Rheumatoid arthritis is a disease leading to disability and even death. It is very difficult to recover from this disease, but remission in rheumatoid arthritis is quite possible. Inflammation and damage to the joints are localized with drugs and medicines prescribed by the attending physician. In this case, diagnosis at an early stage of the disease plays a decisive role.
Arthritis is rheumatism with symmetrical changes in the joints and inflammation of the connective tissue. Quite often, joint diseases are associated with older people. But arthritis can appear at any age. Doctors have not established the reasons for the development of the disease. Possible factors influencing the occurrence of the disease include:
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Rheumatoid arthritis is considered an autoimmune disease and can affect more than just the joints. The pericardium near the heart becomes inflamed, leading to a heart attack. Rheumatoid nodules in the lungs cause coughing and difficulty breathing. Schergen's syndrome manifests itself in inflammation of the mucous membranes of the eyes and mouth. A rare complication of the disease is vasculitis. It occurs as small sores on the feet and black spots on the nails. All this shows that remission should be achieved as early as possible in order to avoid disability or death of the disease.
Understanding the word remission makes it possible to achieve it; translated from Latin it means reduction, weakening. This is a time when the patient does not have pain, stiffness, swelling, or any manifestations of the disease. The main thing for the patient and the doctor was the possibility of remission. The fact that it has occurred will be indicated by the absence of indicators, such as:
After diagnosing the disease, the doctor prescribes treatment. This includes medical intervention using steroids, anti-inflammatory and hormonal drugs, and physical therapy with therapeutic exercises. Mud and mineral baths are also not contraindicated. Giving up bad habits will improve the patient's condition. Application of all prescribed procedures and treatment will lead to long-term remission. At this time, patients feel completely healthy. When the disease recurs, symptoms return. This period is called a “rheumatoid flare”.
Early treatment of rheumatoid arthritis is successful in achieving remission.
Arthritis, especially rheumatoid arthritis, is a very serious disease because it has many paths of development and complications. It is impossible to completely recover from it, but with treatment in the initial stages, remission occurs. Therefore, when identifying the first signs of the disease, it is recommended to immediately contact your doctor. He will prescribe a diagnosis and, based on the results obtained, provide competent treatment that will help improve a person’s quality of life.
Rheumatoid arthritis is a chronic autoimmune disease of connective tissues with progressive symmetrical destructive damage to peripheral joints.
Arthritis is usually a chronic disease. This suggests that it rarely changes or is slowly progressive. The specific causes of most forms of arthritis are still unknown.
Irina Shipitsina Pro (522), voted 5 years ago
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Galina Barkhatova Guru (3702) 5 years ago
During the 6 years that my grandson has been ill, I have probably learned everything I can about rheumatoid arthritis. And they treated me with all traditional and non-traditional methods; the remission effect was short-lived. In June of this year, he was examined in Moscow at the clinic at the Academy of Medical Sciences. Today I am in remission for 5 months. According to the regimen, he is given REMIKE and methotrexate. The prognosis is that after 2 years of using this drug, remission will be quite long, 7-8 years, and then, as doctors say, scientists will come up with something else. We were told in Moscow that a complete cure for rheumatoid arthritis in pediatrics has not yet been recorded, only remission.
MaLu Master (2090) 5 years ago
take ALL medications prescribed by the doctor, self-medication is dangerous, if there is no improvement for a long time, find another rheumatologist
Rheumatoid arthritis, the causes of which are still not fully understood, is very dangerous and quite painful. Its manifestation is stiffness, swelling and pain in the inflamed joints. Women over forty years of age are most susceptible to this disease.
Rheumatoid arthritis is a chronic inflammation of connective tissue and joints that occurs due to a malfunction of the immune system. The cells begin to act aggressively on the body’s own tissues. The result is joint deformation and bone erosion. In rare cases, this disease can also destroy other organs, such as the heart or lungs.
The reasons may be the following factors:
The causes of death in rheumatoid arthritis can be kidney failure, infectious complications, and gastrointestinal bleeding.
Forms and stages of activity of rheumatoid arthritis
According to the anatomical features, this disease can have various forms:
There are three stages of disease development that require specific treatment.
At the initial stage:
The next stage of the disease has the following symptoms:
Rheumatoid arthritis (RA) is a disease that quite often leads to disability. Fortunately, drugs have recently appeared that successfully fight this disease.
Of course, even now RA remains a serious disease, but, nevertheless, if it is not possible to completely get rid of the disease, then it has become possible to slow down the progression (worsening) of joint damage. Rheumatologists have many new treatment methods that are aimed specifically at eradicating the causes of joint inflammation.
• RA is an autoimmune disease, i.e. this disease is caused by a malfunction in the immune system.
• RA is the most common type of autoimmune arthritis.
• At least 1.5 million adults in Russia suffer from RA.
• Treatment of RA has improved significantly in recent years.
• Rheumatologists have appeared; the narrow specialization of these doctors allows them to accumulate precious experience and, as a result, correctly diagnose the disease, offering patients the most modern treatment methods.
RA is a chronic disease that causes pain, swelling, and limited movement and function of many joints. And while RA can damage any joint, the small joints in the hands and feet are typically most commonly affected. Sometimes this disease is complicated by inflammation of the eyes or lungs.
RA in the active phase is characterized by morning pain. They can last from two hours to the whole day. If a person suffers from morning restriction of movement that lasts more than two hours, it can be assumed that he suffers from rheumatoid arthritis, since other joint diseases (for example, osteoarthritis) do not cause such long-term restriction of movement.
