Kashin-Bek disease is a degenerative process of an endemic nature. The main feature of the disease is that when it occurs, the process of ossification and the cessation of growth and development of tubular bones. This, in turn, leads to deformation of the joints, the appearance of osteophytosis of a complicated stage. In some cases, Kashin-Beck disease is considered a form of endemic deforming osteoarthritis.
Urov disease in Transbaikalia
The first information about such a disease appeared about 150 years ago among residents of certain regions of Russia (Transbaikalia, in the areas of the Urov River). An unusual and previously unknown disease was identified, the main symptoms of which were problems with the functioning of the musculoskeletal system. The disease was described in more detail by military doctors N. I. Kashin and A. N. Beck, after whom it began to be called later.
With a further more in-depth examination, experts were able to understand that in fact the disease is much more widespread than previously thought. Now the areas of infection, in addition to Transbaikalia, are also the east of Chita, certain areas of the Amur Region, Kyrgyzstan, North China, and Korea. Separate cases of lesions are diagnosed in more remote places - Buryatia, Yakutia, Primorsky Krai, as well as the northwestern regions of Ukraine.
In another way, Kashin-Bek's disease can be called endemetric deforming osteoarthritis (the essence of the ailment follows from the name) and Urov's disease (due to the fact that most of the patients were residents of the Urov river basin).
It is important to note that previously from 32 to 46 percent of the inhabitants of the described region suffered from such an indisposition, today, as a result of mass preventive measures, it is detected only in 96 residents out of 1000.
Causes of disease
The main cause of Kashin-Bek's disease (Urov's disease) is an imbalance of trace elements in the land and water of certain regions and regions of the country. Because of this, many residents of these areas simply do not get the right amount of vitamins and minerals.
The exact reasons for the defeat have not yet been established. If joints crunch all over the body, the reasons may be as follows:
- Mineral (geobiochemical theory). In a detailed study of the pathology, scientists were able to determine that in endemic areas the mineral composition of water, soil and food consumed is slightly different - they contain a huge amount of manganese, phosphates and strontium, and calcite, on the contrary, is less than the established norm. In addition, they lackamount of selenium and iodine.
- Cracking joints throughout the body due to the spread of the fungus F. Sporotichilla. According to the statements, the toxins of the described fungus deform the cells of the articular cartilage - chondrocytes, which leads to the formation of toxic cells of lipid peroxidation products.
- The third and final opinion is that Kashin-Beck disease is actually hereditary. Direct evidence of this has not yet been found, but there is information that children of adults with pathology suffer from the same disease several times more often than children of he althy people. There is also a high risk of developing the disease in close relatives. Most likely, there is a certain genetic predisposition to the development of deforming osteoarthritis in a person, but this does not guarantee the development of the disease in a particular person, but it significantly increases the risk of this in certain environmental conditions (for example, when living in an endemic area).
A predisposing factor for the development of pathology is rickets (lack of vitamin D, which leads to poor absorption of potassium s alts in the body), frequent hypothermia, long-term high-intensity work, lack of rest.
What happens in the patient's body?
In the bones of a sick person there is an acute lack of calcium and an excessive amount of iron, manganese, zinc, silver. Phosphorus levels are elevated in both serum and urine.
Doctors say that the lack or excess of certain trace elementsoccurs due to a lack of calcium in certain areas of the bone, which provokes problems with collagen metabolism, impaired microcirculation, inhibition of regeneration and recovery, changes in osteogenesis and early formation of fixed joints on the human body.
All the factors described lead to the beginning of the spread of degenerative changes in human tissues, joints and internal organs.
How does sickness develop?
The basis of the malaise is a generalized process of degeneration of all bones of the skeleton. Worst of all, such changes are perceived by the end sections - the epiphyses (heads) and metaphyses (necks) - short and long tubular bones, in which the growth center is localized - this leads to an increase in the length of the bone itself. Cartilaginous tissue in areas where the pathological process spreads, thickens significantly and begins to sclerosis, and then disappears altogether.
Articular surfaces begin to be damaged - they form defects that differ in size and type. The articular cavities begin to change, change their shape to a bell or niche. Epiphyses wedged into niches and begin to actively develop, spreading to new areas.
Due to damage to the growth sections of the bone, the growth of all bones slows down, especially the short tubular ones - the phalanges of the fingers. A person develops a pathology called short-fingeredness.
Articular surfaces no longer adjoin each other normally (there are problems with their congruence), articular cartilage flakes off over time, itthe structure is deformed and destroyed over time, which leads to the development of deforming arthrosis.
Peel off dead cartilage
Osteophytes appear on the surface of the joint. All the described changes can be explained by the displacement of the articular surfaces in relation to each other - the development of subluxations. The joints in which the pathological focus develops begin to be rapidly damaged, the patient loses the ability to perform a set of movements that was previously available, he develops muscle contractures.
