Psoriasis of the joints is an inflammatory process that occurs in a chronic form and affects the articular surfaces. According to statistics, from 8 to 10% of patients face such a problem as psoriatic arthritis. Joint psoriasis ranks second among diseases that affect bone tissue, after rheumatoid arthritis. It is worth noting the fact that the disease never affects all the joints of the body. Psoriasis can be inactive - a state of remission, and active - exacerbation.
Classification
According to the international classification of diseases, the following types of disease are distinguished:
- Oligoarthritis is an asymmetric inflammation of several joints, but no more than three.
- Distal interphalangeal psoriatic arthritis. This disease is characterized by damage to the small joints of the fingers.
- Psoriatic spondylitis. This disease affectsspinal column and extends to any of its parts.
- Mutilating arthritis. This type of joint psoriasis affects the bones and causes their complete destruction. The disease can develop both in the upper and lower extremities, and swelling of the soft tissues is observed. Due to the destruction of bones, further shortening of the fingers of the limbs occurs.
- Symmetrical polyarthritis. This disease is characterized by a symmetrical lesion of both limbs.
Signs of illness
Some symptoms of joint psoriasis are similar to those of rheumatoid arthritis. But there are a number of signs that are unique to this disease.
- When psoriasis hurts the joints located directly in the heel.
- Often, not one, but several joints on the fingers are often affected.
- The localization site turns purple and swells. This can be clearly seen in the photo of psoriasis of the joints. In addition, with this disease, the temperature in the area of the affected joint rises.
- Pain in the big toe.
The disease mainly affects the joints of the fingers. Psoriasis of the knee is rare, but much more severe. With this type of pathology, pain prevents the patient from going up and down the stairs normally, the joint is deformed, due to which there is a restriction in the mobility of the knee. Ultimately, all this can lead to completeloss of motor function.
Etiology of the phenomenon
The causes of bone psoriasis are still not fully understood, but it is believed that the main ones are:
- Injury to limbs and joints.
- Infectious and viral diseases occurring in severe acute form.
- Pathology can also develop while taking high doses of drugs such as Vasocordin, Egilok, Atenolol.
- Frequent stress, psycho-emotional disorders, nervous tension.
- High physical activity.
Risk factors
The risk of developing psoriasis of the joints is significantly increased in the presence of the following factors:
- Weakened immune system.
- Intoxication of the body due to prolonged use of medications, alcohol and tobacco products, as well as drugs.
- Metabolic disorders.
- Genetic predisposition.
- Human Immunodeficiency Virus and AIDS.
- Overweight - obesity, overeating.
- Inadequate rest, that is, a violation in sleep and wakefulness.
- Physical fatigue and emotional exhaustion of the body.
- Working in factories with a high dose of chemical radiation.
Diagnostic measures
If psoriatic joint damage is suspected, the doctor carefully examines the patient, after which he sends him to take tests and undergo all necessary examinations.
- Complete blood count. ESR, globulin, sialic acids and fibrinogen increase in psoriasis.
- X-ray. This analysis helps to determine the decrease in the joint space, which indicates the development of arthrosis. In addition, with the help of X-rays, you can find out the degree of damage to the joint and the severity of the disease.
- The study of synovial fluid. This analysis is carried out only with the defeat of large joints. The development of arthrosis is indicated by a decrease in the viscosity of the synovial fluid and increased cytosis.
- Differential diagnosis. Appointed in order to clarify the presence or absence of the disease. In this case, an analysis for rheumatoid factor is performed. If the answer is yes, then the patient has rheumatoid arthritis. A negative result means that the patient has joint psoriasis.
Drug therapy
Medical therapy is indicated to achieve the following goals:
- Stopping the progression of the disease and partial relief of inflammation.
- Elimination of discomfort and pain.
- Strengthening and supporting the immune system.
- Reducing the functionality of the musculoskeletal system.
The treatment of joint psoriasis depends on the symptoms and associated signs of the disease. For therapy, the following groups of medications are used:
- Anti-inflammatory drugs of non-steroidal origin. This group helps to eliminate pain, significantly reduce inflammation andswelling of the joint, eliminate discomfort, manifested in the form of stiffness of movements. The main drugs prescribed for psoriasis of the joints are Ibuprofen, Diclofenac, Nimesulide, Voltaren, Piraxicam, Movalis and Methotrexate.
- Corticosteroids. This group of drugs helps the patient get rid of all the unpleasant manifestations of psoriasis of the joints. The most effective drugs for psoriasis include Dexamethasone, Prednisolone, Hydrocortisone. The use of hormonal ointments for a long time can cause necrosis of the skin, so these drugs are prescribed in the form of injections directly into the cavity of the joints or muscles.