• Dry mucous membranes of the eyes and mouth (Sjögren's syndrome)
• Rheumatoid nodules that grow under the skin in places such as the elbows and knuckles
Remission (lat. remissio - decrease, weakening) - the period of a chronic disease,
characterized by a significant weakening or disappearance of its signs (symptoms).
The main goal of treatment for rheumatoid arthritis is complete remission .
Complete remission returns the joy of movement to a patient with rheumatoid arthritis and leads to social adaptation in society.
Remission of rheumatoid arthritis is indicated by the complete absence of the following signs:
Thanks to a systematic approach and the use of disease-modifying (basic) drugs, remission of rheumatoid arthritis is no longer a rare occurrence.
Arthritis, like any other rheumatism, is characterized by pain with limited mobility. Functional actions are blocked, causing aggravation in the joints and connective tissues in the body. Rheumatic diseases include diseases in which there is pain, physical tightness, swelling of joints or other appendage parts of the body, such as muscles, tendons, ligaments, bones. Such diseases are often mistakenly associated with old age, which is why osteoarthritis (the most common type of arthritis) is more common among older people. However, arthritis and similar forms of the disease can appear in people of any age.
The cause of rheumatoid arthritis remains a mystery. Infections such as viruses, bacteria and fungi have no solid evidence as a cause, although they were once suspected by doctors. The cause of rheumatoid arthritis is a pressing global issue with hundreds of institutes working on it. It is assumed that the appearance of rheumatoid arthritis is hereditary. This is because certain genes have been identified, thereby increasing the risk of rheumatoid arthritis. One of the causes of the disease may also be environmental influences. This is due to the presence of infections in the outside world and how the human immune system perceives this. If the immune system is damaged, it attacks its own tissues. This phenomenon leads to various inflammations of the joints, and also, in rare cases, in body organs, such as the lungs or eyes.
Environmental circumstances can also play an important role in the development of rheumatoid arthritis. Scientists report that smoking tobacco causes an exacerbation of silica (mineral) and chronic periodontal disease, which is one of the causes of the disease rheumatoid arthritis.
Symptoms of rheumatoid arthritis arise and subside depending on the extent of the damage to the inflamed tissue. If the body tissues are inflamed, the disease is active. If tissue inflammation subsides, this indicates that the disease is in remission. Remission may appear unexpectedly. Remission, which is justified by therapeutic support, can last from a week to a year. During the period when remission occurs, signs of the disease may disappear and patients, as a rule, feel healthy. When the disease becomes active again (relapsing phenomenon), symptoms resume. The phenomenon in which arthritis activity returns is called a “rheumatoid flare.” The state of flare and remission is a typical case during the disease of rheumatoid arthritis, they vary in random order.
Symptoms during the active phase of the disease include: feeling tired and loss of energy, loss of appetite, fever, muscle itching, joint colic, and stiffness. Muscle pain and blocking joint functionality are most often noticeable in the morning and after sleep (explained by prolonged inactivity). This is explained as a fact of morning stiffness. Arthritis flares are a characteristic phenomenon for this disease. During flare-ups, joints often become warm, reddish in appearance, swollen, painful, and weak. This occurs because the synovial membrane becomes inflamed, resulting in excess joint fluid. With inflammation, the synovial membrane increases (the phenomenon of synovitis).
Rheumatoid arthritis typically spreads to multiple joints, thereby affecting both sides of the body. Based on its characteristics, it is called symmetrical polyarthritis. Early symptoms include pain in the small joints of the hands and wrists. The first sign of rheumatoid arthritis is difficulty performing small tasks in daily life. For example, it is difficult to open a can or turn a doorknob. In the same way, the joints of the legs are involved and lead to painful activities. Difficulty when walking is noticeably manifested, especially in the morning, when a person has just woken up and got out of bed. In some cases, inflammation may spread to only one joint.
Arthritis can reproduce inflammation of other joints that were caused by forms of gout during a general infection. A chronic form of inflammation causes damage to the body's connective tissues, including cartilage and bones. This process contributes to the destruction of weak bones, as well as muscles, as a result of which the arthritis clinic leads to joint deformation and loss of functional activity. At times, rheumatoid arthritis can affect the joint that controls the vocal cords. In this case, the joint becomes inflamed and the voice becomes hoarse. In young children, symptoms include irritability, crying, loss of appetite, and lameness when walking.
Since rheumatoid arthritis is an autoimmune disease, its inflammation can affect not only the joints, but also organs and areas of the body. Specific syndromes may appear. One of them is Schergen's syndrome. It appears when the eye glands and mouth become inflamed, leading to dryness in these areas. Dry eyes can damage the cornea. Inflammation of the white parts of the eye (sclera) causes a condition called scleritis. Scleritis can be a very dangerous condition for the eye. Inflammation of the lining of the lungs (pleurisy) contributes to chest pain due to deep breathing, shortness of breath and coughing. Lung tissue can also become inflamed and scarred, and sometimes inflamed nodules develop in the lungs themselves. Inflammation of the tissue (pericardium) near the heart causes pain in the chest area, which is usually caused by changes in intensity when lying down or bending over.
Rheumatoid arthritis is associated with an increased risk of heart attack activity. During the course of the disease, the number of red blood cells (a state of anemia) and white blood cells in the body may decrease. A decrease in the level of white blood cells may be associated with an enlargement of the spleen during the course of the disease (Felty's immune syndrome). This phenomenon may increase the risk of infections. Patients with rheumatoid arthritis are at increased risk for cancer of the lymph nodes (lymphoma), especially when there is persistent, active inflammation. Rheumatoid nodules (subcutaneous nodules) can occur around the elbows or fingers.
