{"id":301,"date":"2026-03-15T18:06:37","date_gmt":"2026-03-15T17:06:37","guid":{"rendered":"https:\/\/erlaxatu.fr\/index.php\/arthrose\/"},"modified":"2026-03-15T21:16:06","modified_gmt":"2026-03-15T20:16:06","slug":"arthrose","status":"publish","type":"page","link":"https:\/\/erlaxatu.fr\/index.php\/arthrose\/","title":{"rendered":"Arthrose"},"content":{"rendered":"<p><strong>Arthrose <\/strong><\/p>\n<p><strong>Introduction<\/strong><\/p>\n<p>L\u2019arthrose est la maladie articulaire la plus fr\u00e9quente. Elle touche environ <strong>10 % de la population<\/strong> et affecte principalement les <strong>genoux, les hanches, les mains et le rachis<\/strong>. <\/p>\n<p>Elle correspond \u00e0 une <strong>atteinte d\u00e9g\u00e9n\u00e9rative de l\u2019ensemble de l\u2019articulation synoviale<\/strong>, avec alt\u00e9ration du cartilage mais aussi de l\u2019os sous-chondral, de la synoviale et de la capsule articulaire. <\/p>\n<p>Lorsque la maladie devient symptomatique, elle entra\u00eene :<\/p>\n<ul>\n<li>douleur articulaire<\/li>\n<li>raideur<\/li>\n<li>limitation fonctionnelle<\/li>\n<\/ul>\n<p>La forte pr\u00e9valence de l\u2019arthrose repr\u00e9sente un <strong>enjeu majeur de sant\u00e9 publique<\/strong> en raison du handicap fonctionnel et des co\u00fbts m\u00e9dicaux qu\u2019elle engendre. <\/p>\n<p><strong>1. Physiopathologie<\/strong><\/p>\n<p>L\u2019arthrose est une maladie de <strong>l\u2019articulation synoviale dans son ensemble<\/strong>.<\/p>\n<p>Une articulation synoviale comprend :<\/p>\n<ul>\n<li><strong>cartilage articulaire<\/strong><\/li>\n<li><strong>os sous-chondral<\/strong><\/li>\n<li><strong>membrane synoviale<\/strong><\/li>\n<li><strong>capsule articulaire<\/strong><\/li>\n<\/ul>\n<p>Le cartilage articulaire est un tissu particulier :<\/p>\n<ul>\n<li>non vascularis\u00e9<\/li>\n<li>non innerv\u00e9<\/li>\n<li>constitu\u00e9 de chondrocytes et d\u2019une matrice riche en eau et prot\u00e9oglycanes.<\/li>\n<\/ul>\n<p>Il assure l\u2019<strong>absorption des contraintes m\u00e9caniques<\/strong> entre deux surfaces osseuses. <\/p>\n<p>Dans l\u2019arthrose, plusieurs ph\u00e9nom\u00e8nes surviennent :<\/p>\n<p><strong>D\u00e9gradation du cartilage<\/strong><\/p>\n<p>Production d\u2019enzymes prot\u00e9olytiques (m\u00e9talloprot\u00e9ases) d\u00e9truisant la matrice cartilagineuse.<\/p>\n<p><strong>Inflammation synoviale<\/strong><\/p>\n<p>Inflammation locale de bas grade li\u00e9e aux d\u00e9bris cartilagineux.<\/p>\n<p><strong>Remodelage osseux<\/strong><\/p>\n<ul>\n<li>scl\u00e9rose sous-chondrale<\/li>\n<li>g\u00e9odes<\/li>\n<li>ost\u00e9ophytes.