Bone hyperplasia

Introduction to bone hyperplasia Osteoporosis is a disease in which local joints, muscles, and ligament activity disorders are caused by bone pathological hyperplasia, accompanied by pain as the main symptom. Can occur in the cervical vertebrae, lumbar vertebrae, joints and calcaneus, including hypertrophic spondylitis, hypertrophic osteoarthrosis and calcaneus. The disease occurs in middle-aged and older people over the age of 40 and is engaged in weight-bearing, long-standing, sedentary staff, with more common joints and spine lesions. The etiology of bone hyperplasia has not been known so far, and it is mostly attributed to the category of senile degenerative diseases. There are many hypotheses about the etiology and pathogenesis, such as mechanical theory, functional theory, vascular disorders, metabolic disorders, and endocrine disorders. The basic understanding is based on internal factors, caused by the induction of external causes. At present, Western medicine uses non-hormonal anti-inflammatory analgesic drugs, physiotherapy and surgical treatment, which has certain effects on relieving symptoms, but so far there is no special effective therapy. basic knowledge The proportion of illness: 0.078% Susceptible people: good for middle-aged and older people over 40 years old and engaged in weight-bearing, long-standing, sedentary staff Mode of infection: non-infectious Complications: swelling

Cause of bone hyperplasia

Pathology (15%):

Irregular cartilage damage, subchondral bone sclerosis, cysts, marginal epiphyseal hyperplasia, increased blood flow to the metaphysis, and varying degrees of synovitis in the weight-bearing area. At present, Western medicine has no effective treatment for this disease, and it is often treated with symptomatic treatment.

Histology (10%):

Early cartilage surface fragmentation, chondrocyte proliferation, cartilage surface longitudinal splitting, crystal deposition, cartilage repair, osteophyte hyperplasia; late cartilage destruction, manifested as cartilage sclerosis, cartilage disappearance and subchondral focal bone Necrosis.

Biomechanical and biochemical changes (35%):

Articular cartilage has reduced stretchability, anti-stress, shear resistance and cartilage permeability. The cartilage has increased moisture, excessive swelling, and hardening of the subchondral bone. The content (concentration) of proteoglycan decreased, the molecular size and aggregation degree changed, and the size and arrangement of collagen fibers and the synthesis and degradation of matrix macromolecules all changed abnormally.

Nutrition: The underlying cause of bone hyperplasia is calcium deficiency. It is the result of a stress response.

Osteoporosis is a category of "sputum syndrome" of traditional Chinese medicine, also known as "bone callus". Chinese medicine believes that this disease is related to trauma, strain, blood stasis, feeling cold and dampness, phlegm and dampness, liver and kidney deficiency.

Cervical bone hyperplasia

Age factors, chronic strain, trauma, throat inflammation, developmental spinal stenosis, congenital malformations of the cervical spine, metabolic factors, and mental factors can all cause cervical hyperplasia.

Lumbar vertebrae hyperplasia

(1) From time to time:

The first stage is the concealed stage, and the hyperplasia has actually appeared. The thickness or length of the hyperplasia is only about 1 to 2 mm. At this time, it does not affect people's activities, and there is no self-feeling, or a slight feeling is not reflected as obvious symptoms. Therefore, in the hidden period generally can not attract people's attention. This phase lasts approximately one to two years.

The second stage is an obvious stage. The length of bone hyperplasia exceeds 5 mm, which has a significant effect on human activities. When the left intervertebral disc proliferates, the human body tilts and bends to the left, and the left limb causes acid, pain, and numbness. The opposite is also true. Some people also have some symptoms when they are in normal position, which means that somewhere nerves have been oppressed for a long time. If you don't get radical treatment at this stage, you may suffer from long-term pain and even affect normal life activities. This phase can last for many years and continues to enter the third phase.

The third stage is the stage of paralysis or dyskinesia. Generally, there are many sites of hyperosteogeny, and the length of hyperplasia exceeds 10 mm. It has not been well treated for many years, leading to difficulty in walking or walking. This situation is relatively rare in the clinic.

(2) From the form:

1. Bubbling: The most common clinically, that is, the outer layer of the bone is thickened to make the surface layer bulge. It is called disc bulging, also called protrusion or hypertrophy.

