The anti-inflammatory and anti-rheumatic drug is produced by a well-known pharmaceutical factory in Italy - Rottapharm. Arthril in ampoules (instructions below) is produced in 20 pieces, it is a non-steroidal drug belonging to the oxicam group. The medicine is used for.
Metoject is a drug indicated for use in rheumatoid and psoriatic arthritis of the joints. This drug cannot cure joint diseases, but it can slow down their progression. Metoject (reviews) for rheumatoid arthritis prevents the appearance.
The inflammatory process occurring in the joints is commonly called arthritis. For a successful and quick cure, doctors prescribe medications, and you will also need to follow a special diet. A diet for joint arthritis will increase the effectiveness of drug treatment and.
Despite the similarity of the symptoms of these pathologies, arthritis and arthrosis are completely different diseases. They differ in their onset and subsequent development. Sometimes it is difficult to distinguish pathologies, but an experienced rheumatologist (arthrologist) will immediately see what the patient is sick with. Article.
An X-ray image allows you to determine not only the condition of the patient’s bone structures affected by the disease, but also determine the stages of development, thanks to good visualization of cartilage and bones. Rheumatoid arthritis is a chronic systemic disease.
Each joint in our body contains synovial fluid, cellular matter and white blood cells. When a bacterial infection enters the joint cavity, inflammation begins, which subsequently causes purulent arthritis. He is considered the most dangerous type.
The type of undifferentiated arthritis refers to all forms of this pathology, the symptoms of which fit more than one rheumatic disease. The damage to joints and surrounding tissues by this type of arthropathy is unpredictable, unlike others. Under.
Due to the penetration of bacteria called chlamydia into the human body, an autoimmune type of infection is fought, as a result of which the bacterium penetrates the joints, chlamydial arthritis occurs. The disease is not age-related; the disease is diagnosed.
Arthritis is a condition characterized by inflammation of the joints, which can lead to serious complications of the bone and surrounding tissues. The disease is caused by various factors. Allergic arthritis occurs due to the consumption of certain foods and...
Arthritis is inflammation of the joints. The most common cause is wear and tear on the articular surface. Post-traumatic arthritis is a joint disease that occurs as a result of multiple injuries. Degenerative pathology is progressive.
The main danger of rheumatism is that in the absence of appropriate treatment and observation by a specialist, it is possible to develop serious pathologies that affect the central nervous system and disrupt cardiovascular activity, which can lead not only to a deterioration in the quality of life in general, but also to disability and loss of ability to work.
Inflammatory processes occurring in connective tissues and joints against the background of previous infectious diseases caused by streptococcal infection often lead to the development of rheumatism. This disease is systemic in nature, predominantly affecting the cardiovascular system. In medicine, the term “acute rheumatic fever” is commonly used, which has replaced the concept of “rheumatism”.
With this disease there is a high risk of developing severe heart pathologies: heart disease and heart failure. Inflammation of the joints is reversible and responds well to medical therapy.
Rheumatism most often affects women; it occurs in them several times more often, unlike men. In children, after reaching 3 years of age, rheumatism is also common.
Scientific research on the development of rheumatism notes that recently the disease has become very “younger”. It mainly affects children and adolescents aged 7-15 years. For children, a consequence of the development of rheumatism can be the appearance of chorea - damage to the central nervous system. As a result, the child becomes noticeably more irritable, restless, academic performance decreases, sleep disturbances, and absent-mindedness are observed. The combination of these phenomena may at first be regarded as the child’s capriciousness, and not the development of a serious illness.
The development of rheumatism is manifested by the presence of a wide range of symptoms, which depend on the cause of the disease. Its development occurs quite rapidly, and the symptoms are pronounced. The disease occurs in mild, moderate and severe forms.
With a mild form of the disease, the blood circulation of the heart is not disrupted, since only certain areas of the heart muscle are affected. External symptoms are practically invisible and do not affect general well-being.
Moderate rheumatism has a more noticeable effect on cardiac activity; arrhythmia, shortness of breath, and chest pain are possible.
In severe forms of the disease, the heart is significantly damaged, and pathologies in the form of heart defects may develop. Severe pain appears in the chest area, swelling of the lower extremities, and the size of the heart, as a rule, is significantly increased.
Typical symptoms of rheumatism are:
Rheumatism is characterized primarily by damage to large and medium-sized joints. These are knee, elbow, shoulder, ankle joints.
In the case when pain and inflammatory syndrome affects the spine, the painful sensation and feeling of stiffness are concentrated in the lower back, in the lower back and radiate to the sacrum. The pain occurs mainly after sleep and a long period of rest, and goes away after performing a number of movements and during physical exercise. As the disease progresses, the pain spreads to the entire spine, a characteristic stoop and its curvature in the shape of an arc appear.
