Arthropathy in congenital disorders of lipid metabolism

main causes and mechanism of development of arthropathy in disorders of fat metabolism and hereditary nature of their principal manifestations.

Due to the increasing number of obese people acquired or congenital (hereditary) nature, are increasingly common and arthropathy associated with lipid metabolism disorders, and in the first place - cholesterol.

Causes of arthropathy in hypercholesterolemia

most common inflammatory changes in the joints develop on the background of hereditary disorders of lipid metabolism, called dislipoproteinemia, or dyslipidemia.

this pathology often observed in families with several generations and is always accompanied by high cholesterol (hypercholesterolemia) and other lipids in the blood serum, in violation of their factions relations.This leads to excessive deposition of not only the skin and the walls of arteries, but also in other tissues and organs, including joint.

This gives rise to the phenomenon of synovitis - inflammation of the inner membrane lining the c

avity of joints and periarticular bag (bursa).This is due to the release of the joint cavity of cholesterol crystals from synovial membrane and other periarticular tissues, which accumulate excess lipids.

There are 5 types of hereditary disease, but most often develop arthropathy in the second and fourth type.

main manifestations dislipoproteinemia

This disease often appears in childhood.At the same time parents notice the appearance of a child on the back surface of the elbow and knee joints, as well as the feet and hands of multiple shades of yellow plaques of various shapes and sizes, slightly protruding above the surface of the skin called xanthomas.

With age, they tend to increase, and the surface becomes more convex.Over the years, many patients with similar, but smaller plaques (xanthelasma) formed on the eyelids, the upper most, and at the edge of the cornea is a thin (1-2 mm) lipoic arc grayish color.

Almost all patients have the early development of atherosclerosis and its attendant multiple manifestations (coronary heart disease, cerebral and peripheral circulation, etc.), as well as obesity.Sometimes there is the development of sclerotic processes in the aortic valve of the heart, which significantly worsens the prognosis of the disease.

Manifestations arthropathy when dislipoproteinemia

affected joints often appear in the form of periodically increasing and migratory polyarthritis with mono- or severe pain, swelling of the periarticular tissues and accumulation of effusion in the joint cavity, redness of the skin and increase its temperature.But the manifestation of the sharpening is not accompanied by fever and usually do not last more than a week, so they are often mistaken for gout.At this time, the blood test can reveal a pronounced acceleration of ESR.

In cases where the disease is immediately takes subacute, slow character, exacerbation duration can be up to 2-4 weeks.In such a patient eventually develop symptoms of osteoarthritis with periodic and gradually extended to several months exacerbations.It is accompanied by a limitation of range of motion in the joints, flexion contractures of the formation and development of growths synovium.Over time develop symptoms deforming osteoarthritis, reducing the patient's ability to work.

When excess deposition of lipids in the tendons in them as there is an inflammatory process, accompanied by swelling, tenderness, limitation of motion, and subsequently - the seal and loss of elasticity.Most often it occurs in the Achilles tendons and tendons of the extensor of the fingers, with their rear surfaces are formed and painless nespayannye skin tight rounded nodules 3-10 mm in diameter.

This defeat of the joints, skin and tendons is observed in all types of dislipoproteinemia, but congenital dislipoproteinemia third, fourth and fifth type is very often marked by the development of secondary gout, caused by an increase in serum uric acid and urate deposition in the joints.

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