In fact, arthritis is a collective term that covers about 100 joint diseases, including systemic lupus and gout. In the medical reference book, you will find the following definition of this disease - inflammation of the inner lining of the joint, which is accompanied by pain and stiffness of movement.
Unfortunately, in our country there are no statistics on the prevalence of this disease, but we can provide data collected in the USA. There, about 40 million people suffer from this inflammatory disease, and every 4th case leads to disability.
Our doctors claim that joint inflammation is diagnosed in 60% of patients who seek help after the age of 65. However, the real figure is much higher because it does not take into account those who try to treat themselves at home.
Like any other disease, the signs of arthritis can be recognized at the initial stages, because everyone knows that the sooner you start treatment, the greater the chances of getting rid of the disease once and for all. It should also be noted that the symptoms directly depend on the type of this disease.
Speaking about arthritis, we cannot ignore such an important issue as the degree of development of the disease. Regardless of the cause of the disease and its type, doctors distinguish 4 degrees.
At this stage, the infection spreads inside the body. Primary symptoms are quite mild and cause confusion rather than concern. The X-ray shows the first signs of thinning of the bones. Depending on the location, signs may vary.
Hands. The “leather glove” syndrome is pronounced in the morning. It is difficult for a person to perform work that requires the use of fine motor skills: fastening a button, turning a tap, threading a needle. As a rule, such sensations disappear by lunchtime.
Foot. It is difficult for a person to bend and straighten the ankle. One of the most important signs is swelling, which makes it impossible to comfortably wear almost any shoe.
Knee and shoulder. The appearance of mild, insignificant pain during physical activity, which disappears almost immediately at rest.
This stage is characterized by a progressive increase in bone erosion, along with further thinning of the bone tissue.
Hands. A crunching and crackling sound is heard when flexing/extending the hand and fingers, swelling around them is clearly visible. There is pain when using the hands and fingers.
Feet. Pronounced swelling in the ankle area. The skin in this area becomes red and hot. Movements are significantly difficult, especially in the morning, and a characteristic crunching sound can be heard. Severe pain appears that does not subside even at night, especially if we are talking about gouty arthritis. If the cause of the disease is psoriasis, then a curvature of the big toe is possible.
Knee and shoulder. Severe limitation of maneuverability: it is difficult to sit down or stand up, get a book from the top shelf, and so on. Symptoms appear more clearly in the morning, then the person “paces” and becomes lighter. Obvious swelling and redness at the site of the inflammatory process.
The x-ray clearly shows the deformation of the joints, the lack of permanent fixation and its tension. Grade 3 is an indication for disability, since in most cases patients lose their ability to work, and in some cases even the ability to self-care.
Hands. Absolute curvature of fingers and hands on both hands. Movements are very constrained. Severe pain that intensifies after a period of rest.
Foot. Complete deformation of the ankle, almost complete loss of mobility.
Knee. The pain is so severe that it causes muscle spasms. Gradual fixation of the joint in an incorrectly curved position.
Shoulder. The ability to move the arm is almost completely lost. Shoulder movements are accompanied by characteristic clicks. Pain is felt even with mild palpation.
Irreversible changes in bone and cartilage were revealed. Absolute helplessness of the patient. Complete disability.
Whatever joint of the body is affected by arthritis, stage 4 leads to complete immobility. At the same time, the painful sensations do not go away, and the person can no longer live without painkillers.
As you can see, time is of the essence in the fight against this disease. And if at stage 1 you can get rid of almost any type of arthrosis of the joints, at stage 2 it can be slowed down or even stopped, then at stages 3 and 4 doctors are practically powerless to do anything.
The main diagnostic tools in this case are x-rays and laboratory tests, which include not only a blood test, but also a cystological and bacterial analysis of synovial fluid from the affected joint. In addition, for such a patient it is mandatory to consult a rheumatologist, who will rule out the presence of autoimmune diseases.
Using an x-ray, you can determine not only the degree of development of the disease, but also its type, since each type of arthritis gives its own specific picture.
X-rays help to see joint damage, inflammatory processes in bone and cartilage, including thinning and other degenerative changes, and possible pathological neoplasms.
When the knee joint is affected, arthroscopy is often used, which involves examining the cartilage and soft tissue around the joint. Often this method is combined with a biopsy (a laboratory study of the affected tissue and joint fluid). Contraindications for such procedures are acute arthritis, as well as sensitivity to iodine-based drugs.
Also often used as an examination method is the method of determining the amplitude of active/passive movement, as well as recording individual phases of a step (podography).
Diagnosis is carried out in a laboratory under the strict guidance of a rheumatologist.