The onset of the disease is acute and subacute. Pain in the joints can be pronounced; any movement is difficult and aggravates the pain syndrome. The skin over the joints has an increased temperature, may turn red, and is painful on palpation.
With rare exceptions, rheumatoid nodes form, which are located in the area of the wrist joints, as well as in the area of the shoulder-elbow joints. They are small, painless lumps under the skin that last from several days to several months.
The child often experiences sharp pain in the abdominal area, which is diffuse in nature. For this reason, certain diagnostic problems arise. In this case, the pain may soon go away on its own, as well as in response to antirheumatic therapy.
Very rarely, the appearance of annular rash or colvidous erythema is observed - in the form of pale pink, dim, rim-shaped rashes that disappear with pressure. This phenomenon is extremely rare.
Against the background of a general deterioration in well-being, in some cases, there is a disturbance in the functioning of the heart - shortness of breath, disturbances in heart rhythm, and pain in the chest are noted.
More about rheumatism
When diagnosing rheumatism, complex long-term therapy is required, aimed both at relieving symptoms and at eliminating the causes of the disease and preventing its further development. Treatment objectives consist of the need to suppress the activity of streptococcal infection and reduce inflammatory processes that provoke the development of pain.
Treatment consists of several stages. At the first stage, it is carried out in a hospital setting, then the patient undergoes a rehabilitation course of sanatorium-resort treatment, and at the final stage, the patient is registered with a dispensary at the clinic at his place of residence.
Antirheumatic therapy in a hospital setting includes:
With inpatient treatment, it is possible to eliminate foci of chronic infection through surgery. Thus, the tonsils, which are a source of spread of streptococcal infection, are removed. The operation is performed 2 months after the onset of the disease and stabilization of the patient’s condition.
If a positive effect from treatment in a hospital setting is achieved and stable remission is achieved, the patient may be recommended to undergo sanatorium-resort treatment. During your stay in the sanatorium, the course of treatment continues, aimed at eliminating foci of infection, general strengthening and hardening of the body, restoring the full functioning of the cardiovascular system, and physical therapy is carried out.
The final stage is aimed at preventing further relapses. The patient is observed on an outpatient basis; regular examination and observation by a doctor is necessary. For prevention purposes, a course of penicillin drugs, bicillin-5, is prescribed.
As a general strengthening and tonic, it is recommended to take the juice of half a lemon diluted with a glass of warm boiled water. Should be taken in the morning on an empty stomach 30 minutes before meals.
When exacerbating pain and inflammation in the joints, a potato compress helps well. It is prepared from fresh potatoes, which must be grated, wrapped in a clean soft cloth and applied to the sore spot overnight. Also in this case, baths with black currant leaves are useful. To do this, you need to rinse the leaves, brew with boiling water, let it brew for 15-20 minutes and pour this infusion into a bath, which is taken before bed for 30 minutes.
Heat compresses made from sand heated in a frying pan, which is wrapped in a rag or sock and applied to the sore spot, also help relieve pain, especially in the legs. Sand can be replaced with coarse salt.
The diet should be enriched with the consumption of watermelons, blueberries, lingonberries, black currants, cranberries, both fresh and in the form of jelly.
Detection of rheumatism in the early stages, especially if there is a predisposition to this disease, is very important for the effectiveness of its further treatment. However, as a rule, the diagnosis is made in the presence of reliable symptoms indicating the development of rheumatism.
It is necessary to pay timely attention to both individual signs and their totality.
Against the background of neuropsychic disorders, excessive irritability may occur, children’s academic performance may decline, absent-mindedness appears, fatigue is observed, general muscle weakness throughout the body, headaches, sleep disturbances, etc. are typical.
Early signs of rheumatism appear in combination with muffled heart sounds, inconsistent systolic murmur at the apex of the heart, cardiac arrhythmia, pain in the chest, in the heart area, intermittent pain in the joints, body temperature above 38 0 C, moderate leukocytosis and slightly accelerated ROE.
A harbinger of the onset of the development of rheumatism can be inflammatory processes that affect the joints one by one. The inflammation first begins in one joint, then passes and affects the next one.
The combination of these signs makes it possible to think about the possibility of the development of rheumatism as a cause of cerebral pathology.
The main task of preventing rheumatism consists of two components.
The first component of prevention: prevention of rheumatism.
Is as follows:
The second component of prevention: prevention of relapse of the disease and its progression. The main task in this case is clinical observation and regular visits to the attending physician in case of any suspicion of the development of the disease, as well as following all the specialist’s recommendations.
