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Arthritis (from Latin arthritis – aches in joints) is a general designation of all kinds of inflammatory processes in the joints that act as independent nosological forms or manifestations of systemic pathology. With a progressive disease, the inflammation spreads to the adjacent tissues: the synovial membrane, the bursa, ligaments, tendons, muscles and bones.

Causes of Arthritis and Risk Factors

The causes of the development of inflammatory processes in the joints can be very diverse. Acute inflammation can be caused by trauma, infection, an allergic reaction or the ingestion of toxic substances into the joint cavity with the bites of snakes, spiders and poisonous insects.

The chronic form often develops against a background of various abnormalities in the functioning of internal organs and systems:

  • endocrine disorders;
  • diseases of the nervous system;
  • autoimmune, allergic and atopic conditions;
  • congenital anomalies of the structure of the musculoskeletal system and birth trauma – for example, dysplasia of the head of the hip joint.

Causes of arthritis: bacterial infection in the body

The emergence of reactive arthritis is most often associated with enterobacteria, chlamydia and mycoplasmas. In the case of rheumatoid arthritis, genetic predisposition is of primary importance.

Among the statistically significant risk factors for developing arthritis, WHO calls age over 65, overweight, hypertension, kidney disease and gender: women are more likely than men to fall ill due to sudden changes in the hormonal background during menopause.

In USA, inflammation of the joints is observed in about 60% of persons of retirement age against the background of a tendency to increase the incidence and reduce the age of the first manifestation of the disease. Diagnosis of neuro-arthritic diathesis in childhood increases the likelihood of arthritis in adulthood.

The predisposing factor of arthritis is the elderly age and the presence of chronic diseases.

Often the cause of arthritis is the permanent microtrauma of joint structures in professional sports and heavy physical work, when there is an intense load on the same muscle groups. On the other hand, a sedentary lifestyle also contributes to the development of inflammatory processes in the joints, especially when alcohol abuse, unbalanced diet and a lack of vitamins in the diet are mixed with hypodynamia.

Forms and types of arthritis

Due to the variety of manifestations of arthritis in clinical practice, it is customary to distinguish different forms of the disease, which differ in the specificity of the clinical picture and therapeutic measures. Depending on the nature of the course distinguish between acute and chronic arthritis, and the number of affected joints differentiate three forms of the disease:

  • monoarthritis – inflammation of one joint;
  • oligoarthritis – inflammation affected from two to four joints;
  • polyarthritis – inflammation of five or more joints.

Based on the prevailing etiologic factor, primary arthritis is distinguished with independent pathogenesis and secondary arthritis as a consequence of the background disease. Primary forms include infectious, traumatic and rheumatoid arthritis, juvenile idiopathic arthritis, Still’s disease, as well as inflammation of the joints with osteoarthritis and spondylitis.

When polyarthritis affects five or more joints

Secondary arthritis occurs against a background of a number of diseases, of which dysentery, tuberculosis, gout, diabetes mellitus, systemic lupus erythematosus, gonorrhea, borreliosis, psoriasis, purpura, hepatitis, granulomatosis, hemochromatosis, Reiter’s syndrome and others are the most known.

Inflammation of the joints, which developed after the transfer of nasopharyngeal, intestinal and genito-urinary infections, is called reactive arthritis.

In the early stages of acute infectious arthritis is well treatable until the full restoration of the function of the joint.

Stages of athritis

In the dynamics of the pathological process in arthritis, four stages are distinguished:

  • Clinically, the disease does not manifest itself, but the x-ray images of the joints have the first signs of inflammation.
  • Sometimes there is a slight stiffness of movements and periodic pain during exercise.
  • Progressive inflammatory process leads to thinning of the tissues of the joint structures and erosion of the heads of bones. There are swelling in the area of ​​the affected joints; often there is a local increase in temperature and redness of the skin, the movements are accompanied by a crunch.
  • The gradual destruction of the joint structures leads to a considerable deformation of the joints, limited mobility, constant pain and partial loss of joint functions, which are partly compensated by muscle tension.
  • Pathological changes in the joint tissues are irreversible; the diseased joint is completely immobilized. When the knee joints are affected, contractions are formed, ankylosis develops in the hip joints – fusion of the joints heads due to the filling of the joint capsule with a replacement bone or fibrous tissue.