A rare, serious complication that usually occurs with long-term rheumatoid arthritis is vasculitis. Vasculitis is another criterion for rheumatoid arthritis, in which inflammation of the blood vessels occurs and the blood supply to the tissues deteriorates, as a result of which they die (a state of necrosis). Symptoms of vasculitis become noticeable quite early. This is reflected in the form of small ulcers on the feet or black spots on the nails.
There are 4 degrees of activity, but a significant role is assigned to the last three, since they already have health problems. Grade zero is defined as a normal, healthy condition that does not exhibit exacerbation of rheumatoid arthritis. Zero degree is a condition in which there is no disturbance in the balance and level of blood cells. There are 3 degrees of activity of rheumatoid arthritis:
An arthritis rehabilitation program is designed to meet the individual patient's own needs, depending on the severity of the disease. Active patient and family participation is vital to the success of the program.
Rehabilitation has its goal - to help the patient return to a full life. Rehabilitation implies a course of treatment to restore functional mobility, emotional state, and social fitness. To achieve all of these goals, a rheumatoid arthritis rehabilitation program should include the following:
The goal of hip and knee surgery is replacement through endoprosthetics to improve joint function. Full recovery after endoprosthetics usually takes from 3 to 6 months, depending on the type of operation, the general health of the patient, and the success of rehabilitation.
The rehabilitation program after endoprosthetics may include the following:
A rheumatoid arthritis rehabilitation program can be an inpatient or outpatient program. Many qualified professionals are part of the rehabilitation process. The rehabilitation procedure includes the supervision of the following specialists and doctors:
In order to understand what remission is in rheumatoid arthritis, it is necessary to become familiar with the term remission itself in order to understand the essence and meaning. Remission is a state when the patient feels that the disease has passed. During this period, the patient does not have any signs or symptoms of the disease, does not suffer from pain and feels the same activity. However, during rheumatoid arthritis, remission does not guarantee that the pain has disappeared forever; at least there is a chance that the symptoms of the disease will decrease. For example, if morning stiffness and joint pain lasted about 4 hours, then in remission it will last about 15 minutes. In simple words, during the period of remission there are improvements in the healing process of the disease.
Periods of remission in rheumatoid arthritis are not necessarily consistent across patients. Some may be off previous medications and feel well, and some may still need to maintain treatment while in remission. Remission of rheumatoid arthritis is characterized by the absence of fatigue, pain, swollen joints, and morning stiffness. Remission is determined by the type of medication the patient took. If a patient has taken more than one medication, then the chance of remission is generally greater than for a patient with the usual course of treatment. This situation is explained by the fact that there is always a chance of developing cross-forms of arthritis, and the use of different medications contributes to the appearance of remission. By taking a combination of two drugs, it is possible to go into remission faster and start a full, healthy life.
The period during which rheumatoid arthritis is in remission can determine your chances of completely healing the disease. In various cases, the disease may stop without any reason, in which case it is unlikely to enter the active phase again, and the patient can enjoy a healthy life. If symptoms and signs of the disease return after remission, you should not lose hope. Your doctor will recommend new treatments that will help bring you back into remission over a long period, and possibly make the disease go away forever.
Arthritis is a disease characterized by inflammation in the joints. The inflammatory process can begin in any joint, but most often it is arthritis of the fingers.
The result of arthritis is thinning of articular cartilage, changes in the shape of ligaments and joint capsules. As a result of such changes, irreversible deformation of the joints and curvature of the fingers occurs.
There are several factors that contribute to the development of finger arthritis:
1. The infectious factor takes first place. The causative agents of this disease are considered to be bacteria such as streptococci and Staphylococcus aureus. People suffering from frequent colds, ARVI and flu are at risk.
Also, people suffering from various sexually transmitted diseases, tuberculosis and diabetes are susceptible to this form of joint inflammation.
2. Injuries, joint bruises, or surgical interventions can contribute to the development of arthritis.
3. Heredity. Science has not definitively confirmed that the tendency to inflammation of the joints is inherited, however, the pathological structure of the joints can be traced in blood relatives. If you have relatives in your family who suffer from arthritis of the finger joints, you need to systematically carry out preventive measures to avoid the occurrence of the disease.
4. Hyperactivity of the immune system, which provokes the body’s production of antibodies to its own connective tissue cells, which provokes the development of rheumatoid arthritis, a disease that is very difficult to treat.
5. Excess weight, smoking, hypothermia of the extremities and a weakened immune system play an important role in the development of the disease.
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If we exclude traumatic causes and the factor of unknown etiology, the first place among the causes of arthritis of the fingers is occupied by rheumatoid arthritis - damage to connective tissues.
Rheumatoid arthritis is characterized by symmetrical damage to the joints, that is, if inflammation occurs on the phalanges of the fingers of the right hand, it will certainly appear on the left hand. As a rule, the interphalangeal and metacarpal joints are susceptible to inflammation.
Pain syndrome, or pain in the fingers, which is localized in the area of the diseased joint, is most pronounced in the morning and is characterized by disturbance and stiffness of movements.
In the initial stages of the disease, severe pain can last for half an hour, but as it progresses it reaches a period of 3-4 hours. In addition to pain, the diseased joint and periarticular tissues swell, the skin of the affected area turns red, and the temperature in the area of inflammation rises.
Timely contact with a doctor, identification and adequate treatment of inflammation and pain in the fingers can prevent joint deformation, which manifests itself in the last stages of the disease.
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Treatment of arthritis of the fingers is a comprehensive approach, which is selected individually by the attending physician, depending on the stage of the disease and its form.