As a rule, rheumatoid tests are prescribed:
Based on laboratory tests, the doctor can give a conclusion about the presence of signs of streptococcal infection and inflammatory immunopathological processes in patients with rheumatism.
Also, ECG and ECHO CG can be used as additional research methods to exclude involvement of the myocardium in the process and disruption of heart function; radiography to exclude other pathologies such as arthrosis, arthritis, gout.
The administration of the portal categorically does not recommend self-medication and advises consulting a doctor at the first symptoms of the disease. Our portal presents the best medical specialists with whom you can make an appointment online or by phone. You can choose a suitable doctor yourself or we will select one for you absolutely free . Also, only when you make an appointment through us, the price for a consultation will be lower than in the clinic itself. This is our little gift for our visitors. Be healthy!
Rheumatoid arthritis is an autoimmune disease of joint tissue. The disease is always chronic and has two forms, which differ significantly in symptoms and developmental features.
In 80% of cases, rheumatologists diagnose seropositive rheumatoid arthritis. What it is? This form of the disease is characterized by the presence of rheumatoid factor in the blood - a certain type of protein in a biochemical blood test (autoantibodies) produced to IgG immunoglobulins (defenders of the immune system).
The seropositive form of rheumatoid arthritis is the most dangerous and destructive for humans. It causes destructive effects on joints and surrounding tissues, affects the membranes of internal organs and provokes disruptions in the functioning of the circulatory system.
For a long time, the disease does not manifest itself in any way, so it manages to cause serious and often irreparable damage to the joints, which can lead to disability.
The remaining 20% of cases belong to the seronegative form of rheumatoid arthritis, in which rheumatoid factor is absent in the blood test. This form of pathology begins abruptly and with pronounced symptoms:
The symptoms of the seropositive form are different and much less pronounced (more on them later).
Some encouraging news: the seropositive form of the disease is treatable in the early stages of development. While the seronegative form of the disease practically does not respond to therapy. Fundamentally new drugs are also appearing that affect not only the symptoms, but also the very problem of an inadequate immune response.
The use of basic therapy together with drugs containing vitamin D in large quantities allows you to change the immune response and stop the destruction of joints.
IU (International Unit) is a unit of measurement of the dose of a substance based on its biological activity. Click on photo to enlarge
The formation and initial development of seropositive rheumatoid arthritis is practically asymptomatic. Symptoms are expressed indirectly; their exacerbation occurs extremely rarely, which quickly subsides. Therefore, as a rule, the patient turns to a rheumatologist and receives a diagnosis when the disease has already taken a chronic form, and many pathological changes have become irreversible.
feeling of weakness throughout the body;
unexplained weight loss;
constant increase in body temperature in the evening;
joint stiffness in the morning and after prolonged immobility;
swelling in joint tissues.
Symptoms are extremely rarely severe. Most often they are lubricated and cause minor discomfort. The main confirmation of seropositive rheumatoid arthritis is the results of a blood test.
In the seropositive form of the disease, the joints are affected symmetrically (for example, the same joints of the thumb on the right and left hands are affected).
First of all, the disease affects small joints, then larger ones. “Increasingly” joints are affected:
Seropositive rheumatoid arthritis can provoke severe concomitant diseases.
Beginning its destructive activity in the joint tissues, the disease penetrates the internal organs and systems, destroying their protective membranes and structure. This leads to disruption of the functioning of most internal organs and systems and is fraught with the development of serious pathologies:
The capabilities of modern medicine make it possible to stop the pathological processes that cause seropositive rheumatoid arthritis in the early stages of their appearance. It is very important to contact a rheumatologist in time and undergo a full examination.
Treatment must be comprehensive: the combination of drug therapy, traditional recipes, physiotherapy and exercise therapy in most cases allows to slow down the destruction of tissues and organs. And with early diagnosis and timely treatment, stable remission and improvement in the patient’s general health are possible.
The seropositive form of rheumatoid arthritis, in contrast to the seronegative form, responds quite well to treatment if timely contact with a rheumatologist and immediate initiation of treatment. If you scrupulously follow all the doctor’s prescriptions, a person will be able to get rid of unpleasant symptoms and continue to lead a normal lifestyle.
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Rheumatism (or rheumatoid arthritis) is part of a group of autoimmune pathologies that affect the joints of the locomotor system. The trigger for this disease of the articular system is an aggressive reaction of the human body’s immune defense to its own connective tissue cells.
