Signs of Arthritis

Arthritis is the most common pathology of articular structures. Depending on the cause of the disease, 5 of its main forms are distinguished: rheumatoid, reactive, infectious, gouty and psoriatic. Symptoms of arthritis and its manifestations in each case will depend precisely on the clinical variant of the disease.

Ailment can affect different joints

Symptoms of reactive arthritis

Reactive arthritis is an inflammatory disease of a non-purulent nature, which manifests itself after an acute genitourinary or intestinal infection. This pathology often affects young men.

The first signs usually appear in the form of a general malaise: weakness, increased fatigue, headache. Sometimes there is an increase in total body temperature, which rarely exceeds 38 ° C.

A characteristic symptom of this form of the disease is asymmetric damage to the joints of the legs (for example, ankle, knee or hip), which appears a few days after non-specific signs (that is, signs of the disease that are not associated with joint damage). Sometimes the joints between the pelvic bones are involved in the pathological process. Often inflamed ligaments and tendons (for example, damage to the Achilles tendon). The pains have varying degrees of severity, but are rarely intense.

These symptoms in parallel can be accompanied by an inflammatory process in the organs of the genitourinary system. In this case, there is constant urge to urinate (a sharp desire to urinate) – there may also be a burning sensation and pain at this moment.

Soreness, irritation and redness of the eyes, as well as a violation of visual acuity, are associated with the appearance of conjunctivitis (the inflammatory process of the mucous membrane covering the eyelid and eyeball), which can occur both before the onset of joint damage and at the same time.

Red eyes may be a sign of arthritis, although at first glance, damage to the eyes and joints is in no way related.

Symptoms of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic chronic disease, the symptoms of which lead to a significant decrease in the quality of life, primarily due to pain and changes in the shape of the joints. This pathology often becomes a causal disability.

Classical rheumatoid arthritis (it may be erroneously called rheumatic) has quite characteristic symptoms:

First signs: metacarpophalangeal joints on the middle and index fingers become swollen and inflamed. Often this is combined with a similar lesion of the wrist joint.

In almost every case, the joints are affected symmetrically (that is, the same, for example, on the right and left leg).

Arthritis pain intensifies at night, closer to the morning. It is quite intense until noon, and then almost stops. If the pathology is at the initial stage, then the painful sensations disappear after exercise. But the feeling of relief is never long – after a few hours or in the morning, the pain attack resumes.

Stiffness of the body in the morning, feeling of weakness. A patient may complain of a “feeling of a numb body,” “tight gloves on his hands,” or “a tight corset on his body,” with which people describe their condition. These sensations disappear 1-2 hours after waking up, but in the case of a severe form of the disease, they can disturb a person throughout the day.

Often along with the inflamed joints of the hands, the small joints of the feet that are at the base of the fingers are also affected. The process is also symmetrical. On examination, the patient notes pain while pressing on the toes of the toes.

If the disease progresses, then the inflammation passes to larger joints (for example, knee, shoulder, elbow or ankle). But it happens that at the initial stage, the calcaneal tendons and larger joints become inflamed, and after this the process spreads to the feet and hands – this form of the disease is often manifested in elderly people.

Rheumatoid nodes arise – small dense formations under the skin in areas where elbows, hands and feet are bent. These nodules can constantly change in size, then disappear, then reappear, and sometimes not change for years. They do not cause any sensations, they simply create a cosmetic defect.

With the advanced stage of the disease, the symptoms intensify, severe deformation of the hands and fingers occurs. Such a violation can occur when the hands and fingers begin to deviate outwards, and the wrist is fixed in the wrong position – because of this, mobility in the wrist joints decreases. As a result, blood circulation and innervation * of the hands are disturbed: they turn pale, muscle atrophy appears.

* Innervation – the connection of organs and tissues with the central nervous system through nerves.

The disease is accompanied by periodically occurring signs of intoxication of the body, which include the following symptoms: weakness, chills, weakness, weight loss, loss of appetite, fever up to 38,5 ° C.

Over time, the disease affects all articular surfaces. The larger ones can become inflamed without significant discomfort, but their mobility is noticeably worse.

A Baker cyst may appear – a symptom that occurs when an excess fluid accumulates in the knee capsule, which stretches it. If there is a lot of this fluid (exudate), then this can lead to rupture of the cystic formation. As a result, the liquid impregnates the tissues on the back surface of the lower leg, there is swelling and pain in this area.

There may also be other signs accompanying rheumatoid arthritis:

  • inflammation of the salivary glands,
  • numbness of the limbs
  • pain in the eyes
  • chest pain while breathing.

Rheumatoid joint damage differs from rheumatism in that the inflammatory process is more persistent, because the painful sensations and swelling of the tissues can bother for many years. The disease differs from arthrosis in that the painful sensations do not intensify under exertion, but rather subside after active exercises.

Symptoms of Infectious Arthritis

An infectious variant of the disease, also called septic or pyogenic, is a serious infectious disease. It is based on the penetration of microorganisms into articular structures, followed by active inflammation of the latter. This condition needs emergency medical attention.

The most common signs of arthritis of infectious origin:

  • A sharp start. In rare cases, a gradual increase and intensification of symptoms over three weeks (for example, the disease in infants).
  • Symptoms of intoxication: fever (usually above 38,5 ° C), chills, pain in the muscles, headache. Young children may have vomiting or nausea.
  • Severe swelling of the affected joint, constantly growing and causing a change in its shape.
  • Most often affected are the knee, elbow, shoulder, hip, wrist joints and articular surfaces of the fingers.
  • Increased pain during movement. For example, when the hip joint is affected, the pain radiates to the inguinal region and intensifies during walking.
  • Movement becomes limited, and the position of the limb is forced: one in which pain is felt the least.
  • An increase in temperature in the area above the affected joint (skin is hot).
  • In older people, the symptoms may be more erased, and in young children, on the contrary, the clinic is very stormy.