- Drugs that improve blood circulation. This group of drugs includes Curantil, Drotaverin, Pentilin and Pyridoxine.
It is worth noting that a drug such as Methotrexate should be used with extreme caution due to side effects affecting the liver and kidneys.
If a bacterial infection is attached, the doctor may prescribe the use of a drug such as Sulfasalazine. Due to the large list of side effects, this drug should be used with caution.
All drugs used for psoriasis of the joints should be prescribed only by a doctor, self-medication in this case is unacceptable. Since only a doctor can choose the optimal scheme and dosage individually for eachpatient.
Physiotherapy activities
In combination with drug therapy for psoriasis of the joints, the patient is prescribed physiotherapeutic procedures. The main methods of such therapy are:
- exercises used in physical therapy;
- electrophoresis with analgesics;
- ozocerite applications;
- magnetotherapy;
- laser therapy;
- UHF and PUVA therapy.
Surgery
Surgeries to eliminate psoriasis of the joints are extremely rare, as in most cases they are simply not necessary. Surgery is only indicated when no other therapies are working.
One of the methods of surgical intervention is synovectomy. The main goal of this intervention is to restore the functionality of the affected joint.
In the most advanced cases, joint arthroplasty or cartilage arthroplasty are used, in which the affected joint is replaced with an artificial one. Sometimes the patient undergoes surgical fixation of the cartilage of the wrist and ankle joint, as well as fingers and toes.
Many patients after surgery to eliminate joint lesions in psoriasis experience significant relief. So, pain and discomfort disappear, joint functions are restored.
Features of food
Strict adherence to diet is a very important factor in the treatment of psoriasis of the joints. All foods should be completely eliminated from the diet.pickled, smoked, spicy, s alty, sweet, citrus and alcohol.
The patient's daily diet should contain fermented milk products, herbs, fish, fresh vegetables, fruits and vegetable oil. Patients with overweight should follow a low-calorie diet and carefully monitor that meals must be fractional.
Prognosis and possible complications
With untimely or incorrect treatment, psoriasis of the joints can lead to further disability of the patient. In addition, the disease can be fraught with such consequences and complications:
- Ethnesopathy. The inflammatory process develops at the points of attachment to the bone of ligaments and tendons. This process is observed mainly on the feet. As a result, the functionality of the limb is significantly reduced, since when walking the patient experiences very severe pain, difficulties begin when trying to bend or straighten the toes.
- Dactylitis. Inflammation develops on the phalanges of the fingers. As a result of the pathology, the fingers greatly increase in size, pain appears, the functions of the hand are impaired, and, as a result, the patient cannot perform any finger movements. Often, dactylitis affects the toes, while walking the patient feels very severe pain.
- Inflammation of the intervertebral joints. This type of complication leads to the fact that the patient experiences unbearable pain when trying to bend or straighten his back. The main place of localization of the pathology is the region of convergence of the pelvis andspine.
Psoriasis is difficult to identify at the initial stage, so in most cases it is diagnosed at a later stage, when there are already some consequences. As a result, therapy becomes much more difficult.
The effect of joint psoriasis on internal organs
In psoriasis of the bones, the inflammatory process in the joints may be the only manifestation of the disease. But often such inflammation is part of such systemic diseases as pathologies of the gastrointestinal tract, diseases of the kidneys, liver and heart, polyneuritis, amyloidosis.
Diseases of this kind are difficult to detect at an early stage, since in this case only an increase in body temperature is a characteristic symptom. The inflammatory process develops as a result of impaired blood circulation in the vessels. In addition, antigens are deposited on the walls of blood vessels, leading to the appearance of seals and a decrease in elasticity in tissues.
Prevention measures
There are no special preventive measures to prevent and prevent psoriasis of bones and joints. But doctors recommend following a number of general measures that will help the body resist the development of the disease. The main ones are:
- Prevention of overload and injury to the joints.
- Getting rid of bad habits, in particular avoiding drinking and smoking.
- You need to eat only the right balanced food. Limit s alt intake andsugar.
- Overeating and obesity should be avoided.
- In the cold season, it is important not to overcool the joints, that is, dress warmer.
- Periodically you need to drink mineral water from healing sources. If possible, you need to relax at sea.
It is impossible to completely get rid of psoriasis of the joints, however, following all the recommendations of the attending physician, you can bring the disease into a stable period of remission. Following the rules of preventive measures will help prevent the development of the disease.