Symptoms of Arthritis

Symptoms of Athritis

The symptomatology of arthritis depends on the stage and form of the disease. Common signs of inflammation of the joints are non-specific: in the early stages of the pathological process, moderate pain and stiffness in the joints are often attributed to fatigue, hypothermia and age-related changes. If some joints become inflamed, alarming signals may appear:

  • swelling of the feet and increased fatigue when walking with ankle injury;
  • “Symptom of gloves” with inflammation of the joints of the hand;
  • lameness and pain, giving to the knee, with arthritis of the hip joint;
  • difficulty in lifting and retracting the limb when the shoulder is injured.

In the early stages, arthritis is manifested by moderate pain and stiffness in the joints. In the early stages, arthritis is manifested by moderate pain and stiffness in the joints

Most patients go to the doctor at stage II of the disease. Constant discomfort in the joints, the appearance of sensitive swelling caused by excessive production of synovial fluid, characteristic crunch, erythema and puffiness of problem areas are obvious signs of inflammation.

Forced position of the body and limbs can indicate a strong muscle spasms against the loss of mobility of the joints.

Specific symptoms are inherent only in certain forms of the disease. For reactive arthritis is characterized by asymmetric inflammation of the joints of the extremities against the background of fever, headache and conjunctivitis. In some cases, signs of urinary tract infection are added.

Valgus deformities of the thumbs and toes give reason to suspect gouty arthritis, and in the case of psoriatic arthritis, the joints of the wrist are severely deformed and thickened.

In rheumatoid arthritis joints are affected symmetrically, and dense nodules are formed in the folding sites. During the period of remission, discomfort is felt mainly in the mornings and practically disappears by the second half of the day. Exacerbations are accompanied by febrile condition, numbness of limbs, pain during inspiration, inflammation of lymph nodes and salivary glands, photophobia and incision in the eyes.

Arthritis in children

There are two forms of arthritis that are diagnosed exclusively in childhood: juvenile idiopathic arthritis and juvenile rheumatoid arthritis, or Still’s disease. Both diseases are characterized by a persistent current and a weak response to therapy, in addition to joints, the internal organs are often affected in the case of Still’s disease.

Diagnosis of neuro-arthritic diathesis in childhood increases the likelihood of arthritis in adulthood.

Children also tend to have a more acute course of infectious arthritis compared to older patients. Soreness and pronounced deformations of the joints are accompanied by high fever and pronounced intoxication of the body – severe head and muscle pain, confusion, nausea and vomiting.

Diagnosis of arthritis

Although the signs of inflammation of the joints are clearly visible even to the layman, it is not possible to determine the exact form and stage of arthritis accurately, as well as to develop the correct strategy of therapy, based solely on the history and physical examination data.

Athritis

When setting a preliminary diagnosis, the doctor pays attention to the size, shape and sensitivity and mobility of the joints, the color and temperature of the skin, muscle tone; conducts functional tests.

The next stage of diagnostic search should be instrumental techniques that visualize the characteristic signs of arthritis:

  • thickening and thickening of adjacent soft tissues;
  • calcification;
  • tendinitis and tendosynovitis;
  • osteoporosis;
  • cystic enlightenment of bone tissue;
  • roughness of the articular surfaces;
  • bone erosion;
  • narrowing of the joint space;
  • osteophytes, etc.

Passage of MRI ensures maximum accuracy of diagnosis of articular pathologies due to qualitative visualization of hard and soft tissues. Radiography and CT of the joint in a straight, lateral and oblique projection can reveal changes from the side of the bone apparatus.