Hip Joint Reactive Arthritis

Symptoms of Gouty Arthritis

Gout – a disease associated with metabolic disorders and the accumulation in the body of an excessive amount of uric acid salts. As a rule, the disease affects the joint tissue.

The following symptoms are characteristic of this form of the disease:

  • A sharp onset of a pain attack, most often at night and after a significant error in the diet – eating large amounts of meat and alcohol.
  • Most often, the first joint of the big toe is affected, less often the knee or elbow is inflamed.
  • The affected area becomes red, swollen, touching it causes severe pain.
  • Fast resolution of the attack. Even without treatment, all clinical manifestations disappear after a few days.
  • The general condition of the patient is not greatly disturbed, body temperature does not rise.

A typical manifestation of gout is damage to the joint of the big toe.

Symptoms of Psoriatic Arthritis

The psoriatic variant of the disease develops against the background of a specific lesion of the skin and nails. It can affect absolutely any joint in the human body, but most often its manifestations are found in the fingers.

Inflammation in the joint tissues develops gradually, with swelling and redness of the affected areas (when the fingers are damaged, they become “sausages”), as well as a local increase in temperature. In the initial stages, pain and limitation of mobility are not characteristic. As the process progresses in the morning hours, stiffness of movements appears, which disappears during the first hour. Inflammation can also spread to the periarticular structures, causing damage to the tendons and ligaments.

Joint manifestations of the disease are accompanied by the appearance of red scaly spots, itching and discomfort on the skin and scalp.

Conclusion

In addition to the common forms of arthritis considered in this article, there are more rare variants of arthritis: for example, idiopathic, endocrine. For more information about them, see the section “Arthritis”.

As you can see, arthritis is a serious disease with a variety of manifestations. It is important to diagnose the disease on time, and treatment should be carried out under the guidance of qualified specialists. Self-medication can lead to serious complications or even disability.

The most common signs of arthritis are arthritis symptoms.

In this chapter, I will tell you about special “alarming” symptoms that are uncharacteristic for arthrosis, but typical for arthritis. These symptoms can serve as a hint and direct your diagnostic search in the right direction.

Signs of arthritis.

1. You feel increased pain in the joints at night, between three and five in the morning – increased pain at this time often indicates their rheumatic, inflammatory origin, and may be a symptom of some kind of arthritis. You should especially be wary if the pains are so severe that they wake a person in the middle of the night amid complete rest. But if the pain occurred in the middle of the night from movement, when you roll over from side to side or stand in the toilet, then such pain is not an indicator of inflammation. It can be a symptom of any disease – from arthrosis to tendon inflammation.

2. You should be wary if you feel stiffness in the whole body and joints in the mornings, immediately after waking up, which disappears within an hour or during the first half of the day — such stiffness is characteristic of inflammatory joint diseases, especially rheumatoid arthritis, Ankylosing spondylitis and rheumatic polymyalgia. A very alarming sign is the morning stiffness of the hands, the feeling that tight gloves are put on the hands. The symptom of “tight gloves” is one of the manifestations of rheumatoid arthritis. However, the same sensations occur with some non-inflammatory diseases of the hands – in particular, with carpal tunnel syndrome.

3. You should be wary if you have inflammation and swelling of the metacarpophalangeal joints, that is, the joints located at the base of the fingers (bulging bones of a clenched fist). Swelling and inflammation of these joints are most often a sign of rheumatoid arthritis, less often a sign of psoriatic arthritis. Unless, of course, it arose as a result of an injury or a punch against the wall.

4. You should be wary if your wrist joints are inflamed and swollen. Inflammation of the wrist joints is most often a sign of rheumatoid arthritis, less often a sign of reactive or psoriatic arthritis, rheumatism, or a peripheral form of ankylosing spondylitis. Particularly alarming is the inflammation of two wrist joints at once. Such inflammation in 99% of cases is a sign of arthritis.

5. You should be wary if at least one of your fingers or toes is red and swollen from the base to the very tip and looks like a sausage. This “sausage-like configuration” of the fingers is most often a symptom of psoriatic arthritis, sometimes reactive arthritis. Less commonly, a similar deformation of the fingers, with redness and swelling, occurs with gout – but then it is combined with inconceivable acute pain in the affected finger. Whereas with psoriatic arthritis, the pain can be quite bearable.

6. One should be wary if inflammation of the joints is “volatile” – when one joint swells at first, then after a few days its inflammation passes without a trace, but immediately after that the other joint becomes inflamed, then the third, etc. Such alternate “flare-up” of the joints with their complete subsequent recovery is most often the result of articular rheumatism. Or a sign of gouty arthritis – but then joint inflammation is almost always combined with inconceivable acute pain and redness of an inflamed joint. With articular rheumatism, reddening of the joints is almost non-existent.

7. You should be wary if you experience bouts of severe pain in the joints of the big toes, or in the knee joints or ankle joints, accompanied by their swelling and obvious redness, which occur for no reason and also suddenly disappear after 3–7 days, and then again regularly repeated at approximately the same intervals. Such attacks are 90% a sign of gouty arthritis. With gout, the pain is usually so severe that the patient is ready to “climb the wall” because of them.

8. One should be wary if joint pain is clearly reduced by active, energetic movements. Most often, joint pain from vigorous movements decreases precisely with arthritis. But with arthrosis and other non-inflammatory joint diseases, too energetic movements often lead, on the contrary, to increased pain in the damaged joint.

