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Orthopaedics

Orthopaedics

Orthopaedics

Ankylosing spondylitis (AS) is a type of arthritis in which there is a long-term inflammation of the joints of the spine. Typically, the joints where the spine joins the pelvis are also affected. Occasionally other joints such as the shoulders or hips are involved. It is not uncommon for this condition to affect other organs, such as e.g., the eyes. It belongs to the group of autoimmune diseases.

AS is a chronic pathological condition, but for the majority of the patients’, symptoms are relatively limited. It is usually common among young people at the age of 20–30-year-old, more frequent in men, rather than women.

Symptoms appear in outbreak of the disease but between these many patients do not appear pain or stiffness. Patients need to be undergone regular measurements and evaluations of mobility with the doctor and the physiotherapist, so that it can be treated in time any recrudescence.

Pain is an unpleasant feeling that arises due to an intense or harmful physical stimulus and acts as a "signal" to the nervous system that there is a problem in the body. The pain may be acute or dull, appearing, or intermittent, or persistent. It can be located at one point (eg joints) or diffuse in the body. Pain is experienced subjectively and helps in the diagnosis of a problem. Acute pain occurs suddenly and may be due to illness, injury, or inflammation, is diagnosed and treated. It is usually removed but, in some cases, can become chronic. 

Inflammation is a set of processes and mechanisms that the body mobilizes as a reaction to various harmful factors. It is an immune defense process against causes such as injury, infection or allergy, tissue necrosis, various natural causes (natural or thermal) and other inflammatory reactions such as hypersensitivity and is characterized by increased blood flow, white blood cell migration and chemical release. In some diseases such as arthritis, inflammatory mechanisms are activated by the immune system without an external factor to treat it. In "autoimmune" diseases, the immune system mistakenly attacks healthy cells. 

Magnesium is an intracellular mineral found in all tissues of the body and especially in the bones and plays an important role in controlling important biochemical functions (activation of enzymes involved in DNA replication and transcription), calcium transport to cell membranes, and in the secretion of parathyroid hormone. It affects the muscular and nervous function, while it works synergistically with the calcium with which it must be in balance. It contributes to the absorption of calcium and the good health of denture and plays an important role in bone health, reducing the possibility of osteoporosis especially during menopause. It is absolutely necessary during pregnancy and breastfeeding as it lack can cause very serious damage to the fetus and even death. The proper functioning of our muscular system is largely dependent on magnesium, as it relaxes the muscles and tissues. It also contributes to the regulation of sugar as it participates in the process of secretion and transport of insulin to all individual tissues.

It is involved in more than 300 metabolic processes in the body, while more than 3,750 magnesium binding sites have been found in human proteins. The proper functioning of the metabolism also depends on magnesium as this contributes to energy production.

Osteoarthritis is a type of degenerative joint disease that results from gradual breakdown of joint cartilage and underlying bone. A common disease among million people all over the world. Osteoarthritis is not only the most common joint disease, but also one of the most common among humans.

Usually affects elderly people, however it may be caused by an injury or because of obesity. It occurs when the protective cartilage that cushions the ends of bones wears down over time, mostly in hands, knees, elbows, shoulders, and hips. The symptoms progress slowly over the years. Initially they may occur only after exercise but can become constant over time.

Among others, symptoms are joint pain, stiffness, “crepitation” (a cracking or grating sensation the patient hears or feels when moves the joint), as well as swelling or even joint deformity in a later stage of the disease.

Even though symptoms may be handled, damage occurred is irreversible.

By maintaining a steady weight, by mild physical exercise, and receiving the right treatment, functionality can be restored.

Osteoporosis is a chronic disease of bone metabolism in which low bone mass and micro-architectural deterioration of bone tissue, leading gradually to increased bone fragility. Osteoporosis causes bones to become weak and brittle - so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture causing a growing risk of fracture.

Osteoporosis is sometimes referred to as the “silent disease” without apparent symptoms until a fracture occurs. Osteoporosis affects men and women regardless ace. Especially older women who are past menopause - are at highest risk.  

Main clinical demonstration is low-impact fracture, this defined as a fracture occurring spontaneously or from a fall no greater than standing height.

Osteoporosis-related fractures most commonly occur in the hip (20%), wrist (20%), spine (40%) and a 20% in other bones.

Loss of height and kyphosis are late clinical features of the disease due to spine fractures. Other consequences are backpain and waist pain, psychological problems, and finally bad quality of life.

Medications, healthy diet, and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.