For the development of a reactive onset, certain conditions and certain causes are needed, such as sore throat, acute respiratory diseases, long-term treatment with antibiotics, as well as allergies, stressful situations and eating large amounts of food with preservatives. Rheumatism is divided into seropositive and seronegative types. The latter type occurs in the early stages of the development of the disease, then after time the rheumatism factor appears. In order not to start the process to the chronic stage, everyone, without exception, needs to know about seropositive rheumatoid arthritis - what it is, symptoms, treatment and diet.
The detection of a certain titer of a rheumatoid agent in the blood of patients diagnosed with rheumatism classifies the disease as a seropositive type of pathology. This rheumatic index is present in 80% of cases of biochemical blood testing of patients with chronic autoimmune joint disease. Over time, or rather as the disease enters the chronic stage, especially when it worsens, the immune system enhances the production of antibodies that destroy healthy cells. This leads to an inflammatory-destructive process in the joints and in places where there is collagen, that is, in cartilage tissue, the ligamentous ligament system and internal organs.
According to medical research, women of all ages suffer from rheumatism of the seropositive type, men suffer half as often, as well as older people (especially men). The first signs of rheumatism appear at the age of 35-40, when the immune system begins to malfunction due to hormonal imbalance and stress. Small joints of the upper extremities are affected, then, due to the spread of the disease, larger joints and internal organs are involved. Limited mobility plus constant pain brings inconvenience and loss of work. Many patients become disabled for life.
Attention! At the first signs of pain in small joints, contact a rheumatologist or arthrologist and get tested for rheumatic factor. If this factor is not detected, do not stop, consult an endocrinologist + immunologist to find out the cause of joint pain.
The symptomatic picture of seropositive rheumatoid arthritis consists of pain, limited motor function of the affected joints, deformation of the articular structure, as well as the presence of rheumatoid factor in a biochemical study, which is carried out after examining the patient in an outpatient or inpatient setting. Pain in the joints of the locomotor system is completely different, it depends on the degree of damage and the titer of antibodies in the blood. The peak of the pain syndrome occurs in the morning, and then, as the process becomes chronic, it is constantly present. If the cardiovascular system is involved in the process, pain occurs in the heart. They are constantly sharp.
Damage to the connective tissue of vascular ramification leads to the development of vasculitis, that is, inflammation of the vascular walls. Arteries, veins, capillaries completely change their structure, they become impenetrable due to sclerosis. This pathology gives rise to metabolic disorders. Patients with a seropositive type of rheumatism suffer from lung diseases, namely fibrosing alveolitis, inflammation of the pleura, and interstitial fibrosis. These pathologies are expressed in deep shortness of breath and a constant dry cough. If a viral or microbial infection occurs, immediate hospitalization is required.
Seropositive rheumatism affects all internal organs. In the liver, spleen, pancreas, kidneys, and intestines, rheumatoid plaques develop, sclerosis appears, which leads to cirrhosis, obstruction of the intestinal walls, imbalance of nutrients, and persistent glomerulonephritis. Certain groups of lymph nodes become inflamed, increase in size, and are painful on palpation. Digestion is completely disrupted: constipation is replaced by persistent diarrhea. Over time, urolithiasis + kidney failure may develop. The anatomical shape of the affected joints or organs is completely changed.
Joint disease in the presence of a seropositive rheumatic factor progresses in several stages, which are characterized by alternating damage to systems and organs. These stages can smoothly transition to each other or develop rapidly, without adhering to these stages of etiology and pathogenesis.
Stages of development of seropositive rheumatism:
Brief description of processes
Rheumatoid arthritis is a systemic inflammatory disease. The synovial membrane of the joint is affected, with subsequent erosive and destructive effects on the joint itself.
There are many reasons for the development of the disease, but genetic predisposition also plays an important role. Statistics indicate that the disease is more common in women (closer to old age).
The disease develops gradually and slowly. Characteristic signs practically do not appear in the first months. This complicates early diagnosis and, when pain, stiffness, and swelling of the joints occur, forces a differential diagnosis to be made - to reject diseases with identical symptoms.
Most often (about 10% of patients), at the very beginning the disease is diagnosed as mono- or oligoarthritis of large joints. And only later the affected area is detailed.
According to statistics, approximately 1% of the population of the entire planet has this disease. Mortality is quite low. Thus, about 0.01% of patients die from rheumatoid arthritis. However, it often leads to severe disability and complete loss of ability to work. Almost 70% of patients become disabled several years after diagnosis. Women get sick several times more often than men. The disease develops mainly during menopause in women and by the age of 60 in men.
Most often the small joints of both hands are affected. Then the process moves on to the middle groups of joints. Large joints are involved in the process very rarely.