9. One should be wary if joint pain is quickly and almost completely eliminated by non-steroidal anti-inflammatory drugs. Such a tangible effect of taking non-steroidal anti-inflammatory drugs occurs only with certain types of arthritis: most often with ankylosing spondylitis, and less often with gout. In these diseases, non-steroidal anti-inflammatory drugs sometimes reduce pain by almost 90-100%. With arthrosis and other non-inflammatory joint diseases, such a pronounced effect from taking non-steroidal anti-inflammatory drugs is rare, pain decreases only by 50-60 percent. With arthrosis, it almost never happens that the pain in the affected joints from anti-inflammatory drugs goes away completely.

10. You should be wary if for several months or years you feel a clear stiffness in the lower back and sacrum, and a severe restriction of mobility in the lumbar spine or in the entire spine. This limitation of spinal mobility may be a sign of ankylosing spondylitis. With ankylosing spondylitis, the ability to turn in both directions, to the right or left, and to lean forward, backward or sideways is sharply reduced. A sick person usually turns or leans with his whole body, with a “straight back.”

11. You should be wary if dense pea-sized nodules appear under the skin of joints in the elbow area under your skin – they may be the result of rheumatoid arthritis. Sometimes gouty tofuses also form in the elbow area.

12. You should be wary if the inflammation of your joints is combined with a prolonged increase in temperature to 37 ° C or higher (for more than 4 weeks). A combination of prolonged fever and joint inflammation can be a sign of rheumatoid or reactive arthritis, ankylosing spondylitis, or articular rheumatism.

13. You should be wary if inflammation of your joints is combined with prolonged inflammation of the eyes, a sensation of itching or “sand” in the eyes. Such phenomena are often an additional symptom of reactive arthritis, or, less commonly, ankylosing spondylitis.

14. You should be wary if your joint inflammation is combined with your skin disease – psoriasis. Or if your next of kin gets psoriasis. In this case, joint inflammation may be due to psoriatic arthritis.

15. You should be wary if you have a clear weakness during your illness. Especially if, in addition, you have dramatically lost weight, despite the fact that your diet has not changed. Or if you have a sharp decrease in appetite or a clear change in eating habits during your illness. Such symptoms, coupled with severe weakness, are often a symptom of polymyalgia rheumatism or a complication of rheumatoid arthritis.

16. You should be wary if inflammation of the joints has been combined for a long time with chills or frequent “torrential sweat” – this combination is often the result of reactive or rheumatoid arthritis, ankylosing spondylitis or articular rheumatism (unless “torrential sweat” and chills are a consequence of menopause body restructuring).

17. You should be wary if inflammation of the joints is combined with abnormal discharge from the genital tract, or if the onset of the disease was preceded by a prolonged violation of the intestines (we are talking only about loose stools). Or if your joint damage is combined with inflammation of the skin of the feet, without itching, but with the formation of blisters and redness on the skin (of course, we are not talking about fungal infections of the feet – it is most often present with fungal infections). All of these symptoms can be a manifestation of reactive arthritis.

An article by Dr. Evdokimenko © for the book Arthritis, published in 2003.
Edited in 2011.
Все права защищены.

Arthrosis and arthritis – what is it. What is the difference between arthrosis and arthritis. Arthrosis and arthritis are diseases in which joint damage occurs. That is why, and also because of the consonance of the names, many people do not understand the difference between arthrosis and arthritis, and perceive them as something similar in nature. Meanwhile, arthrosis and arthritis are far from the same thing.

Signs of arthrosis (symptoms of arthrosis). Osteoarthritis most often affects the knee and hip joints, as well as the joints of the big toe. A little less often – the ankle joints and those joints of the fingers that are closer to the nails (distal interphalangeal joints).

Examinations required for differential diagnosis between arthritis and arthrosis. Clinical blood test, biochemical blood test and analysis for rheumatic tests, joint x-rays, X-rays of the sacroiliac joints, in some cases, spinal X-rays, radioisotope skeleton scans, computed tomography or magnetic resonance imaging (CT or MRI).

Other causes of joint pain. Sore tendon pain. Pain with blockade or pinching of the joint. Joint pain due to circulatory disorders.

The first signs of arthritis and modern diagnosis

In fact, arthritis is a collective term that combines about 100 joint diseases, including systemic lupus and gout. In the medical guide, you will find the following definition of this disease – inflammation of the inner lining of the joint, which is accompanied by pain and stiffness of movements.

Unfortunately, in our country there are no statistics on the prevalence of this ailment, but we can provide data collected in the USA. There, about 40 million people suffer from this inflammatory disease, and every 4th case leads to disability.

Our doctors say that joint inflammation is diagnosed in 60% of patients who seek help after the age of 65. However, the real figure is much larger, since it does not take into account those who try to be treated at home on their own.

If you are at risk for arthritis?

Like any other disease, the signs of arthritis can be recognized even at the initial stages, because everyone knows that the sooner you start treatment, the more chances to get rid of the disease once and for all. It should also be noted that the symptoms directly depend on the type of the disease.