A disease in which the patient's finger joints begin to ache is called arthritis. This pathology occurs quite often; women are more susceptible to its occurrence, since they are more often engaged in small manual labor. Arthritis of the arms (hands) is a serious pathology that can lead to social disability of the patient due to cosmetic defects and the inability to perform usual work.
Every person needs to know how arthritis and arthrosis of the hands manifest themselves and its treatment in order to avoid serious complications in the future. Timely treatment will help avoid complete destruction of the joint and disruption of its function, so at the first symptoms of the disease you should immediately consult a doctor.
Arthritis of the hands (hands) is an inflammatory disease that usually occurs against the background of other concomitant pathologies, most often infectious and rheumatic pathologies. The disease develops gradually and manifests itself mainly in old age, the fingers swell and begin to hurt.
Pathology can develop at a young age, but this is rare. Usually the disease is associated with a hereditary predisposition, as well as with heavy loads on the joints. It was noted that arthritis of the finger joints often occurs in basketball players, volleyball players, tennis players, and other athletes who constantly work with their hands.
Many patients are interested in the difference between arthritis and arthrosis of the hands, because the disease has very similar symptoms. Osteoarthritis is much less common than arthritis, as it is associated with degenerative changes in the tissues of the joint. With arthritis, the cause of pain is an inflammatory process in tissues caused by other pathologies.
Osteoarthritis usually affects joints that undergo great physical stress, these are in most cases the ankle, knee and hip. Arthritis often occurs in a variety of places, and if left untreated, it spreads to neighboring joints.
Another question that often comes up in the doctor's office is whether arthritis can be in one finger. The disease can affect one or several joints; most often, the pathology develops in one joint, but if left untreated, the disease spreads to neighboring ones.
Let's look at how arthritis of the wrist begins. Pathology can manifest itself in different ways, depending on its type. Thus, rheumatoid arthritis of the hands is characterized by symmetrical damage to the joints on both hands, and the joints at the base of the fingers begin to hurt.
Signs of arthritis in the fingers due to gout appear in sudden attacks. In this case, the pain appears suddenly, the finger becomes very swollen and red, and after a few days the symptoms of the disease disappear on their own.
Symptoms of hand arthritis with psoriasis also differ. In this case, the pathology affects the entire finger with a cavity, it swells and becomes like a sausage. In addition, the disease can affect one hand, or both at once, but not symmetrically, as with gout.
The first signs of arthrosis and arthritis of the hand joints often go unnoticed. At first, slight restrictions in movements may appear, which disappear during the day, then mild pain begins to bother you. Typically, patients consult a doctor only when the pain becomes severe, or even unbearable.
Symptoms of hand arthritis can manifest themselves to varying degrees, depending on the type of pathology and stage of the disease, but a number of general symptoms characteristic of this pathology can be identified:
Bumps on the fingers with arthritis and arthrosis are called Heberden's nodes; they are usually painless, but pain can occur with large bumps when the soft tissue surrounding them is injured. Such bumps usually do not require special treatment if they do not cause pain.
Rheumatoid arthritis of the hands can also cause lumps to form under the skin, but in this case the tumor is not always associated with Heberden's nodes. A lump may appear due to inflammation of a blood vessel; such a pathology requires mandatory consultation with a doctor.
Also, patients often mistake swelling of the finger for a bump; in this case, the joint greatly increases in size, turns red and hurts. This often occurs with gouty arthritis, during an exacerbation.
Only a doctor can correctly diagnose hand arthritis, compare symptoms and prescribe treatment, so at the first signs of pathology you should immediately consult a general practitioner, and the therapist, if necessary, will refer you to a rheumatologist. To quickly identify pathology, the patient can look at a photo of a hand with rheumatoid arthritis.
Treatment for hand arthritis is prescribed after passing the following tests:
The doctor will also conduct an external examination of the patient, collect anamnesis and listen to complaints. In most cases, a preliminary diagnosis can be made after the initial examination of the patient.
Treatment for arthritis of the wrist and hand is always comprehensive. It is necessary not only to eliminate the symptoms of the disease, but also to identify and treat the cause of its occurrence. Therefore, treatment of finger arthritis always begins with identifying concomitant pathologies and visiting specialized specialists.
Arthrosis or arthritis of the hands requires reducing the load on the joints during an exacerbation, so patients are prohibited from doing minor work or typing at a computer. To relieve pain and inflammation, medications and physical therapy are prescribed. Diet, therapeutic exercises, and massage also play an important role.
Treatment of arthritis of the hand joints should be carried out under the supervision of a rheumatologist. After testing, patients are prescribed medication, depending on the type of disease.