The etiology of this disease is still unknown. There are many different theories, but none of them have been confirmed by research.
It is believed that, like any autoimmune disease, rheumatoid arthritis occurs against the background of a hereditary predisposition. That is, if one of the parents had this disease, then the children also have the prerequisites for its development.
In addition, there are factors that contribute to exacerbations:
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[/tie_list]It turns out that the onset of the disease occurs at the moment when the corresponding virus enters the body of a predisposed person. Then each exacerbation is provoked by unfavorable factors. It is worth saying that arthritis does not always develop, even in the presence of a viral infection in a predisposed person.
In rheumatoid arthritis, antibodies attack your own body and primarily the joints. The following processes occur sequentially in them:
Depending on what is found in peripheral blood during its analysis, the following types are distinguished:
[/tie_list]Rheumatoid factor (RF) is the name given to class G immunoglobulins, to which antibodies arise in RA. It is found in the blood in approximately half of the cases; it is always present in the synovial fluid.
Antibodies to cyclic citrulline peptide (ACCP) are formed when the concentration of citrulline in the blood increases. This happens in almost every RA patient.
In order to understand why rheumatoid arthritis should be treated on time, you need to know about the stages of its development.
There are clinical and radiological stages, as well as functional classes of the disease.
Clinical stages depend on the subjective manifestations of the disease:
[/tie_list]In addition, there are 4 stages of rheumatoid arthritis, depending on what X-ray signs of the disease are present in the patient at the moment:
The most common extra-articular diseases are:
[/tie_list]All of these diseases are of an inflammatory or dystrophic nature.
The symptoms of rheumatoid arthritis are:
[/tie_list]In addition, there is a sign that allows you to distinguish rheumatoid arthritis from other types of arthritis, namely: morning stiffness. This is a violation of mobility in the affected joints in the morning after waking up. It disappears on its own.
These symptom complexes are characteristic of the typical course of the disease. In addition, there are atypical forms that significantly complicate diagnosis, but are rare. These include:
It is worth remembering that rheumatoid arthritis is an autoimmune disease, which is why it is characterized by intoxication syndrome. It manifests itself in:
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Kidney damage manifests itself in the form of lower back pain and difficulty urinating. At the same time, nocturnal diuresis increases, and the urine becomes cloudy. Visual disturbances, pain and a burning sensation in the eyes are also possible.
First of all, the patient's blood is taken for rheumatoid factor. This study is not very accurate, but it is the cheapest and safest. Even if the result is negative, the presence of RA cannot be excluded, since it exists in a seronegative form.
As an analogue of a blood test for RF, you can perform the same analysis, but on synovial fluid. The procedure is quite traumatic, since it requires penetrating deep into the joint with a special needle. In RA, antibodies are found in the joint fluid in 100% of cases, so the analysis is very accurate.
In addition to laboratory diagnostics, an important method is x-ray examination of the affected joints. It allows not only to establish a diagnosis, but also to determine the x-ray stage of the disease.
X-ray examination can be supplemented with magnetic resonance imaging. If an x-ray allows you to see only the bone and joint space, then an MRI clearly shows the joint itself and all the tissues surrounding it. This greatly simplifies diagnosis.
If the disease has been progressing for a long time and has more than the third clinical stage, a symptom characteristic of RA occurs - ulnar deviation. This is a change in the hand in which the fingers become forced outward from the main axis of the hand. This symptom is called "walrus flippers." In addition, the fingers can be bent or extended at the phalangeal joints, this change is called the “swan neck”.
During pregnancy, exacerbation of this disease does not occur often. The fact is that in this position, the woman’s body begins to produce fewer antibodies, which reduces the manifestation of all autoimmune reactions. However, sometimes exacerbations still occur.
Treating rheumatoid arthritis during pregnancy is a very difficult task. Most anti-inflammatory drugs should not be prescribed in the first two trimesters, and cytostatics are strictly prohibited throughout pregnancy. In the third trimester, you can take small doses of glucocorticosteroids. It is better to choose aspirin from NSAIDs.
In addition, pregnancy puts a lot of stress on the musculoskeletal system, which affects the condition of the joints. Carrying a child is especially dangerous for those who have developed arthritis in the joints of the legs.
After childbirth, RA usually worsens. Then the woman is prescribed a full range of treatment, but she will have to stop breastfeeding.
Rheumatoid arthritis has a poor prognosis. It is very rarely fatal, but often causes disability. If you adhere to the prescribed treatment, you can maintain physical activity into old age. However, it is worth remembering that all drugs have side effects, which is why patients with RA are often treated for many concomitant diseases.