  • Joint pain. As a rule, the pain intensifies at night, especially in the interval from 3 to 5 in the morning. Moreover, it is not associated with movement and arises on its own. Often this causes a sleepless night.
  • Stiffness of movements. In the early stages, it is felt only in the morning, after sleep. It’s hard to walk, squat, and often there is a feeling that his hands are wearing tight gloves, but after a couple of hours a person “walks around” and safely forgets about this trouble until the next awakening. Symptoms worsen over time.
  • Swelling of the knuckles, as well as the wrists. If you have not had any recent injuries to your hand, swelling is definitely a sign of the development of arthritis of the hands or phalanges of the fingers. A swelling on both hands is cons >

  • Spontaneous inflammation. It seems to “wander” from one joint to another. First, one joint swells, the skin turns red over it and pain appears, but after a couple of days the inflammation disappears by itself, so that after a while it breaks out already in another area.
  • Pain in the legs. Acute pain in the big toes, feet and knees, which occurs suddenly and disappears on its own in 3-7 days. Pain may be accompanied by reddening of the skin over the inflamed area and swelling. In 90% of cases, this is a sign of gouty arthritis.
  • The pain decreases with active movements. This is a very alarming symptom, since a decrease in pain during vigorous movements characterizes arthritis.
  • Quick effect of treatment. Do not rejoice if with the help of ointments and other non-stero >

  • “Nodules” under the skin. They form above the focus of inflammation. These are dense pea-sized lumps that indicate the development of a rheumatoid form of the disease.
  • Low-grade fever. This is an indirect sign, however, in the presence of pain in the joints, elevated body temperature (within 37 ° C-37.5 ° C) for a month may indicate the development of the disease.
  • Inflammation of the eyes. Another indirect symptom, which in combination with inflammation of the joints gives an unsightly picture. In this case, there is a burning sensation, itching, a feeling that sand was poured into the eyes.
  • Psoriasis. Arthritis is often a consequence of psoriasis, especially if a person has been suffering from this skin disease for years.
  • Weakness and weight loss. Fatigue even with minor physical exertion, as well as weight loss with a stable habitual diet. Often a person’s eating habits change.
  • Chills and sweating. This combination of symptoms can signal a rheumatoid or reactive form. It should be noted that this is only an indirect symptom, which can also indicate many diseases that are not related to the joints.

Degrees of arthritis

Speaking of arthritis, one can not ignore such an important issue as the degree of development of the disease. Regardless of the cause of the disease and its type, doctors distinguish 4 degrees.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

I have been treating joints for many years. I can say with confidence that the joints are always treatable, even in the very ripe old age.

Hondrostrong is an innovative drug that is created to combat joint diseases. It helps with arthritis, arthrosis and other diseases. Thanks to the use of cream, joint mobility quickly returns. Damaged cartilage tissue is regenerated, which prevents the further development of the problem.

Hondrostrong gel for joints

Our medical center was the first to receive certified access to the latest drug for osteochondrosis and joint pain - Hondrostrong. I confess to you when I heard about it for the first time, I just laughed, because I did not believe in its high efficiency.

But I was amazed when we completed testing: 4567 people were completely cured of diseases of the organs of the musculoskeletal system, and this is more than 94% of all subjects. 5.6% felt significant improvement, and only 0.4% did not notice any improvement.

Hondrostrong cream allows you to forget about back and joint pain in the shortest possible time, literally from 4 days, and even very difficult cases can be cured within a couple of months. In addition, the manufacturer of this product is now offering a 50% discount of the full cost of Hondrostrong cream.

1 degree

At this stage, infection spreads within the body. The primary symptoms are mild enough and cause more bewilderment than anxiety. The first signs of thinning of the bones are visible on the radiograph. Depending on the location, signs may vary.

Hands. The “leather gloves” syndrome is pronounced in the morning. It is difficult for a person to do work that requires the use of fine motor skills: to fasten a button, turn a tap, string a thread on a needle. As a rule, by noon, such sensations disappear.

Foot. It is difficult for a person to bend and unbend the ankle. One of the most important signs is edema, which makes it impossible to wear almost any shoe comfortably.

Knee and shoulder. The appearance of slight minor pain during physical exertion, which almost immediately disappears at rest.

2 degree

This stage is characterized by a progressive increase in bone erosion, along with further thinning of the bone tissue.

Hands. There is a crunch and cracking when bending / unbending the hand and fingers, the swelling around them is clearly visible. When using the hands and fingers, pain is felt.

Feet. Pronounced edema in the ankle. The skin in this place becomes red and hot. Movements are especially difficult especially in the morning, a characteristic crunch is heard. There are severe pains that do not subside even at night, especially when it comes to gouty arthritis. If the cause of the disease was psoriasis, then curvature of the big toe is possible.

Knee and shoulder. Strong limitation of maneuverability: it is difficult to sit or stand up, get a book from the top shelf and so on. Symptoms are more pronounced in the morning, then the person “paces” and becomes easier. Obvious swelling and redness at the site of the inflammatory process.

3 degree

The x-ray clearly shows the deformation of the joints, the lack of permanent fixation and its tension. Grade 3 is an indication for disability, since in most cases patients lose their ability to work, and in some cases even the possibility of self-care.

Hands. Absolute curvature of fingers and hands on both hands. The movements are very constrained. Severe pain that intensifies after a period of rest.

Foot. Complete deformation of the ankle, almost complete loss of mobility.

Knee. So severe pain that they cause muscle spasm. Gradual fixation of the joint in the wrong curved position.

Shoulder. The ability to move your hand is almost completely lost. Shoulder movements are accompanied by characteristic clicks. The pain is felt even with mild palpation.

4 degree

Irreversible changes in bone and cartilage were revealed. The absolute helplessness of the patient. Complete disability.

Whatever joint of the body is affected by arthritis, stage 4 leads to its complete immobility. In this case, the pain does not go anywhere, and a person can no longer live without painkillers.

As you can see, in the fight against this ailment, time is very important. And if at the 1st stage practically any type of arthritic lesion of the joints can be eliminated, at the 2nd – it can be slowed down or even stopped, then at the 3rd and 4th – the doctors are practically powerless to do anything.

