Joint pain and swelling are common in many different conditions. The earlier the diagnosis is made and the correct treatment started, the more successful the therapy will be.
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, joint swelling, stiffness of movement, local increase in the temperature of the soft tissues around the joint. General symptoms such as weakness, fever, weight loss are possible. For timely diagnosis and the appointment of the correct treatment, the patient should consult a specialist doctor, a rheumatologist.
Unfortunately, due to the wide publicity for unconventional treatment methods, patients often turn to chiropractors, osteopaths, homeopaths, and time is wasted. In particular, in the treatment of rheumatoid arthritis, the first 3-6 months of the disease are called the "window of opportunity"; This is the time when the correct treatment can lead to a long-term and persistent remission.
Now let's talk about the symptoms of the most common rheumatological diseases.
Osteoarthritis
Osteoarthritis is the most common joint disease that usually occurs in people older than 40 to 45 years. Women suffer from osteoarthritis almost 2 times more often than men.
The most clinically important and disabling forms of osteoarthritis are coxarthrosis (osteoarthritis of the hip joint) and gonarthrosis (osteoarthritis of the knee joint). With nodular osteoarthritis, there is an injury to the interphalangeal joints of the hands (pain and deformity).
The main clinical symptom of osteoarthritis is pain in the affected joint during exercise. With osteoarthritis of the knee or hip joint, the patient experiences pain when walking, when getting up from a chair, when walking down the stairs (especially when descending), when carrying weights. In addition to pain, the patient is concerned about the limitation of movement in the joint, creaking during movement.
Sometimes there is a swelling (effusion) of the knee joint (it may be swollen behind, below the knee). This is a symptom of joint inflammation.
In the case of effusion (synovitis), the nature of the pain changes: the pain appears at rest, not associated with stress.
Rheumatoid arthritis
Rheumatoid arthritis generally occurs in middle-aged women. The most characteristic symptoms are symmetric arthritis (in the right and left extremities) (pain, swelling) of the wrist joints, small joints of the hands and feet. Joint pain is most worrisome in the morning. It is difficult for the patient in the morning to clench the hand into a fist, raise the hand (comb his hair), step on the feet (due to pain under the "pads" of the toes). Joint pain is accompanied by a characteristic symptom: "morning stiffness. "
Patients describe morning stiffness as a sensation of "swelling, joint stiffness", "tight gloved hands. "In addition to joint syndrome, rheumatoid arthritis is characterized by general symptoms such as weakness, weight loss, weight loss, sleep disorders, and fever.
You should know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be disabling if it is diagnosed late and treated poorly. Often the disease begins gradually, often with arthritis of one joint, then other joints "come together. "
To take advantage of the "window of opportunity" and quickly begin treatment for persistent arthritis (2-3 weeks), especially arthritis of the small joints, it is necessary to consult a rheumatologist. To confirm the diagnosis, immunological tests, radiography and MRI are used.
Spondyloarthritis
This is a group of diseases including ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondyloarthritis associated with inflammatory bowel diseases, reactive arthritis (associated with urogenital or intestinal infection), undifferentiated spondyloarthritis.
This group of diseases is linked by common genes and common clinical symptoms. Spondyloarthritis usually occurs in young people (up to 40 years old). Spondylitis is an inflammation of the joints in the spine. Often the first symptoms of spondylitis are pain in the lumbosacral region, alternating pain in the buttocks (sometimes on one side or the other). These pains are inflammatory in nature: they intensify in the second half of the night or in the morning, decrease after warming up, do not disappear at rest and are accompanied by morning stiffness in the spine. Spondyloarthritis often affects the hip joints (the first symptom is usually groin pain).
Spondyloarthritis is characterized by the presence of asymmetric arthritis, mainly of the joints of the lower extremities. Unfortunately, the correct diagnosis is often made between 8 and 10 years after the onset of the disease, especially in the case that the patient has pain in the spine, but not arthritis.
These patients have long been followed by neurologists and chiropractors with a diagnosis of osteochondrosis. For a correct diagnosis, an additional examination is required: MRI of the sacroiliac joints, X-ray of the pelvis, blood tests for the presence of a specific gene.
Drop
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 of the big toe. Arthritis occurs acutely, most often at night or early in the morning, after a heavy meal, drinking alcohol, as well as after a minor injury, physical exertion.
Gouty arthritis is accompanied by severe pain (the patient cannot step on the foot, the pain does not sleep at night, the pain intensifies even when the joint is touched with a blanket). In addition to severe pain, there is a pronounced swelling of the joint, redness of the skin over the joint, movements in the inflamed joint are almost impossible. Arthritis can be accompanied by a high fever. A gout attack disappears after a few days (early in the disease, even without treatment).
In most patients, the second "attack" of gout is seen after 6 to 12 months. In the future, there is a gradual increase in the frequency of "attacks" of arthritis, there is a trend to its more prolonged nature. All new joints are involved: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofus (nodules with significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders, increased uric acid levels. In most patients, the cause of the disease is impaired renal excretion of uric acid. Patients with gout, as a rule, have other metabolic disorders: overweight, increased blood pressure, increased cholesterol levels, urolithiasis, ischemic heart disease. This requires a thorough examination and treatment.
Polymyalgia rheumatica
Older people (after age 50) 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 the patient to determine what hurts: joints, muscles or ligaments.
With polymyalgia rheumatica, the general condition of the patient suffers, there are often symptoms such as fever, weight loss, loss of appetite, lack of sleep and depression. There is a marked increase in ESR.
Patients generally undergo a comprehensive cancer examination. If the patient does not go to a rheumatologist, then the appointment of the correct treatment is "postponed" for a long time. It should be noted that joint pain and arthritis are also a symptom of rarer rheumatological diseases: diffuse 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 much more often they occur as a result of local overloads, microtraumas, overvoltage. Inflammatory changes in soft tissues, as a rule, respond well to periarticular (periarticular) drug administration. Inflammation in the joints can occur after injuries and require surgical intervention. These problems are treated by orthopedists.
Osteoporosis can be a complication of chronic joint diseases. Densitometry is required to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint diseases is also carried out by a rheumatologist. 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 point out once again that the diagnosis of joint diseases is carried out by a specialist rheumatologist. The treatment of joint pathology must be comprehensive and differentiated. With the correct and timely diagnosis, the treatment will be more successful.