Patients most often complain of joint pain in initial flexion-extension (so called "rusty joints"), as well after prolonged activity (when pain becoming stronger as day wears on). A medical inspection of such patients typically reveals palpable particular cartilage friction and minor limitation in the range of motion (except for the hip joint).
Knee arthritis patients usually complain of pain when descending stairs.

Hip arthritis. A hip arthritis patient suffers pain in the hip joint, and limitation in internal and external rotation as well in as abduction. At later stages, difficulty with extension and adduction occurs, and in advanced cases flexion limitation as well. Late in the disease contractures emerge, along with adductor and poses shortening, resulting in the pelvis skewing towards the affected side.

Treatment.
Usually in case of knee or hip degenerative dystrophic changes (osteoarthritis), patients are offered the following treatment:

• decrease in the weight on the affected joint (walking with a cane, losing body weight);
• physiotherapy;
• applied heat to the affected joint;
• X-ray therapy in low-level radiation doses.

In more severe cases nonsteroidal anti-inflammatory drugs (NSAID) are prescribed beyond the acute phase (though only in minimally effective dosage), for alleviating inflammation and pain. Unfortunately NSAIDs have a number of side effects and contraindications. Recently such chondroprotectors as ARTHRON^® COMPLEX, ARTHRON^® CHONDREX, ARTHRON^® FLEX have been successfully used in the therapy of degenerative dystrophic changes in joints. In some extremely apparent degenerative dystrophic changes, patients may need endoprosthesis, joint replacement, osteoarthrotomy or arthrodesis.

Spondylarthrosis.
Degenerative dystrophic changes in spine manifest as small vertebral joints - especially those of cervical and lumbar parts. X-ray images show the following changes:

• narrowing of the joint spaces;
• sclerotic degeneration in the margins of vertebral bodies (osteochondrosis);
• Bone excrescence on vertebral bodies (osteophytes leading to alkalosis or vertebral stiffness).

Patients coming to a doctor with cervical spondylopathy complaints are usually troubled by neck and nape pain in the frontal region of the head. They may experience giddiness, tinnitus, shoulder and/or arm pain.
In case of the degenerative dystrophic affection (arthritis) of the lumbar vertebrae patients usually complain of dull pain in the low back during long recumbence or physical activity.

Arthritis of wrist joints.
The following symptoms are the most frequent for this pathology:

• Two-sided thickening of distal interphalangeal joints, due to particular cartilage and periosteum excrescence (the so-called Heberde's nodes). Approximately in 50% of these node cases are accompanied by proximal interphalangeal joint intumescences. Such changes are most frequent in menopausal women.
• Bursiform swelling of proximal interphalangeal joints with swollen articular cartilage (so-called Bouchard's nodes, indicating degenerative changes in proximal interphalangeal joints).
• Thumb rhizartrosis or degenerative changes in carpometacarpal saddle joint at the bottom of the I metacarpal bone.

In such cases heat and motion activity are usually recommended to patients. In drug therapy NSAID and/or chondroprotectors are administered. In severe cases, e.g. in rhizarthrosis, surgery may be indicated.

Painful shoulder syndrome.
This term includes all disease states of the shoulder caused by shoulder arthritis (degenerative dystrophic changes), as well as those of the soft tissues of the shoulder joint, including scapulohumeral periarthritis. In such cases it is best to take an X-ray of the assumed calcification area (usually it is the tendon area of supraspinous muscle). Ultrasonic scanning (US) of the shoulder can also show rotator muscle ruptures as well as calcification areas. It is advisable to use X-rays for cervical spine examination.

Clinical states:

• Supraspinous muscle syndrome appears as painful shoulder abduction.
• Arm biceps syndrome manifests itself in pain during compound motion, including abduction, extension and internal rotation (as in the case of using a screwdriver).
• Still (frozen) shoulder syndrome is associated with evident joint limitation in mobility, caused by fibrous degeneration of particular tissues.