Arthritis Diagnosis

The main diagnostic tools in this case are x-rays and laboratory tests, which include not only a blood test, but also a cystological and bacterial analysis of synovial fluid from the affected joint. In addition, a consultation of a rheumatologist is mandatory for such a patient, who will exclude the presence of autoimmune diseases.

Using an x-ray, you can determine not only the degree of development of the disease, but also its type, because of the types of arthritis gives its own specific picture.

An x-ray helps to see joint damage, inflammatory processes in the bone and cartilage, including its thinning and other degenerative changes, possible pathological neoplasms.

When the knee joint is affected, arthroscopy is often used, which involves examining the cartilage and soft tissues around the joint. Often this method is combined with a biopsy (a laboratory study of the affected tissue and joint fluid). Contraindication for such procedures is acute arthritis, as well as sensitivity to iodine-based drugs.

Also often used as a survey method is the methodology for determining the amplitude of the active / passive movement, as well as the registration of individual phases of the step (podography).

Laboratory tests for arthritis

  1. A complete blood count is necessary to determine the erythrocyte sedimentation rate (ESR). An increased indicator may indicate that the disease is in an acute stage. ESR is not an absolute indicator of the presence of arthritis, but it indicates the presence of an inflammatory process of unknown etymology.
  2. A biochemical blood test is used to determine the level of sialic and uric acid, as well as fibrogen. Fibrogen indicates the presence of an inflammatory process, and overestimated acid levels indicate the development of a gouty form of the disease.
  3. Immunological markers are determined if there is a suspicion of the development of rheumatoid arthritis (elevated levels of antinuclear and other antibodies).
  4. The HLA-B27 genetic test is used in the diagnosis of inflammatory spinal arthritis and psoriatic forms of the disease, as well as Reiter’s disease and ankylosing spondylitis.

Diagnosis is carried out in a laboratory under the clear guidance of a rheumatologist.

Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory disease characterized by symmetrical joint damage and inflammation of the internal organs.

The cause of rheumatoid arthritis is unknown. The possible cause can be various viruses, bacteria, trauma, allergies, heredity and other factors.

The frequency of occurrence is 1% in the general population. The prevailing age is 22–55 years. The predominant gender is female (3: 1).

  • Fatigue
  • A slight increase in body temperature
  • Enlargement of lymph nodes
  • Losing weight.

Symmetry of joint damage is an important feature of rheumatoid arthritis (for example, the right and left elbow joints or the right and left knee joints are affected)

  • Morning stiffness of joints lasting more than 1 hour
  • Rheumatoid brush: deformations of the type of “buttonhole”, “swan neck”, “hands with lorgnet”
  • Rheumatoid foot: 1 toe deformity
  • Rheumatoid knee joint: Baker cyst, flexion deformities
  • Cervical spine: subluxations of the atlantoaxial joint
  • Cervical joint: coarsening of the voice, impaired swallowing.

Damage to the periarticular tissues

Tendosynovitis in the area of ​​the wrist joint and hand (inflammation of the tendon, characterized by swelling, pain and a distinct creak during movement).

Bursitis, especially in the area of ​​the elbow joint.

The defeat of the ligamentous apparatus with the development of increased mobility and deformities.

Muscle damage: muscle atrophy, often drug (steroid, as well as with penicillamine or aminoquinoline derivatives).

Rheumatoid nodules are dense subcutaneous formations, in typical cases localized in areas often subjected to trauma (for example, in the region of the ulnar process, on the extensor surface of the forearm). Very rarely found in internal organs (for example, in the lungs). Observed in 20-50% of patients.

Anemia due to a slowdown in iron metabolism in the body caused by impaired liver function; platelet count reduction

Felty’s syndrome, including a decrease in neutrophil blood, an enlarged spleen,

  • fever 39 ° C and above for one or more weeks;
  • joint pain 2 weeks or more;
  • spotted rash of the color of a salmon appearing during a fever.

Sjogren’s syndrome – dryness of the mucous membrane of the eyes, mouth.

Also, with rheumatoid arthritis, signs of osteoporosis (this is a rarefaction of bone tissue), amyloidosis can occur.

Often there are ulcers on the skin of the legs, inflammation of the arteries.

In general and biochemical analysis of blood:

  • anemia,
  • increase in ESR,
  • increase in the content of C-reactive protein.

The joint fluid is cloudy, with a low viscosity, the number of leukocytes and neutrophils is increased.

Rheumatoid factor (antibodies to class M immunoglobulins) is positive in 70–90% of cases.

Urinalysis: protein in the urine.

Increased serum creatinine, urea (assessment of renal function, a necessary step in the selection and control of treatment).

Diagnosis Criteria for Rheumatoid Arthritis of the American Rheumatological Association (1987). At least 4 of the following symptoms are present:

  • morning stiffness for more than 1 hour;
  • arthritis of 3 or more joints;
  • arthritis of the joints of the hands;
  • symmetric arthritis;
  • rheumatoid nodules;
  • positive rheumatoid factor;
  • radiological changes.

Drug therapy includes the use of three groups of drugs:

Nonsteroidal anti-inflammatory drugs

Representatives of non-steroidal anti-inflammatory drugs are

These drugs have a minimal side effect and retain high anti-inflammatory and analgesic activity.

Meloxicam (movalis) at the beginning of treatment with the activity of the inflammatory process is prescribed at 15 mg / day., And then move on to 7,5 mg / day. as maintenance therapy.

Nimesulide is prescribed in a dose of 100 mg twice a day.

Celecoxib (celebrex) is prescribed 100-200 mg twice a day.

