Diseases of Musculoskeletal System and Connective Tissue

In the following, “musculoskeletal system – connective tissue” describes diseases that are assigned to this category according to ICD-10 (M00-M99). The ICD-10 is used for the International Statistical Classification of Diseases and Related Health Problems and is recognized worldwide.

Musculoskeletal system – connective tissue

Mobility is one of the things we take for granted in modern life, and it takes on a special significance as we age. In this context, our bones and joints face daily challenges that are often at the limits of their load-bearing capacity. Only healthy, functioning bones and joints can meet the diverse requirements that are essential for mobility. If you want to successfully master these challenges into old age, you should pay attention to optimal bone and joint health as well as to maintaining your musculature at an early stage in order to prevent diseases such as arthrosis, osteoporosis or back pain as well as sarcopenia. Sarcopenia is not only an age-related excessive loss of muscle mass and strength, but also a loss of muscle function. Exercise helps joint cartilage to regenerate and thus remain mobile, and muscles to strengthen. If muscles are not sufficiently trained, pain can occur even with low loads. However, muscles must not only be trained, but also relaxed. Both can be achieved through targeted regular training, such as strength and balance training, even at an advanced age. A common term for the musculoskeletal system is “movement and support apparatus”. The two components form a functional unit. The musculoskeletal system can be divided into active and passive apparatus, with the passive apparatus corresponding to the supporting apparatus.

Anatomy

The supporting apparatus (passive musculoskeletal system) includes:

  • Bones and cartilage
  • Joints
  • Intervertebral discs
  • Ligaments

In summary, we speak of the skeleton (framework). The active musculoskeletal system includes:

  • Skeletal muscles
  • Tendons and tendon sheaths
  • Fascia
  • Bursa

Bones (ossa) and cartilage (cartilago)The human body consists of over 200 bones. Different types of bones are distinguished depending on their location and function, for example, long bones (tubular bones; lat. : ossa longa) such as the humerus and forearm bones, short bones (lat. : ossa brevia) such as the carpal bone and flat bones (lat. : ossa plana) such as the scapula. The largest bone is the femur. The anatomy of a bone depends on its function.Cartilages are very resistant, elastic supporting tissue. They are found in many places in our body, such as joints or intervertebral discs. They consist of a smooth and vascular tissue. Since blood vessels are also absent, cartilage defects cannot heal. The following types of cartilage tissue are distinguished: hyaline cartilage, elastic cartilage and fibrocartilage. Joints (Articulationes)Humans have approximately 100 movable joints. A joint is a connection of two or more bones. There are different forms of joints – ball, saddle, hinge, etc. Furthermore, a distinction is made between real joints (diarthroses; with joint space) and unreal joints (synarthroses; without joint space).A joint consists of a condyle and a socket, the surfaces of which are covered by cartilage. Between them is a cavity filled with synovial fluid. A joint is encased by a capsule (layer of connective tissue). Intervertebral discs (Discus intervertebralis)Intervertebral discs are located between the individual vertebrae. An intervertebral disc consists of an outer fibrous ring (lat. : Anulus fibrosus) and an inner gelatinous nucleus (lat. : Nucleus pulposus). During the day, the intervertebral discs become flatter and flatter due to pressure, they lose water. Therefore, one is smaller in the evening than in the morning. When the pressure is relieved, they take up water again. Ligaments (Ligamenta)Ligaments are made of collagen fibers that have little elasticity, so they can be overstretched quickly. They surround joints. In some cases, they are also located in joints, such as the knee joint (cruciate ligaments). Muscles (musculus)Muscles consist of muscle fibers (= spindle-shaped cellular basic unit of the (striated) muscles of the skeleton).Several muscle fibers form a muscle fiber bundle, and several bundles form a muscle surrounded by fascia (thin, tendon-like muscle skin).Humans have more than 650 muscles. The largest muscle is the gluteus maximus muscle. Tendons and tendon sheathsTendons are made of collagenous connective tissue. They are not very stretchy, rather firm, but flexible. One end of the tendons is fused to the muscle fibers in the muscle and the other end is attached to the bone. Particularly long tendons are guided in tendon sheaths (lat. : vagina synovialis tendinis), which are filled with fluid. This protects the tendons from unnecessary friction, which can lead to tendon damage. The strongest tendon in our body is the Achilles tendon. FasciaFascia are also known as muscle skin. They are part of the connective tissue. A distinction is made between superficial (very elastic), deep and visceral fasciae (not very elastic). Bursa (synovial bursa)This is a tissue sac filled with synovial fluid. They are located under the tendon and occur mainly where joints are subjected to particularly heavy loads, e.g. at the knee joint. Connective tissueConnective tissue connects numerous different types of tissue in the body. It is a component of the skin and organs.

