Joint pain and swelling are common in many different conditions. The sooner the diagnosis is made and the correct treatment started, the more successful the therapy will be.
Arthritis is considered "early" if the diagnosis is made within 6 months of the first symptoms of the disease. There are early arthritis clinics in several European countries.
Symptoms of arthritis are: joint pain, joint swelling, stiffness of movement, local increase in the temperature of the soft tissue around the joint. General symptoms such as weakness, fever and weight loss are possible. For a timely diagnosis and scheduling of the correct treatment, the patient should consult a specialist physician - a rheumatologist.
Unfortunately, due to widespread publicity for unconventional methods of treatment, patients often turn to chiropractors, osteopaths, homeopaths - and time is wasted. In particular, in treating rheumatoid arthritis, the first 3-6 months of the disease are called the "window of opportunity" - this is the time when correct treatment can lead to persistent, long-term remission.
Now let's talk about the symptoms of the most common rheumatologic diseases.
osteoarthritis
Osteoarthritis is the most common joint disease that usually occurs in people over 40-45 years of age. Women suffer from osteoarthritis almost 2 times more often than men.
The clinically significant and disabling forms of osteoarthritis are coxarthrosis (arthrosis of the hip joint) and gonarthrosis (arthrosis of the knee joint). In nodular osteoarthritis, damage to the interphalangeal joints of the hands (pain and deformity) occurs.
The main clinical symptom in osteoarthritis is pain in the affected joint during exercise. In arthrosis of the knee or hip joint, the patient experiences pain when walking, when getting up from a chair, when climbing stairs (especially when descending), when carrying weights. In addition to pain, the patient is concerned with limiting joint movement, grinding during movement.
Sometimes there is swelling (spill) of the knee joint (may be swollen behind under the knee). This is a symptom of joint inflammation.
In the case of effusion (synovitis), the nature of the pain changes: the pain appears at rest, not associated with stress.
Rheumatoid arthritis
Rheumatoid arthritis usually occurs in middle-aged women. The most characteristic symptoms are symmetric arthritis (in the right and left extremities) (pain, swelling) of the wrist joints, small joints of the hands and feet. Joint pain is more worrying in the morning. It is difficult for the patient in the morning to clench their fists, raise their hand (comb their hair), step on their feet (due to the pain under the "cushions" of the toes). Joint pain is accompanied by a characteristic symptom - "morning stiffness".
Patients describe morning stiffness as a feeling of "swelling, stiff joints", "hands with tight gloves. "In addition to the joint syndrome, rheumatoid arthritis is characterized by general symptoms such as weakness, weight loss, weight loss, sleep disturbances, and fever.
You need to know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be disabling if diagnosed late and treated incorrectly. Often the disease starts gradually, often with arthritis in one joint and then other joints "join up. "
To use the "window of opportunity" and immediately start treatment for persistent arthritis (2-3 weeks), especially for small joint arthritis, it is necessary to consult a rheumatologist. To confirm the diagnosis, immunological tests, radiography and MRI are used.
spondyloarthritis
This is a group of diseases that include ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondyloarthritis associated with inflammatory bowel disease, reactive arthritis (associated with urogenital or intestinal infection), undifferentiated spondyloarthritis.
This group of diseases is linked by common genes and common clinical symptoms. Spondyloarthritis usually occurs in young people (up to 40 years old). Spondylitis is an inflammation of the joints in the spine. Often the first symptoms of spondylitis are pain in the lumbosacral region, alternating pain in the buttocks (sometimes on one side or the other). These pains are inflammatory in nature: they intensify in the second half of the night or in the morning, lessen after warming up, do not disappear at rest, and are accompanied by morning stiffness of the spine. Spondyloarthritis usually affects the hip joints (the first symptom is usually groin pain).
Spondyloarthritis is characterized by the presence of asymmetric arthritis, especially in the joints of the lower limbs. Unfortunately, the correct diagnosis is usually made 8 to 10 years after the onset of the disease, especially if the patient has back pain but no arthritis.
These patients have been followed up by neurologists and chiropractors for a long time with a diagnosis of osteochondrosis. For a correct diagnosis, additional examination is necessary: MRI of the sacroiliac joints, X-ray of the pelvis, blood test for the presence of a specific gene.
Drop
Men get about 20 times more gout than women. Gout develops mainly during the fifth decade of life.
The "classic" symptom of gout is paroxysmal arthritis, usually of the big toe. Arthritis occurs acutely, most often at night or early in the morning, after a heavy meal, drinking alcohol, as well as after a minor injury, physical exertion.
Gouty arthritis is accompanied by severe pain (the patient cannot step on the foot, the pain does not sleep at night, the pain intensifies even when the joint is touched with a blanket). In addition to the intense pain, there is pronounced swelling of the joint, redness of the skin over the joint, movement in the inflamed joint is nearly impossible. Arthritis may be accompanied by a high fever. An attack of gout goes away after a few days (at the onset of the illness - even without treatment).
In most patients, the second "attack" of gout is seen after 6-12 months. In the future, there is a gradual increase in the frequency of arthritis "flashes", with a tendency towards their more prolonged character. All new joints are involved: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous tofuse formation (nodules with significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders, increased uric acid levels. In most patients, the cause of the disease is impaired renal excretion of uric acid. Patients with gout, as a rule, have other metabolic disorders: overweight, increased blood pressure, increased cholesterol levels, urolithiasis, ischemic heart disease. This requires comprehensive examination and treatment.
Polymyalgia rheumatica
Older people (over 50) get sick. At the peak of the disease, pain and limitation of movement are characteristic in three anatomical areas: the shoulder girdle, the pelvic girdle and the neck. It can be difficult for the patient to determine what is hurting: joints, muscles, or ligaments.
In polymyalgia rheumatica, the patient's general condition suffers, often there are symptoms such as fever, weight loss, loss of appetite, poor sleep and depression. There is a sharp increase in ESR.
Patients usually undergo a complete cancer screening. If the patient does not go to the rheumatologist, the consultation of the correct treatment is "postponed" for a long time. It should be noted that joint pain and arthritis are also a symptom of rarer rheumatologic diseases - diffuse connective tissue diseases (systemic lupus erythematosus, systemic scleroderma, dermatomyositis, Sjogren's disease, Behcet's disease, systemic vasculitis).
There is a whole group of extra-articular soft tissue diseases, the so-called "periarthritis" (tendonitis, tendovaginitis, bursitis, enthesopathy).
Soft tissue changes can be one of the manifestations of systemic diseases, but much more often they occur as a result of local overloads, microtraumas, overtensions. Inflammatory changes in soft tissue, as a rule, respond well to periarticular (periarticular) drug administration. Inflammation in the joints can occur after injuries and requires surgical intervention. These problems are treated by orthopedists.
Osteoporosis can be a complication of chronic joint disease. Densitometry is necessary to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint disease is also performed by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatic diseases.
Arthritis occurs in tuberculosis, sarcoidosis, malignant neoplasms, amyloidosis, endocrine diseases, blood system diseases and other conditions.
In conclusion, I would like to emphasize once again that the diagnosis of joint diseases is made by a specialist rheumatologist. The treatment of joint pathology must be comprehensive and differentiated. With correct and timely diagnosis, treatment will be more successful.