For the elderly, the selection of the dosage of the drug is not required. However, in patients with a body weight below average (50 kg), it is advisable to start treatment with the lowest recommended dose.

A combination of two or more non-steroidal anti-inflammatory drugs should be avoided, as their effectiveness remains unchanged and the risk of side effects increases.

Basic preparations are recommended immediately after diagnosis.

The main drugs for the basic treatment of rheumatoid arthritis are:

Ineffective basic preparations for 1,5–3 months should be replaced or their combinations with hormones in small doses should be used, which reduces the activity of rheumatoid arthritis.

Six months is a critical period, no later than which an effective basic therapy should be selected.

In the process of treatment with basic drugs, the activity of the disease and side effects are carefully monitored.

The use of high doses of hormones (pulse therapy) in combination with slow-acting agents can increase the effectiveness of the latter.

With a high degree of inflammation activity, hormones are used, and in cases of systemic manifestations of rheumatoid arthritis, in the form of pulse therapy (only hormones or in combination with a cytostatic cyclophosphamide), without systemic manifestations, as a course of treatment.

Hormones are also used as supportive anti-inflammatory therapy for the ineffectiveness of other drugs.

In some cases, hormones are used as local therapy. The drug of choice is diprospan, which has a prolonged effect.

Ointments, creams, gels based on non-steroidal anti-inflammatory drugs (ibuprofen, piroxicam, ketoprofen, diclofenac) are used in the form of applications for inflamed joints.

To enhance the anti-inflammatory effect, applications of the above ointment forms of drugs are combined with applications of a dimethyl sulfoxide solution in a dilution of 1: 2–1: 4.

In the absence of a response to standard drug treatment in patients with high activity of rheumatoid arthritis, plasmapheresis and lymphocytapheresis are used.

An important point in the treatment of rheumatoid arthritis is the prevention of osteoporosis – the restoration of impaired calcium balance in the direction of increasing its absorption in the intestine and reducing excretion from the body.

For this, a diet with a high content of calcium is used.

Sources of calcium are dairy products (especially hard cheese, as well as processed cheese; to a lesser extent cottage cheese, milk, sour cream), almonds, hazelnuts and walnuts, etc., as well as calcium preparations in combination with vitamin D or its active metabolites.

The drug, which can be attributed to the basic anti-osteoporotic drugs, is myakaltsik. It is available for intramuscular injection at 100 ME and in the form of a nasal spray; prescribed according to the scheme in conjunction with calcium preparations (calcitonin) and derivatives of vitamin D.

Laser therapy is also used to treat rheumatoid arthritis. Especially in severe exacerbations of rheumatoid arthritis in recent years, extracorporeal methods of treatment (primarily hemosorption and plasmapheresis) are widely used.

Laser therapy is especially indicated in the early stages of the process. The course is no more than 15 procedures.

In order to reduce pain and eliminate spasm of periarticular tissues, cryotherapy (cold treatment) is applied, for a course of 10-20 procedures.

In order to influence allergic processes, improve tissue nutrition and eliminate inflammation, other physical methods of treatment are also used.

In the early stage of rheumatoid arthritis, ultraviolet irradiation of the affected joints, electrophoresis of dimethyl sulfoxide, calcium, salicylates is recommended.

When more persistent changes in the joints appear and in the absence of signs of high activity, hydrocortisone phonophoresis, magnetotherapy, and pulsed currents are prescribed.

Physiotherapy exercises and massage are prescribed to all patients in order to relieve muscle spasm, the quickest restoration of joint function.

All patients with rheumatoid arthritis should be systematically observed and examined by a rheumatologist.

Patients with a slowly progressing course without damage to internal organs should appear at the rheumatologist 1 time in 3 months. In the presence of damage to the internal organs, patients are examined by a rheumatologist 1 time in 2-4 weeks.

Spa treatment of patients with rheumatoid arthritis is recommended to be carried out annually outside the acute phase.

With a benign course of the process without marked changes in the joints, the use of radioactive baths in Tskhaltubo and Belokurikha is indicated; with a typical progressive process – treatment with hydrogen sulfide baths in Sochi, Sernovodsk, Pyatigorsk, Kemeri; with severe deformations and contractures – treatment with mud applications in Yevpatoriya, Saki, Pyatigorsk, Odessa.

Arthritis

Overview

Arthritis is a condition in which an inflammatory process occurs in a person’s joints. In patients diagnosed with arthritis, the symptoms are manifested by pain during movement or when lifting weights. The joints gradually become less mobile, they can change shape. Sometimes with arthritis, tumors appear, redness of the skin over the joint, fever may occur.

With a sharp manifestation of the disease, the patient is diagnosed with acute arthritis, with its gradual formation – chronic arthritis.

Arthritis can be an independent disease, and arise as a manifestation of another disease. According to statistics, arthritis is observed in every hundredth person in the world. The disease is diagnosed in people of different age groups, but most often arthritis affects the elderly and middle-aged women.

Among the risk factors for the disease, genetic (sex, the presence of hereditary problems with the joints) and acquired (obesity, smoking, allergic tendency) are distinguished.

Signs of Arthritis

The symptoms of this disease are most often a feeling of some stiffness in the joints, as well as an increase in the temperature of the tissues over the joint. A person feels pain in a joint affected by arthritis, later a swelling appears, the joint begins to move less clearly.

If the patient has pronounced acute arthritis, the symptoms may be more diverse. Under such circumstances, the patient has bouts of fever, a constant feeling of general malaise and weakness, leukocytosis. Inflammation is manifested primarily in the inner lining of the joint. Sometimes in the joint cavity there is an accumulation of inflammatory effusion – exudate. Later, the pathology grows on the joint bones, cartilage, joint capsule, spreads to the tissues near the joints – ligaments, tendons.