<\/li>\n<\/ul>\n<p>Ces modifications expliquent les <strong>signes radiologiques typiques de l\u2019arthrose<\/strong>. <\/p>\n<p><strong>2. Facteurs de risque<\/strong><\/p>\n<p>Plusieurs facteurs favorisent l\u2019apparition de l\u2019arthrose :<\/p>\n<p><strong>\u00c2ge<\/strong><\/p>\n<p>Rare avant 40 ans, l\u2019incidence augmente fortement apr\u00e8s 60 ans. <\/p>\n<p><strong>Ob\u00e9sit\u00e9<\/strong><\/p>\n<p>Facteur majeur, notamment pour les articulations portantes comme le genou.<\/p>\n<p><strong>Facteurs g\u00e9n\u00e9tiques<\/strong><\/p>\n<p>Fr\u00e9quent dans l\u2019arthrose digitale.<\/p>\n<p><strong>Sexe f\u00e9minin<\/strong><\/p>\n<p>Pr\u00e9valence plus \u00e9lev\u00e9e apr\u00e8s la m\u00e9nopause.<\/p>\n<p><strong>Contraintes m\u00e9caniques<\/strong><\/p>\n<ul>\n<li>microtraumatismes r\u00e9p\u00e9t\u00e9s<\/li>\n<li>port de charges<\/li>\n<li>anomalies d\u2019axe (genu varum \/ genu valgum)<\/li>\n<li>ant\u00e9c\u00e9dents traumatiques ou chirurgicaux.<\/li>\n<\/ul>\n<p>Trois ph\u00e9notypes d\u2019arthrose sont classiquement d\u00e9crits :<\/p>\n<ul>\n<li>arthrose li\u00e9e au vieillissement<\/li>\n<li>arthrose m\u00e9tabolique<\/li>\n<li>arthrose post-traumatique. <\/li>\n<\/ul>\n<p><strong>3. Signes cliniques de l\u2019arthrose<\/strong><\/p>\n<p><strong>Douleur m\u00e9canique<\/strong><\/p>\n<p>Caract\u00e9ristiques :<\/p>\n<ul>\n<li>d\u00e9clench\u00e9e par l\u2019effort<\/li>\n<li>calm\u00e9e par le repos<\/li>\n<li>absence de r\u00e9veil nocturne<\/li>\n<li>d\u00e9rouillage matinal court (&lt;15 min)<\/li>\n<\/ul>\n<p><strong>Raideur articulaire<\/strong><\/p>\n<p>Surtout apr\u00e8s repos.<\/p>\n<p><strong>G\u00eane fonctionnelle<\/strong><\/p>\n<p>Selon l\u2019articulation atteinte :<\/p>\n<ul>\n<li>limitation de la marche<\/li>\n<li>difficult\u00e9 pour s\u2019habiller<\/li>\n<li>g\u00eane dans les activit\u00e9s quotidiennes.<\/li>\n<\/ul>\n<p><strong>4. Signes radiologiques<\/strong><\/p>\n<p>Les radiographies montrent quatre signes caract\u00e9ristiques :<\/p>\n<p><strong>Pincement de l\u2019interligne articulaire<\/strong><\/p>\n<p>T\u00e9moin de la destruction du cartilage.<\/p>\n<p><strong>Ost\u00e9ophytes<\/strong><\/p>\n<p>Excroissances osseuses marginales.<\/p>\n<p><strong>Scl\u00e9rose sous-chondrale<\/strong><\/p>\n<p>Condensation osseuse sous le cartilage.<\/p>\n<p><strong>G\u00e9odes sous-chondrales<\/strong><\/p>\n<p>Lacunes osseuses intra-osseuses. <\/p>\n<p>Il peut exister une <strong>discordance radio-clinique<\/strong> : une arthrose radiologique importante peut \u00eatre peu douloureuse et inversement. <\/p>\n<p><strong>5. Coxarthrose (arthrose de la hanche)<\/strong><\/p>\n<p><strong>\u00c9pid\u00e9miologie<\/strong><\/p>\n<p>La coxarthrose symptomatique touche environ <strong>1 \u00e0 5 % des adultes entre 40 et 75 ans<\/strong>. <\/p>\n<p>Dans environ <strong>50 % des cas<\/strong>, elle est secondaire \u00e0 une dysplasie de hanche.