The following medications are used for arthritis:
Also, to relieve pain and inflammation, the use of external agents is prescribed, these can be ointments with a non-steroidal anti-inflammatory drug, for example diclofenac, nise, as well as compresses with dimexide, traditional medicine recipes.
Nutrition for rheumatoid arthritis of the hands should be balanced and low in calories. It is recommended to eat at least 5 times a day in small portions, exclude spicy, salty, sweet and fatty foods from the diet, and also not eat fast food.
If a patient has been diagnosed with gouty arthritis of the wrist, he will have to give up foods that contain a large amount of purines, mainly red meat and offal, fish and legumes.
Treatment of arthritis of the joints of the hand is also carried out with the appointment of physical therapy. Exercises are necessary to develop the joint, strengthen the muscles, and also improve blood circulation in the tissues and nutrition of the joints.
Gymnastics are prescribed after inflammation and pain have been relieved; if the joint is still swollen and painful, exercises can only do harm. Physical activity during an exacerbation provokes rapid destruction of the joint.
You can perform gymnastics for hands with arthritis from a video, but before the first workout you need to consult with a specialist, he will tell you when you can start training and what exercises are suitable in a particular case.
An example of exercises for doing hand exercises for arthritis:
It is very important to perform gymnastics correctly for rheumatoid arthritis of the hands, so as not to harm the joints. The patient should do all exercises slowly, carefully, and do not put too much strain on the sore hand. If pain appears during the exercise, it is better to pause the gymnastics and reduce the load during the next workout.
To make the treatment of rheumatoid arthritis of the hands as effective as possible, it is recommended to massage daily. During an exacerbation, it is necessary to massage the skin around the joint without affecting the painful area. The procedure will help improve blood circulation and tissue nutrition, thus accelerating joint recovery.
As soon as the inflammation passes, you can massage the area around the joint; massage after gymnastics and therapeutic baths is especially effective. It is very important to perform the procedure carefully; you should not knead your sore hands too much or put pressure on the affected joints, and you can use a rich nourishing cream or massage oil to moisturize the skin.
Many patients are interested in how to cure arthritis of the hand at home using traditional medicine recipes. Folk remedies can be used as an addition to the main therapy, but alone they will not help get rid of the pathology, but only temporarily alleviate the symptoms.
Arthritis of the wrist is treated with the following recipes:
We looked at how hand arthritis manifests itself. The disease is chronic and it is completely impossible to cure it, but with timely consultation with a doctor, it is possible to achieve stable remission and prevent complete destruction of the joint. In this case, the prognosis is quite favorable, the patient can take care of himself for the rest of his life, and does not become disabled.
Arthritis of the hands and phalanges of the fingers can be prevented by leading an active lifestyle and preventing the development of infectious and endocrine pathologies. If the patient constantly performs monotonous work. It is recommended that he give his fingers time to rest during the day, and in the evenings take baths with salt or decoctions of injuries, massage his hands to improve blood circulation in the joints and prevent their destruction.
According to statistics, people with rheumatoid, gouty and some other types of arthritis are much more susceptible to developing arterial hypertension than healthy people. High blood pressure, in turn, significantly increases the risk of heart attacks, strokes and other serious diseases. Therefore, the prevention and treatment of hypertension in patients with arthritis is so relevant today.
People suffering from chronic inflammation of the joints need to regularly monitor their blood pressure, making sure that it does not exceed the permissible limit (140/90 mmHg). To do this, it is necessary not only to follow the doctor’s recommendations and take all prescribed medications, but also to lead a healthy lifestyle with arthritis. A balanced diet, proper regimen and adequate physical activity will help avoid the development of arterial hypertension, slow down the progression of arthritis and significantly improve a person’s well-being.
Recently, many studies have been conducted that examined the effect of chronic joint inflammation on blood pressure. To date, it has been established that arterial hypertension in patients with rheumatoid arthritis is much more common than in the general population. Moreover, the likelihood of an excessive increase in pressure directly depends on the activity of the pathological process in the joints. Therefore, the more severe the form of arthritis a person has, the higher the likelihood of developing arterial hypertension.
The presence of both hypertension and deforming osteoarthritis (osteoarthritis) in elderly people significantly accelerates the progression of both diseases. This combination very often leads to calcium metabolism disorders and the development of osteoporosis. Therefore, replacement therapy (calcium supplements) is recommended for people with hypertension and osteoarthritis.
As you know, non-steroidal anti-inflammatory drugs and corticosteroids are used to treat most arthritis. When used systemically, these drugs slightly increase blood pressure. Long-term treatment with these drugs can lead to the development of arterial hypertension.