In addition, extra-articular manifestations of arthritis lead to the death of patients in 10-15% of cases. According to statistics, this disease is not a cause of death, but can reduce life expectancy by 5-7 years.
The doctor must determine the prognosis of the disease for each individual patient. It depends on the degree of RA activity, on the time elapsed from the onset of the disease to seeing a doctor, as well as on the presence of concomitant pathology. Rheumatoid arthritis is not always a death sentence. Currently, research is underway on various drugs that may be able to effectively treat rheumatoid arthritis in the future.
Arthropathy is a term used to describe various joint lesions that occur against the background of other diseases and occur in both children and adults. Their causes can be infections, inflammation, metabolic disorders and much more.
They have one thing in common - such pathology never occurs on its own, but is always secondary and is a manifestation of some other disease. Moreover, you may not even be aware of the presence of the latter, and joint problems will be its first manifestation. The mechanisms of arthropathy will also vary depending on what exactly triggered it.
Arthropathy is secondary destruction of joints against the background of other pathologies and painful conditions. It is able to begin its development in case of allergic reactions, various diseases associated with infections, endocrine system disorders, pathologies of chronic internal organs, metabolic disorders, and nervous system disorders.
The reliable reasons for the development of reactive inflammation of the joints are still unknown. It is believed that joints become inflamed due to an abnormal response of the immune system to pathogens entering the body.
The underlying cause of the disease is an infection of the joints. As a result of improper functioning of the immune system, joint tissues are perceived as foreign. Antibodies are released that attack cartilage and tendons. Some people are particularly susceptible to reactive arthritis due to the increased sensitivity of the immune system to pathogens. Typically, the disease develops from two weeks to 1 month after infectious diseases of the genitourinary system, intestines or respiratory system.
The most common microorganisms that cause reactive arthritis are:
According to statistics, arthropathy most often occurs after chlamydial infection.
As a rule, reactive arthritis develops a month after a genitourinary, intestinal or respiratory infection. The disease affects one or more large joints of the legs (usually the knee, ankle, metatarsophalangeal joint of the big toe). The spine, muscle tendons, and joint capsules are often affected. Sometimes neighboring joints are involved in the process.
The defeat is accompanied by the following symptoms:
The disease is not accompanied by significant changes in articular structures. Arthropathy is often accompanied by lesions of the skin and mucous membranes with the appearance of autoimmune inflammation on the mucosa without pronounced symptoms. Most often the eyes, urethra, tongue, and gums are affected. Keratoderma (painless wart-like growths) may form on the skin. In most cases, growths form on the feet and hands. Sometimes the nails are involved in the process, they become thickened, yellowish and brittle.
Reiter's syndrome (a special form of reactive arthritis) is characterized by a triad of symptoms: arthritis, conjunctivitis and urethritis. Sometimes keratoderma is associated. Symptoms appear 2-4 weeks after an infectious disease.
Joint pain occurs due to an allergic reaction. Arthropathy can develop almost immediately after contact with the allergen, or several days later. The diagnosis is made on the basis of characteristic allergic symptoms: the presence of fever, skin rash, lymphadenopathy, broncho-obstructive syndrome, etc. Blood tests reveal hypergammaglobulinemia, eosinophilia, plasma cells and IgG antibodies. The symptoms of arthropathy disappear after desensitizing therapy.
Reiter's syndrome is a triad that includes damage to the organs of vision, joints and the genitourinary system. Most often, the cause of development is chlamydia; less commonly, the syndrome is caused by salmonella, shigella, yersinia, or occurs after enterocolitis.
Persons with a hereditary predisposition suffer. Typically, symptoms appear in the following sequence: first - acute genitourinary infection (cystitis, urethritis) or enterocolitis, soon after this - eye damage (conjunctivitis, uveitis, iridocyclitis, retinitis, keratitis, iritis) and only after 1-1.5 months - arthropathy . In this case, eye symptoms may appear within 1-2 days, be mild and go unnoticed.
Arthropathy is the leading symptom of Reiter's syndrome and is often the first reason for seeking medical help. Typically, asymmetric arthritis affects the joints of the lower extremities: ankles, knees and small joints of the foot. In this case, the joints, as a rule, are involved in the inflammatory process sequentially, from bottom to top, with an interval of several days.
A patient with arthropathy complains of pain that worsens at night and in the morning. The joints swell, local hyperemia is noted, and in some patients effusion is detected. Sometimes pain occurs in the spine, sacroiliitis develops, heel bursitis is possible with the rapid formation of a heel spur and inflammation of the Achilles tendon.
