Kashin-Beck disease is a degenerative process of an endemic nature. The main feature of the disease is that with it there is a process of ossification and cessation of growth and development of tubular bones. This, in turn, leads to joint deformation, the appearance of an osteophytosis of a complicated stage. In some cases, Cachin-Beck disease is considered as a form of endemic deforming osteoarthrosis.
Level disease in Transbaikalia
The first information about such a disease appeared about 150 years ago among residents of certain regions of Russia (Transbaikalia, in the regions of the River Level). An unusual and previously unknown disease was identified, the main symptoms of which were problems with the functioning of the musculoskeletal system. The disease was described in more detail by the military doctors N.I. Kashin and A.N. Beck, in whose honor it began to be called subsequently.
With a further more in-depth examination, specialists were able to understand that in fact the disease is spread much wider than previously thought. Now, apart from Transbaikalia, the regions of infection are also the east of Chita, certain regions of the Amur Region, Kyrgyzstan, North China, and Korea. Some cases of damage are diagnosed in more remote places - Buryatia, Yakutia, Primorsky Territory, as well as the northwestern regions of Ukraine.
In another way, Kashin-Beck disease can be called endemetric deforming osteoarthritis (the name implies the essence of malaise) and Urayskaya disease (due to the fact that most of the cases were residents of the Urea river basin).
It is important to note that earlier, from 32 to 46 percent of the inhabitants of the described region suffered from this malaise, today, as a result of mass preventive measures, it is detected only in 96 out of 1000 residents.
Causes of the disease
The main cause of Kashin-Beck disease (Level disease) is an imbalance of trace elements in the land and water of individual regions and regions of the country. Because of this, many residents of these areas simply do not get the right amount of vitamins and minerals.
The exact causes of the lesion have not yet been established. If joints crackle throughout the body, the causes may be as follows:
- Mineral (geobiochemical theory). With a detailed study of pathology, scientists were able to determine that in the endemic areas the mineral composition of water, soil and consumed food is slightly different - they reveal a huge amount of manganese, phosphate and strontium, and calcite, on the contrary, is less than the established norm. In addition, they contain an insufficient amount of selenium and iodine.
- Joints are crunched throughout the body due to the spread of fungus F. Sporotichilla. According to the statements, the toxins of the described fungus deform articular cartilage cells - chondrocytes, which leads to the formation of toxic cells of lipid peroxidation products.
- The third and final opinion is that Kashin-Beck disease is actually hereditary. Direct evidence for this has not yet been found, but there is information that children of adults with pathology suffer from this ailment several times more often than children of healthy people. Also, the risk of developing the disease in close relatives is also high. Most likely, there is a certain genetic predisposition to the development of deforming osteoarthritis in a person, but it does not guarantee the development of a disease in a particular person, however, it significantly increases the risk of this in certain environmental conditions (for example, when living in an endemic area).
A predisposing factor to the development of pathology is rickets (lack of vitamin D, which leads to poor absorption of potassium salts in the body), frequent hypothermia, prolonged labor of high intensity, lack of rest.
What happens in the patient’s body?
In the bones of a sick person there is an acute lack of calcium and an excessive amount of iron, manganese, zinc, silver. Phosphorus levels are elevated in both serum and urine.
Doctors say that a deficiency or excess of certain trace elements occurs due to a lack of calcium in certain areas of the bone, which causes collagen metabolism problems, poor microcirculation, inhibition of regeneration and recovery, a change in osteogenesis and early formation of motionless joints on the human body.
All the described factors lead to the beginning of the spread of degenerative changes in the tissues, joints and internal organs of a person.
By what principle does malaise develop?
The basis of malaise is a generalized process of degeneration of all skeleton bones. The terminal sections — the epiphyses (heads) and metaphyses (necks) —short and long tubular bones in which the growth site is localized — are worst perceived by such changes, which leads to an increase in the length of the bone itself. Cartilage tissue in areas where the pathological process spreads, significantly thickens and begins to sclerosize, and after it disappears completely.
Joint surfaces begin to become damaged - defects form on them that differ in size and type. Joint cavities begin to change, change their shape to a bell or a niche. Epiphyses wedge into niches and begin to actively develop, spreading to new areas.
Due to damage to the sprout of the bone, the growth of all bones slows down, especially the short tubular phalanges of the fingers. A person develops a pathology called short-fingered.
Joint surfaces cease to adjoin normally (problems arise with their congruence), articular cartilage peels off over time, its structure deforms and collapses over time, which leads to the development of deforming arthrosis.
Exfoliation of dead cartilage
Edge and osteophytes flowing onto the surface of the joint arise. All the described changes can be explained by the displacement of the articular surfaces in relation to each other - the development of subluxations. The joints in which the pathological focus develops begin to damage rapidly, the patient loses the ability to perform the complex of movements that was available earlier, he develops muscle contractures.