2. Keratosis: At the upper corner of the disc, it is shaped like a horn plate, and it is lifted upwards, and the edge has a pointed protrusion, which is most likely to cause serious symptoms. It usually occurs on the cervical and lumbar discs.

3. Columnar hyperplasia: occurs in small joints with large angles of activity, such as knuckles, knee joints, etc. Local symptoms are more obvious but have little effect and less pain. However, some people also grow a column of up to 20 mm in the lumbar vertebrae, the impact is very serious.

4. Granular sputum: occurs in the active joints of the thumb and palm, and a globular bone is produced outside the joint joint, with a particle size of about 4 to 6 mm. Affects the normal operation of his fingers, even powerless. This can also occur at the knee joint.

Knee hyperplasia

1 Trauma factors due to injury, knee deformity or inflammation and other factors cause changes in the negative gravity line of the knee joint, so that the effective weight-bearing area of the knee joint surface is reduced, the joint surface is unevenly stressed, and the impact-concentrated part is prone to damage of the articular cartilage, and Caused a small fracture of the trabecular bone (sub-fracture), bone collapse, followed by subchondral bone sclerosis. At the same time, due to changes in the articular cartilage matrix and synovial fluid components of patients with knee joint hyperplasia, the cartilage elasticity and the lubrication of the surrounding synovial fluid are lost, so that the cartilage is susceptible to wear. The epiphyseal hyperplasia around the knee joint is a kind of repairing phenomenon of joint damage. The body is to increase the joint weight area and reduce the pressure to produce the modern compensatory epiphyseal hyperplasia.

2. Autoimmune response After the knee joint cartilage is damaged by mechanical factors, the "concealed antigen" of articular chondrocytes, mucopolysaccharide and collagen is exposed, causing an autoimmune reaction and causing secondary damage to the cartilage. Knee joint hyperplasia patients often have joint swelling, repeated joint synovitis, increased monocytes, immunoglobulins and complements in synovial fluid, hyperemia in the synovium and mononuclear cell infiltration, which suggest knee bone Hyperplasia may be related to autoimmune responses.

Heel bone hyperplasia

Heel bone hyperplasia is a normal physiological degradation phenomenon, which is a protective physiological response of the human body. It is difficult for everyone to avoid. The difference is that some people appear earlier and some appear later, After the age of 40, bone hyperplasia gradually becomes obvious, and the degree of hyperplasia is also different. Any joint with more activity and the largest negative body has bone hyperplasia earlier, and the lumbar vertebrae and the lower visceral joints are major, so it is often bone hyperplasia. The most part of the hair. The heel hyperplasia of the heel is especially frequent.

Prevention of bone hyperplasia

1. Avoid long-term intense exercise. Long-term excessive exercise is one of the causes of bone hyperplasia. Long-term intense exercise can cause uneven stress on the bones and surrounding soft tissues, and the load is too heavy, leading to bone hyperplasia.

2. Proper physical exercise to avoid long-term intense exercise, does not require exercise. On the contrary, proper physical exercise is a good method to prevent bone hyperplasia, because the nutrition of articular cartilage comes from joint fluid, and the joint fluid only depends on "Squeeze" can enter the cartilage, promote bone metabolism, proper exercise, especially the necessary movement of the joint, can increase the pressure in the joint cavity, facilitate the penetration of cartilage between the joint fluid, and reduce the degenerative changes of articular cartilage, Thereby reducing or preventing bone hyperplasia, especially the proliferation and degenerative changes of articular cartilage.

Therefore, the method of rehabilitation of bone hyperplasia is exercise, the significance is to eliminate or reduce the pain of the hyperplasia site and the resulting dysfunction, to maximize the recovery of their living and labor ability, improve and improve the quality of life of patients.

Bone hyperplasia complications Complications swelling

Different complications may occur depending on the location of the bone hyperplasia.

Symptoms of bone hyperplasia Common symptoms Tired spine degeneration neck and back pain Foot heel long bone spine bone bone changes joint pain index finger and middle finger stiffness pain mammary bone wear and osteophyte hyperplasia lumbar long bone stab lower limb weakness

Bone hyperplasia occurs mostly in middle age. It is generally believed that due to the weak constitution and degenerative changes after middle age; standing or walking for a long time and holding in a certain position for a long time, due to muscle pulling or avulsion, hemorrhage, hematoma is formed, forming a thorny or lip-like bone Hyperplasia; spurs produce mechanical stimulation of soft tissue and soft tissue injury, hemorrhage, swelling after trauma.

