Arthropathy in lung diseases

causes and mechanism of development osteoarthropathy with lung diseases, the main manifestation of the principles of diagnosis and treatment.

Hypertrophic pulmonary osteoarthropathy (Marie's disease - Bamberger) -changes of bones and joints, arising under the influence of toxic effects on bone tumor and / or chronic inflammatory factors.

Features of development of arthropathy with lung diseases.

  • In most cases osteoarthropathy is one of the earliest signs of emerging peripheral lung cancer, even when there are no clinical and radiological evidence of tumor.In these cases, it develops quickly, within a few months.
  • Much less osteoarthropathy common in Hodgkin disease, metastatic tumors in the organs of the chest, under such purulent chronic respiratory diseases as bronchiectasis, chronic abscess, pneumonia and others.Thus arthropathy develops slowly (typically over several years), and are often not noticed by the patient.
  • also hypertrophic osteoarthropathy common in long-existing, chronic digest
    ive diseases (ulcerative colitis, cirrhosis, etc.), with heart defects, etc.

At the heart of hypertrophic osteoarthropathy, one manifestation of which is the deformation of the fingers in the form of so-called "drumsticks" is a chronic toxic effects of tumor and / or chronic inflammatory factors, as well as the disruption of the autonomic nervous system is always available for severe chronicdiseases.

In the soft tissue of nail phalanges marked edema, increased production of collagen, fibrosis, and spasm of the small peripheral vessels.This leads to a decrease in bone density of nail phalanges, and sometimes middle phalanges, combined with irritation of the periosteum and Response formation periosteal layers.

At the same time marked symptoms of synovitis (inflammation and proliferation of synovial joints), as well as the accumulation of a small amount of effusion in interphalangeal, at least - in the knee, ankle wrist and elbow joints.

main manifestations of arthropathies in diseases of the chest.

  • Malignant lung tumors expressed high-growth and manifestations of articular syndrome combined deformation of nails in the form of "time windows", and accompanied by lesions of bone.At the same time concerned about pain patients not only in nail phalanges, but also in other bones of the hands, worse on palpation.
  • With the development of arthropathy with chronic purulent diseases of the chest in patients phalanges pain usually do not feel.
  • But with involvement of other joints (elbow, knee, wrist and knee) in which there is pain, edema, limitation of motion and stiffness in the morning as in rheumatoid arthritis.The changes in the bones and joints often symmetrical.
  • Very often in patients with arthropathy observed disorders of the autonomic nervous system: skin rash hands and feet, hot flushes, paleness of skin, hormonal disruptions (gynecomastia in men may develop).

Diagnostic osteoarthropathy in diseases of the lungs

If arthropathy occurs on the background of tumor lesions in the blood has accelerated erythrocyte sedimentation rate, leukocytosis, in the synovial fluid is only a small leukocytosis.The rest - the changes specific to the underlying disease.

radiologically determined only small periosteal (periosteal) layers with a long-term chronic disease, ultrasonography of the joints can be detected a slight accumulation of intra-articular fluid.

Treatment for mild arthropathy

disease most often symptomatic, anti-inflammatory treatment of joints.Thus, unlike metastatic lesions, such treatment can be effective, accompanied by a decrease of pain and edema.

In cases where surgery is performed lung disease (for cancer, abscess, or bronchiectasis), "drumsticks" and periosteal layers decrease effusion disappears in the joints.

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