The villi of the synovial membrane expand, and from time to time, together with pieces of dead articular cartilage, exfoliate, passing into the joint cavity, and begin to form a “joint mouse”. All described processes take place against a background of severe swelling of the joint.
The end plates of the vertebrae also suffer from the disease, intervertebral discs are built into their recesses, the height of which is less than or greater than normal. On the vertebrae, marginal bone growths - osteophytes begin to form.
What signs of the disease exist?
Children of the age from 4 to 5 and from 14 to 15 years (during the period of active growth and development of bones) are more susceptible to the described disease. In young children, particularly striking signs of damage are not observed, in people over 25 years of age, the problem is detected only in isolated cases. The incidence rate does not depend on gender.
Endemic deforming osteoarthrosis develops at a slow pace, but progresses steadily, which at some point leads to the appearance of severe deformity of many joints.
Symptoms of Cachin-Beck disease in childhood can be as follows:
- pain in the joints, adjacent muscles, spine (characterized by aching pain), increase in the evening and during sleep;
- stiff joints are characteristic in the morning, after waking up, and at a late stage and throughout the day;
- the presence of crunch in the joints;
- numbness, crawling sensation in the muscles of the leg and fingers.
Pathological processes
Pathological processes originate in the area of the interphalangeal joints of the 2, 3 and 4 fingers. In many patients, the pathological process spreads only within the described area, while in others it switches to overlying joints of a larger size - wrist, elbow, knee and others. All changes are distinguished by their symmetry - the joints of both upper and lower extremities are equally deformed. The patient develops cramps in the fingers.
The described joints swell, greatly increase in size, deform, the range of motion in them is significantly reduced, and the muscles begin to atrophy. The fingers are very curved, there is an X- or O-shaped deformation of the lower extremities.
If a free body (“articular mouse”) enters the cavity of the knee joint and remains there at the moment of movement, then the patient suddenly experiences acute pain that prevents the diseased joint from moving and fixes it in one position. Movement in this joint is severely limited due to soreness.
External signs of the disease
It is possible to identify those suffering from Kashin-Beck disease by external signs. Most often, they are characterized by the following features:
- short stature (women no higher than 147 centimeters, and men up to 160 centimeters);
- fingers are very short (in other words “bear paw”);
- contracture may appear and the shape of the joints themselves may change
- lumbar lordosis progresses, forward bending is much deeper than in healthy people;
- there is a valgus (X-shaped) or varus (O-shaped) deformation of the lower extremities;
- the patient has a duck walk.
Patient Complaints
In addition to bone changes, an imbalance of trace elements in the patient's body leads to the appearance of other unpleasant symptoms. Many people with pathology complain of:
- severe pain in the head;
- complete or partial lack of appetite;
- heartache;
- aching pain in the joints and muscles;
- dystrophic changes in the skin, nails and hair (dry skin appears, wrinkles appear, the color fades, brittle nails and hair, their tarnishing).
Accompanying illnesses
Some patients develop concomitant pathologies:
- atrophic rhinitis;
- change in the shape and growth line of teeth in the oral cavity;
- inflammation in the ears;
- chronic pharyngitis;
- chronic inflammation in the bronchial mucosa, emphysema;
- gastroenterocolitis;
- dystrophy of the heart muscle;
- VVD;
- deterioration of the brain, degradation begins;
- encephalopathy;
- astheno-neurotic syndrome.
Preventive actions
Measures for the prevention of Kashin-Beck disease will consist in enriching the soil, water and food products of endemic areas with useful trace elements that are important for the human body. The population living in such areas receives vegetables and fruits brought from other regions, water from artesian wells. Animals at local farms receive feed mixtures with normalized mineral composition.
Persons predisposed to the disease take multivitamin complexes and drugs with calcium in the courses twice a year. They are also advised to regularly eat dry seaweed.
How is the treatment?
Treatment for Cachin-Beck disease consists of the following:
- Taking drugs with phosphorus, calcium, selenium, vitamins D, B, ascorbic acid.
- The restoration of metabolic processes in diseased tissues using biostimulants: aloe, ATP, FiBS and others.
- Physiotherapy, which helps to get rid of the pain syndrome, reduces muscle contractures, increases the range of motion in the joints, restores previous working capacity. To do this, use mud applications, radon baths, paraffin therapy, UHF current and ultrasound to the area of the affected joint. All procedures are carried out by courses or comprehensively.
It is important to remember that in the late stages of the progression of malaise, it will not be possible to cope with it alone with medication and physiotherapy. Such patients need to undergo orthopedic correction of contracture or even surgery.