Остеоартрит является общепопуляционной патологией, что свидетельствует о большой медицинской и социальной значимости этого заболевания. В статье рассматриваются вопросы патогенеза, факторов риска и диагностики профессионального и профессионально обусловленного остеоартрита: возраст начала заболевания, специфика трудовой деятельности, локализация поражения суставов. Обсуждаются вопросы дифференциальной диагностики.
Osteoarthritis is a common pathology, which indicates the great medical and social significance of this disease. The article discusses the issues of pathogenesis, risk factors and diagnosis of professional and professionally caused osteoarthritis: the age of onset of the disease, the specifics of work, the localization of joint damage. Differential diagnosis issues are discussed.
Keywords: osteoarthritis, occupational factors, knee joints, hip joints.
Список литературы
1. Мартынов А.И., Наумов А.В., Верткин А.Л. и др. Ведение больных с остеоартритом и коморбидностью в общей врачебной практике: мнение экспертов, основанное на доказательной медицине. Лечащий врач. 2015;4:39-46 [Martynov AI, Naumov AV, Vertkin AL, et al. Vedenie bol'nyh s osteoartritom i komorbidnost'ju v obshej vrachebnoj praktike: mnenie jekspertov, osnovannoe na dokazatel'noj medicine. Lechashhij vrach. 2015;4:39-46 (In Russ.)].
2. Алексеева Л.И., Таскина Е.А., Кашеварова Н.Г. Остеоартрит: эпидемиология, классификация, факторы риска и прогрессирования, клиника, диагностика, лечение. Совр. ревматология. 2019;13(2):9-21 [Alekseeva LI, Taskina EA, Kashevarova NG. Osteoarthritis: epidemiology, classification, risk factors, and progression, clinical presentation, diagnosis, and treatment. Sovremennaya Revmatologiya =
Modern Rheumatology Journal. 2019;13(2):9-21 (In Russ.)].
doi: 10.14412/1996-7012-2019-2-9-21
3. Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis Cartilage. 2013;21:16-21. doi: 10.1016/j.joca.2012.11.012
4. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis – a disease of the joint as an organ. Arthritis Rheum. 2012 Jun;64(6):1697-707. doi: 10.1002/art.34453
5. Насонова В.А. Остеоартроз. Проблема полиморбидности.
Consilium Medicum. 2009;11(2):34-45 [Nasonova VA. Osteoartroz. Problema polimorbidnosti. Consilium Medicum. 2009;11(2):34-45 (In Russ.)].
6. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence ofarthritis and otherrheumatic conditionsin the United States. Part II. Arthritis Rheum. 2008;58:26-35. doi: 10.1002/art.23176
7. Canizares M, Power JD, Perrucio AV, Badley EM. Association of regional racial/cultural context and socioeconomics status with arthritis in the population: A multilevel analysis. Arthritis Rheum. 2008;59:399-407. doi: 10.1002/art.23316
8. Gignac MA, Cao X, Davis AM, et al. Understanding social role participation: what matters to people with arthritis? J Rheumatol. 2008;35(8):1655-63.
9. Rossignol M, Leclerc A, Hilliquin P, et al. Primary osteoarthritis and occupations: a national cross sectional survey of 10 412 symptomatic patients. Occup Environ Med. 2003;60:882-6. doi: 10.1136/oem.60.11.882
10. Профессиональная патология. Национальное руководство. Под ред. Н.Ф. Измерова. М.: ГЭОТАР-Медиа, 2011 [Occupational pathology. National leadership. Ed. NF Izmerov. Moscow: GEOTAR-Media, 2011 (In Russ.)].
11. Профессиональные болезни. Под ред. Н.А. Мухина, С.А Бабанова. М.: ГЭОТАР-Медиа, 2018 [Occupational diseases. Ed. NA Mukhina, SA Babanov. Moscow: GEOTAR-Media, 2018 (In Russ.)].