Treatment of the disease is divided into several stages:
2. Remission period. During a period of illness not associated with an exacerbation, it is necessary to direct efforts to restore the function of diseased joints, as well as try to eliminate the cause of the development of the disease and normalize the functioning of the body’s immune system. For this purpose, immunosuppressants, cytostatics and monoclonal antibodies are prescribed.
Chondroprotective drugs will help restore the structure of cartilage tissue and prevent its subsequent destruction.
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To restore the function of the articular joint, they resort to physiotherapy: electrophoresis, ultrasound, massage, gymnastics for the fingers, paraffin therapy and mud applications. Such procedures are painless, but at the same time, in combination with drug treatment, they can significantly reduce the manifestations of arthritis of the fingers.
Also, we should not forget that throughout the entire period of treatment it is necessary to monitor nutrition, take vitamins, especially vitamin E, and not overload the fingers.
3. The last stage of the disease is the stage of destruction of the diseased joint. Unfortunately, the only treatment option is surgery, which consists of arthroscopic surgery and endoprosthetics.
In addition, there are also traditional methods for treating arthritis of the fingers, but remember that before using such traditional medicine methods, it is very important to first discuss the possibility of their use with your doctor.
In order not to waste time, effort and money on treating this difficult disease, follow the following preventive measures:
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Psoriatic arthrosis is a type of inflammatory arthritis that occurs in 30% of people with chronic psoriasis. Psoriatic arthrosis is a condition that causes red patches of skin covered with silvery scales. In most cases, the problem of psoriasis appears first, and later the diagnosis of psoriatic arthritis appears. Sometimes such problems can develop before skin lesions appear.
Joint pain, stiffness and swollen areas of the body are the main symptoms of psoriatic arthritis. Such signs can affect absolutely any part of the body, even the spine. Symptoms tend to be mild to severe. In both cases (psoriasis or arthritis), there is a chance that outbreaks will be paused by periods of remission.
There is no specific treatment for psoriatic arthritis, so the emphasis is on managing symptoms and preventing joint damage.
Psoriatic arthrosis, like psoriasis, is a chronic type of disease that appears over time. Patients may have periods when symptoms improve, thereby going into remission. This happens periodically and spontaneously.
Psoriatic arthrosis in some cases can affect your body on both sides at once. The symptoms and signs of psoriatic arthritis are almost similar to rheumatoid arthritis, as both diseases cause pain in the joints and have the same pattern of swelling and redness in areas of the skin.
Psoriatic arthrosis can be characterized by the following symptoms:
If you have psoriasis or psoriatic arthrosis, be sure to tell your doctor. Regardless of how quickly complications develop, these diseases can have serious consequences if left untreated.
Psoriatic arthritis occurs when the body's immune system begins to attack its own healthy cells and tissues. Abnormal behavior of the immune system causes inflammation in the joints and disruption of the structure of skin cells.
There is no precise explanation for why the immune system has a negative effect on healthy tissue, but it is plausible that genetic and environmental factors play a role. Many people with psoriatic arthritis have a family history of the disease. Researchers say that certain genetic cells are associated with the occurrence of psoriasis and psoriatic arthritis.
Physical trauma or some kind of viral-bacterial infection can cause psoriatic arthrosis in people with a hereditary tendency.
There are a certain number of factors that cause psoriatic arthrosis:
Psoriatic arthrosis is diagnosed on the basis of clinical diseases, mainly psoriasis, inflammatory types of arthritis, etc. One of the first steps should be an X-ray examination to check for joint damage. For a more detailed study of the joints, procedures such as MRI (magnetic resonance imaging), ultrasound (ultrasound), CT (computed tomography) are used.
A blood test may be done to help identify and rule out other forms of arthritis that have similar signs and symptoms. These symptoms can act as gout, osteoarthritis and rheumatoid arthritis. A blood test will provide readings of ESR (erythrocyte sedimentation rate), which will help find the correct answer to the diagnosis. In patients with psoriatic arthritis, blood tests may show high levels of inflammation or a state of mild anemia. In some cases, a biopsy procedure (small areas of skin is removed for analysis) is used to confirm the diagnosis.
Chronic arthritis and its types
Chronic arthritis is a process of joint inflammation that lasts more than a couple of months. An important task is to prevent the risks of joint damage. Chronic arthritis has the following symptoms: lasts more than 10 weeks, constant morning stiffness, the appearance of synovitis, confirming signs of compressed feet, visible bone erosion on x-ray examination. Chronic arthritis includes a huge variety of variations of rheumatic diseases.
Diseases that include chronic arthritis:
If you have psoriatic arthrosis, your condition most likely falls under one of the following conditions:
People suffering from arthrosis need to develop joint mobility. For this, there is a special set of exercises that improve overall health and joints become flexible. You can also use special exercise equipment for quick recovery. The exercise bike provides constant tone, which will develop the functionality and mobility of the legs.
Walking is also an excellent way to restore joints, but for this you need to purchase special insoles for shoes that will prevent excessive stress on the ankle, knee and ankle.
It is necessary to take the medications prescribed by your rheumatologist on an ongoing basis, since there is no specific cure for arthritis yet.
Infectious-allergic arthritis (polyarthritis) is an acute, recurrent disease that occurs as a result of the body's increased sensitivity to a certain infectious pathogen (most often streptococcus, staphylococcus). Infectious-allergic polyarthritis is more common (75%) in women, mainly young women. Most scientists involved in this pathology point to a certain connection between the occurrence of arthritis and an acute infection of the upper respiratory tract.
The mechanism of development of infectious-allergic arthritis has not yet been studied. Polyarthritis occurs only in a small number of patients who have had streptococcal or other respiratory tract infections. The implementation of the action of an infectious pathogen is enhanced in conditions of a specific allergy to this pathogen, a violation of immunological defense mechanisms, neurohormonal abnormalities, and aggravated heredity.