Arthropathy often appears against the background of various pathologies that are associated with infections and parasites. When a person has suffered from Lyme pathology, brucellosis and trichinella, he develops flying arthralgia. Rubella occurs in combination with symmetric polyarthritis. And arthropathy in combination with mumps is similar to rheumatoid arthritis. The following signs are observed:
From chicken pox, mononucleosis with infections, arthropathy appears, which is an unstable arthritis. It quickly disappears if the symptoms of the main pathology disappear.
Artopathy accompanied by meningococcal infection is observed a week after the development of the pathology. Most often this is accompanied by monoarthritis of the knee joint, but sometimes polyarthritis of large joints appears. Viral hepatitis also provokes the appearance of arthropathy, while the pathology manifests itself as arthralgia or volatile arthritis, joint damage occurs symmetrically. Artopathies make themselves felt at the beginning of the development of the disease, when there is not even jaundice.
HIV infections are accompanied by various signs of joint disorders:
If the underlying disease is treated, then the signs of the affected joints disappear.
This is a rheumatological disease, which is characterized by the deposition of calcium pyrophosphate dihydrate in the joint cavity.
Pyrophosphate arthropathy is divided into three forms.
It is unknown why pyrophosphate arthropathy appears in the human body; for this reason, there is no prevention as such. The big plus is that even the most severe form of the disease – genetic pyrophosphate arthropathy – does not threaten the patient’s life.
Comprehensive treatment of arthropathy should begin as soon as the diagnosis has been established. Conducted in two directions:
Antibiotics are prescribed to destroy infectious agents that provoke the progression of pathology in children and adult patients.
The duration of treatment is 7 days. Drugs of choice:
The standard treatment plan also includes the following medications:
Since the disease develops secondary, it is important to treat the underlying pathology. Therefore, the basic treatment plan can be supplemented by:
Treatment of arthropathy is long-term. It is usually carried out on an outpatient basis and only in severe cases is the patient hospitalized in a hospital.
Osteomyelitis is a disease that includes inflammation of the bone (ostitis), periosteum (periostitis), and bone marrow (myelitis). The route of infection into bone tissue can be hematogenous (with blood flow). This type of bone osteomyelitis is more common in childhood and adolescence. Hematogenous osteomyelitis usually develops after infections (otitis media, sinusitis, measles, scarlet fever, caries, pneumonia). There are 3 possible forms of the process: septic-pyemic, local, adynamic (toxic).
Exogenous entry of infection is possible - from the external environment. This is observed in open injuries with damage to bone tissue, gunshot wounds, after surgery on bones using metal structures (post-traumatic osteomyelitis) and when the inflammatory process moves from soft tissue to bone (contact), this occurs with an abscess and phlegmon. Let us consider in detail how osteomyelitis is treated, what kind of disease it is, and how to recognize it.
The causative agents of hematogenous osteomyelitis are most often streptococci and staphylococci. With the post-traumatic development of infection, it can be a combination of microorganisms, often Pseudomonas aeruginosa, Escherichia coli.
Factors contributing to the development of osteomyelitis:
According to the variants of the course, acute, chronic, fulminant, protracted, and also primary chronic osteomyelitis, including atypical forms, are distinguished. These include Brody's abscess, Ollier's albuminous osteomyelitis, Garre's sclerosing osteomyelitis, and antibiotic osteomyelitis.
Based on the localization of the process, osteomyelitis of tubular, flat, and mixed bones is distinguished. Osteomyelitis of tubular bones is divided according to location into diaphyseal, metaphyseal, epiphyseal, mixed (metaphyseal, etc.), total.
There are general and local symptoms of osteomyelitis. General manifestations are nonspecific, they are caused by bacteremia. These are chills, increased body temperature, tachycardia, weakness, fatigue, decreased performance, and drowsiness.
After a few days, local signs of osteomyelitis appear in the affected area: redness of the skin, swelling, local rise in temperature, limitation of movements, pain, a feeling of bursting inside the bone in the affected area. The pain syndrome increases with movements and tapping on the bone.
Later, fistulas with purulent discharge appear. After the fistula breaks through, pain and other signs of inflammation decrease. In chronic osteomyelitis, the presence of old fistula tracts can be seen.
Atypical forms differ in their characteristics. Brody's abscess is characterized by a poor clinical picture. This form of osteomyelitis develops with good immunity. Localization of the pathogen is formed by encapsulating an intraosseous abscess. Pain is detected when the bone is tapped. The X-ray picture is specific - periostitis is weakly expressed, a cavity is found in the bone.
In albuminous osteomyelitis, the soft tissue around the bone becomes saturated with fibrin. Radiologically, the picture of periostitis is not clearly expressed; fibrinous deposits are detected.