The mechanism of action of angiotensin-2.
In addition, regular pain and chronic inflammation contribute to increased blood pressure in patients with arthritis. The latter leads to disruption of the normal functioning of the vascular endothelium, which contributes to the development of atherosclerosis. Damaged endothelium tends to synthesize excess amounts of angiotensin-2, a substance that increases blood pressure.
As a rule, arterial hypertension develops with a long course of rheumatoid polyarthritis. Chronic inflammation and regular use of NSAIDs (Diclofecac, Ibuprofen, Indomethacin) contribute to the development of this pathology. Methotrexate (a drug widely used to treat rheumatoid arthritis) reduces the risk of cardiovascular disease.
This disease mainly affects older people. They most often affect the hip, knee, elbow and other large joints. This, in turn, leads to limitation of physical activity. It is difficult for a person to walk, work, or perform usual activities. An inactive lifestyle contributes to the development of coronary heart disease and hypertension. Therefore, people with osteoarthritis are much more likely to suffer from cardiovascular pathology.
Rheumatism is a systemic inflammatory disease in which rheumatic carditis very often develops.
In acute rheumatic arthritis, blood pressure may increase due to severe intoxication. However, inflammatory damage to the heart muscle is more dangerous for humans. This can lead to heart failure, acquired heart defects and other serious complications.
The main cause of hypertension in this disease is persistent hyperuricemia - an increase in the level of uric acid salts in the blood. According to scientific research, this factor leads to increased blood pressure in almost half of people suffering from this disease.
Causes of hypertension in gout:
The main measure in the prevention of arterial hypertension is the judicious use of medications. Treatment must be carried out under the strict supervision of a doctor, and any pharmaceuticals should be taken only with his permission. Among non-steroidal anti-inflammatory drugs, preference should be given to selective COX-2 inhibitors - they are safer and much less likely to cause any side effects. These drugs include Meloxicam, Celecoxib, Xefocam.
It must be remembered that timely treatment of arthritis can significantly reduce the risk of developing hypertension. Therefore, measures such as following a diet for gout, avoiding hypothermia for rheumatoid arthritis and intense physical activity for osteoarthritis are so important.
To correct blood pressure, patients with arterial hypertension and arthritis should take drugs from the group of calcium antagonists or angiotensin-converting enzyme inhibitors. The first include Amlodipine, Verapamil, Diltiazem, Nifedipine. The most well-known ACE inhibitors are Enalapril, Captopril, Lisinopril. You can start treatment with these drugs only after consulting a specialist.
To prevent osteoporosis, people with deforming osteoarthritis need to ensure that a sufficient amount of calcium enters the body. When taking calcium supplements, you should take into account the risk of developing urolithiasis. Naturally, kidney pathology will only aggravate the course of hypertension and significantly worsen the person’s condition. Therefore, preference should be given to drugs based on calcium citrate or calcium hydroxyapatite (Calcium D3 citrate, Calcimax, calcium hydroxyapatite).
Calcium in the body is necessary to maintain bone structure, normal functioning of the nervous and cardiovascular systems.
As for diuretics, it is strictly forbidden to take them if you have gout, since these drugs additionally increase the level of uric acid in the blood. In all other cases, they can be drunk only with the permission of a doctor.
Replacing a joint affected by osteoarthritis (hip, knee) significantly reduces the risk of developing heart attacks and other cardiovascular pathologies. This can be explained by a decrease in the need for non-steroidal anti-inflammatory drugs, a decrease in pain stress and a noticeable increase in motor activity. Surgery allows many people to return to a normal lifestyle.
As you already know, arthritis is a disease that causes inflammation of the joints. It can appear spontaneously and abruptly, usually indicating acute arthritis, or it may happen that the disease attacks your joints gradually, as happens in chronic forms. It is important to understand that if you pay attention to the early symptoms of arthritis in time, defeating this disease will be much faster and easier, and if the diagnosis is made in the later stages, the only thing that can be done is to slow down the destruction of the joints.
They are quite extensive. It can be:
In addition, arthritis can develop independently, or it can occur against the background of another disease. Thus, some types of arthritis can be caused by medications taken. For example, drugs used in the treatment of cancer provoke an increase in the concentration of urate in the blood, causing gouty arthritis.
Due to the widespread prevalence of the disease (about 80% of humanity of any age faces this disease), the symptoms of arthritis are already familiar to many. If inflammation of the joints has not affected you or your loved ones, then you probably have friends who suffer from this disease.