Typically, 10-15 days after an acute infection (the period of greatest allergization of the body), acute and subacute inflammation of the joints occurs. Pain, swelling, hyperemia, and increased local temperature increase over 2-3 days. Some patients experience limited movement in the joints due to pain. But since many patients with acute respiratory diseases of the upper respiratory tract take anti-inflammatory and desensitizing drugs, the inflammatory process in the joints is often sluggish. In most patients, swelling of the joints is hardly noticeable and is mainly explained by the accumulation of exudate in the joint cavity. On palpation, a slight or moderate increase in local temperature and the appearance of pain are observed.
Under the influence of anti-inflammatory therapy, as a rule, the process reverses quickly, the shape and size of the joints are completely normalized, and function is restored. After the disappearance of arthritis, no fibrotic changes are detected clinically and radiologically. The duration of arthritis is 1-2 months. However, in some patients it persists for more than 6 months. Most of them experience a relapse of arthritis after repeated acute infection or hypothermia.
A clinical blood test during a relapse rarely reveals an increase in ESR to 40-50 mm/h.
For the diagnosis of infectious-allergic polyarthritis, anamnesis is especially important: the onset of the disease after an acute respiratory infection, the development of arthritis during the period of the highest allergization of the body, the rapid increase in inflammatory signs.
To treat infectious-allergic arthritis, it is necessary to use antimicrobial, anti-inflammatory and desensitizing drugs. Before prescribing antibiotics, their tolerability should be determined. For a more active effect on streptococcus, penicillin is recommended; if it is poorly tolerated, it is replaced with erythromycin . The course of treatment is 7-8 days. Of the general anti-inflammatory drugs, acetylsalicylic acid is prescribed 0.5 g 4 times a day or brufen 0.25 g 4 times a day. The duration of taking the drugs depends on the persistence of the arthritis. At the same time, suprastin or diphenhydramine is prescribed in the appropriate dose. It is advisable after treatment, even in the absence of relapses of arthritis, to carry out balneological treatment (hydrogen sulfide, radon, sea baths).
Inflammation of joints and muscles with influenza is well known. Influenza is an acute viral infection characterized by damage to the mucous membranes of the respiratory tract, gastrointestinal tract, urogenital organs, conjunctiva, synovial lining of joints, and muscle tissue. Most patients with influenza already in the initial period have subjective signs of damage to muscles and joints, pain, weakness, stiffness, spasms, twitching of individual muscle groups. During the height of the flu, joints are affected less frequently. However, after some time (10-15 days), the likelihood of arthritis increases. In this case, allergies to both viral and microbial agents may play a role.
Arthritis that occurs at the end of an influenza illness is often more persistent. In many patients they can become chronic.
Influenza arthritis has all the clinical manifestations characteristic of infectious-allergic arthritis: distinct inflammation of joint tissues, increased body temperature, increased ESR, leukocytosis, positive reaction to acetylsalicylic acid. Radiological changes in the joints are not detected. Biochemical and immunological changes in the blood, as a rule, are not detected.
Therapy is carried out with non-hormonal anti-inflammatory drugs: brufen, flugalin, naproxen, butadione, indomethacin, voltaren. Desensitizing therapy - suprastin, diphenhydramine; ultraviolet irradiation is prescribed. Food should be rich in vitamins and low in carbohydrates. Ascorbic acid is recommended in large doses of 1 g 3 times a day.
The primary focus of tuberculosis may be in the lungs, lymph nodes, or have another location. In most cases, the infection spreads hematogenously.
Tuberculosis of the joints is now rare. Most often, large joints are affected: the hip, knee, and especially often the spine. Clinically, the gradual development of arthritis is characteristic. Pain is observed both at rest and with movement. Swelling occurs both as a result of the appearance of exudate in the joint cavity and as a result of damage to the periarticular tissues. Skin color changes little. On palpation, pain and a moderate increase in local temperature are determined. Atrophy of regional muscles gradually occurs. Without treatment, a fistula or abscess may develop. Radiologically, in the early stage of the process, narrowing of the joint space, destruction of bone tissue, and the usuration and sequestration of necrotic masses are observed.
Laboratory signs: increased ESR, positive Pirquet and Mantoux tests.
Specific tuberculosis therapy consists of the use of streptomycin, ethambutol, rifampicin, isoniazid, PAS. In complex treatment, much attention is paid to diet and resort factors. Orthopedic methods are widely used - immobilization of the affected joint (plaster splint, special splints). At a later stage, surgical intervention is resorted to.
Brucellosis arthritis is one of the common manifestations of brucellosis infection. Usually there is swelling of the joints due to exudative processes, and an increase in local temperature.
When a joint is infected with Brucella, the process progresses rapidly, severe destruction of bone tissue occurs with the development of ankylosis of the joint. The synovial fluid has a serous-purulent appearance and contains brucella. In the toxic-allergic form of brucellosis arthritis, the clinical symptoms are less pronounced; several joints are usually affected. After specific treatment, as a rule, complete restoration of joint function occurs.
Radiologically, no changes are detected in toxic-allergic forms of brucellosis arthritis. Infection of the joint leads to the development of destructive changes, but destruction of bone tissue is rare. X-ray changes are more often detected in the elbow and knee joints: focal osteoporosis, narrowing of the joint space, sclerotic changes. The surfaces of the sacroiliac joints are usually uneven, eroded, round-shaped foci of destruction, narrowing of the joint spaces and their ankylosis are found.