Types of Arthritis

By the number of affected joints, arthritis is usually divided into monoarthritis (one affected joint), oligoarthritis (two or three affected joints), polyarthritis (many affected joints).

Acute arthritis is characterized by fairly intense pain in the joint. Chronic arthritis, which develops gradually, is accompanied by periodically manifested pains, less severe than in the acute form of the disease.

According to the types of joint damage, several types of the disease are distinguished. Traumatic arthritis is manifested in the presence of open and closed joint injuries and in the case of regularly occurring minor injuries.

Dystrophic arthritis is manifested due to changes in metabolic processes, with strong cooling, excessive physical stress, vitamin deficiency.

Infectious arthritis manifests itself under the influence of a specific infection.

If the patient manifests arthritis, the symptoms of the disease can be reduced to a lower intensity for several days or for a longer time. Most important for patients with arthritis is to prevent the inflammatory process from intensifying again. Therefore, with this disease requires constant monitoring and supervision of an experienced doctor.

arthritis treatment

It is important to consider that the treatment of arthritis is time-consuming and difficult. The main task in the treatment of arthritis is the reduction of the manifestations of the disease, the resumption of metabolic processes in the joint. All efforts should also be directed towards preserving the functions of the joints affected by arthritis to the maximum.

A number of factors that negatively affect the healing process are also highlighted. They should be anticipated during treatment. So, it is important to carry out effective treatment of the disease that has become the root cause of arthritis, or the cause of arthritis should be eliminated.

Today, some types of treatment for arthritis are used, which are selected depending on the type and characteristics of the disease. Therapy of arthritis can be complex, long-term, systematic.

In this case, the treatment of this disease without fail includes methods aimed at restoring processes in the cartilage tissue, as well as methods of complex effects on the patient’s body.

In the treatment of the disease, both pharmacological and non-pharmacological methods are used, as well as surgical methods. When using the pharmacological method of treating arthritis, the patient is prescribed local therapy using non-steroidal ointments or creams with anti-inflammatory effects. Glucocorticosteroid drugs are also administered intraarticularly or periarticularly. If the pain in the joints is not too severe, then the periodic use of conventional analgesics (for example, paracetamol) is possible. Of great importance in the process of treating arthritis with the help of pharmacological agents are drugs that not only anesthetize, but also slow down or reverse pathological processes in the joints. These drugs, called chondroprotectors, stop the production of an enzyme that destroys cartilage, and at the same time improve the synthesis of the main substance of the cartilage. Such drugs significantly reduce pain and practically do not cause side effects.

As non-pharmacological methods of treatment, the use of special orthopedic shoes, knee pads, arch support, a cane while walking is used. It is recommended that the patient minimize the load on the joints, if necessary, lose weight, exercise physical therapy and undergo a course of individually selected physiotherapeutic treatment. In no case should you perform exercises that include squats, as well as exercises on bent knees. The latter is especially important for those who are diagnosed with arthritis of the knee joint. The ideal sport for arthritis patients is swimming.

An important step in the treatment of arthritis is the fight against bad habits. So, a patient with arthritis should stop smoking, do not abuse coffee.

As a surgical treatment, the method of joint replacement is used. Such treatment is advisable exclusively in severe forms of the disease.

If a person has already developed arthritis, he should be very competent in choosing exercises for sports. No need to stand too long. Particular attention must be paid to the selection of products for everyday diet. Animal fats, flour, spicy should be excluded. At the same time, cereal fiber is an extremely useful food for arthritis.

The most common signs of arthritis are arthritis symptoms.

In this chapter, I will tell you about special “alarming” symptoms that are uncharacteristic for arthrosis, but typical for arthritis. These symptoms can serve as a hint and direct your diagnostic search in the right direction.

Signs of arthritis.

1. You feel increased pain in the joints at night, between three and five in the morning – increased pain at this time often indicates their rheumatic, inflammatory origin, and may be a symptom of some kind of arthritis. You should especially be wary if the pains are so severe that they wake a person in the middle of the night amid complete rest. But if the pain occurred in the middle of the night from movement, when you roll over from side to side or stand in the toilet, then such pain is not an indicator of inflammation. It can be a symptom of any disease – from arthrosis to tendon inflammation.

2. You should be wary if you feel stiffness in the whole body and joints in the mornings, immediately after waking up, which disappears within an hour or during the first half of the day — such stiffness is characteristic of inflammatory joint diseases, especially rheumatoid arthritis, Ankylosing spondylitis and rheumatic polymyalgia. A very alarming sign is the morning stiffness of the hands, the feeling that tight gloves are put on the hands. The symptom of “tight gloves” is one of the manifestations of rheumatoid arthritis. However, the same sensations occur with some non-inflammatory diseases of the hands – in particular, with carpal tunnel syndrome.

3. You should be wary if you have inflammation and swelling of the metacarpophalangeal joints, that is, the joints located at the base of the fingers (bulging bones of a clenched fist). Swelling and inflammation of these joints are most often a sign of rheumatoid arthritis, less often a sign of psoriatic arthritis. Unless, of course, it arose as a result of an injury or a punch against the wall.

4. You should be wary if your wrist joints are inflamed and swollen. Inflammation of the wrist joints is most often a sign of rheumatoid arthritis, less often a sign of reactive or psoriatic arthritis, rheumatism, or a peripheral form of ankylosing spondylitis. Particularly alarming is the inflammation of two wrist joints at once. Such inflammation in 99% of cases is a sign of arthritis.