Cervical bone hyperplasia

Cervical vertebrae 4, 5, and 6 vertebral bodies are the most common. If bone hyperplasia occurs in the cervical vertebrae, the bone spur compression blood vessels directly affect blood circulation, and the performance is various. Mainly have neck and back pain, upper limb weakness, finger numbness, dizziness, nausea and even blurred vision, swallowing blurred. If the bone spurs press the spinal cord into the spinal canal, it can also lead to unstable walking, paralysis of the limbs, numbness of the limbs, incontinence and other serious consequences.

Clinical manifestations: the neck has a strong feeling, limited activity, and the neck activity has a sound of sound. The pain is often radiated to the shoulders and upper limbs. The hands and fingers have numbness and electric shock, which can be aggravated by the neck activity. Different lesions involve different parts, and different symptoms appear, which can lead to paralysis in the late stage. Patients with severe cervical hyperplasia can also cause cervical spondylosis, cardiovascular and cerebrovascular diseases, gastritis, angina pectoris, and difficulty swallowing.

1, nerve root type

Symptoms: Pain and radiation pain in the neck, shoulders, buttocks, and wrists. And the range is consistent with the area dominated by the cervical spinal nerve. Severe neck movements can be limited, especially when stretched and rotated.

Neck pain is the main symptom of the nerve root type.

2, spinal cord type

Symptoms: numbness of the limbs, soreness, burning. When walking, it feels like stepping on cotton, the body is unstable, and it is easy to fall.

3, vertebral artery type

Symptoms: dizziness, migraine, visual impairment, dysphonia, tinnitus, deafness, and tripping.

4, esophageal type

Symptoms: There are symptoms such as throat discomfort, foreign body sensation, and difficulty swallowing.

5, sympathetic type

Symptoms: One side of the eye is small, the pupil is not large, the vision is blurred, the face is dry, and sweating is less.

Lumbar vertebrae hyperplasia

Clinical manifestations: the most common site, with waist three and waist four are the most common. Clinically, lumbar and lumbar soft tissue pain, pain, stiffness and fatigue often occur, and even bending is limited. If the adjacent nerve root is compressed, it can cause the corresponding symptoms, local pain, stiffness, post-root neuralgia, numbness and so on. Such as compression of the sciatic nerve can cause sciatica, severe limb pain, burning, pain, string pain, radiation to the entire lower extremity.

Knee hyperplasia

Clinical manifestations: In the early stage, the knee pain is not serious, the pain is persistent, the pain is aggravated when the temperature is lowered, and it is related to climate change. After the morning, the activity starts, walking for a long time, strenuous exercise or sitting up and starting to walk. The knee joint is stiff and stiff. After a little activity, it is better to go up and down the stairs. When going downstairs, the knee joint is soft and easy to fall. Pain, stiffness, severe, joint pain and pain, sputum walking, joint swelling and rheumatism, deformity, limited function, flexion and flexion of extension and flexion, some patients can see joint effusion, local swelling, Compression phenomenon.

Heel bone hyperplasia

Clinical manifestations: The symptoms are foot tenderness, pain in the soles of the feet, heavy in the morning, light in the afternoon, the first step of getting up under the pain can not be tolerated, when the time is light and heavy, the heel does not dare to use when walking, there is the feeling of stone scorpion, acupuncture, activity Symptoms are relieved after opening, and long bone spurs in the calcaneus are more common in middle-aged and elderly people.

Examination of bone hyperplasia

If patients with osteoarthritis do blood routine, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor and other tests, generally in the normal range, a small number of severe inflammation, erythrocyte sedimentation rate and C-reactive protein may be slightly elevated.

Synovial fluid examination: affected joints such as conjunctivitis may have increased synovial fluid volume, typical clear, sticky, low cell count (<20X109 / liter), mostly monocytes, cartilage or bone fragments visible in sputum Chondrocytes are visible in the granules and cartilage fragments.