Laboratory tests in the blood show an increase in ESR within the range of 25-35 mm/h, leukopenia with relative lymphocytosis. Immunological studies are carried out: Wright and Hudelson reactions, complement coagulation reaction, passive hemagglutination reaction, determination of opsonin activity. Bacteriological examination of blood, bone marrow, urine, and lymph nodes is indicated. The answer to sowing can be obtained in 25-30 days, since Brucella grows slowly. The results of the Burnet skin test are taken into account after 24-48 hours, since earlier it may be non-specific.
To establish a diagnosis, anamnesis of the disease (place of residence, consumption of raw milk, etc.) is important.
The main diagnostic signs are mono-oligoarthritis, accompanied by damage to the periarticular soft tissues, the appearance of chills, increased sweating, inflammatory changes in the joint in the absence of changes on the radiograph, detection of Brucella in the synovial fluid, in the blood, sputum, bone marrow, urine, lymph nodes, positive Wright reactions , Hudelson, complement fixation, opsoninin activity.
For the treatment of brucellosis arthritis, antibiotics are recommended, chloramphenicol, tetracycline, streptomycin 1-2 mg, after 2 days 5 mg and then at the same interval the dose is increased to 125 mg. It should be remembered that the vaccine can cause a deterioration in the general condition, including collapse and shock. Treatment with the vaccine is contraindicated for endocrine, nervous and mental disorders. Anti-inflammatory and diuretic drugs can be prescribed simultaneously with the vaccine. Physiotherapy is recommended: electrophoresis, inductothery, diadynamic currents. After eliminating the inflammatory process, sanatorium treatment is carried out using mud applications and hydrogen sulfide baths.
Purulent arthritis occurs as a result of infection, most often staphylococcus, entering the joint and the subsequent development of acute septic inflammation. Depending on the route of infection, primary purulent arthritis is distinguished, which occurs when the microbe penetrates directly into the joint during surgery, a puncture biopsy, or in the presence of open wounds; secondary purulent arthritis, when the microbe enters the joint from neighboring tissues (with abscesses, phlegmon, osteomyelitis), as well as hematogenously (with sepsis).
Purulent inflammation of the joint is characterized by pronounced symptoms: severe pain in the joint of a constant nature, redness and a significant increase in local temperature, swelling of the joint due to the accumulation of exudate in the joint cavity and swelling of the periarticular tissues. Restriction of movement in the joint occurs due to severe pain and swelling of the joint. The patient's general condition worsens: body temperature rises, chills and general weakness appear.
In the absence of appropriate treatment, the inflammatory process progresses rapidly. Lysis occurs of all elements of the joint and, above all, the synovial membrane and osteochondral tissue. As a result of the destruction of the epiphyses of the bones, displacement and subluxation are observed. X-rays reveal a narrowing of the joint space at an early stage; the contours of the joint are uneven and fringed. The symptom of shinets is noted. In some cases, septic necrosis of one of the epiphyses occurs. Destruction of the ligamentous apparatus leads to the development of subluxations, dislocations and bone displacement.
Leukocytosis and increased ESR are detected in the blood. When inoculating synovial material, microorganisms are detected. Synovial fluid is cloudy. 1 mm contains more than 100,000 leukocytes. The diagnosis is established on the basis of the following signs: acute onset of rapidly progressing inflammation of the joint, pronounced clinical signs of arthritis, unevenness, fringed articular contours on radiography, changes in the joint blood.
The clinical picture is characterized by an acute onset, severe pain in the joints and muscles, and the appearance of a nodular or erythematous rash (usually 10-20 days after infection).
Monoarthritis is accompanied by clear signs of inflammation. A reliable diagnosis is established based on the detection of microorganisms in the synovial fluid or synovium. Antibiotics and general anti-inflammatory drugs are used to treat purulent arthritis. In some cases, it is necessary to remove necrotic masses surgically.
Lyme disease is an infectious multisystem disease that has a variety of clinical manifestations. The causative agent of the disease is the spirochete Borrelia Burgdaiteria. This is the largest species of spirochete, capable of causing major immunological disorders. The spirochete is carried by lice and ticks 1-2 mm long. The hosts of ticks are: field mice, deer, and less commonly, domestic animals.
The following stages of disease development are distinguished: Stage I (erythematous), characterized by neck stiffness, fever, and arthralgia. Usually develops in summer, lasting several weeks; Stage II (neurological): duration from 1 week to 1 month; Stage III (arthritic). Usually after a few months the patient develops arthritis. The division of these stages is somewhat arbitrary, since in the early stage of the disease there may be arthritis, and in the later stage neurological disorders may occur.
Redness and papules appear at the site of the bite, which after a few days expand and become red around the edges. The spirochete migrates across the skin. In the early stage, general weakness, fever, headache, stiffness of the wives, back pain, nausea, vomiting, and sore throat are noted. An enlarged spleen, redness of the throat, capillaritis of the palm, lymphadenopathy, and maculopapular rash are detected. 30% of patients do not have skin manifestations (however, they appear in later stages when neurological disorders develop).
In stage II of the disease, aseptic meningitis is most often diagnosed. This disease is characterized by damage to the cranial nerves. Less common: radiculitis, encephalitis, myelopathy, paralysis of half the face. Heart damage appears after a few months. Cardiac activity returns to normal after treatment with penicillin.
Laboratory tests in the blood reveal lymphocytic leukocytosis, increased ESR, eosinophilia (30%), and high levels of immunocomplex titers in the synovial fluid. Serological reactions become positive only 2-4 weeks after the appearance of chronic, migratory erythema.