12. Palmer KT. Occupational activities and osteoarthritis of the knee. Br Med Bull. 2012;102:147-70. doi: 10.1093/bmb/lds012
13. Vignon E, Valat JP, Rossignol M, et al. Osteoarthritis of the knee and hip and activity: a systematic international review and synthesis (OASIS). Joint Bone Spine. 2006;73(4):442-55. doi: 10.1016/j.jbspin.2006.03.001
14. Schram B, Orr R, Pope R, et al. Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A narrative umbrella review. J Occup Health. 2020;62:e12103. doi: 10.1002/1348-9585.12103
15. McWilliams DF, Leeb BF, Muthuri SG, et al. Occupational risk factors for osteoarthritis of the knee: a meta-analysis. Osteoarthritis Cartilage. 2011;19(7):829-39. doi: 10.1016/j.joca.2011.02.016
16. McMillan G, Nichols L. Osteoarthritis and meniscus disorders of the knee as occupational diseases of miners. Occup Environ Med. 2005;62(8):567-75. doi: 10.1136/oem.2004.017137
17. Berryman P, Lukes E, Aluoch MA, Wao HO. Risk factors for occupational osteoarthritis: a literature review. AAOHN J. 2009;57(7):283-90. doi: 10.3928/08910162-20090625-10
18. Thambyah A. How critical are the tibiofemoral joint reaction forces during frequent squatting in Asian populations? Knee. 2008;15(4):286-94. doi: 10.1016/j.knee.2008.04.006
19. Fransen M, Agaliotis M, Bridgett L, Mackey MG. Hip and knee pain: role of occupational factors. Best Pract Res Clin Rheumatol. 2011;25(1):81-101. doi: 10.1016/j.berh.2011.01.012
20. Richmond SA, Fukuchi RK, Ezzat A, et al. Are joint injury, sport activity, physical activity,obesity, or occupational activities predictors for osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2013;43(8):515-9. doi: 10.2519/jospt.2013.4796
21. Seidler A, Luben L, Hegewald J, et al. Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment. BMC Musculoskelet Dis. 2018;19(1):1-12. doi: 10.1186/s12891-018-2085-8
22. Bergmann A, Bolm-Audorff U, Krone D, et al. Occupational strain as a risk for hip osteoarthritis. Dtsch Arztebl Int. 2017;114(35–36):581-8. doi: 10.3238/arztebl.2017.0581
23. Jensen LK. Hip osteoarthritis: influence of work with heavy lifting, climbing stairs or ladders, or combining kneeling/squatting with heavy lifting. Occup Environ Med. 2008;65(1):6-19. doi: 10.1136/oem.2006.032409
24. Sulsky SI, Carlton L, Bochmann F, et al. Epidemiological evidence for work load as a risk factor for osteoarthritis of the hip: a systematic review. PLoS One. 2012;7(2):e31521. doi: 10.1371/journal.pone.0031521
25. Solovieva S, Kontio T, Viikari-Juntura E. Occupation, Physical Workload Factors, and Disability Retirement as a Result of Hip Osteoarthritis in Finland, 2005–2013. J Rheumatol. 2018 Apr;45(4):555-62. doi: 10.3899/jrheum.170748
26. Вакуленко О.Ю., Жиляев Е.В. Остеоартроз: современные подходы к лечению. РМЖ. 2016;22:1494-8 [Vakulenko OYu, Zhilyaev EV. Modern treatment approaches to osteoarthrosis. RMJ. 2016;22:1494-8 (In Russ.)].
27. Кашеварова Н.Г., Алексеева Л.И. Факторы риска прогрессирования остеоартроза коленных суставов. Научно-практич. ревматология. 2014;52(5):553-61. [Kashevarova NG, Alekseeva LI. Risk factors of the knee osteoarthritis progression. Rheumatology Science and Practice. 2014;52(5):553-61 (In Russ.)]. doi: 10.14412/1995-4484-2014-553-561
28. Jacobsen S. Adult hip dysplasia and osteoarthritis. Studies in radiology and clinical epidemiology. Acta Orthop (Suppl.). 2006;77(324):1-37. doi: 10.1080/17453690610046505
________________________________________________
1. Martynov AI, Naumov AV, Vertkin AL, et al. Vedenie bol'nyh s osteoartritom i komorbidnost'ju v obshej vrachebnoj praktike: mnenie jekspertov, osnovannoe na dokazatel'noj medicine. Lechashhij vrach. 2015;4:39-46 (In Russ.)
2. Alekseeva LI, Taskina EA, Kashevarova NG. Osteoarthritis: epidemiology, classification, risk factors, and progression, clinical presentation, diagnosis, and treatment. Sovremennaya Revmatologiya = Modern Rheumatology Journal. 2019;13(2):9-21 (In Russ.) doi: 10.14412/1996-7012-2019-2-9-21
3. Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis Cartilage. 2013;21:16-21.
doi: 10.1016/j.joca.2012.11.012
4. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis – a disease of the joint as an organ. Arthritis Rheum. 2012 Jun;64(6):1697-707. doi: 10.1002/art.34453
5. Nasonova VA. Osteoartroz. Problema polimorbidnosti. Consilium Medicum. 2009;11(2):34-45 (In Russ.)
6. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence ofarthritis and otherrheumatic conditionsin the United States. Part II. Arthritis Rheum. 2008;58:26-35. doi: 10.1002/art.23176
7. Canizares M, Power JD, Perrucio AV, Badley EM. Association of regional racial/cultural context and socioeconomics status with arthritis in the population: A multilevel analysis. Arthritis Rheum. 2008;59:399-407. doi: 10.1002/art.23316
8. Gignac MA, Cao X, Davis AM, et al. Understanding social role participation: what matters to people with arthritis? J Rheumatol. 2008;35(8):1655-63.