Physiology/function

BonesBones are part of the passive musculoskeletal system, the supporting apparatus. It ensures the body shape (shaping) and posture. The skeleton also has a protective function for the internal organs. A good example of this is the thorax (chest) and the bones of the skull. The bones contain the bone marrow, where the erythrocytes (red blood cells), thrombocytes (platelets) and leukocytes (white blood cells) are formed.Cartilage allows elasticity and protects against pressure loads. JointsThe joints connect the bones to each other. The different joints allow for different directions and radii of movement of the bones. Intervertebral discsIntervertebral discs act as shock absorbers. They distribute the pressure on them evenly. The intervertebral discs allow the spine to bend in all directions first. LigamentsLigaments stabilize the joints. They provide a connection between two bones. MusclesBy contracting (contracting), muscles develop strength. In addition, they play a role not only for the body statics, but above all for the function, i.e. for the mobility and mobility (locomotion). This is usually neglected. Coordination exercises are particularly important in old age.Not all muscles can be moved voluntarily. These include the so-called smooth muscles, which are found, for example, in the urinary bladder and intestines, as well as the heart muscles (myocardium). Transversely striated muscles can be moved voluntarily. This includes, for example, skeletal muscle. Tendons and tendon sheathsTendons connect muscles to bones. Tendons transmit the force generated by the muscles to the bones. FasciaFascia are a connecting tissue of various structures of the human body (muscles, tendons, bones, blood vessels, organs). Among other things, they perform important tasks for the stability and mobility of the body. When overloaded, they can become congested and painful. BursaThey act as a cushion to protect the tendon against “chafing”. They are located in places that are particularly stressed, such as the hip and elbow. The pressure exerted by the tendon is thus distributed over a larger area. Connective tissueConnective tissue has the following functions: Defense function, support function, water storage, energy storage function (fatty tissue).

Common diseases of the musculoskeletal system – connective tissue

  • Arthralgia (joint pain)
  • Osteoarthritis (joint wear and tear)
  • Bursopathies (bursa diseases)
  • Thoracic spine syndrome
  • Coxarthrosis (hip osteoarthritis)
  • Discopathy (damage to the intervertebral disc) – Banscheibenprolaps (disc prolapse).
  • Epicondylitis humeri (tennis elbow)
  • Fractures (bone fractures)
  • Foot deformities – bent foot, flat foot, sickle foot, splay foot.
  • Gonarthrosis (knee osteoarthritis)
  • Hallux valgus
  • Cervical spine syndrome (cervical spine syndrome)
  • Lumboischialgia (pain conditions in the supply area of the nervus ischiadicus).
  • Mouse arm (repetitive strain injury syndrome).
  • Myalgia (muscle pain)
  • Omarthrosis (shoulder arthritis)
  • Osteochondrosis of the spine
  • Osteoporosis (bone loss)
  • Rheumatoid arthritis – chronic inflammatory multisystem disease.
  • Back pain
  • Sarcopenia – age-associated excessive loss of muscle mass and strength and functional decline.
  • Shoulder lesions
  • Scoliosis (lateral curvature of the body axis).
  • Spondylosis (degenerative arthritic change of the spine).
  • Tendinosis calcarea (calcifying shoulder)

Many diseases of the musculoskeletal system can be prevented by a healthy lifestyle, appropriate sports and preventive measures. Effective therapy methods offer help to the affected patient.

The main risk factors for diseases of the musculoskeletal system – connective tissue

Behavioral causes

  • Diet
    • Insufficient protein intake – proteins are important for building or maintaining muscle.
    • In inflammatory diseases: high intake of omega-6 fatty acid arachidonic acid, low intake of omega-3 fatty acids.
    • Micronutrient deficiency – v. a. Calcium, vitamin D.
  • Pleasure food consumption
    • Alcohol consumption
    • Tobacco consumption
  • Psycho-social situation
    • High occupational demands/chronic stress
  • Lack of exercise, competitive sports
  • Chronic overload, one-sided movement sequences such as at computer workstations, incorrect working posture.
  • Overweight
  • Underweight

Causes due to disease

Medications

  • Glucocorticoids

Please note that the enumeration is only an extract of the possible risk factors. Other causes can be found under the respective disease.

The main diagnostic measures for diseases of the musculoskeletal system – connective tissue

  • Arthroscopy (joint endoscopy).
  • Arthrosonography (ultrasound examination of joints).
  • Osteodensitometry (bone density measurement).
  • X-ray diagnostics
  • Ultrasound diagnostics
  • Electromyography (EMG; measurement of electrical muscle activity)/nerve conduction velocity.
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • 3D spine measurement – provides information about anatomical changes of the back and spine without radiation exposure.
  • Gait analysis (3-D gait analysis)
  • Myelography (radiological contrast imaging of the spine and spinal canal/vertebral canal).

Which doctor will help you?

For diseases of the musculoskeletal system and connective tissue should first see the family doctor. Depending on the disease or its severity, a presentation to a specialist, in this case the orthopedist, will be necessary.