Arthritis is an inflammatory disease of the whole body, in particular the joints. The disease causes severe pain, which increases significantly at night. The disease begins to develop in youth from 30 years and older. Most often, women suffer from pathology, since the problem is transmitted to them through the genetic line, so early diagnosis of arthritis is very important.
Definition
The joint consists of a capsule, articular surfaces and a cavity with fluid, all covered with cartilage. Arthritis causes inflammation in the synovium. Further, this process passes to other elements of the joint: capsule, cartilage, tendons and ligaments. At the time of the examination, a change in all parts is observed. In severe cases, complete deformity is present. Photos of symptoms, treatment and diagnosis of arthritis are described below, so that you can fully understand the clinic of this disease.
Location locations
The skeleton is a complete systemflexible connections, allowing a person to easily perform various movements. After the first signs of the appearance of an ailment, one or another part begins to malfunction.
According to the localization, the disease can be divided into the following categories:
- Arthritis of the hands - this inflammation occurs in the area of the elbow joint, shoulder, hand or individual fingers. The common cold and flu, as well as diabetes, tuberculosis and sexual infections can affect the formation of the disease.
- Arthritis of the legs - covers the defeat of the knee joints, hip area and foot with the capture of fingers. The reasons for the development are the same as in the previous version. Among the main symptoms, one can single out severe pain, which becomes greater at the time of movement, swelling and redness in this area, as well as stiffness of movements. Diagnosis of arthritis of the fingers is quite important, since the problem appears due to a hereditary factor, so if it is possible to prevent the disease, then it is better to do it.
- And also the disease affects the cervical region, such a pathology occurs even in young people. The reason for this is a genetic predisposition, poor posture, bad habits, hypothermia, heavy loads and the presence of injuries and wounds in this department.
Symptoms
Methods for diagnosing arthritis are different, but in order to decide which one to choose, you need to know the main factors that indicate the presence of the disease. The pathology clinic develops from a generalmalaise, which is initially regarded as overwork or fatigue. However, all feelings gradually build up and soon affect daily functioning and activity.
The main symptom of the disease is considered to be arthralgia, in which there is a steady wave-like character, which increased significantly in the second half of the night. Its intensity varies from minor pain to severe and severely limiting mobility.
Typical clinic for the diagnosis of rheumatoid arthritis and its other types is supplemented by local hyperemia and hyperthermia, sensations of stiffness, swelling and limited mobility. Palpation can determine the soreness of the entire plane of the joint and the joint space. Further, deformity, as well as joint disorders, modification of the skin and the formation of exostoses, join the listed symptoms.
If an infectious form is present, chills and fever will appear.
Reasons
The following factors for the occurrence of the disease are distinguished:
- contusions, repetitive injuries, closed and open joint injuries;
- metabolic problems and vitamin deficiencies;
- fungal, infectious and viruses: colds, SARS, tuberculosis;
- diseases of the nervous system;
- physical overload;
- hereditary predisposition;
- immune disorders.
Very often, the disease can occur due to hypothermia, excess weight, allergies,smoking and a sedentary lifestyle. Diagnosis of arthritis of the fingers is most often performed by persons of such professions: seamstresses, hairdressers and massage therapists. Problems with the spine are often found among movers and builders.
Views
Arthritis is a very broad disease, so it has many forms. Affects many parts of the body, both soft tissue and joints.
1. If the differential diagnosis of reactive arthritis is carried out, then it can be determined that this disease develops under the influence of infections:
- intestinal, due to the use of low-quality products;
- inflammation of the respiratory tract (tracheitis, pneumonia and bronchitis);
- Salmonella stick and other dangerous microbes that penetrate the bloodstream into the joints, causing inflammation;
- chlamydia, provoking the development of infection of the genitourinary system.
Reactive arthritis has another subtype - aseptic, appears when the immune system forms antibodies that infect the cells of its own body, as it takes them for bacteria. Leflunomide, Sulfasalazine, ASD and monoclinal drugs are used as therapy.
2. Diagnosis of rheumatoid arthritis most often takes place in the later stages, since this disease is called "long-playing", it develops slowly and does not appear immediately. Most often, lesions form symmetrically and are localized in the limbs: ankles, knees, from the shoulders to the hands. The main reason is considered to be a failure of the immune system due to hormonaldeviation or virus. The walls of blood vessels begin to be perceived as harmful bacteria, and they are destroyed. In this case, it is recommended to use the immunomodulator "ASD", the antimicrobial drug "Sulfasalazine", as an anesthetic "Paracetamol".