Arthroscopy: can directly observe the internal conditions of the joint, can clearly observe the articular cartilage and its surrounding tissue, but because this examination is a traumatic examination, it may be accompanied by adverse reactions such as infection or bleeding, and the cost is high, it is impossible to be a routine an examination.

X-ray plain film is not only a routine examination method for this disease, but some scholars also believe that it is the gold standard for tracking changes in the condition. When taking a knee joint piece, the patient should take the standing position and the lateral position piece, hip joint and The hand joints can only take the anterior and posterior slices. In the early stage, the X-ray films are mostly normal. In the middle and late stages, the asymmetry of the joint space is narrow, the articular surface is hardened and deformed, the osteophytes of the joints are formed, the subcapsular cysts and the joint cavity. Free liquid, etc., the x-ray characteristics of osteoarthritis are:

1 joint gap is narrow, as in the knee joint, can be less than 3 mm;

2 joint surface hardening deformation;

3 joint edge osteophytes;

4 joint rats;

5 subchondral cystic changes, the edge boundary is clear;

6 bone deformation or joint subluxation.

X-ray films can be divided into five grades, grade 0: no change; grade 1: minor osteophytes grade 2: obvious osteophytes, normal joint space; grade 3: moderate stenosis of joint space outside the epiphysis; grade 4: outside the epiphysis The joint space is severely narrowed with subchondral bone sclerosis. With the application of new imaging techniques such as micro-focus photography; CT, magnetic resonance and three-dimensional reconstruction, in addition to the diagnosis of osteoarthritis, it has reference value for detailed understanding of the pathological progress of osteoarthritis and drug efficacy.

Diagnosis and differentiation of bone hyperplasia

General diagnosis

(1) The patients with this disease are mostly middle-aged and elderly people over 40 years old, accompanied by lumbar stiffness pain or numbness of lower extremities. Some patients may have abnormal lumbar vertebral curvature; some muscles on both sides of the lumbar spine have tenderness.

(2) changes in lumbar X-ray films (positive position, lateral position, left and right oblique position), such as patients with lumbar curvature abnormalities, lumbar scoliosis, lumbar vertebral body space narrowing, lumbar vertebral body and facet joint hyperplasia, Lumbar spondylolisthesis, intervertebral foramen stenosis and other changes.

(3) The various symptoms of lumbar vertebra hyperplasia should be differentiated from a variety of lumbar diseases, such as lumbar disc herniation, vertebral body malformation, vertebral body tumor, lumbar tuberculosis and other diseases. Generally, people over the age of 40 have the highest incidence among the population.

Self-diagnosis

Judging from the feeling of the individual. Most of the bone hyperplasia occurs in the cervical and lumbar spine, and can occur at the fingers, knee joints, and heel. The hyperplasia of the cervical vertebrae has its symptoms in the head and upper limbs, and may also affect the whole body, and more of the upper limbs. There are no obvious symptoms in the cervical vertebrae, and the upper limbs are obvious. Generally, hyperplasia is on one side (not left or right), and there may be pain, swelling, and numbness in one line from the shoulder joint to the upper arm and the lower arm.

When the right arm has this symptom, if the head is tilted to the right, the symptoms will be aggravated. Symptoms within the muscle are not related to weather changes and are only related to activity. When the hyperplasia is at the waist, the symptoms are not at the waist, but from the hip sciatic nerve, along the sciatic nerve to the heel, especially in the calf muscles. This indicates that the bone hyperplasia is caused by compression of the nerve, which can basically confirm the diagnosis. If it appears at a certain point in the local area, especially only at the joint, it should not be regarded as hyperplasia (except for knee joint hyperplasia). It is better to test rheumatism first.

Pain in other muscle parts and pain caused by bone hyperplasia are different. Other pains may have redness and fever at the same time, and the pain of bone hyperplasia does not produce any other symptoms, just soreness, numbness, etc., when the weight is heavy, the course of disease is long, and the disease is healed for many years.

Moreover, the condition of the disc protrusion should be excluded. If there is trauma and sprain, it is better to take the film first. Because the symptoms of prominence and hyperplasia are similar, so as not to treat the symptoms.

Differential diagnosis

Various symptoms of lumbar vertebra hyperplasia should be differentiated from a variety of lumbar diseases, such as lumbar disc herniation, vertebral body malformation, vertebral body tumor, lumbar tuberculosis and other diseases.

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