The main symptoms of arthritis include the following:
In addition to the above symptoms, a person suffering from any type of arthritis is bothered by frequent and severe pain in the joints, especially in the morning. The result is weakness, impotence, periodic aching pain, rapid and constant fatigue, insomnia, and, sometimes, fever.
Take responsibility for your health. If you suddenly notice that when you wake up, your fingers are a little swollen and not as mobile as before, their development takes more and more time, a feeling of stiffness and pain appears - this is undoubtedly arthritis!
If you feel the first signs of arthritis, consult a doctor immediately! If arthritis is not treated on time, then over time the shape of the joint will begin to deform, which contributes to the development of arthrosis. Physiotherapeutic procedures, therapeutic exercises, and drug treatment for joint inflammation will help you stop and slow down the destruction of cartilage, allow you to maintain joint movement and get rid of stiffness and pain.
Many people suffer from different types of arthritis. And as we get older, we are more susceptible to this disease, and it becomes much more difficult to treat.
Arthritis mainly manifests itself between the ages of 40 and 50, but in early and teenage years the occurrence of this disease is also no exception.
Another dangerous and negative factor of arthritis is that this disease can cause complications in the heart. Under no circumstances should you spread the disease and take care of your health!
Arthritis of the fingers is one of the most common forms of peripheral arthritis, in which the inflammatory process involves the metacarpophalangeal and interphalangeal joints. The first to become inflamed is the inner synovial membrane of the joint, then the pathological process spreads to the joint capsule, cartilage, tendons, ligaments, muscles and bones.
The primary inflammatory process usually develops against the background of infection, rheumatic or metabolic pathology, and less often due to trauma or surgery. In the case of rheumatoid arthritis, hereditary predisposition plays an important role.
Secondary arthritis of small joints, as a rule, is a complication of allergic, atopic and autoimmune conditions, common infectious diseases or an underlying somatic disease such as gout, diabetes mellitus or psoriasis. In the pathogenesis of reactive arthritis, the leading role is played by a history of tuberculosis, dysentery, hepatitis, granulomatosis, influenza, measles, mumps, scarlet fever, tonsillitis and chronic tonsillitis, borreliosis, Reiter's syndrome and sexually transmitted diseases. In children, vaccination can play a role as a provoking factor.
The likelihood of an inflammatory process in the joints of the fingers increases with frequent microtrauma of the articular structures during manual labor. The disease often occurs in tailors, seamstresses, shoemakers, watchmakers and jewelers.
Exacerbations of chronic arthritis of the fingers can be provoked by hypothermia, dampness or changes in weather, vibration, stressful situations and changes in the hormonal status of the body. Since hormonal fluctuations are more common in women, the incidence of arthritis of the fingers among them is 3–5 times higher than among men. Arterial hypertension, old age, poor nutrition, bad habits and diseases of the excretory system also increase the likelihood of arthritis.
Arthritis of the fingers has a variety of manifestations that influence the choice of therapeutic strategy and medications. Depending on the nature of the course of the disease, acute and chronic forms of arthritis are distinguished, and in the course of identifying the main etiological factors, primary arthritis of the fingers is differentiated as an independent nosological form and secondary arthritis of the fingers as a symptom complex in the clinic of concomitant infectious, rheumatic and metabolic diseases. It should be noted that secondary arthritis of the fingers is much more common than an independent disease.
Based on the number of affected joints, polyarthritis and oligoarthritis of the fingers are distinguished: in the first case, four or more small joints are involved in the inflammatory process, in the second - from two to four. Monoarthritis is extremely rare; Of these, the most common is rhizarthritis - inflammation of the first metacarpal joint.
Arthritis of the fingers is a rapidly progressing disease. Depending on the degree of joint damage, four stages of the pathological process are distinguished.
The clinical picture of arthritis of the fingers is highly variable and depends on the etiological form and stage of the disease. The early stage of rheumatoid arthritis is characterized by joint stiffness in the morning and after prolonged rest. In this case, there is a characteristic sensation of tight gloves that limit the mobility of the hand. In some cases, the patient may have no complaints at all, and the only manifestations of the disease are early radiological signs of arthritis of the fingers:
Characteristic signs of inflammation of the joints of the fingers, as a rule, are observed at stage II of the disease, starting with the appearance of painful swelling, erythema and crepitus in the affected joints, and to the radiological signs are added multiple narrowing of the interarticular spaces, cystic clearing of the bone tissue and marginal deformations of the epiphyses of the bones. Dislocations, subluxations and ankylosis of joints are detected mainly in the terminal stages of the disease.