Rheumatoid arthritis, or RA, is chronic, autoimmune, symmetric (in the appearance of symptoms) and systemic inflammatory disease. Rheumatoid arthritis mainly attacks the joints, usually many joints at once. RA commonly affects joints in the hands, wrists, and knees and may cause chronic impairment. In a joint with RA, the lining of the joint becomes inflamed, causing damage to joint tissue. This tissue damage can cause long-lasting or chronic pain, unsteadiness (lack of balance), and deformity (misshapenness).

Rheumatoid arthritis is a chronic, typically lifetime disease, with progressing course. As the most frequent, chronic inflammatory arthropathy, occurs in 1% of the general population, regardless race. Onset is most frequent during middle age and women are affected 3 times as frequently as men. Divided into two categories: adult rheumatoid arthritis and juvenile rheumatoid arthritis. The clinical picture and course of patients in these two categories are quite different from each other.

In most cases, patients with RA, onset is insidious, often beginning with fever, malaise, arthralgias, and weakness before progressing to joint inflammation and swelling. Signs and symptoms of RA may include persistent symmetric polyarthritis (synovitis) of hands and feet (hallmark feature), progressive articular deterioration, extra-articular involvement, difficulty performing activities of daily living, constitutional symptoms, weight loss and limitation of motion, particularly in the morning.

Treatment aims to relief from symptoms and to enable patient to continue a normal everyday life.

Carpal tunnel syndrome is a collection of characteristic symptoms and signs like numbness and the sensation of tingling, caused by pressure on the median nerve when passing through the wrist. The carpal tunnel is a narrow anatomic passageway surrounded by bones and ligaments on the palm side of the hand. When the median nerve is compressed, the symptoms can include numbness, tingling and weakness in the hand and arm.

The anatomy of the wrist, diseases such as rheumatoid arthritis, thyroid disorders, diabetes, and possibly repetitive hand motions can contribute to carpal tunnel syndrome.

Proper treatment usually relieves the tingling and numbness and restores wrist and hand function.

Tendons are structures of connective tissue that connect muscles to the bones and transmit the mechanical force of muscle contraction to the bones. They are firmly connected to muscle fibres at one end and to components of the bone at their other end. The tendons are remarkably strong and have high tensile strength so that they work together with the muscles in a way that enables the person to perform movements that require force for the muscle to move the joint.

The tendon is formed by bundles of type I collagen fibers and cellular elements, surrounded by an extracellular matrix rich in proteoglycans and aminoglycans.

Tendonitis is an inflammatory condition that leads to pain, swelling and impaired function. The pain is usually worse with movement. It occurs most often around the shoulder (rotator cuff tendonitis, biceps tendonitis), elbow (tennis elbow, golfer's elbow), wrist, hip, knee (jumper’s knee, popliteus tendonitis) or ankle (Achilles Tendonitis).

Common causes of tendonitis are injuries or repetitive movements. The symptoms of tendonitis vary depending on the area in which they occur. At-risk groups include manual workers, musicians, and athletes. Less common causes of tendonitis are infection, arthritis, gout, thyroid disease, and diabetes.

The diagnosis is made by a clinical examination based on the patient's symptoms. Tendons are suitable for storing energy and restoring it ideally secondary to movement. According to their anatomical location and function, tendons have different mechanical properties (viscosity compliance) There are tendons in which it is more important the transformation of the muscle contraction force in movement and others also have an important function of subjection. Tendons most affected are Achilles, Plantar fascia (plantar fasciitis), Rotator cuff, Rotuliano, wrist extensors and flexors. The diagnosis is usually based on symptoms and occasionally medical imaging.

Sciatica refers to pain that radiates along the path of the sciatic nerve, typically, sciatica affects only one side of the body. The term back pain refers to the bony lumbar spine anatomic area. Back pain is one of the most common reasons people go to the doctor. The two symptoms may coexist but may also occur individually.

Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve.

This causes inflammation, pain and often some numbness in the affected leg.

The initial treatment of sciatica is conservative, with medication and physiotherapy.

When the pain does not subside despite conservative treatment or when there is neurological damage, then surgery is appropriate.

• ο μυικός σπασμός ή φλεγμονή των μυών της ράχης ή της πυέλου και

• η διαταραχή της ιερολαγονίου άρθρωσης.

Σαν αποτέλεσμα έχουμε τη φλεγμονή,  πόνο και συχνά μούδιασμα στο προσβεβλημένο πόδι.

Η αρχική θεραπεία της ισχιαλγίας είναι συντηρητική, με φαρμακευτική αγωγή και φυσικοθεραπεία.

Όταν ο πόνος δεν υποχωρεί παρά τη συντηρητική θεραπεία ή όταν υπάρχει νευρολογική βλάβη, τότε η χειρουργική επέμβαση είναι κατάλληλη.