RU2436500C1 - Method of early diagnostics of posttraumatic osteoarthrosis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine and can be used for early diagnostics of posttraumatic osteoarthrosis. For this purpose temperature is measured in five symmetric points of injured joint: external condyle, tuberosity of tibia, internal condyle, joint space from medial and lateral side and in the similar points of healthy extremity. After that difference between symmetric sections of healthy and injured extremities is calculated. Control of temperature is carried out every month. In case if difference of temperatures between symmetric sections of injured and healthy joints is more than 0.5° and there is no tendency to reduction during 4 months, development of early posttraumatic osteoarthrosis is diagnosed.

EFFECT: method makes it possible to reduce radiation exposure of patient, prescribe timely restorative treatment, prevent severe consequences of trauma and disability of patients.

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Description

The present invention relates to medicine, in particular to methods for the early diagnosis of post-traumatic osteoarthritis.

Diagnosis of diseases of the musculoskeletal system is especially relevant in connection with the recent increase in the frequency of their development among the population.

As a prototype, an X-ray method for early diagnosis of post-traumatic osteoarthritis based on determining changes in narrowing of the joint gap, sclerosis of the subchondral plate, marginal osteophytes, cystic degeneration of the articular ends of the bones that form the joint (Kosinskaya N.S. apparatus .-- L .: Medgiz. - 1961. - P.17-19).

However, the known method is associated with radiation exposure to the patient, depends on the quality of the x-ray image. The assessment of the radiograph is subjective and depends on the experience of the doctor. Another disadvantage limiting the use of the known method is the high cost of the equipment and the examination itself. In addition, the known method does not allow to reliably identify changes that occur in the bone and soft tissue structures of the knee joints in many diseases at the pre-radiological stages of development.

The task of the invention is to reduce radiation exposure to the patient.

EFFECT: determination of changes that occur in bone and soft tissue structures of knee joints.

The technical result is achieved by the fact that the method measures the temperature at five symmetric points of the damaged joint: the external condyle, the tuberosity of the tibia, the internal condyle, the joint space from the medial and lateral sides, and at the same points of the healthy limb, calculate the difference between the symmetrical parts of the healthy and damaged limbs, temperature control is performed every month, and if the temperature difference between the symmetrical sections of the damaged and healthy joints is more than 0.5 ° and the absence of a downward trend within 4 months is diagnosed with the development of early post-traumatic osteoarthrosis.

A method for the early diagnosis of post-traumatic osteoarthritis is as follows. The temperature is measured at five symmetric points of the damaged joint: the external condyle, the tibial tuberosity, the internal condyle, the joint space from the medial and lateral sides. Similarly, temperature is measured in the symmetrical areas of a healthy limb. The temperature value is displayed on the display of the device, which is recorded in a standard form. Calculate the temperature difference in healthy and damaged joints. Temperature control is performed every month. With normal consolidation of the fracture, the temperature difference is equalized in terms of up to 4 months. If the temperature difference in the symmetrical joints of the joints is more than 0.5 ° and there is no tendency to decrease within 4 months, the early (pre-roentgenological) stage of deforming osteoarthrosis is determined.

Clinical example 1.

Patient T., 57 years old, and.b. 234569, was admitted to the department of acute injury with a diagnosis of closed comminuted intraarticular fracture of the external condyle of the left tibia with displacement of fragments. He was injured in an accident. An operation was performed - open reduction, osteosynthesis of the external condyle of the left tibia with a plate with angular stability of the screws, suture of the internal lateral ligament. The postoperative period was calm, the wounds healed by first intention. According to the prescribed recommendations, the patient walked on crutches for 2 months without resting on the operated limb. 2 months after the surgery, the temperature was measured at five symmetric points of the damaged and healthy joints: the outer condyle, tuberosity of the tibia, inner condyle, joint space from the medial and lateral sides. The measurement results are shown in table 1.

Table 1 Duration after surgery Healthy limb Injured limb Nar toe. Mound. bones Int. toe. Sust. slot outside The internal crevice Nar toe. Mound. bones Int. toe. Sust. slot outside The internal crevice 8 weeks 32.7 ° 32.2 ° 32.4 ° 32.3 ° 33.3 ° 34.8 ° 34.2 ° 34.5 ° 35.2 ° 34.4 ° 12 weeks 32.4 ° 32.2 ° 33.3 ° 31.9 ° 32.8 ° 35.0 ° 35.1 ° 34.8 ° 35.1 ° 34.8 ° 24 weeks 32.2 ° 31.0 ° 32.5 ° 31.1 ° 32.2 ° 34.4 ° 34.3 ° 34.2 ° 34.1 ° 34.2 ° 1 year 32.8 ° 32.1 ° 33.5 ° 32.8 ° 33.4 ° 35.2 ° 35.2 ° 34.9 ° 34.7 ° 34.7 °

