{"id":301,"date":"2026-03-15T18:06:37","date_gmt":"2026-03-15T17:06:37","guid":{"rendered":"https:\/\/erlaxatu.fr\/index.php\/arthrose\/"},"modified":"2026-04-06T18:40:13","modified_gmt":"2026-04-06T16:40:13","slug":"arthrose","status":"publish","type":"page","link":"https:\/\/erlaxatu.fr\/index.php\/arthrose\/","title":{"rendered":"Arthrose"},"content":{"rendered":"<p>Arthrose <\/p>\n<p><strong>Introduction<\/strong><\/p>\n<p><\/p>\n<p>L\u2019arthrose est la maladie articulaire la plus fr\u00e9quente. Elle touche environ 10 % de la population et affecte principalement les genoux, les hanches, les mains et le rachis. Elle correspond \u00e0 une atteinte d\u00e9g\u00e9n\u00e9rative de l\u2019ensemble de l\u2019articulation synoviale, avec alt\u00e9ration du cartilage mais aussi de l\u2019os sous-chondral, de la synoviale et de la capsule articulaire. <\/p>\n<p><\/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 enjeu majeur de sant\u00e9 publique en raison du handicap fonctionnel et des co\u00fbts m\u00e9dicaux qu\u2019elle engendre. <\/p>\n<p><\/p>\n<p><strong>1. Physiopathologie<\/strong><\/p>\n<p><\/p>\n<p>L\u2019arthrose est une maladie de l\u2019articulation synoviale dans son ensemble.<\/p>\n<p>Une articulation synoviale comprend :<\/p>\n<ul>\n<li>cartilage articulaire<\/li>\n<li>os sous-chondral<\/li>\n<li>membrane synoviale<\/li>\n<li>capsule articulaire<\/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\u2019absorption des contraintes m\u00e9caniques entre deux surfaces osseuses. <\/p>\n<p>Dans l\u2019arthrose, plusieurs ph\u00e9nom\u00e8nes surviennent :<\/p>\n<p>D\u00e9gradation du cartilage<\/p>\n<p>Production d\u2019enzymes prot\u00e9olytiques (m\u00e9talloprot\u00e9ases) d\u00e9truisant la matrice cartilagineuse.<\/p>\n<p>Inflammation synoviale<\/p>\n<p>Inflammation locale de bas grade li\u00e9e aux d\u00e9bris cartilagineux.<\/p>\n<p>Remodelage osseux<\/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 signes radiologiques typiques de l\u2019arthrose. <\/p>\n<p><\/p>\n<p><strong>2. Facteurs de risque<\/strong><\/p>\n<p><\/p>\n<p>Plusieurs facteurs favorisent l\u2019apparition de l\u2019arthrose :<\/p>\n<p>\u00c2ge<\/p>\n<p>Rare avant 40 ans, l\u2019incidence augmente fortement apr\u00e8s 60 ans. <\/p>\n<p>Ob\u00e9sit\u00e9<\/p>\n<p>Facteur majeur, notamment pour les articulations portantes comme le genou.<\/p>\n<p>Facteurs g\u00e9n\u00e9tiques<\/p>\n<p>Fr\u00e9quent dans l\u2019arthrose digitale.<\/p>\n<p>Sexe f\u00e9minin<\/p>\n<p>Pr\u00e9valence plus \u00e9lev\u00e9e apr\u00e8s la m\u00e9nopause.<\/p>\n<p>Contraintes m\u00e9caniques<\/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>3. Signes cliniques de l\u2019arthrose<\/p>\n<p>Douleur m\u00e9canique<\/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>Raideur articulaire<\/p>\n<p>Surtout apr\u00e8s repos.<\/p>\n<p>G\u00eane fonctionnelle<\/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<li><\/li>\n<\/ul>\n<p><strong>4. Signes radiologiques<\/strong><\/p>\n<p><\/p>\n<p>Les radiographies montrent quatre signes caract\u00e9ristiques :<\/p>\n<p>Pincement de l\u2019interligne articulaire<\/p>\n<p>T\u00e9moin de la destruction du cartilage.<\/p>\n<p>Ost\u00e9ophytes<\/p>\n<p>Excroissances osseuses marginales.<\/p>\n<p>Scl\u00e9rose sous-chondrale<\/p>\n<p>Condensation osseuse sous le cartilage.<\/p>\n<p>G\u00e9odes sous-chondrales<\/p>\n<p>Lacunes osseuses intra-osseuses. <\/p>\n<p>Il peut exister une discordance radio-clinique : une arthrose radiologique importante peut \u00eatre peu douloureuse et inversement. <\/p>\n<p><\/p>\n<p><strong>5. Coxarthrose (arthrose de la hanche)<\/strong><\/p>\n<p><\/p>\n<p>\u00c9pid\u00e9miologie<\/p>\n<p>La coxarthrose symptomatique touche environ 1 \u00e0 5 % des adultes entre 40 et 75 ans. <\/p>\n<p>Dans environ 50 % des cas, elle est secondaire \u00e0 une dysplasie de hanche.