Arthrose und Arthritis
详细信息 查看全文
- 作者：S. Egger
- 关键词：SchlüsselwörterGelenkerkrankungen ; Arthrose ; Synovialitis ; Inflammation ; Entzündungsmediatoren
- 刊名：Manuelle Medizin
- 出版年：2017
- 出版时间：March 2017
- 年：2017
- 卷：55
- 期：1
- 页码：14-17
- 全文大小：
- 刊物类别：Medicine
- 刊物主题：Chiropractic Medicine; Orthopedics; Conservative Orthopedics; Rehabilitation; Sports Medicine;
- 出版者：Springer Medizin
- ISSN：1433-0466
- 卷排序：55
文摘
Arthrosis is accompanied by degenerative alterations to the joint cartilage, joint capsule and subchondral bone. Arthritis is characterized by inflammatory alterations, which initially appears as synovitis, an inflammatory process of the joint capsule. Despite being two different medical conditions, ongoing arthritis can lead to secondary osteoarthritis and progression of osteoarthritis often causes inflammation of the capsule, resembling arthritis. Osteoarthritis and arthritis seem to have several features in common. The pathogenic pathway of both diseases appears to consist of three stages. Furthermore, the diagnostics of both joint ailments rely mostly on taking the patient history and physical examination due to the limitations of laboratory tests and imaging tools. In addition, therapeutic management aims at rapid symptom control as well as improving long-term outcome. Despite these similarities between arthrosis and arthritis, there remains one important difference: the kind of inflammation observed with both diseases show essential differences. Synovial inflammation in arthrosis represents a chondrodendritic synovitis and is therefore a reaction to exfoliation products of the cartilaginous joint capsule. At the cellular level mediators are released with proteolytic (MMP and collagenases) and proinflammatory (IL-1, NF-B, PGE2) effects; however, this additionally results in the formation of a highly aggressive tissue destructive connective tissue proliferation in which mediators, such as TNF-alpha and IL-6 play a key role. This results in extensive destruction of bone and soft tissue components with skeletal deformation and permanent disability.