Antibiotic osteomyelitis occurs when antibiotics are taken irrationally. The concentration of the drug is insufficient to destroy the microbe. It is encapsulated. The clinic is sluggish, asymptomatic.
With sclerosing osteomyelitis, a subacute onset is noted, with an increase in temperature to subfebrile levels. Periods of remission are followed by exacerbation. Sclerosis of the bone marrow canal occurs, which is confirmed by x-ray.
In addition to examining the patient, questioning complaints, and ascertaining the medical history, laboratory examinations (CBC, urine, blood biochemistry), and radiography are carried out.
A blood test reveals an increase in the level of leukocytes, a shift in the leukocyte formula to the left, and an increase in ESR. These changes are characteristic of inflammation.
X-ray changes do not appear immediately. They are delayed by 10–14 days compared to the clinic.
Chronic osteomyelitis of the tibia on x-ray
An x-ray can identify signs of periostitis, osteoporosis of bone tissue, and sequestration. Against this background, there may be a pathological fracture.
In addition to radiography, there are more accurate diagnostic methods that can detect pathology at an early stage. These are CT and MRI. Moreover, computed tomography can only show the layer-by-layer structure of bone tissue, while MRI, in addition to this, will also give an idea of the condition of the soft tissues. MRI is the method of choice for diagnosing osteomyelitis.
An additional examination method is ultrasound, which allows one to determine the presence of purulent leaks, fistulas, the condition of the periosteum, and blood circulation.
When performing fistulography, a contrast agent is injected into the fistulous tract and pictures are taken. Thus, it is possible to identify the true size and direction of the fistula.
Radionuclide diagnostics is a modern, expensive research method for osteomyelitis. It is based on the ability of radioactive drugs to accumulate in the lesion of bone tissue.
After confirming the symptoms of osteomyelitis with the data of instrumental examination methods, treatment begins.
Treatment of osteomyelitis is carried out in an inpatient setting at a specialized department (trauma, surgery), follow-up treatment is possible on an outpatient basis. The patient must be provided with adequate nutrition containing sufficient amounts of proteins, fats, carbohydrates, vitamins and minerals.
A set of measures is used, including conservative and surgical treatment. Let's consider conservative methods.
Antibiotic therapy - broad-spectrum drugs are prescribed. Lincomycin has the ability to penetrate bone tissue. It is the drug of choice in the treatment of osteomyelitis. In severe cases of the disease, a combination of 2-3 drugs is used.
If there is such a possibility, then the sensitivity of the causative agent of osteomyelitis to various antibiotics is determined and treatment is carried out taking this into account. It is better to use the injection method of administering antibiotics (intravenous, intraarterial, intramuscular). It is more effective compared to taking tablet forms. Intraosseous administration of drugs during surgery is also used.
Immobilization of the damaged area. For this purpose, a plaster splint is applied. Creating immobility of the affected area helps reduce inflammation.
Normalization of microbial flora. To do this, in parallel with taking antibacterial drugs, Bifiform, Linex and other drugs that restore intestinal biocenosis are prescribed.
Plasmapheresis, hemosorption, ultraviolet or laser irradiation of blood are carried out to stimulate the body's defenses and remove toxins.
Stimulation of immunity (Polyoxidonium, T-activin).
Drugs that improve blood supply to tissues (Trental, Pentoxifylline).
Treatment of the wound with antiseptics (Chlorhexidine, Dioxidine, Hypertonic solution), wound healing agents (Panthenol), enzymes.
Treatment of concomitant diseases (diabetes mellitus, malnutrition, metabolic, vascular disorders).
The abscess is opened surgically, washed, drained, sequestered, purulent leaks are removed, and fistulas are excised. Bone perforation (osteoperforation) is performed in several places, and the bone marrow canal is washed with antiseptics.
This helps to decompress the medullary canal, reduce pain, improve blood supply to areas of inert tissue, and stimulate bone tissue regeneration. Replenishment of the bone defect is carried out by performing osteosynthesis with an Ilizarov apparatus, filling of bone tissue, and autotransplantation of its fragments.
After the acute process has subsided, exercise therapy and physiotherapy (magnetic therapy, phonophoresis, electrophoresis, ultrasound, radon baths) are prescribed during the rehabilitation period.
If treatment is not started in a timely manner or is incorrect, complications may develop, leading to disability or even death of the patient. They can be local or general.
Amyloidosis of internal organs (usually kidneys), developing as a result of a long course of the infectious process. Preventing the development of complications is to seek medical help early. It is necessary to promptly diagnose and properly treat the disease.