<\/p>\n<p><strong>Clinique<\/strong><\/p>\n<p><strong>Interrogatoire<\/strong><\/p>\n<ul>\n<li>douleur du <strong>pli de l\u2019aine<\/strong><\/li>\n<li>irradiation possible vers cuisse ou genou<\/li>\n<li>douleur m\u00e9canique<\/li>\n<li>limitation de la marche<\/li>\n<li>difficult\u00e9s pour enfiler chaussettes ou chaussures.<\/li>\n<\/ul>\n<p><strong>Examen clinique<\/strong><\/p>\n<ul>\n<li>boiterie<\/li>\n<li>limitation de la rotation interne<\/li>\n<li>limitation de l\u2019extension.<\/li>\n<\/ul>\n<p><strong>Imagerie<\/strong><\/p>\n<p>Radiographie du bassin avec :<\/p>\n<ul>\n<li>pincement de l\u2019interligne<\/li>\n<li>ost\u00e9ophytes<\/li>\n<li>scl\u00e9rose sous-chondrale<\/li>\n<li>g\u00e9odes.<\/li>\n<\/ul>\n<p>L\u2019IRM n\u2019est <strong>pas n\u00e9cessaire en cas de coxarthrose typique<\/strong>. <\/p>\n<p><strong>Traitement<\/strong><\/p>\n<p><strong>Mesures non m\u00e9dicamenteuses<\/strong><\/p>\n<ul>\n<li>perte de poids<\/li>\n<li>kin\u00e9sith\u00e9rapie<\/li>\n<li>activit\u00e9 physique adapt\u00e9e<\/li>\n<li>aide \u00e0 la marche.<\/li>\n<\/ul>\n<p><strong>Traitement m\u00e9dicamenteux<\/strong><\/p>\n<ul>\n<li>antalgiques<\/li>\n<li>AINS<\/li>\n<li>infiltrations.<\/li>\n<\/ul>\n<p><strong>Traitement chirurgical<\/strong><\/p>\n<p>Proth\u00e8se totale de hanche en cas d\u2019\u00e9chec du traitement m\u00e9dical.<br \/>Dur\u00e9e de vie moyenne : <strong>environ 20 ans<\/strong>. <\/p>\n<p><strong>6. Gonarthrose (arthrose du genou)<\/strong><\/p>\n<p>C\u2019est la localisation <strong>la plus fr\u00e9quente de l\u2019arthrose des membres inf\u00e9rieurs<\/strong>. <\/p>\n<p>Elle peut toucher :<\/p>\n<ul>\n<li>compartiment f\u00e9moro-tibial m\u00e9dial<\/li>\n<li>compartiment f\u00e9moro-tibial lat\u00e9ral<\/li>\n<li>compartiment f\u00e9moro-patellaire.<\/li>\n<\/ul>\n<p><strong>Clinique<\/strong><\/p>\n<p><strong>Interrogatoire<\/strong><\/p>\n<ul>\n<li>douleur m\u00e9canique du genou<\/li>\n<li>douleur dans les escaliers<\/li>\n<li>craquements<\/li>\n<li>\u00e9pisodes de blocage.<\/li>\n<\/ul>\n<p><strong>Examen clinique<\/strong><\/p>\n<ul>\n<li>d\u00e9viation axiale (varus ou valgus)<\/li>\n<li>\u00e9panchement articulaire<\/li>\n<li>craquements<\/li>\n<li>amyotrophie du quadriceps.<\/li>\n<\/ul>\n<p><strong>Imagerie<\/strong><\/p>\n<p>Radiographies indispensables :<\/p>\n<ul>\n<li>face en charge<\/li>\n<li>profil<\/li>\n<li>schuss<\/li>\n<li>incidence f\u00e9moro-patellaire.<\/li>\n<\/ul>\n<p>Les m\u00eames signes radiologiques d\u2019arthrose sont retrouv\u00e9s. <\/p>\n<p><strong>Traitement<\/strong><\/p>\n<p><strong>Mesures g\u00e9n\u00e9rales<\/strong><\/p>\n<ul>\n<li>perte de poids<\/li>\n<li>kin\u00e9sith\u00e9rapie<\/li>\n<li>activit\u00e9 physique adapt\u00e9e.<\/li>\n<\/ul>\n<p><strong>M\u00e9dicaments<\/strong><\/p>\n<ul>\n<li>antalgiques<\/li>\n<li>AINS<\/li>\n<li>infiltrations de cortico\u00efdes.