Joint pain and swelling are common in a variety of conditions. The earlier a diagnosis is made and proper treatment is initiated, the greater the success of therapy.
Arthritis is considered "early" if the diagnosis is made within 6 months of the first symptoms of the disease. There are early arthritis clinics in several European countries.
Symptoms of arthritis are: joint pain, swelling of the joints, stiffness of movement, local increase in temperature of the soft tissues around the joints. Common symptoms such as weakness, fever, weight loss are possible. For timely diagnosis and appointment of proper treatment, patients should consult a specialist doctor - rheumatologist.
Unfortunately, due to widespread advertising of unconventional treatment methods, patients often turn to chiropractors, osteopaths, homeopathy - and time is lost. In particular, in the treatment of rheumatoid arthritis, the first 3-6 months of the disease are called a "window of opportunity" - this is the time when proper treatment can lead to sustained and long -term remission.
Now let’s talk about the most common symptoms of rheumatological diseases.
Osteoarthritis
Osteoarthritis is the most common joint disease that usually occurs in people over the age of 40-45 years. Women experience osteoarthritis almost 2 times more often than men.
The most pronounced and clinically crippling forms of osteoarthritis are coxarthrosis (arthrosis of the hip joint) and gonarthrosis (arthrosis of the knee joint). With nodular osteoarthritis, there are lesions on the interphalangeal joint of the hand (pain and deformity).
The main clinical symptom in osteoarthritis is pain in the affected joint during exercise. With arthrosis of the knee or hip joint, patients experience pain when walking, when getting up from a chair, when walking on stairs (especially when descending), when carrying loads. In addition to pain, patients worry about limitations of movement in the joints, crackling during movement.
Sometimes there is swelling (effusion) at the knee joint (it can be swelling in the back, below the knee). This is a symptom of joint inflammation.
In the case of effusion (synovitis), the nature of the pain changes: pain appears at rest, not associated with stress.
Rheumatoid arthritis
Rheumatoid arthritis usually occurs in middle -aged women. The most characteristic symptom is symmetry (on the right and left leg) arthritis (pain, swelling) of the wrist joints, small joints of the hands and feet. Joint pain is more worrying in the morning. It is difficult for the patient in the morning to clench his fists into fists, raise his hands (comb his hair), step on his feet (because of pain under the "pad" of the toes). Joint pain is accompanied by characteristic symptoms - "morning stiffness".
Patients described morning stiffness as a feeling of "swelling, stiffness in the joints, " "hands with tight gloves. " In addition to articular syndrome, rheumatoid arthritis is characterized by common symptoms such as weakness, weight loss, weight loss, sleep disturbances, andfever.
You need to know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be crippling if diagnosed late and not treated properly. Often the disease begins gradually, often with arthritis of one joint, then the other joints "join".
To use the "window of opportunity" and immediately begin treatment for persistent arthritis (2-3 weeks), especially for arthritis of the small joints, it is necessary to consult a rheumatologist. To confirm the diagnosis, immunological tests, radiography, and MRI were used.
Spondyloarthritis
These are a group of diseases that include ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondyloarthritis associated with inflammatory bowel disease, reactive arthritis (associated with urogenital or intestinal infections), undifferentiated spondyloarthritis.
This group of diseases is united by common genes and common clinical symptoms. Spondyloarthritis usually occurs in young people (up to 40 years). Spondylitis is an inflammation of the joints in the spine. Often, the first symptom of spondylitis is pain in the lumbosacral area, alternating pain in the back (sometimes on one side or the other). This pain is inflammatory in nature: it intensifies in the second half of the night or in the morning, decreases after warming up, does not disappear during rest, and is accompanied by morning stiffness in the spine. Spondyloarthritis often affects the hip joint (the first symptom is usually groin pain).
Spondyloarthritis is characterized by the presence of asymmetric arthritis, especially in the joints of the lower legs. Unfortunately, a correct diagnosis is often made 8-10 years after the onset of the disease, especially in cases when the patient has pain in the spine, but no arthritis.
This patient has been followed by a neurologist and chiropractor for a long time with a diagnosis of osteochondrosis. For a correct diagnosis, additional examinations are needed: MRI of the sacroiliac joint, X-ray of the pelvis, blood tests for the presence of certain genes.
Gout
Men get gout about 20 times more often than women. Gout develops mainly during the fifth decade of life.
The "classic" symptom of gout is paroxysmal arthritis, usually on the big toe I (big). Arthritis occurs acutely, more often at night or early in the morning, after heavy eating, drinking alcohol, as well as after minor injuries, physical exercise.
Gouty arthritis is accompanied by severe pain (the patient cannot step on his feet, pain does not sleep at night, pain worsens even if the joint is touched with a blanket). In addition to severe pain, there is significant swelling of the joints, redness of the skin over the joints, movement of the inflamed joints is almost impossible. Arthritis can be accompanied by high fever. Gout attacks disappear after a few days (at the beginning of the disease - even without treatment).
In most patients, a second "attack" of gout is observed after 6-12 months. In the future, there is a gradual increase in the frequency of "attacks" of arthritis, there is a tendency for their nature to be more protracted. All new joints are involved: knees, ankles, elbows. Without treatment, patients develop chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofuses (nodules with significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders, increased levels of uric acid. In most patients, the cause of the disease is a disorder of uric acid excretion by the kidneys. Patients with gout, as a rule, have other metabolic disorders: overweight, increased blood pressure, increased cholesterol levels, urolithiasis, ischemic heart disease. This requires comprehensive examination and treatment.
Polymyalgia rheumatica
Older people (after 50 years) get sick. At the peak of the disease, pain and limitation of movement are characteristic in three anatomical areas: in the shoulder girdle, pelvic girdle and neck. It can be difficult for a patient to determine what is painful: a joint, muscle or ligament.
With polymyalgia rheumatica, the general condition the patient suffers from, there are often symptoms such as fever, weight loss, loss of appetite, lack of sleep, and depression. There was a significant increase in ESR.
Patients usually undergo thorough cancer screening. If the patient does not go to a rheumatologist, then the appointment of proper treatment is "delayed" for a long time. It should be noted that joint pain and arthritis are also symptoms of more rare rheumatological diseases - pervasive connective tissue diseases (systemic lupus erythematosus, systemic scleroderma, dermatomyositis, Sjogren's disease, Behcet's disease, systemic vasculitis).
There is a whole group of extra-articular soft tissue diseases, called "periarthritis" (tendinitis, tendovaginitis, bursitis, enthesopathy).
Changes in soft tissues can be one of the manifestations of systemic diseases, but more often they occur as a result of local overload, microtraumas, overvoltage. Inflammatory changes in soft tissues, as a rule, respond well to the administration of periarticular (periarticular) drugs. Inflammation of the joints can occur after an injury and requires surgical intervention. This problem is addressed by an orthopedic specialist.
Osteoporosis can be a complication of chronic joint disease. Densitometry is needed to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint disease is also carried out by rheumatologists. Finally, arthritis can be a symptom of other non -rheumatological diseases.
Arthritis occurs in tuberculosis, sarcoidosis, malignant neoplasms, amyloidosis, endocrine diseases, diseases of the blood system and other pathologies.
In conclusion, I would like to note once again that the diagnosis of joint disease is carried out by a rheumatologist. Treatment of articular pathology should be comprehensive and differentiated. With proper and timely diagnosis, treatment will be more successful.