The localization of the inflammatory process and the nature of joint deformities also have important diagnostic significance. In rheumatoid arthritis, the first signs of inflammation affect the second and third metacarpophalangeal joints and the third proximal interphalangeal joint. Later, the pathological process spreads to the distal interphalangeal joints, and then to the osteoarticular structures of the wrist, as well as the styloid process of the ulna. Joint damage is usually symmetrical. In the later stages of the disease, characteristic deformations of the hand are observed: curvature of the fingers like a “boutonniere” or “swan neck”, a spindle-shaped hand shape and ulnar deformities caused by partial dislocations of the metacarpophalangeal joints.
In the case of reactive and psoriatic arthritis, the joints are affected asymmetrically. The psoriatic form is characterized by thickening of the joints and sausage-shaped fingers. As a rule, morning stiffness is not observed; flexion functions are primarily limited.
In the reactive form of arthritis, inflammation of the joints of the fingers occurs against the background of fever, chills, headache, conjunctivitis and symptoms of infectious inflammation of the genitourinary tract.
In gouty arthritis, the metacarpophalangeal joint of the thumb is mainly affected, in the area of which elastic subcutaneous tophi nodules filled with urate crystals are formed.
In childhood, infectious and reactive arthritis is more often diagnosed, most often developing against the background of streptococcal infection. The clinical picture of arthritis of the fingers in children is more pronounced than in adults: severe pain and severe joint deformities are accompanied by severe fever and general intoxication of the body.
The rheumatoid form of arthritis in children is characterized by a persistent course and poor response to therapy. Inflammation of the joints of the fingers usually develops against the background of damage to large joints and internal organs. If it is not possible to detect the etiological factor of inflammation of the finger joints in a child, a diagnosis of juvenile idiopathic arthritis is made.
A clear clinical picture of the inflammatory process in the joints of the fingers allows one to diagnose arthritis with a high degree of confidence, however, to clarify the etiological form and stage of the disease, a number of additional diagnostic procedures will be required.
When collecting anamnesis, the doctor pays attention to the connection between the manifestations of arthritis and previous infectious diseases, metabolic and somatic pathologies, as well as exposure to damaging factors. During a physical examination, the size, shape and temperature of the joints, the color of the skin, the nature of the painful sensations, functional tests, the presence of extra-articular manifestations, etc. become a valuable source of diagnostic information. Sometimes consultations with other specialists are necessary - an orthopedic traumatologist, a dermatologist and an allergist-immunologist. Identification of characteristic changes in the joints of the fingers requires the use of instrumental techniques - radiography, MRI and CT of the hands, ultrasound of small joints.
Laboratory diagnosis plays a crucial role in determining the cause of the inflammatory response. A general blood test reliably reveals signs of the inflammatory process. During a biochemical blood test, the level of uric and sialic acid is determined, which allows you to confirm or exclude the diagnosis of gouty arthritis. High levels of rheumatoid factor and C-reactive protein, fibrinogen, seromucoid, cryoglobulins, etc. indicate rheumatoid pathology. In some cases, laboratory testing of synovial fluid punctate is indicated.
The medical strategy for arthritis of the fingers is based on a combination of pathogenetic and symptomatic approaches. During the acute phase of the disease, the main goal is to eliminate inflammation and pain. In the early stages, a course of analgesics, muscle relaxants, and non-steroidal anti-inflammatory drugs is usually sufficient, and in some cases it is possible to get by with the external use of ointments containing cyclooxygenase-1 (COX-1) blockers, painkillers and vasodilators. For infectious and reactive arthritis, antibiotics are included in the treatment regimen; in the presence of an allergic component - antihistamines, and in rheumatoid arthritis - immunosuppressants and immunomodulators.
In more severe forms of arthritis, it may be necessary to evacuate exudate from the joint cavity, followed by the administration of corticosteroids with a 1% solution of lidocaine or novocaine. Quick relief is brought by hemocorrection carried out extracorporeally - cryoapheresis, leukocytapheresis or cascade filtration of blood plasma.
After achieving remission, the therapeutic strategy focuses on normalizing trophism and local metabolism in the area of the affected joints, stimulating regenerative processes in articular structures and restoring hand functions. Individually selected combinations of physiotherapy and exercise therapy speed up the patient’s rehabilitation, helping to return to an active lifestyle as soon as possible.
When treating arthritis of the fingers, the following physical procedures have a good effect:
For persistent joint deformities, conservative treatment is ineffective. In order to prevent patient disability, arthroplasty or endoprosthetics is recommended.
