Condropatia - Condropatie

Generality

A chondropathy is a cartilage disease.

Cartilage, or cartilage tissue, is a connective tissue that has a supporting function and is extremely flexible and resistant.

Chondropathies can affect all three types of cartilage tissue.

The nature of a chondropathy can be post-traumatic, degenerative or inflammatory.

The most known chondropathies, which can affect the human being, are: osteoarthritis, chondrosarcoma, polychondritis, costochondritis, Tietze's syndrome, chondromalacia patellar, herniated disc, osteochondritis dissecan, the femoral epiphysiolysis, chondrodysplasia and achondroplasia.

Brief review of cartilage or cartilage tissue

Cartilage tissue, better known as cartilage, is a connective tissue that has a supporting function and is extremely flexible and resistant.

Cartilage consists of particular cells - the so-called chondrocytes - and is devoid of blood vessels.

In the human body, the cartilaginous tissue present may have different peculiarities, depending on the functions it has to perform. In this regard, consider for example the cartilage of the auricular pavilions and the cartilage of the menisci of the knee: although belonging to the same category of tissue and being composed of chondrocytes, these two cartilaginous tissues differ considerably in consistency and specific properties.

There are three types of cartilage:

• Hyaline cartilage
• Elastic cartilage
• The fibrous cartilage

What is chondropathy?

Condropatia is the non-specific term by which doctors indicate any cartilage disease, regardless of whether it is hyaline cartilage, elastic or fibrous type.

According to what the experts say, a chondropathy can be characterized by 5 degrees of gravity :

• Grade 0 chondropathy : means that the cartilage has a normal appearance, in spite of a symptomatology and a diagnosis of chondropathy.
• Grade 1 chondropathy : means that the cartilage has minimal weak points or small areas comparable to blisters.
• Grade 2 Condropathy : means that the cartilage has minor cracks.
• Grade 3 chondropathy : means that the cartilage has deep cracks on more than 50% of the constituent cartilage layer.
• Grade 4 condropathy : means that the cartilage has such deep cracks, that the underlying bone is visible (where present, clearly).

Causes

The causes of chondropathy are numerous and may have a post-traumatic, degenerative or inflammatory nature.

Types

There are numerous types of chondropathy .

The most well-known types are: osteoarthritis, chondrosarcoma, polychondritis, costochondritis, Tietze's syndrome, patellar chondromalacia, disc hernia, osteochondritis dissecans, femoral epiphysiolysis, chondrodysplasia and achondroplasia .

OSTEOARTHRITIS

Osteoarthritis, or osteoarthritis, is the most common form of arthritis in the world. With the term " arthritis ", doctors indicate any inflammatory process involving one or more joints.

Osteoarthritis is included in the list of chondropathies, because the inflammatory state that characterizes it arises due to the progressive deterioration of the cartilaginous layer covering the articular surfaces.

Osteoarthritis risk factors are different; among the most important, we note the advanced age, belonging to the female sex, joint injuries and obesity.

Osteoarthritis can affect any joint; however, he has a predilection for the joints of the hand, knees, hips and joints of the spine.

In addition to pain, joint stiffness, swelling and reduced ability to move, it also involves the formation of osteophytes (or bone spurs).

At an advanced stage, osteoarthritis makes it very difficult to use the joints involved in the inflammatory state. For example, if you hit your hands, even a simple task like writing can be complex to do.

chondrosarcoma

Chondrosarcoma is a malignant skeletal tumor that originates from cartilage cells and can also affect the underlying bone tissue.

Although it develops from cartilage tissue, it is included in the list of bone neoplasms: in this category, it represents the third most widespread tumor in humans, after osteosarcoma and Ewing's sarcoma .

The bone cartilages most affected by chondrosarcomas are those of the femur, pelvis, scapula, humerus and ribs.

Chondrosarcoma mainly affects adults over the age of thirty.

The symptoms and consequences typical of chondrosarcoma are:

• Bone pain
• Cachexia
• Joint pain
• Predisposition to bone fractures
• Bone swelling
• Distance metastases

polychondritis

Polychondritis is a multisystemic condition characterized by inflammation and degeneration of specific cartilages.

Among the most affected cartilaginous tissues are those of the nose, ears (auricle), larynx, trachea, bronchi and ribs.

According to the most reliable hypotheses, the polychondritis would have an autoimmune origin. Autoimmune diseases are morbid conditions characterized by an exaggerated and improper response of the immune system.

Symptoms of polychondritis vary depending on the cartilage involved.

For example, if the disorder is located at the level of the ears, the auricle swells, tends to be painful, reddens and becomes warm to the touch. If, on the other hand, the problem is located at the level of the larynx, the patient complains of pain just above the thyroid, dysphonia (or hoarse voice) and, in the most serious cases, difficulty breathing.

costochondritis

Costochondritis - also known as chest wall syndrome, costosternal syndrome and costosternal chondrite - is a set of symptoms and signs, the result of an inflammation of the costal cartilages connected to the first seven pairs of ribs.

They can cause costochondritis:

• Strong intensity chest trauma. Traumas of such intensity as to cause costochondritis are the blows that people who practice contact sports receive, such as: rugby, ice hockey, American football or soccer.
• Some intense physical efforts, such as lifting objects of considerable weight.
• Some forms of arthritis, including rheumatoid arthritis, osteoarthritis, ankylosing spondylitis or psoriatic arthritis.
• Some bacterial, viral or fungal infections. Some examples of infectious diseases capable of causing costochondritis are: tuberculosis, syphilis, candida, salmonella, aspergillosis, Staphylococcus aureus infections and viral respiratory tract infections.
• Tumors of origin in the breast, at the level of the thyroid or at the level of the lungs.
• Fibromyalgia. It is a rheumatic disease that affects the musculoskeletal system, characterized by chronic and diffuse pain, increased muscle tension and stiffness in numerous sites of the musculoskeletal system.