To eliminate the infection, antibiotics must be used in large doses. Usually, penicillin 20,000,000 units intravenously or tetracycline 1,200,000 units per day is prescribed for 10-12 days. For chronic cases and damage to joints and muscles, anti-inflammatory drugs are prescribed. Arthritis associated with clinical pathology is varied. These arthritis are characterized by lesions of predominantly large joints of the lower extremities.
Inflammation of the joints in this disease occurs acutely or subacutely with severe pain and exudative changes. However, both acute and chronic dysenteric arthritis, as a rule, disappear completely after a certain time, without leaving any irreversible changes in the joints. A reliable diagnosis is established based on the medical history, detection of bacilli in the stool, and positive serological reactions.
Treatment is carried out with general anti-inflammatory medications and antibiotics.
Arthritis due to ulcerative colitis
This disease most often begins with damage to the rectum or sigmoid colon, subsequently moving to other parts of the intestine. The connection between arthritis and ulcerative colitis is indicated by the following:
With ulcerative colitis, mainly large joints (shoulder, hip) are affected. With exudative changes, there is a slight increase in local temperature, pain, and the color of the skin over the affected joint is practically unchanged. The inflammatory process in the joint is persistent, but does not lead to fibrous changes and contractures. Peripheral arthritis in ulcerative colitis and ankylosing spondylitis cannot be distinguished; only after some time do signs of spondyleoarthritis appear.
Arthritis in Crohn's disease
Intestinal damage in this disease is severe and often spreads to the entire intestine. Crohn's disease most often affects the large joints of the upper extremities. Arthritis is recurrent in nature: its course is relatively benign. Relapses occur during exacerbation of enterocolitis. Treatment of the underlying disease helps eliminate or temporarily remit arthritis. During the period of exacerbation, general anti-inflammatory therapy, physical methods of treatment, diet, and spa treatment are recommended.
Arthritis in Whipple's disease
The disease has the following clinical manifestations of multisystem damage. Abdominal pain, severe general weakness, weight loss, loss of appetite, enlarged liver and spleen appear. The causative agent of the disease is Y. enterocolitica. It is found in both domestic and wild animals. From them, the infectious pathogen is transmitted to humans through vegetables, fruits, dairy products, and water. Transmission of infections from a sick person occurs through the oral-fecal route.
The onset of the disease is most often acute or subacute with the development of general weakness, nausea, abdominal pain, diarrhea, chills, fever and other symptoms of intoxication. Leukocytosis and an increase in ESR are observed in the blood. If left untreated, the disease can become chronic. Symptoms of damage to muscles and joints appear in severe forms of yersiniosis.
Radiological changes in the joints are not detected. To establish a diagnosis, bacteriological examination of infected material is of primary importance. For culture purposes, blood, synovial fluid, urine, and feces are used. Antibiotics are used in accordance with the sensitivity of the pathogen for 8-12 days, anti-inflammatory drugs. In the presence of persistent arthritis, hormonal drugs are prescribed.
During the period of exacerbation of intestinal syndrome, synovitis of individual joints or oligoarthritis usually occurs, less often polyarthritis with damage to large joints. Later, the spine is involved in the process, which makes differential diagnosis with ankylosing spondylitis difficult. X-ray changes are detected in persistent arthritis. In the area of the sacroiliac joints, compaction of the subchondral bone, uneven surfaces of the articular contours, jaggedness, and narrowing of the joint space are detected.
In laboratory blood tests, an increase in ESR, leukocytosis, moderate anemia, an increase in the content of fibrinogen, a and b globulins, and seromucoid in the blood serum are observed. To establish a diagnosis, in addition to clinical and laboratory signs, histological examination of the intestinal mucosa is of great importance. The treatment package includes the use of corticosteroids and antibiotics, physiotherapy and spa treatment.
Arthritis due to yersiniosis (an infectious disease caused by a gram-negative bacillus), urogenital arthritis. These include arthritis caused by microbial infection (gonococcus), viral infection (chlamydia), as well as their combination with other infectious agents (gonococci and trichomonas, gonococci and viral infection).
The symptoms of gonococcal arthritis have changed somewhat recently. Cases of difficult identification of microbes due to their accumulation in the ascending part of the genital organs and rectum and the periodic occurrence of intoxication and allergic reactions have become more frequent. It is these forms of joint damage that have a peculiar, sometimes erased form with a chronic or recurrent course.
The clinical picture of gonorrheal arthritis depends on the nature of the infection. In case of penetration of gonococcus into joint tissues (metastatic form), there is an incubation period (from 1 to 20 days). In the prodromal period, weakness, malaise, pain in the joints and tendons are observed. During this period, microbes accumulate in the joint cavity, and in the presence of a certain amount of pus, acute purulent arthritis occurs. Gonococcus is detected in the synovial fluid.
If treatment is not carried out, the inflammatory process quickly increases, destruction of articular tissues occurs, contractures and ankylosis form. Gonococci can enter the bloodstream when the fallopian tubes are damaged, from the urethra, prostate gland, seminal vesicles or other organs that serve as a source of gonococcemia. The anatomical features of the genitourinary organs predispose to the spread of gonococcal infection.
The bacteremic form (toxic-allergic arthritis) has a number of features. The onset may be less acute and often gradual. Several joints are involved in the pathological process, and the attachment points of muscles and tendons are affected. The joints of the lower extremities—the knees and ankles—are most often affected.
X-rays of the affected joints (when there is septic arthritis) reveal pronounced destructive changes in the osteochondral tissue. In the toxic-allergic form of gonococcal arthritis, changes are observed in a later stage of the disease. Increased ESR and leukocytosis are detected in the blood. More pronounced leukocytosis is observed in patients with gonococcemia, and less pronounced - when gonococcus is detected in the genitourinary organs. In the synovial fluid, cytosis increases (up to 82,000 per 1 mm). To detect gonococcal infection, the complement fixation reaction with a standard antigen is used.
