Diagnosis and treatment of hyperparathyroidism with osteoarthropathy

Major changes in the bone and joint system with hyperparathyroid dystrophy diagnosis and treatment guidelines Recklinghausen disease.

Increased production of parathyroid hormone leads to the emergence of the state, called giperpartireozom, one manifestation of which is the development of a variety of changes in the musculoskeletal system in the first place - in the bones and joints.These changes are called hyperparathyroid osteodystrophy, or Recklinghausen's disease.

Changes in bone and joint system with hyperparathyroidism

disease can occur long time without any visible changes of bones and joints, despite the fact that in some cases the patients impose expressed complaints.And only with time appear deformation of the skeleton in the form of:

  • increase kyphosis of the thoracic spine, reducing growth;
  • chest strain - lower than before, settle the costal arch, as well as change the shape of ribs and sternoclavicular joints;
  • curvature of the long bones, especially after fractures;
  • deformity of the joints due to the phenomena of arthrosis and hypermobility (looseness) in them because of the weakness of ligament-muscular system.

also due to increasing weakness and muscle wasting observed gait disturbance, distortion stress on the joints, which exacerbates their deformation.If the disease develops in childhood or adolescence, before the end of the growth period, there may be a slowdown in growth.

diagnosis of bone and joint changes in disease Recklinghausen

Leading diagnostic method - X-ray (Review and computed tomography).This reveals a pronounced diffuse osteoporosis, the presence of lacunar areas (focal) in bone resorption, cystoid phenomenon restructuring areas of osteoporosis in the sternum, clavicles, ribs, flat bones and the bones of the forearm.

Furthermore, there may be portions hyperostosis (compacting bone structure) and osteophytes.Specific changes observed in the structure of the vertebral bodies - along with osteoporosis change their shape - they acquire a "waist" and their upper and lower plates bend, which gives them the appearance of "fish vertebrae" and the intervertebral disk - lenticular shape.Very often, patients are identified consolidated microfractures in the flat bones (usually the bones of the pelvis and / or ribs), and in old age - pathological compression fractures of the vertebral bodies.

When the possibility of magnetic resonance imaging can provide valuable additional information, particularly from the spine and internal organs.

additional and refined diagnostic technique is ultrasonography of the joints and para-articular soft tissue (bursitis presence ossificans, periarthrosis, lime, phenomena chondrocalcinosis, etc.)

ultrasound of internal organs, especially the kidneys, and helps identify fibrosis and calcification, MCD,ICD, cholelithiasis.

great importance and densitometry (ultrasound or X-ray), which helps to track the dynamics of change in bone density (in the course of the disease and its correction)

also using additional diagnostic methods, including biochemical and instrumental.

osteoarthropathy Treatment of Recklinghausen disease

  • Usually it is the elimination of the main causes of the disease - parathyroid adenoma or operational beam method.
  • treatment of osteoporosis drugs directional (bisphosphonates, calcium supplements with vitamin D3, and others.).
  • Anti-inflammatory therapy, phytotherapy.
  • osteopathic therapy (massage and physical therapy are contraindicated, especially in patients with severe osteoporosis).
  • physiotherapy, reflexology, balneotherapy.
  • Developing rational mode of work and recreation, physical activity, as well as special diet, compensates for the deficiency of trace elements, but does not lead to the progression of the disease and the development of IBC, cholelithiasis, ossification.All this requires constant monitoring by a doctor and does not allow self-medication.

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