Based on the data obtained, the temperature difference between the corresponding departments of the knee joints and its dynamics were calculated. The dynamics of temperature in the postoperative period are presented in table 2.

table 2 Duration after surgery Outer condyle Bumpiness b / b bone Inner condyle Joint gap outside Joint gap inside 8 weeks 2.1 ° 2.0 ° 1.9 ° 2.9 ° 1.1 ° 12 weeks 2.6 ° 2.9 ° 1.5 ° 3.2 ° 2.0 ° 24 weeks 2.2 ° 3.3 ° 1.7 ° 3.0 ° 2.0 ° 1 year 2.4 ° 3.1 ° 1.4 ° 1.9 ° 1.3 °

The table shows that the temperature difference between the departments of the joints after 8 weeks reached a maximum of 2.9 °. Each month, temperature was measured according to the described method. The temperature difference in the symmetrical areas of the joints after 24 weeks increased to 3.3 °, indicating the development of post-traumatic osteoarthritis.

Clinical example 2.

Patient E., 41 years old, and.b. No. 241938, was admitted to the department of acute injury with a diagnosis of closed comminuted intraarticular fracture of the external condyle of the right tibia with displacement of fragments. She was injured as a result of an accident. An operation was performed - open reduction, osteosynthesis of the external condyle of the left tibia with a plate with angular stability of the screws. The postoperative period was calm, the wounds healed by first intention. According to the prescribed recommendations, the patient walked on crutches for 2 months without resting on the operated limb. 2 months after the surgery, the temperature was measured at five symmetric points of the damaged and healthy joints: the outer condyle, tuberosity of the tibia, inner condyle, joint space from the medial and lateral sides. The measurement results are shown in table 3.

Table 3 Duration after surgery Healthy limb Injured limb Nar toe. Mound. bones Int. toe. Sust. slot outside The internal crevice Nar toe. Mound. bones Int. toe. Sust. gap outside The internal crevice 8 weeks 31.5 ° 31.3 ° 30.6 ° 32.4 ° 31.7 ° 31.3 ° 31.5 ° 31.6 ° 31.0 ° 30.9 ° 12 weeks 31.6 ° 31.8 ° 30.6 ° 32.2 ° 31.7 ° 31.3 32.1 ° 31.7 ° 31.2 ° 30.8 ° 24 weeks 30.5 ° 30.8 ° 30.1 ° 30.8 ° 30.1 ° 30.5 ° 31.3 ° 30.1 ° 30.2 ° 30.1 ° 1 year 32.5 ° 32.7 ° 31.6 ° 33.3 ° 32.6 ° 32.7 ° 32.7 ° 31.9 ° 33.7 ° 32.9 °

Based on the data obtained, the temperature difference between the corresponding departments of the knee joints and its dynamics were calculated. The dynamics of temperature in the postoperative period are presented in table 4.

Table 4 Duration after surgery Outer condyle Bumpiness b / b bone Inner condyle Joint gap outside Joint gap inside 8 weeks 0.2 ° 0.2 ° 1.0 ° 1.4 ° 0.6 ° 12 weeks 0.3 ° 0.3 ° 0.9 ° 1.0 ° 0.9 ° 24 weeks 0 0.5 0 ° 0.6 ° 0 ° 1 year 0.2 ° 0 0.3 ° 0.4 ° 0.3 °

The table shows that the temperature difference after 24 weeks did not exceed 0.5 °. 1 year after surgery, the patient walks with full support on the limb, no complaints. Clinical and radiological examination revealed no signs of deforming osteoarthrosis.

The proposed method is simple, non-invasive, harmless, cheap and highly informative, can be used for early detection of deforming osteoarthritis based on changes that occur in the bone and soft tissue structures of the knee joints, at the stage of the disease. The method allows to reduce the radiation load on the patient, prescribe timely rehabilitation treatment, to prevent the serious consequences of trauma and disability of patients.

Claims (1)

A method for the early diagnosis of post-traumatic osteoarthritis, characterized in that the method measures the temperature at five symmetric points of the damaged joint: the external condyle, the tibial tuberosity, the internal condyle, the joint space from the medial and lateral sides, and at the same points of a healthy limb, calculate the difference between symmetrical sections of healthy and damaged limbs, temperature control is performed every month and if the temperature difference between the symmetrical sections of the damaged nnogo and healthy joints more than 0,5 ° and no downward trend over the 4 months is diagnosed early development of post-traumatic osteoarthritis.