The villi of the synovial membrane expand, and from time to time, together with pieces of dead articular cartilage, they exfoliate, passing into the joint cavity, and begin to form a “joint mouse”. All the described processes take place against the background of severe swelling of the joint.
The endplates of the vertebrae also suffer from the disease, intervertebral discs are embedded in their recesses, the height of which is less or more than normal. Marginal bone outgrowths, osteophytes, begin to form on the vertebrae.
What are the signs of the disease?
Children aged 4 to 5 and 14 to 15 years old (during the period of active growth and development of bones) are more susceptible to the described disease. In young children, there are no particularly striking signs of damage; in people over 25 years old, the problem is detected only in isolated cases. The incidence rate does not depend on gender.
Endemic deforming osteoarthritis develops slowly, butsteadily progresses, which at a certain point leads to the appearance of pronounced deformities of many joints.
Symptoms of Kashin-Beck disease in childhood can be as follows:
- pain in the joints, adjacent muscles, spine (different aching pain), increase in the evening and during sleep;
- characteristic stiffness of the joints in the morning, after waking up, and at a late stage and throughout the day;
- the presence of a crunch in the joints;
- numbness, crawling sensation in the muscles of the lower leg and fingers.
Pathological processes
Pathological processes originate in the area of the interphalangeal joints of the 2nd, 3rd and 4th fingers. In many patients, the pathological process extends only within the described area, while in others it passes to the overlying joints of a larger size - the wrist, elbow, knee, and others. All changes are distinguished by their symmetry - the joints of both upper and lower extremities are deformed to the same extent. Patient develops finger cramps.
The described joints swell, greatly increase in size, deform, the range of motion in them is significantly reduced, and the muscles begin to atrophy. The fingers are strongly twisted, there is an X- or O-shaped deformity of the lower extremities.
If a free body (“articular mouse”) gets into the cavity of the knee joint and remains there at the moment of movement, then the patient suddenly experiences acute pain that prevents the patient from movingjoint, fixing it in one position. Movement in this joint is severely limited due to soreness.
External signs of disease
It is possible to identify those suffering from Kashin-Beck disease by external signs. Most often, they are characterized by the following features:
- short stature (women no taller than 147 centimeters and men up to 160 centimeters);
- fingers are very short (in other words "bear paw");
- contracture may appear and the shape of the joints themselves may change
- progressive lumbar lordosis, bend forward much deeper than in he althy people;
- there is a valgus (X-shaped) or varus (O-shaped) deformity of the lower extremities;
- the patient has a duck walk.
Patient complaints
In addition to bone changes, the imbalance of trace elements in the patient's body leads to other unpleasant symptoms. Many people with pathology complain about:
- severe headache;
- complete or partial lack of appetite;
- pain in the heart;
- aching pain in joints and muscles;
- dystrophic changes in the skin, nails and hair (dry skin occurs, wrinkles appear, the color turns pale, brittle nails and hair, their tarnishing).
Comorbidities
Some patients develop comorbidities:
- atrophic rhinitis;
- changing the shape and growth line of teeth in the oral cavity;
- inflammatory process in the ears;
- chronic pharyngitis;
- chronic inflammation in the bronchial mucosa, emphysema;
- gastroenterocolitis;
- heart muscle dystrophy;
- VSD;
- deterioration of the brain, degradation begins;
- encephalopathy;
- astheno-neurotic syndrome.
Prevention measures
Measures to prevent Kashin-Bek disease will be to enrich the soil, water and food products of endemic areas with useful microelements important for the human body. The population living in such areas receives vegetables and fruits brought from other regions, water from artesian wells. Animals on local farms receive feed mixtures with a normalized mineral composition.
Persons predisposed to the disease take multivitamin complexes and medicines with calcium in the course twice a year. They are also encouraged to eat dry seaweed regularly.
How is the treatment?
Treatment for Kashin-Beck disease consists of the following:
- Taking drugs with phosphorus, calcium, selenium, vitamins D, B, ascorbic acid.
- Restoration of metabolic processes in diseased tissues with the help of biostimulants: aloe, ATP, FiBS and others.
- Physiotherapy, which helps to get rid of pain, reduces muscle contractures, increases the range of motion in the joints, and restores the previous performance. To do this, use mud applications, radon baths, paraffin therapy, UHF current and ultrasound on the patient's site.joint. All procedures are carried out in courses or in a complex.
It is important to remember that in the later stages of the progression of the ailment, it will not be possible to cope with it with medications and physiotherapy alone. Such patients need orthopedic contracture correction or even surgery.
