CALCIFICATION OF THE KNEE JOINT (GONARTROZ)
Knee joint calcification (Gonarthrosis) is a very common knee joint disease that is the most common reason to apply to orthopedics outpatient clinics. The basis of this disease, known as calcification, is the wear of the articular cartilage. While its onset is only in the form of abrasion in the articular cartilage, it causes deterioration in the joint and all structures around the joint over time. As a result, a painful, reduced mobility, hardened and deformed knee joint is faced.
There are two types of Gonarthrosis:
- Primary (Primary) Gonarthrosis: Primary Gonarthrosis is the most common type of Gonarthrosis, which usually shows symptoms in the 50s, and progresses slowly, regardless of trauma or preparative joint disease. The main factor that determines the formation of this type of Gonarthrosis is the age of the person. If there is a cartilage resistance resulting from the genetic structure of the individual, although it has been years, the person is protected against Gonarthrosis. The only factor that can be controlled to prevent this type of gonarthrosis is weight. With weight control and genetic robustness, the person may not encounter Gonarthrosis problem throughout his life.
- Secondary Gonarthrosis: The person has a history of disease or trauma that initiates secondary Gonarthrosis and is responsible for its progression (broken joint, intra-articular, meniscus-ligament injury, rheumatological diseases, gout, past infection, and joint deformity, etc.). There is no genetic protection shield in this type of Gonarthrosis. It can occur at any age. It progresses rapidly and mostly requires surgery and treatment at an early age.
WHAT ARE THE SYMPTOMS?
The main complaint in gonarthrosis is pain. The character and severity of the pain depends on the stage of the disease. Pain at the beginning of the disease, pain in the form of burning and tingling in the knee after long standing and long distance walking begins. Movements such as knee bending and stair climbing become difficult and painful. By bending the knee, rough voices begin to come from the knee during sitting-up and using the stairs. With time and with the progression of the disease, the walking distance is getting shorter due to pain, rapid fatigue and joint stiffness. Night pain begins and patients have difficulty sleeping due to night pain. Occasionally, swelling occurs due to fluid accumulation in the knee. Slimming and melting in the muscles around the knee. Generally, the knees are distorted and deformed, called ‘O’ leg or 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 unable to walk.
HOW IS GONARTROZ DIAGNOSED?
Usually, the patient is diagnosed with Gonarthrosis by listening and examining. X-ray and blood analysis are performed for definitive and differential diagnosis, accompanying problems, determining the stage of the disease and treatment plan. In order to detect cartilage abrasion and take precautions in the early stages of the disease, it is important to take a cartilage structure-specific image. The earliest diagnosis of gonarthrosis is made with MR examination showing the softening and swelling stage of cartilage.
WHAT IS THE PLACE OF MR IN GONARTROZ?
Gonarthrosis is a joint cartilage disease. The first changes begin in the articular cartilage. In the initial stage of the disease, it is possible to determine the softening and swelling stage of cartilage by MR. The course of the disease can be greatly changed by taking necessary precautions in these early stages. Patients with Gonarthrosis, diagnosed and followed up, may suddenly experience unusual pain, increased bone marrow edema and associated bone death (osteonecrosis), additional meniscus tear, cartilage-bone fragmentation, joint membrane fire. These problems, especially bone marrow edema and bone death, can be detected at an early stage with MRI and significantly alter the course and treatment approach of Gonarthrosis. Especially when bone marrow edema is detected at an early stage with MR and appropriate treatment is initiated, the patient will mostly recover. If the diagnosis was made late and treatment was not initiated for the patient, recovery may be too long or result in bone death. If the deterioration in the course of gonarthrosis is due to a mechanical knee problem and is determined by MR, great relief can be achieved by arthroscopic method. As a result; It is the only diagnostic method of imaging at the onset of cartilage problem in the early stage of MR Gonarthrosis. MR provides important information in determining certain conditions during the course of the disease, early intervention, treatment and planning of surgery. However, MR examination is unnecessary in every Gonarthrosis patient and if the patient’s complaint and examination findings indicate some of the disorders mentioned above, the patient should be given an MR examination.
Ali YILMAZ, M.D.
Orthopedics and Traumatology Specialist