<\/li>\n<\/ul>\n<p><strong>Chirurgie<\/strong><\/p>\n<ul>\n<li>proth\u00e8se totale de genou<\/li>\n<li>proth\u00e8se unicompartimentale<\/li>\n<li>ost\u00e9otomie de r\u00e9axation chez le sujet jeune. <\/li>\n<\/ul>\n<p><strong>7. Arthrose digitale<\/strong><\/p>\n<p>L\u2019arthrose des doigts est une localisation tr\u00e8s fr\u00e9quente, surtout chez la <strong>femme apr\u00e8s la m\u00e9nopause<\/strong>. <\/p>\n<p><strong>Clinique<\/strong><\/p>\n<ul>\n<li>douleurs m\u00e9caniques des doigts<\/li>\n<li>nodules articulaires<\/li>\n<\/ul>\n<p><strong>Nodules caract\u00e9ristiques<\/strong><\/p>\n<ul>\n<li><strong>nodules d\u2019Heberden<\/strong> : IP distales<\/li>\n<li><strong>nodules de Bouchard<\/strong> : IP proximales.<\/li>\n<\/ul>\n<p>Une atteinte de la base du pouce correspond \u00e0 la <strong>rhizarthrose<\/strong>.<\/p>\n<p><strong>Forme particuli\u00e8re : arthrose \u00e9rosive<\/strong><\/p>\n<p>Forme plus s\u00e9v\u00e8re :<\/p>\n<ul>\n<li>douleurs importantes<\/li>\n<li>synovite<\/li>\n<li>destructions articulaires radiologiques.<\/li>\n<\/ul>\n<p><strong>Traitement<\/strong><\/p>\n<p>Principalement m\u00e9dical :<\/p>\n<ul>\n<li>antalgiques<\/li>\n<li>AINS<\/li>\n<li>infiltrations.<\/li>\n<\/ul>\n<p>La chirurgie est rarement n\u00e9cessaire. <\/p>\n<p><strong>8. Autres localisations<\/strong><\/p>\n<p><strong>Omarthrose (\u00e9paule)<\/strong><\/p>\n<p>Deux formes :<\/p>\n<ul>\n<li>omarthrose excentr\u00e9e (rupture de coiffe)<\/li>\n<li>omarthrose centr\u00e9e.<\/li>\n<\/ul>\n<p>Clinique :<\/p>\n<ul>\n<li>douleur m\u00e9canique<\/li>\n<li>raideur.<\/li>\n<\/ul>\n<p><strong>Arthrose de cheville<\/strong><\/p>\n<p>Souvent secondaire :<\/p>\n<ul>\n<li>traumatisme<\/li>\n<li>n\u00e9crose du talus<\/li>\n<li>chondrocalcinose<\/li>\n<li>h\u00e9mochromatose. <\/li>\n<\/ul>\n<p><strong>Points cl\u00e9s<\/strong><\/p>\n<ul>\n<li>L\u2019arthrose est une <strong>maladie d\u00e9g\u00e9n\u00e9rative articulaire fr\u00e9quente<\/strong>.<\/li>\n<li>Le diagnostic est <strong>clinique et radiographique<\/strong>.<\/li>\n<li>Les signes radiologiques principaux sont :\n<ul>\n<li>pincement articulaire<\/li>\n<li>ost\u00e9ophytes<\/li>\n<li>g\u00e9odes<\/li>\n<li>scl\u00e9rose sous-chondrale.<\/li>\n<\/ul>\n<\/li>\n<li>Les localisations principales sont :\n<ul>\n<li>genou<\/li>\n<li>hanche<\/li>\n<li>mains.<\/li>\n<\/ul>\n<\/li>\n<li>Le traitement associe toujours :\n<ul>\n<li>mesures non pharmacologiques<\/li>\n<li>antalgiques<\/li>\n<li>chirurgie si handicap important.