5. You should be wary if at least one of your fingers or toes is red and swollen from the base to the very tip and looks like a sausage. This “sausage-like configuration” of the fingers is most often a symptom of psoriatic arthritis, sometimes reactive arthritis. Less commonly, a similar deformation of the fingers, with redness and swelling, occurs with gout – but then it is combined with inconceivable acute pain in the affected finger. Whereas with psoriatic arthritis, the pain can be quite bearable.

6. One should be wary if inflammation of the joints is “volatile” – when one joint swells at first, then after a few days its inflammation passes without a trace, but immediately after that the other joint becomes inflamed, then the third, etc. Such alternate “flare-up” of the joints with their complete subsequent recovery is most often the result of articular rheumatism. Or a sign of gouty arthritis – but then joint inflammation is almost always combined with inconceivable acute pain and redness of an inflamed joint. With articular rheumatism, reddening of the joints is almost non-existent.

7. You should be wary if you experience bouts of severe pain in the joints of the big toes, or in the knee joints or ankle joints, accompanied by their swelling and obvious redness, which occur for no reason and also suddenly disappear after 3–7 days, and then again regularly repeated at approximately the same intervals. Such attacks are 90% a sign of gouty arthritis. With gout, the pain is usually so severe that the patient is ready to “climb the wall” because of them.

8. One should be wary if joint pain is clearly reduced by active, energetic movements. Most often, joint pain from vigorous movements decreases precisely with arthritis. But with arthrosis and other non-inflammatory joint diseases, too energetic movements often lead, on the contrary, to increased pain in the damaged joint.

9. One should be wary if joint pain is quickly and almost completely eliminated by non-steroidal anti-inflammatory drugs. Such a tangible effect of taking non-steroidal anti-inflammatory drugs occurs only with certain types of arthritis: most often with ankylosing spondylitis, and less often with gout. In these diseases, non-steroidal anti-inflammatory drugs sometimes reduce pain by almost 90-100%. With arthrosis and other non-inflammatory joint diseases, such a pronounced effect from taking non-steroidal anti-inflammatory drugs is rare, pain decreases only by 50-60 percent. With arthrosis, it almost never happens that the pain in the affected joints from anti-inflammatory drugs goes away completely.

10. You should be wary if for several months or years you feel a clear stiffness in the lower back and sacrum, and a severe restriction of mobility in the lumbar spine or in the entire spine. This limitation of spinal mobility may be a sign of ankylosing spondylitis. With ankylosing spondylitis, the ability to turn in both directions, to the right or left, and to lean forward, backward or sideways is sharply reduced. A sick person usually turns or leans with his whole body, with a “straight back.”

11. You should be wary if dense pea-sized nodules appear under the skin of joints in the elbow area under your skin – they may be the result of rheumatoid arthritis. Sometimes gouty tofuses also form in the elbow area.

12. You should be wary if the inflammation of your joints is combined with a prolonged increase in temperature to 37 ° C or higher (for more than 4 weeks). A combination of prolonged fever and joint inflammation can be a sign of rheumatoid or reactive arthritis, ankylosing spondylitis, or articular rheumatism.

13. You should be wary if inflammation of your joints is combined with prolonged inflammation of the eyes, a sensation of itching or “sand” in the eyes. Such phenomena are often an additional symptom of reactive arthritis, or, less commonly, ankylosing spondylitis.

14. You should be wary if your joint inflammation is combined with your skin disease – psoriasis. Or if your next of kin gets psoriasis. In this case, joint inflammation may be due to psoriatic arthritis.

15. You should be wary if you have a clear weakness during your illness. Especially if, in addition, you have dramatically lost weight, despite the fact that your diet has not changed. Or if you have a sharp decrease in appetite or a clear change in eating habits during your illness. Such symptoms, coupled with severe weakness, are often a symptom of polymyalgia rheumatism or a complication of rheumatoid arthritis.

16. You should be wary if inflammation of the joints has been combined for a long time with chills or frequent “torrential sweat” – this combination is often the result of reactive or rheumatoid arthritis, ankylosing spondylitis or articular rheumatism (unless “torrential sweat” and chills are a consequence of menopause body restructuring).

17. You should be wary if inflammation of the joints is combined with abnormal discharge from the genital tract, or if the onset of the disease was preceded by a prolonged violation of the intestines (we are talking only about loose stools). Or if your joint damage is combined with inflammation of the skin of the feet, without itching, but with the formation of blisters and redness on the skin (of course, we are not talking about fungal infections of the feet – it is most often present with fungal infections). All of these symptoms can be a manifestation of reactive arthritis.

An article by Dr. Evdokimenko © for the book Arthritis, published in 2003.
Edited in 2011.
Все права защищены.

Arthrosis and arthritis – what is it. What is the difference between arthrosis and arthritis. Arthrosis and arthritis are diseases in which joint damage occurs. That is why, and also because of the consonance of the names, many people do not understand the difference between arthrosis and arthritis, and perceive them as something similar in nature. Meanwhile, arthrosis and arthritis are far from the same thing.

Signs of arthrosis (symptoms of arthrosis). Osteoarthritis most often affects the knee and hip joints, as well as the joints of the big toe. A little less often – the ankle joints and those joints of the fingers that are closer to the nails (distal interphalangeal joints).

Examinations required for differential diagnosis between arthritis and arthrosis. Clinical blood test, biochemical blood test and analysis for rheumatic tests, joint x-rays, X-rays of the sacroiliac joints, in some cases, spinal X-rays, radioisotope skeleton scans, computed tomography or magnetic resonance imaging (CT or MRI).

Other causes of joint pain. Sore tendon pain. Pain with blockade or pinching of the joint. Joint pain due to circulatory disorders.

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles

Expertnews