The typical symptom of costochondritis is chest pain, which can also radiate to the abdomen or back.

Costochondritis does not cause any type of swelling.

TIETZE SYNDROME

Tietze's syndrome is an inflammatory disorder of the cartilages present at the costal level (costocondral cartilage) and at the level of the joints that join the ribs to the sternum (cost-sternal cartilage) and the sternum to the clavicle (sternoclavicular cartilage).

The classic manifestations of Tietze syndrome are pain, swelling and soreness in the affected cartilage tissue.

Despite numerous studies on the subject, the precise causes of Tietze's syndrome still remain a mystery. According to some experts, they could play a decisive causal role:

• Upper airway infections, such as sinusitis or laryngitis;
• The cough and / or strong and repeated vomiting, which strongly stress the rib cage;
• Strong chest trauma;
• The physical efforts that put the chest in great tension;
• The after-effects of a chest radiotherapy.

The tendency to confuse Tietze syndrome with costochondritis is quite widespread.

However, as can also be seen from what has been reported regarding the two conditions, these two inflammatory disorders are decidedly different.

ROTARY CONDROMALACY

The chondromalacia patella, or patellar chondropathy or patellar chondromalacia, is a painful condition, characterized by the deterioration and softening of the cartilage present on the inner side of the patella (or patella) of the knee.

The onset of the patellar chondromalacia depends on an improper movement of the patella, which involves rubbing the inner part of the patella itself against the distal portion of the femur (femoral region involved in the formation of the knee joint).

Possible causes of improper patella movement are:

• Congenital malformations, which determine the absence of a correct alignment between the femur, patella and tibia.
• The presence of an anterior and posterior musculature of the thigh is very weak.
• A strong imbalance between the adductor muscles of the thigh (inner side) and the abductor muscles of the thigh (outer side).
• Repeated stress on the knee, due for example to activities such as cycling, skiing or running. The high level practice of these activities increases the risk.
• A strong trauma to the patella.

SLIPPED DISC

With the term " herniated disc ", doctors indicate the leakage, from its natural site, of the pulpous nucleus contained within the intervertebral disc; the intervertebral disc represents a sort of cushion, interposed between one vertebra and the other.

The fibrous nucleus is caused by the breakage of the fibers of the fibrous ring, a cartilaginous structure that wraps around the same nucleus pulposus and anchors the intervertebral disc to the nearest vertebrae.

Various factors can contribute to the appearance of a herniated disc, including:

• Trauma to the back of a certain amount and to the load of specific points of the spine;
• The repeated lifting of weights;
• The habit of incorrect positions;
• Excessive weakening or thinning of back muscles and ligaments;
• Aging, which involves a certain loss of elasticity on the part of the spine, in particular of the intervertebral discs.

The presence of a herniated disc can determine a wide variety of symptoms: back pain, sciatica (or lumbosciatica), aching legs, tingling in the legs, neck pain, back pain, stiffness of the back and neck muscles etc. .

DISSECTING OSTEOCONDRITE

Osteochondritis dissecans is a joint disease, which involves fragmentation, first, and necrosis, then, of the cartilage and the underlying bone of a joint.

Osteocondritis dissecan is a form of osteochondrosis . In medicine, the term osteochondrosis identifies a group of degenerative bone syndromes, which induce the fragmentation of the ends of the affected bone elements.

The typical symptoms of osteochondritis dissecans consist in pain, limited joint motion, joint swelling and a feeling of weakness in the affected joint.

The joints most at risk of osteochondritis dissecans are: the knees, ankles and elbows.

The main factors favoring osteochondritis dissecans include:

• Joint injuries (sprains etc.)
• The practice of high impact sports activities for the joints, such as running, the obstacle course or high jump.

Osteocondritis dissecans mainly affects children and adolescents.

FEMORAL EPIFISIOLYSIS

Femoral epiphysiolysis, also known as slipping of the femoral head, is a rare condition, characterized by the detachment of the cartilage present on the femoral head, with respect to the underlying bone portion.

Typical of subjects between the ages of 10 and 16, femoral epiphysiolysis causes: pain, joint stiffness and lameness.

Currently, the precise causes of femoral epiphysiolysis are unknown.

chondrodysplasia

In medicine, the term " chondrodysplasia " identifies a heterogeneous group of hereditary diseases, characterized by dysplastic cartilage changes (see the article on dysplasia ) and consequently by skeletal deformations, skeletal disharmonies and short stature.

ACHONDROPLASIA

Achondroplasia is an inherited skeletal disease, characterized by the reduced formation of growth cartilage, in long bones.

This reduced growth plate formation in long bones is responsible for the incomplete development of the upper and lower limbs.

As a result, the affected subjects suffer from dwarfism .

According to the latest statistical surveys, achondroplasia is one of the most common causes of dwarfism .

Treatment

Treatment varies according to the type of chondropathy.

In fact, there are: forms of chondropathy for which the treatment envisaged consists of symptomatic remedies (eg: anti-inflammatory drugs, muscle stretching exercises, etc.); forms of chondropathy, so the planned treatment consists of a cartilage repair surgery; forms of chondropathy, for which there is no remedy even if only symptomatic.