Following a diet for arthritis of the fingers helps prolong remission. During exacerbations, it is necessary to abstain from protein foods - meat products and legumes, as well as salty, fried, fatty and spicy foods, chocolate, baked goods, strong tea, coffee, cocoa and alcoholic beverages. After the inflammatory process has stopped, there are fewer dietary restrictions - it is enough to avoid alcohol and limit the consumption of meat, smoked foods and heavy dishes rich in saturated fats and instant carbohydrates.
For gouty arthritis, red meat, offal and smoked foods are also strictly contraindicated. A dairy-vegetarian diet is preferable, with the exception of vegetables and fruits containing solanine. Eggplants, tomatoes, pumpkin, green onions, sorrel, rhubarb and hot peppers should be consumed as rarely as possible.
The patient’s diet must contain foods high in polyunsaturated fatty acids, easily digestible protein and vitamin C:
In case of acute infectious arthritis of the fingers, in the absence of adequate treatment, the risk of developing purulent-septic complications that threaten the patient’s life increases. A prolonged course of the disease threatens to result in irreversible deformation of the finger joints, which leads to disability of the patient. The most dangerous complications of arthritis of the fingers include osteomyelitis, osteolysis and necrosis of bone tissue, which is often followed by generalized sepsis.
Severe side effects from long-term use of non-steroidal anti-inflammatory drugs have also been reported. In some patients receiving COX-1 inhibitors in injection and oral form for a long time, cases of gastroduodenitis, enterocolitis and peptic ulcers were observed due to regular irritation of the mucous membranes of the gastrointestinal tract; Nephropathies were somewhat less common.
The outcome of arthritis of the fingers depends on the nature of the primary manifestations and etiological form, response to therapy, the patient’s age at the onset of the disease, as well as the presence and severity of concomitant pathologies. Early diagnosis and timely treatment increases the chances of recovery.
In order to prevent arthritis of the fingers, it is necessary to monitor your overall health and promptly consult a doctor if signs of infection, metabolic disorders and other pathologies appear. It is especially important to prevent the formation of chronic foci of infection, give up alcohol and control diet. Moderation in eating with a sufficient amount of vitamins and minerals in the diet reduces the likelihood of arthritis and gout; in particular, you should not abuse heavy meat and fatty foods. An active lifestyle, physical exercise and hardening help improve the condition of the joints, but injuries and hypothermia of the hands should be avoided. If you do frequent manual labor, it is recommended to take breaks every 2-3 hours and do finger exercises.
Rheumatoid arthritis (RA) is a chronic, slowly progressive systemic connective tissue disease of an infectious-allergic nature with a predominant lesion of peripheral joints. The pathological process leads to complete destruction of articular tissues, gross deformations and the development of ankylosis, which leads to loss of joint function and disability. In severe cases, at the late stage of rheumatoid arthritis, internal organs (heart, kidneys, lungs, blood vessels, muscles, etc.) can also be affected, which significantly worsens the prognosis of the disease.
Rheumatoid arthritis is classified as a group of autoimmune pathologies, that is, tissue damage is caused by a person’s own immune system, which for some reason failed and began to produce antibodies to its own cells and tissues.
In women, the disease is diagnosed 3 times more often than in men. The pathology develops in people of any age and even in children (juvenile rheumatoid arthritis), but the peak occurs at the age of 40-50 years. The prevalence of the disease is 5.2% for women and 2.5% for men. In the International Classification of Diseases, 10th revision (ICD 10), this pathology is assigned the code M05.
In RA, the immune system begins to destroy its own joint tissue instead of foreign organisms.
The causes of this type of arthritis are not fully understood. Most often you hear about the infectious hypothesis of the development of the disease. Rheumatoid joint damage is associated with the Epstein-Barr virus, rubella, herpes, hepatitis B, etc.
In recent years, the role of genetic factors in the development of rheumatoid arthritis has been increasingly discussed. Certain variants of human genes can lead to disturbances in immunological processes and an inferior immune response. A large number of predisposing factors can trigger the launch of a pathological cascade of immune reactions, which will lead to the formation of autoantibodies, including: infection, hypothermia, stress, hormonal imbalance, trauma, allergic reaction, surgery, etc.
Rheumatoid arthritis is characterized by a wide variety of clinical manifestations and laboratory findings, which creates serious obstacles in recognizing the disease. To simplify this process, there is a classification of rheumatoid arthritis, which is used to make a diagnosis, as well as draw up a treatment program and prognosis.
According to the degree of activity of the pathological process, a distinction is made between remission in rheumatoid arthritis (no joint pain, morning stiffness, ESR up to 15 mm/hour, CRP no more than 1 plus) and an exacerbation phase. Depending on clinical and laboratory data, there are 3 degrees of exacerbation of RA:
X-ray stage (changes that are revealed during X-ray examination in the affected joints):
The x-ray shows stage 4 RA
Thus, a complete diagnosis for rheumatoid arthritis may sound like this: “Seropositive rheumatoid arthritis: polyarthritis, active phase, moderate degree of activity, X-ray stage 2, functional activity –1.”
