pills leads to recovery in 30% of patients, and in more severe forms it can stabilize the process. In endemic foci, measures should be taken simultaneously against Kashin-Bek's disease and endemic goiter in humans, as well as against Urov's disease in animals, since these diseases occur in the same territory.
Preventive measures include land reclamation, soil mineralization, the creation of specialized livestock farms, the enrichment of the animal diet with mineral supplements, the supply of the population with imported products containing a sufficient amount of mineral salts, and with water from artesian wells.
Young people, as well as pregnant and lactating women twice a year for 0.5-2 months are prescribed calcium supplements, seaweed, vitamins A, C and D.
In the foci of endemia, the correct organization of medical control over the physical development of children and adolescents, qualified sanitary and educational work, and the improvement of living and working conditions are of great importance.
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