Joint pain and swelling are common in many different diseases. The earlier the diagnosis and the correct initiation of treatment, the greater the likelihood of successful therapy.
Arthritis is considered "early" if the diagnosis is made within 6 months of the first symptoms of the disease. There are many early arthritis clinics in several European countries.
Symptoms of arthritis are: joint pain, joint swelling, stiffness during movement, local increase in soft tissue temperature around the joint. General symptoms such as weakness, fever, and weight loss may occur. In order to receive a timely diagnosis and prescribe the correct treatment, the patient should consult a specialist - a rheumatologist.
Unfortunately, due to the rampant advertising of unconventional treatments, patients often turn to chiropractors, osteopathic physicians, homeopaths - and lose time. In particular, in the treatment of rheumatoid arthritis, the first 3-6 months of the disease is called the "window of opportunity" - this is the time when the right treatment can lead to persistent and long-lasting remission.
Now let's talk about the symptoms of the most common rheumatic diseases.
Osteoarthritis
Osteoarthritis is the most common joint disease, usually occurring in people over 40-45 years old. Women suffer from osteoarthritis almost 2 times more often than men.
The most clinically significant and disabling forms of osteoarthritis are coxarthrosis (degeneration of the hip) and gonarthrosis (degeneration of the knee joint). With nodular osteoarthritis, there is damage to the intervertebral joints of the hand (pain and deformity).
The main clinical symptom of osteoarthritis is pain in the affected joint during movement. With osteoarthritis of the knee and hip, the patient has pain when walking, when getting up from a chair, when going up stairs (especially when going down), when carrying weights. In addition to the pain, the patient is also worried about the limitation of movement in the joints, crunching when moving.
Sometimes there is swelling (effusion) of the knee joint (possibly behind, below the knee). This is a symptom of arthritis.
In the case of effusion (bursitis), the nature of the pain changes: the pain occurs at rest, not related to stress.
Rheumatoid arthritis
Rheumatoid arthritis usually occurs in middle-aged women. The most characteristic symptoms are symmetric arthritis (right and left side) arthritis (pain, swelling) of the wrist joints, joints of the hands, small feet. Joint pain is more common in the morning. It is difficult for the patient to make a fist, raise his hand (brush his head), step on his foot (due to pain under the "pads" of the toes). Arthralgias are accompanied by a characteristic symptom - "morning stiffness".
The patient describes morning stiffness as a feeling of "swelling, stiffness", "hands wearing tight gloves". In addition to the joint syndrome, rheumatoid arthritis is characterized by general symptoms such as weakness, weight loss, weight loss, sleep disturbances, and fever.
You need to know, rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be disabling if diagnosed late and treated improperly. Often the disease begins slowly, often with arthritis of one joint, then the other joints "step in".
To use the "window of opportunity" and start treatment promptly for persistent arthritis (2-3 weeks), especially arthritis of the small joints, it is necessary to consult a specialist. rheumatism. To confirm the diagnosis, immunological tests, radiographs, and MRIs are used.
Spondylitis
This is a group of diseases that includes ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondylitis associated with inflammatory bowel diseases, reactive arthritis (associated with urogenital orbowel), undifferentiated spondylitis.
This group of diseases is united by common genes and common clinical symptoms. Cervical spondylosis usually occurs in young people (up to 40 years of age). Spondylitis is an inflammation of the joints in the spine. Usually, the first symptoms of ankylosing spondylitis are bilateral, alternating pain in the buttocks (sometimes on one side or the other). These pains are inflammatory in nature: they increase in the second half of the night or morning, subside after warming up, do not disappear at rest, and are accompanied by morning stiffness. Spondylitis usually affects the hip joint (the first symptom is usually groin pain).
Spondylitis is characterized by the presence of asymmetrical arthritis, mainly of the joints of the lower extremities. Unfortunately, the correct diagnosis is usually made 8 to 10 years after the onset of the disease, especially in cases where the patient has pain in the spine, but no arthritis.
These patients were followed for a long time by neurologists and chiropractors with a diagnosis of osteonecrosis. For an accurate diagnosis, further examination is required: an MRI of the sacrum, an X-ray of the pelvis, a blood test for the presence of a specific gene.
Gout
Men get gout about 20 times more often than women. Gout mainly develops in the fifth decade of life.
The "classic" symptom of gout is paroxysmal arthritis, usually in the big toe (I). Arthritis occurs acutely, more often at night or early in the morning, after a heavy meal, alcohol consumption, as well as after a minor injury, physical exertion.
Gout arthritis is accompanied by severe pain (the patient cannot walk, the pain cannot sleep at night, the pain is severe even when touching the joint with a blanket). In addition to severe pain, there is also a marked swelling of the joints, red skin all over the joint, movement in the inflamed joint is almost impossible. Arthritis may be accompanied by a high fever. Gout attacks go away after a few days (when the disease starts - 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, which tend to be more prolonged in nature. All new joints involved: knee, ankle, elbow. If left untreated, the patient will develop chronic gout: chronic arthritis, kidney damage, subcutaneous wart formation (a significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders, increased uric acid. In most patients, the cause is impaired renal excretion of uric acid. Patients with gout, as a rule, have other metabolic disorders: overweight, hypertension, increased cholesterol levels, urolithiasis, ischemic heart disease. This requires a comprehensive examination and treatment.
Rheumatoid arthritis
Older people (after 50 years of age) have the disease. At the peak of the disease, pain and limitation of motion are characteristic of three anatomical regions: the shoulder, the pelvis, and the neck. It can be difficult for patients to determine what is being damaged: joints, muscles, or ligaments.
With polymyalgia rheumatica, the patient's general condition often has symptoms such as fever, weight loss, loss of appetite, poor sleep, and weakness. There was a marked increase in ESR.
Patients are usually screened for cancer thoroughly. If the patient does not go to a rheumatologist, the appointment of the right treatment will be "postponed" for a long time. It should be noted that arthralgia and arthritis are also a symptom of more rare rheumatic 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 diseases of extra-articular soft tissues, called "periarthritis" (tendonitis, tendinitis, bursitis, ankylosing spondylitis).
Changes in soft tissues can be one of the manifestations of systemic diseases, but they occur much more often due to local overloads, microtraumas, overpressure. Inflammatory changes in soft tissues, as a rule, respond well to periarticular administration. Inflammation in the joints can occur after trauma and requires surgical intervention. These problems are handled by chiropractors.
Osteoporosis can be a complication of chronic joint diseases. Densitometry is necessary for an accurate diagnosis of osteoporosis.
Treatment of osteoporosis associated with joint diseases is also performed by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatic diseases.
Arthritis occurs in tuberculosis, sarcoidosis, melanoma, amyloidosis, endocrine disease, blood system disease, and other pathologies.
In conclusion, I would like to note once again that the diagnosis of diseases of the joints is carried out by a rheumatologist. Treatment of rheumatic diseases should be comprehensive and differentiated. With an accurate, timely diagnosis, treatment will be more successful.