<\/p>\n<p>Clinique<\/p>\n<p>Interrogatoire<\/p>\n<ul>\n<li>douleur du pli de l\u2019aine<\/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>Examen clinique<\/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>Imagerie<\/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 pas n\u00e9cessaire en cas de coxarthrose typique. <\/p>\n<p>Traitement<\/p>\n<p>Mesures non m\u00e9dicamenteuses<\/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 ( canne)<\/li>\n<li>La marche &quot;normale&quot; n&rsquo;aggrave pas l&rsquo;arthrose des mb inf., sports conseill\u00e9s : velo &#8211; natation, non portants sur les mb inf  <\/li>\n<\/ul>\n<p>Traitement m\u00e9dicamenteux<\/p>\n<ul>\n<li>antalgiques<\/li>\n<li>AINS<\/li>\n<li>infiltrations.<\/li>\n<\/ul>\n<p>Traitement chirurgical<\/p>\n<p>Proth\u00e8se totale de hanche en cas d\u2019\u00e9chec du traitement m\u00e9dical.<\/p>\n<p>Dur\u00e9e de vie moyenne : environ 20 ans. <\/p>\n<p><\/p>\n<p><strong>6. Gonarthrose (arthrose du genou)<\/strong><\/p>\n<p><\/p>\n<p>C\u2019est la localisation la plus fr\u00e9quente de l\u2019arthrose des membres inf\u00e9rieurs. <\/p>\n<ul>\n<li>Elle peut toucher :<\/li>\n<li>compartiment f\u00e9moro-tibial m\u00e9dial<\/li>\n<li>compartiment f\u00e9moro-tibial lat\u00e9ral<\/li>\n<\/ul>\n<p>compartiment f\u00e9moro-patellaire.<\/p>\n<p>Clinique<\/p>\n<ul>\n<li>Interrogatoire<\/li>\n<li>douleur m\u00e9canique du genou<\/li>\n<li>douleur dans les escaliers<\/li>\n<li>craquements<\/li>\n<\/ul>\n<p>\u00e9pisodes de blocage.<\/p>\n<ul>\n<li>Examen clinique<\/li>\n<li>d\u00e9viation axiale (varus ou valgus)<\/li>\n<li>\u00e9panchement articulaire<\/li>\n<li>craquements<\/li>\n<\/ul>\n<p>amyotrophie du quadriceps.<\/p>\n<p>Imagerie<\/p>\n<ul>\n<li>Radiographies indispensables :<\/li>\n<li>face en charge<\/li>\n<li>profil<\/li>\n<li>schuss<\/li>\n<\/ul>\n<p>incidence f\u00e9moro-patellaire.<\/p>\n<p>Les m\u00eames signes radiologiques d\u2019arthrose sont retrouv\u00e9s. <\/p>\n<p>Traitement<\/p>\n<ul>\n<li>Mesures g\u00e9n\u00e9rales<\/li>\n<li>perte de poids<\/li>\n<li>kin\u00e9sith\u00e9rapie<\/li>\n<\/ul>\n<p>activit\u00e9 physique adapt\u00e9e.<\/p>\n<ul>\n<li>M\u00e9dicaments<\/li>\n<li>antalgiques<\/li>\n<li>AINS<\/li>\n<\/ul>\n<p>infiltrations de cortico\u00efdes.<\/p>\n<ul>\n<li>Chirurgie<\/li>\n<li>proth\u00e8se totale de genou<\/li>\n<li>proth\u00e8se unicompartimentale<\/li>\n<\/ul>\n<p>ost\u00e9otomie de r\u00e9axation chez le sujet jeune. <\/p>\n<p><\/p>\n<p><strong>7. Arthrose digitale<\/strong><\/p>\n<p><\/p>\n<p>L\u2019arthrose des doigts est une localisation tr\u00e8s fr\u00e9quente, surtout chez la femme apr\u00e8s la m\u00e9nopause. <\/p>\n<ul>\n<li>Clinique<\/li>\n<li>douleurs m\u00e9caniques des doigts<\/li>\n<\/ul>\n<p>nodules articulaires<\/p>\n<ul>\n<li>Nodules caract\u00e9ristiques<\/li>\n<li>nodules d\u2019Heberden : IP distales<\/li>\n<\/ul>\n<p>nodules de Bouchard : IP proximales.<\/p>\n<p>Une atteinte de la base du pouce correspond \u00e0 la rhizarthrose.<\/p>\n<p>Forme particuli\u00e8re : arthrose \u00e9rosive<\/p>\n<ul>\n<li>Forme plus s\u00e9v\u00e8re :<\/li>\n<li>douleurs importantes<\/li>\n<li>synovite<\/li>\n<\/ul>\n<p>destructions articulaires radiologiques.<\/p>\n<p>Traitement<\/p>\n<ul>\n<li>Principalement m\u00e9dical :<\/li>\n<li>antalgiques<\/li>\n<li>AINS<\/li>\n<\/ul>\n<p>infiltrations.<\/p>\n<p>La chirurgie est rarement n\u00e9cessaire. <\/p>\n<p><\/p>\n<p><strong>8. Autres localisations<\/strong><\/p>\n<p><\/p>\n<p>Omarthrose (\u00e9paule)<\/p>\n<ul>\n<li>Deux formes :<\/li>\n<li>omarthrose excentr\u00e9e (rupture de coiffe)<\/li>\n<\/ul>\n<p>omarthrose centr\u00e9e.<\/p>\n<ul>\n<li>Clinique :<\/li>\n<li>douleur m\u00e9canique<\/li>\n<\/ul>\n<p>raideur.<\/p>\n<p>Arthrose de cheville<\/p>\n<ul>\n<li>Souvent secondaire :<\/li>\n<li>traumatisme<\/li>\n<li>n\u00e9crose du talus<\/li>\n<li>chondrocalcinose, h\u00e9mochromatose. <\/li>\n<\/ul>\n<p><\/p>\n<p>antalgiques<\/p>\n<p>chirurgie si handicap important. <\/p>\n<p><\/p>\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":4,"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/pages\/301\/revisions"}],"predecessor-version":[{"id":412,"href":"https:\/\/erlaxatu.fr\/index.php\/wp-json\/wp\/v2\/pages\/301\/revisions\/412"}],"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}]}}