9. Rossignol M, Leclerc A, Hilliquin P, et al. Primary osteoarthritis and occupations: a national cross sectional survey of 10 412 symptomatic patients. Occup Environ Med. 2003;60:882-6. doi: 10.1136/oem.60.11.882
10. Профессиональная патология. Национальное руководство. Под ред. Н.Ф. Измерова. М.: ГЭОТАР-Медиа, 2011 [Occupational pathology. National leadership. Ed. NF Izmerov. Moscow: GEOTAR-Media, 2011 (In Russ.)].
11. Occupational diseases. Ed. NA Mukhina, SA Babanov. Moscow: GEOTAR-Media, 2018 (In Russ.)
12. Palmer KT. Occupational activities and osteoarthritis of the knee. Br Med Bull. 2012;102:147-70. doi: 10.1093/bmb/lds012
13. Vignon E, Valat JP, Rossignol M, et al. Osteoarthritis of the knee and hip and activity: a systematic international review and synthesis (OASIS). Joint Bone Spine. 2006;73(4):442-55. doi: 10.1016/j.jbspin.2006.03.001
14. Schram B, Orr R, Pope R, et al. Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A narrative umbrella review. J Occup Health. 2020;62:e12103. doi: 10.1002/1348-9585.12103
15. McWilliams DF, Leeb BF, Muthuri SG, et al. Occupational risk factors for osteoarthritis of the knee: a meta-analysis. Osteoarthritis Cartilage. 2011;19(7):829-39. doi: 10.1016/j.joca.2011.02.016
16. McMillan G, Nichols L. Osteoarthritis and meniscus disorders of the knee as occupational diseases of miners. Occup Environ Med. 2005;62(8):567-75. doi: 10.1136/oem.2004.017137
17. Berryman P, Lukes E, Aluoch MA, Wao HO. Risk factors for occupational osteoarthritis: a literature review. AAOHN J. 2009;57(7):283-90. doi: 10.3928/08910162-20090625-10
18. Thambyah A. How critical are the tibiofemoral joint reaction forces during frequent squatting in Asian populations? Knee. 2008;15(4):286-94. doi: 10.1016/j.knee.2008.04.006
19. Fransen M, Agaliotis M, Bridgett L, Mackey MG. Hip and knee pain: role of occupational factors. Best Pract Res Clin Rheumatol. 2011;25(1):81-101. doi: 10.1016/j.berh.2011.01.012
20. Richmond SA, Fukuchi RK, Ezzat A, et al. Are joint injury, sport activity, physical activity,obesity, or occupational activities predictors for osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2013;43(8):515-9. doi: 10.2519/jospt.2013.4796
21. Seidler A, Luben L, Hegewald J, et al. Dose-response relationship between cumulative physical workload and osteoarthritis of the hip – a meta-analysis applying an external reference population for exposure assignment. BMC Musculoskelet Dis. 2018;19(1):1-12. doi: 10.1186/s12891-018-2085-8
22. Bergmann A, Bolm-Audorff U, Krone D, et al. Occupational strain as a risk for hip osteoarthritis. Dtsch Arztebl Int. 2017;114(35–36):581-8. doi: 10.3238/arztebl.2017.0581
23. Jensen LK. Hip osteoarthritis: influence of work with heavy lifting, climbing stairs or ladders, or combining kneeling/squatting with heavy lifting. Occup Environ Med. 2008;65(1):6-19. doi: 10.1136/oem.2006.032409
24. Sulsky SI, Carlton L, Bochmann F, et al. Epidemiological evidence for work load as a risk factor for osteoarthritis of the hip: a systematic review. PLoS One. 2012;7(2):e31521. doi: 10.1371/journal.pone.0031521
25. Solovieva S, Kontio T, Viikari-Juntura E. Occupation, Physical Workload Factors, and Disability Retirement as a Result of Hip Osteoarthritis in Finland, 2005–2013. J Rheumatol. 2018 Apr;45(4):555-62. doi: 10.3899/jrheum.170748
26. Вакуленко О.Ю., Жиляев Е.В. Остеоартроз: современные подходы к лечению. РМЖ. 2016;22:1494-8 [Vakulenko OYu, Zhilyaev EV. Modern treatment approaches to osteoarthrosis. RMJ. 2016;22:1494-8 (In Russ.)].
27. Kashevarova NG, Alekseeva LI. Risk factors of the knee osteoarthritis progression. Rheumatology Science and Practice. 2014;52(5):553-61 (In Russ.) doi: 10.14412/1995-4484-2014-553-561
28. Jacobsen S. Adult hip dysplasia and osteoarthritis. Studies in radiology and clinical epidemiology. Acta Orthop (Suppl.). 2006;77(324):1-37. doi: 10.1080/17453690610046505
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России, Самара, Россия