Rheumatoid arthritis can begin acutely and subacutely, with the latter type of onset observed in most cases. Signs of pathology can be divided into articular syndrome and extra-articular manifestations. Some patients may notice nonspecific complaints even before joint damage, which is called the prodromal, or latent, period.
The first signs of RA:
As a rule, such manifestations of the disease remain unattended, as they are explained by psychosomatics, life under conditions of chronic stress and overwork. Next, articular syndrome and extra-articular manifestations of the disease develop.
In 70% of patients, RA occurs as polyarthritis (simultaneous damage to more than 3 joints); oligoarthritis (inflammation of 2-3 joints) and monoarthritis (damage to 1 joint) are much less common. A characteristic feature of RA is inflammation of the small joints of the hands and feet. Less commonly, the ankle, elbow, knee joints, and wrist are involved in the pathological process; even less frequently, the hip, shoulder, and spinal joints become inflamed.
Rheumatoid arthritis stage 1, you may notice swelling of the proximal interphalangeal joints
Joint pain has its own characteristics:
Other characteristics of articular syndrome in RA:
Subsequently, the function of the inflamed joints begins to suffer (for example, the patient cannot clench his hand into a fist), and their typical deformities gradually develop:
Deformation of the hands according to the type of ulnar deviation
Muscles and ligaments also suffer. Atrophy of the muscle mass of the hands, tenosynovitis, carpal tunnel syndrome, Baker's cyst, muscle contractures and other symptoms develop.
In RA, peripheral joints are primarily affected, but we must not forget that this is a systemic disease, and any organs and tissues where connective tissue is present can be involved in the pathological process. As a rule, extra-articular symptoms appear in the last stages of the disease, significantly aggravate its course and worsen the prognosis. That is why rheumatoid arthritis is considered dangerous not only to the health, but also to the life of the sick person.
The most common extra-articular signs of RA:
Autoantibodies in RA can affect all organs where connective tissue is present
Making a diagnosis of rheumatoid arthritis is very difficult, since there is no specific marker of the disease. Therefore, diagnosis must be comprehensive and must take into account the possibility of other similar diseases.
Diagnostic criteria for RA:
The diagnosis can be considered reliable if 4 of the 7 criteria described are present, and points 1-4 must be present for at least 6 weeks.
As mentioned, there are no specific methods that can accurately confirm RA, but there are some laboratory tests and instrumental examinations that will help the doctor understand the diagnosis and exclude similar diseases.
Tests for rheumatoid arthritis can be divided into 2 categories:
The mechanism of formation of rheumatoid factor
Instrumental diagnostic methods:
Differential diagnosis of rheumatoid arthritis is an essential component of making the correct diagnosis. Most often you have to look for differences from reactive arthritis, osteoarthritis, psoriatic arthropathy, rheumatic joint inflammation, ankylosing spondylitis, Sjögren's syndrome.
Differential diagnosis of RA
The consequences of rheumatoid arthritis depend on the timeliness of diagnosis and the prescription of specific therapy, on the degree of activity of the process and its course, on the presence of damage to internal organs and compliance with all medical recommendations.
Very often, due to severe joint deformities, patients become disabled, and their quality of life is significantly reduced. In the case of extra-articular lesions, cardiac, pulmonary, and renal failure may develop, which can cause death. The risk of fatal cardiovascular events (heart attack, stroke) increases significantly.
Due to the need to constantly take hormonal drugs, non-steroidal anti-inflammatory drugs and cytostatics, severe side effects of drug therapy develop.
The main therapy for RA is medications. Other methods (physical therapy, massage, physiotherapy) are used only during the period of remission as a general strengthening therapy. It is important to remember that gymnastics is prohibited during the active phase of the disease.
Treatment can be divided into 2 stages:
Methotrexate is the main drug for basic therapy of RA
Drugs that eliminate the symptoms of pathology include:
There are several schemes for using these drugs. In each case, the doctor selects the right medicine and its dose individually.
Basic medications are used not only during exacerbations, but also during remission. They are able to both eliminate the symptoms of the disease and influence its course, prolonging the period of remission. These include:
Treatment of rheumatoid arthritis is a very difficult task, which not every specialist can do. But we must remember that through joint efforts we can take control of the disease and prevent its disabling consequences. The main thing is not to give up, follow all medical recommendations and believe in success.