To assess the condition of cartilage, tendons, ligaments, muscles and nerves, ultrasound of large joints is additionally prescribed. If the knee joint is damaged, arthroscopy may be required to select the synovial fluid and the biopsy specimen. To monitor the dynamics of the process in the absence of exacerbations, contrast arthrography may be appropriate.

Laboratory diagnosis of arthritis involves the conduct of a general, biochemical and immunological analysis of blood. A high erythrocyte sedimentation rate and an elevated fibrinogen concentration confirm the presence of an inflammatory process; increased number of leukocytes – bacterial infection.

With eosinophilia, the likelihood of an allergic reaction is high. Detection of the rheumatoid factor in the serum, along with exceeding the permissible level of antibodies and circulating immune complexes, clearly indicates rheumatoid arthritis. With gouty arthritis, the indicators of sialic and uric acid increase.

In USA, inflammation of the joints is observed in about 60% of persons of retirement age against the background of a tendency to increase the incidence and reduce the age of the first manifestation of the disease.

Treatment of arthritis

The choice of therapeutic strategy depends on the form, etiology and stage of the disease, the localization of inflammation, as well as the age, health status and constitutional features of the patient. For the relief of the inflammatory process and pain syndrome, a complex of non-steroidal anti-inflammatory drugs, muscle relaxants and analgesics in combination with physiotherapeutic procedures is selected.

A good effect is provided by electrophoresis and ultraphonophoresis, Hilt-therapy, amplipulse therapy, magnetotherapy and SMT-therapy (treatment with sinusoidal modulated currents).

An important component of complex treatment is the use of chondroprotectors – for example, the drug Alflutop. The injection mold provides maximum bioavailability and rapidity of the drug that helps stop the progression of cartilage destruction, relieves inflammation and stimulates the synthesis of hyaluronic acid.

Due to the rapid onset of the effect, there is no need for long-term courses of the drug-only 20 injections twice a year. Supplementing them with the treatment of arthritis can reduce the dosage and duration of NSAID use.

In the treatment of arthritis, physiotherapeutic methods are effective. In the treatment of arthritis, physiotherapeutic methods are effective

Corticosteroids in rheumatological practice are used with great care, limited to injections into the affected joint in the absence of reaction to sparing methods of treatment. In the presence of infectious arthritis, courses of antibiotics or antiviral drugs are prescribed, and for rheumatoid arthritis, immunosuppressors and immunomodulators are prescribed. Whenever purulent complications occur, arthrocentesis is performed daily.

The therapeutic diet for arthritis involves the rejection of high-calorie foods, red meat and meat by-products, legumes, salt, spices and alcohol. In rheumatoid arthritis, tomatoes, potatoes, aubergines and other vegetable cultures of Solanaceae family containing solanine should also be discarded. The diet should contain foods rich in fiber and vitamins, as well as sources of easily digestible protein – poultry and sour-milk products.

To consolidate the therapeutic effect, massage, exercise in the exercise therapy group and a course of balneotherapy in the profile sanatorium are recommended. Referring to folk remedies and non-traditional methods is permissible only after consultation with the attending physician.

Arthritis: Complications and possible consequences

Early complications in the form of panartrites, phlegmon and other purulent processes develop mainly with infectious arthritis. Late complications include contractures, pathological dislocations, osteomyelitis, osteolysis, bone necrosis and generalized sepsis. In the absence of adequate treatment, progressive chronic arthritis can lead to disability: the patient loses the ability to self-service and free movement.

Forecast

In the early stages of acute infectious arthritis is well treatable until the full restoration of the function of the joint. If the development of the inflammatory process is associated with endogenous factors, recovery is more difficult to achieve, but it is possible to slow the rate of disease progression, prevent complications and avoid disability.

Prevention

Prevention of arthritis is not particularly difficult. It is enough to lead a moderately active way of life, give up bad habits, adhere to a balanced diet and control weight.

For infectious diseases and joint injuries, you should consult your doctor without relying on home remedies. To prevent exacerbations of chronic arthritis, it is important to follow a diet, avoid hypothermia, do not lift heavy loads and undergo a sanatorium treatment at least once every two years.





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