3. Differential diagnosis of psoriatic arthritis is very detailed, since this ailment belongs to genetic diseases, with it there are skin lesions in almost all members of the same family. In order for the disease to move from the outer surface inwards, exposure to injuries and bruises, operations, wounds, childhood diseases (scarlet fever, chickenpox), as well as shingles, hepatitis and even influenza is required. For therapy, it is recommended to take "Sulfasalazine" and as an anesthetic "Paracetamol".
4. Treatment and diagnosis of the symptoms of gouty arthritis is difficult, since this disease appears due to the ingress of uric acid into the blood. Crystals settle in various tissues, thereby causing a lot of inconvenience. The main factor that provokes the disease is a problem with the kidneys, but development is often observed in violation of metabolic processes. For treatment, it is recommended to use the above-mentioned drugs.
Palpation and general examination
Diagnosis of arthritis begins with a general examination, which helps to see external deviations from the norm. Most often it is manifested by swelling in the area of \u200b\u200bthe joints. At the time of the examination, the doctor often asks the patient to make certain movements in order to recognize the nature of the pain and the area of its distribution.
Another and the most important method is palpation or palpation. With the help of touch, the doctor can assess the external signs of joint disease. Thus, rheumatoid or rheumatic nodules are easily located, and it is also determined where discomfort is observed during movements, the state of the joint capsule and temperature are ascertained.
Diagnosis of arthritis by these methods is the most accessible, but it is carried out without the use of technical means, so it is difficult to present a complete clinical picture of the disease.
Goniometry
This variant of the survey is carried out using a goniometer - a device that allows you to identify the amplitude of joint mobility. It resembles a protractor and helps to calculate the angle of mobility. The patient performs a number of necessary manipulations (extension, flexion, lowering, lifting), and the doctor records the measurements and compares them with the norm.
Laboratory methods
These standards for diagnosing rheumatoid arthritis and other diseases are more accurate, as detailed information about the patient's condition can be obtained.
- Blood test - during a biochemical examination, the doctor will pay attention to the amount of c-reactive protein in the blood serum, to the diphenylamine reaction, as well as other indicators. A serious sign is required to consider an increase in ESR (erythrocyte sedimentation reaction), as it indicates an inflammatory process. In the presence of pathology, immunologicalanalysis shows antinuclear antibodies (ANA). And it should also be noted that the level of urea is significantly increased.
- Urine analysis - it should be noted that this figure will be overestimated only in severe forms of the disease. In he althy individuals, protein in the urine and blood should be absent altogether. Its appearance indicates the presence of the disease.
Radiodiagnosis
Treatment of the rheumatoid arthritis clinic is impossible without such an examination. Allows you to study in detail the condition and structure of the joints. No preparation required.
- X-ray examination - an indication for the use of this technique is pain in the joints, difficulty in mobility and swelling. During the examination, the image of the joint is provoked on a special film with the help of rays. At the time of diagnosis, to protect all other organs, they are covered with a lead apron. An x-ray will help to examine the pathology and deformity of the joints. The results will be presented in 15 minutes as a snapshot. This method of diagnosing arthritis is not suitable for pregnant women, as there is still minimal radiation.
- Arthrography is more accurate than conventional x-rays. It is used for damage to the meniscus and at the time of suspicion of rupture of the joint capsule. Before the procedure, the joints are artificially contrasted. For this, a specialsubstance, after which the patient is asked to perform several movements. At this point, the image is captured by a targeted radiography. The outcome of the examination, depending on the device, can be obtained on film or monitor. The procedure takes literally 10 minutes, and there are no contraindications for it, except for an allergy to iodine.
- Computed tomography (CT) is performed in the diagnosis of seronegative arthritis, and not only, as it is very effective. The method allows you to evaluate the structure to the millimeter and take a picture in any plane. Such a diagnosis greatly facilitates the ability to make a diagnosis. At the time of the procedure, the patient is placed on the couch, which moves during the examination, and then a special tube amplifies and transmits the rays in the required sequence. Everything takes 2-3 minutes, and the degree of exposure is minimal. The result can be obtained both in the picture and in digital format.
Radionuclide methods
The study helps to recognize the pathology with the help of radiopharmaceuticals. The most popular way to diagnose rheumatoid arthritis in the early stages is scintigraphy. During the procedure, radioactive isotopes are introduced into the body, and good images are obtained due to the radiation emitted by them. The procedure is carried out using a tomograph.
