Polyarthrosis: Causes

Pathogenesis (disease development)

Polyarthrosis refers to the occurrence of osteoarthritis in several joints at the same time. Age-related wear and tear is not the cause of osteoarthritis, but at the beginning of joint destruction is usually acute damage to the articular cartilage due to trauma or infection.In osteoarthritis, the following pathomechanisms can be observed:

Primary osteoarthritis occurs as a result of direct or indirect overloading of the joints.Direct overloading occurs during heavy work, sports or due to obesity. Indirect overloads include a reduction in cartilage regeneration due to aging or metabolic disorders. Secondary osteoarthritis can occur as a result of:

  • Congenital / malformation
  • Malalignment (varus – valgus)
  • Endocrinological disorders / diseases
  • Metabolic disorders/diseases
  • Inflammatory joint diseases
  • Chronic inflammatory and non-inflammatory arthropathy (joint disease).
  • Rheumatic joint disease
  • Post-traumatic (after joint trauma/joint injury; dislocation – dislocation/dislocation).
  • Operations

Etiology (causes)

Biographical causes

  • Genetic exposure through parents, grandparents – it is likely that susceptibility of articular cartilage to wear and tear can be inherited
    • Genetic diseases
      • Hemochromatosis (iron storage disease) – genetic disease with autosomal recessive inheritance with increased deposition of iron as a result of increased iron concentration in the blood with tissue damage.
  • Gender – Women are more likely to suffer from osteoarthritis than men. Finger polyarthrosis is 9 times more common in women. Causes are genetic factors and hormonal changes during menopause (menopause).
  • Hormonal factors – menopause / postmenopause.
  • Occupations – occupations with long-lasting heavy physical stress (e.g. construction workers).

Behavioral causes

  • Consumption of stimulants
    • Tobacco (smoking) – nicotine abuse promotes loss of articular cartilage in the knee joint (gonarthrosis)
  • Physical activity
    • Underloading of the cartilage:
      • Lack of physical activity – since cartilage gets its micronutrients from the synovial fluid, it relies on the joint being moved for cartilage growth
      • Nutritive damage (eg, long rest in a cast).
    • Overloading of the cartilage:
      • Competitive and high-performance sports
      • Long-lasting heavy physical stress
  • Overweight (BMI ≥ 25; obesity) – leads to overuse of the joints.

Disease-related causes

  • Congenital/misformity
    • Joint axis displacement – e.g., scoliosis (S-shaped spine), pelvic tilt, knock knees, flat feet.
  • Malalignment (varus – valgus).
    • Coxa valga luxans – shallow socket formation.
    • Subluxation (incomplete dislocation) – e.g. hip, knee.
    • Growth disorders in the epiphyseal region – area of the growth plates.
  • Endocrinological disorders/diseases
    • Acromegaly – endocrinological disorder caused by overproduction of growth hormone (somatotropic hormone (STH), somatotropin), with marked enlargement of the phalanges or acras, such as the hands, feet, lower jaw, chin, nose and eyebrow ridges.
    • Hyperparathyroidism (parathyroid hyperfunction).
  • Metabolic disorders/diseases
    • Chondrocalcinosis (synonym: pseudogout); gout-like disease of the joints caused by deposition of calcium pyrophosphate in cartilage and other tissues; leads, among other things, to joint degeneration (often of the knee joint); symptomatology resembles an acute gout attack
    • Gout (arthritis urica/uric acid-related joint inflammation or tophic gout)/hyperuricemia (increase in uric acid levels in the blood).
    • Hemochromatosis (iron storage disease) – genetic disease with autosomal recessive inheritance with increased deposition of iron as a result of increased iron concentration in the blood with tissue damage.
    • Ochronosis – deposition of homogentisic acid in the skin, connective tissue and cartilage.
    • Rickets (synonym: English disease) – disease of growing bone with disturbed mineralization of bones and disorganization of growth plates in children.
  • Chronic arthropathy – a number of diseases can lead to secondary joint disease. Both inflammatory and non-inflammatory processes can play a role. Examples include joint changes in gout – uric acid-related -, diabetes mellitus – carbohydrate metabolism-related -, hemophilia (hemophilia) or leprosy.
  • Inflammatory joint diseases
  • Rheumatic joint diseases
  • Post-traumatic (after joint trauma/joint injury; dislocation – dislocation/dislocation).

Laboratory diagnoses – laboratory parameters that are considered independent risk factors.