\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<table>\n<thead>\n<tr>\n<th>\n<p><strong>\u00c9l\u00e9ment<\/strong><\/p>\n<\/th>\n<th>\n<p><strong>Arthrose<\/strong><\/p>\n<\/th>\n<th>\n<p><strong>Arthrite<\/strong><\/p>\n<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>\n<p>M\u00e9canisme<\/p>\n<\/td>\n<td>\n<p>D\u00e9g\u00e9n\u00e9rescence articulaire<\/p>\n<\/td>\n<td>\n<p>Inflammation articulaire<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Type de douleur<\/p>\n<\/td>\n<td>\n<p>M\u00e9canique<\/p>\n<\/td>\n<td>\n<p>Inflammatoire<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Douleur \u00e0 l\u2019effort<\/p>\n<\/td>\n<td>\n<p>Augment\u00e9e<\/p>\n<\/td>\n<td>\n<p>Souvent am\u00e9lior\u00e9e par le mouvement<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Douleur au repos<\/p>\n<\/td>\n<td>\n<p>Rare<\/p>\n<\/td>\n<td>\n<p>Fr\u00e9quente<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>R\u00e9veil nocturne<\/p>\n<\/td>\n<td>\n<p>Rare<\/p>\n<\/td>\n<td>\n<p>Fr\u00e9quent<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>D\u00e9rouillage matinal<\/p>\n<\/td>\n<td>\n<p>En se levant<\/p>\n<\/td>\n<td>\n<p>Prolong\u00e9, souvent &gt; 30 min<br \/>avant et apr\u00e8s le lever<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Raideur<\/p>\n<\/td>\n<td>\n<p>Mod\u00e9r\u00e9e<\/p>\n<\/td>\n<td>\n<p>Marqu\u00e9e en pouss\u00e9e<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Chaleur locale<\/p>\n<\/td>\n<td>\n<p>Absente<\/p>\n<\/td>\n<td>\n<p>Possible<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Rougeur<\/p>\n<\/td>\n<td>\n<p>Absente<\/p>\n<\/td>\n<td>\n<p>Possible<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>\u00c9panchement articulaire<\/p>\n<\/td>\n<td>\n<p>  m\u00e9canique<\/p>\n<\/td>\n<td>\n<p>Fr\u00e9quent<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Biologie inflammatoire<\/p>\n<\/td>\n<td>\n<p>VS\/CRP normales<\/p>\n<\/td>\n<td>\n<p>VS\/CRP souvent augment\u00e9es<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Liquide articulaire<\/p>\n<\/td>\n<td>\n<p>M\u00e9canique, pauvre en cellules<\/p>\n<\/td>\n<td>\n<p>Inflammatoire, riche en cellules<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Radiographie<\/p>\n<\/td>\n<td>\n<p>Pincement localis\u00e9, ost\u00e9ophytes, g\u00e9odes, scl\u00e9rose sous-chondrale<\/p>\n<\/td>\n<td>\n<p>Pincement plus diffus, \u00e9rosions possibles<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"<p>Arthrose Introduction L\u2019arthrose est la maladie articulaire la plus fr\u00e9quente. Elle touche environ 10 % de la population et affecte [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-301","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/pages\/301","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/comments?post=301"}],"version-history":[{"count":1,"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/pages\/301\/revisions"}],"predecessor-version":[{"id":303,"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/pages\/301\/revisions\/303"}],"wp:attachment":[{"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/media?parent=301"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}