Visualization is formed at the cellular level, this contributes to the visualization of functional changes that begin to occur in the body before the anatomical ones. The procedure is completely safe asgamma-emitting radionuclides with a short half-life are used. The main contraindication is pregnancy and lactation.
MRI joints
Magnetic resonance imaging (MRI) is often used to diagnose rheumatoid arthritis in its early stages. It is carried out using strong magnetic radiation and radio waves. All this allows you to get a more accurate pattern of the fabric. The patient is placed inside the "pipe" of the device and the main requirement for him is immobility, since the quality of the image will depend on this.
The technique allows to consider in all details the clinical picture in case of injuries and degenerative diseases. The procedure takes 10–20 minutes, and the patient receives a conclusion in 20–30 minutes. MRI is considered non-hazardous, as the applied magnetic field does not pose a threat to the human body, so there are no serious restrictions.
Ultrasound diagnostics
Ultrasound waves are often used in the treatment and diagnosis of rheumatoid arthritis clinics. A special device generates the required frequency, which interacts with soft tissues and enters the examination area. Very often, ultrasound (ultrasound) is prescribed for injuries and rheumatic pathologies, which are accompanied by inflammatory processes.
Sound vibrations are recorded by a special scanner, and the image is immediately shown on the monitor, if anyneed, it can be printed. In order to prevent air from arising between the scanner and the examination site, the plane is lubricated with a special gel. The doctor runs a sensor over the body, and this does not bring even minimal discomfort to the patient. Ultrasound is the safest procedure to perform during pregnancy.
International Standards for ICD-10
In order for any doctor to know about the patient's disease in case of contacting a foreign hospital or center located in another city without a special examination, there is an international classification, which is presented below:
- M00 - pyogenic arthritis.
- M01 - direct infection of the joint in parasitic and infectious diseases.
- M02 - reactive arthropathies.
- M03 - reactive and post-infectious arthropathies, which are classified in other groups.
- M05-M14 - inflammatory polyarthropathies.
- M05 - seropositive rheumatoid arthritis.
- M06 - other rheumatoid arthritis.
- M07 - enteropathic and psoriatic arthropathies.
- M08 - juvenile arthritis.
- M10 - gout.
- M11 - other crystalline arthropathies.
- M12 - other specific arthropathies.
- M13 - other arthritis.
- M14 - Arthropathies in other diseases classified elsewhere.
There are a lot of international standards for the diagnosis of rheumatoid arthritis, but thanks to such a classification, the doctor can always know in any situation what his patient is sick with.
Treatment
Etiological therapy of arthritis is performed only in certain forms of arthritis - gouty, infectious and allergic.
- Diseases with chronic and subacute course are subject to a single pharmacotherapy using anti-inflammatory steroid (Methylprednisolne, Prednisolone) and non-steroidal (Ibuprofen, Naproxen, Diclofenac) drugs. Synthetic steroids are often used for injection into the deepening of the joint (therapeutic punctures).
- As the acute inflammatory process subsides, physiotherapy (UVR (ultraviolet irradiation) in erythemal doses, phonophoresis with hydrocortisone, electrophoresis with analgesics, amplipulse therapy) is actively connected to drug therapy, which has an anti-inflammatory and analgesic effect, preventing joint dysfunction and fibrotic changes.
- It is also recommended to use massage and physiotherapy exercises, as these procedures for arthritis are aimed at preventing the development of functional disorders and contractures in the joints.
- Balneotherapy, mud therapy, spa and sanitary therapy can be used as a recovery complex.
- Application of efferent therapy techniques (cryophoresis, plasmapheresis, cascade fixation of blood plasma), focused on extracorporeal absorption of antibodies in autoimmune arthritis, urate and gouty form of the course. When using extracorporeal pharmacotherapy, the patient's personal blood cells (erythrocytes,leukocytes, platelets) for the correct delivery of medicinal components to the site of inflammation.
- The introduction of stem cells is often used as a therapy for severe forms of arthritis. Such treatment improves the nutrition of the tissues of the joint, resumes metabolism, subsides inflammation and increases resistance to infections, which very often cause the disease. The incredible value of stem cells can be seen in the stimulation of cartilage regeneration, as well as the restoration of its structure.
- In some cases, surgery is required - synovectomy, joint resection, arthrosis, arthrodesis, cheilectomy, arthroscopic interference.
- If there are destructive changes in the joint that are caused due to arthritis, arthroplasty is indicated, as well as reconstructive arthroplasty operations.
