CALCIFICATION OF THE KNEE JOINT (GONARTHROSIS)

Calcification of the knee joint (Gonarthrosis) is a very common knee joint disease and the most common reason for visits to orthopedic clinics. The basis of this disease, commonly known as arthritis, is the erosion of joint cartilage. While it initially involves wear and tear on the joint cartilage, it eventually causes deterioration in the joint and all surrounding structures. The result is a painful, stiff, and deformed knee joint.

There Are Two Types of Gonarthrosis:

1. Primary Gonarthrosis:Primary Gonarthrosis is the most common type of gonarthrosis, progressing slowly and usually manifesting in the 50s, without any trauma or predisposing joint disease. The primary factor determining the development of this type of gonarthrosis is the individual's age. The better the cartilage strength resulting from an individual's genetic makeup, the more protected they are against developing gonarthrosis, even over time. The only factor that can be controlled to prevent this type of gonarthrosis is weight. With weight control and genetic stability, a person can avoid experiencing gonarthrosis throughout their lifetime.
2. Secondary (Secondary) Gonarthrosis:The individual has a history of disease or trauma that initiated and is responsible for the progression of secondary gonarthrosis (intra-articular fracture, meniscal ligament injury, rheumatological diseases, gout, previous infection, and joint deformity, etc.). There is no genetic protection for this type of gonarthrosis. It can occur at any age. It progresses rapidly and often requires surgical treatment at an early age.

HOW DOES IT SYMPTOMS AND WHAT ARE THE SIGNS?

The primary complaint in gonarthrosis is pain. The nature and severity of the pain vary depending on the stage of the disease. At the beginning of the disease, the pain begins as a burning and aching pain in the knee after standing for long periods or walking long distances. Movements such as bending the knee and climbing stairs become difficult and painful. A harsh clicking sound can be heard from the knee when bending the knee, sitting down, standing up, or using stairs. Over time and as the disease progresses, walking distance gradually shortens due to pain, easy fatigue, and joint stiffness. Night pain begins, and patients have difficulty sleeping due to the pain. Occasionally, swelling occurs due to fluid accumulation in the knee. The muscles surrounding the knee weaken and waste away. The knees often develop a deformity and distortion called an "O" leg or a "Skoda" leg. In the final stage, a painful, stiff, swollen, and deformed knee joint is encountered. Patients complain of pain that persists day and night and the inability to walk.

HOW IS GONARTHROSIS DIAGNOSIS MADE?

Gonarthrosis is usually diagnosed by listening to and examining the patient. X-rays and blood tests are used to determine the definitive and differential diagnosis, accompanying problems, the stage of the disease, and the treatment plan. In the early stages of the disease, an MRI, which takes images specific to the cartilage structure, is important to detect cartilage wear and take preventative measures. The earliest diagnosis of gonarthrosis is made with an MRI, which can even show the softening and swelling of the cartilage.

WHAT IS THE ROLE OF MRI IN GONARTHROSIS?

Gonarthrosis is a disease of the articular cartilage. The first changes begin in the articular cartilage. In the initial stages of the disease, MRI can identify the softening and swelling of the cartilage. By taking the necessary precautions in these early stages, the course of the disease can be significantly altered. A patient with gonarthrosis who is diagnosed and followed-up may experience sudden, unusually increased pain, bone marrow edema and associated bone death (osteonecrosis), additional meniscus tears, cartilage-bone fragment separation, and joint membrane inflammation. These problems, especially bone marrow edema and bone death, can be detected with MRI in the early stages and significantly alter the course of gonarthrosis and the treatment approach. When bone marrow edema is detected early on with MRI and appropriate treatment is initiated, the patient usually recovers. If the diagnosis is made late and the patient is not initiated on appropriate treatment, recovery can be very prolonged or result in bone death. If the deterioration in the course of gonarthrosis is due to a mechanical knee problem and is identified with MRI, arthroscopic surgery can provide significant relief. In conclusion: MRI is the only diagnostic imaging method for early-stage gonarthrosis, even at the onset of cartilage problems. MRI provides important information for identifying certain conditions during the course of the disease, as well as for early intervention, treatment, and surgical planning. However, an MRI is not necessary for every gonarthrosis patient, and an MRI should be performed only if the patient's complaints and examination findings suggest any of the aforementioned abnormalities.