The development of acute or subacute arthritis in patients with purulent urethritis and the detection of gonococcus in the urethral material or in the synovial fluid make it possible to reliably establish the diagnosis. Difficulties in diagnosis arise with an atypical or toxic-allergic form. The main diagnostic signs of gonococcal arthritis: acute monoarthritis of the lower extremities in patients with purulent urethritis, a positive Bordet-Tangou reaction, detection of gonococcus in the genitourinary organs. Leukocytosis is observed in synovial fluid or blood, and cytosis is observed in synovial fluid.
In the treatment of gonococcal arthritis, antibiotic therapy is used: penicillin 1,000,000-1,500,000 units or tetracycline 1-1.5 g per day for at least 8-10 days, anti-inflammatory drugs: pyrazolone drugs, salicylates, indole group drugs. First, the synovial fluid is aspirated, and then intra-articular antibiotics are administered.
Reiter's disease occurs after an acute intestinal illness. It is characterized by a triad: urethritis (cystitis, prostatitis), conjunctivitis, arthritis. The disease occurs predominantly in young men. Reiter's disease is infectious in origin. For the development of a pathological process, in addition to the presence of a pathogen, a number of other factors are necessary that contribute to the preservation and reproduction of the virus, in particular, inflammatory processes in the genitourinary area and the presence of pathogenic microbes in these organs.
The disease begins subacutely or acutely with damage to the urethra, skin, conjunctiva, and the presence of fever, then arthritis develops. Discharge from the urethra can be profuse, but most often it is scanty and serous in nature. Patients note discomfort in the lower abdomen and frequent urination. The opening of the urinary canal is hyperemic. If treatment is carried out in a timely manner, vesiculitis, prostatitis, vaginitis, cervicitis, and bartholinitis occur. Skin lesions in Reiter's disease occur in 80% of patients. Most often, small blisters appear in the glans penis area, which can then turn into superficial ulcers. In other cases, spots appear that become crusty.
In 30% of patients, the skin of the palms and soles is affected.
Initially, spots appear, which gradually become denser, slightly elevated and resemble psornatic plaques. Gradually they merge, and in some cases the sole may be completely covered with crusts. At the same time (in the absence of damage to the palms or soles), damage to the nails is noted. Inflammation of the mucous membrane of the oral cavity, cheeks, palate, tongue, and pharynx is accompanied by the appearance of small blisters followed by the formation of ulcers.
One of the main symptoms of Reiter's disease is conjunctivitis of varying severity and duration. Patients note a burning sensation and photophobia. In some patients, conjunctivitis is very mild and short-lived. In addition to conjunctivitis, you can find iritis, episcleritis, corneal ulcers, and recurrent retinitis. Inflammation of the joints can manifest itself violently: severe pain, diffuse swelling of the joint, and severe hyperemia with a bluish tint are observed. The joints of the lower extremities are mainly affected, especially the knees. The joints of the upper extremities become inflamed much less frequently.
Acute symptoms of arthritis can persist from several days to several weeks, and some patients may experience remission after 2-3 months . Most arthritis patients experience recurrent treatment. In some cases, relapse can occur 7-8 times a year. Reiter's disease is not accompanied by the development of productive changes in the spine; damage to internal organs is rarely observed. In the acute period of the disease or during its chronic course, mild myocarditis and aortitis can be detected.
Clinical and biochemical blood tests do not reveal any abnormalities characteristic of this disease. An increase in ESR does not always clearly reflect the degree of the inflammatory process; leukocytosis is moderate. Biochemical indicators (a positive test for C-reactive protein, an increase in the content of seromucoid and protein fractions), unlike those in rheumatoid arthritis, less clearly reflect the activity of the inflammatory process in this disease.
When diagnosing Reiter's syndrome, immunological studies are of great value. Anti-chlamydial antibodies and a positive complement fixation reaction are detected in the blood serum. To make a diagnosis, it is necessary to find chlamydia in material taken from the urethra or conjunctiva.
When diagnosing the early stage of Reiter's disease, one should take into account conjunctivitis, vesiculitis, nonspecific urethritis, prostatitis that occurs in young men, inflammation of the joints of the lower extremities, characteristic lesions of the skin and mucous membranes of the oral cavity and genitals, keratoderma of the palms, soles, damage to the nails, detection viral inclusions, increased levels of complement in the synovial fluid. In the late stage of the disease, in addition to the symptoms listed above, it is necessary to take into account the presence of periostitis (especially the calcaneal bones) and the development of syndesmophytes in the lumbar spine.
In the initial period, the complex of medications must include antibiotics (preferably tetracycline) in large doses (1.5-2 g per day for 1-1.5 months), anti-inflammatory drugs, desensitizing drugs (diphenhydramine, suprastin), phonophoresis of hydrocortisone for affected joints and parts of the spine, intra-articular administration of drugs. In case of high disease activity and in the absence of the desired effect from conventional therapy, a short course of hormonal treatment can be carried out.
In the chronic form, when there are persistent changes in the joints and spine, it is advisable, in addition to symptomatic and antibacterial agents, to prescribe delagil (plaquenil). Arthritis, due to its high tendency to become chronic, often leads to loss of ability to work.
For arthritis, complex pathogenetic therapy should be used aimed at:
An important principle of the treatment of chronic arthritis is long-term staged treatment (hospital-polyclinic-resort), which varies depending on the nature of the arthritis, its form, etc.
Source: Encyclopedia of Traditional and Alternative Medicine