Inflammatory joint disease, which has periods of exacerbation and a progressive course, can appear against the background of many concomitant ailments. Doctors also identify several predisposing factors. The symptomatic picture of chronic arthritis will vary depending on the form of the course of the disease, but there are several common signs. Diagnosis and treatment require an integrated approach. The therapy is drug-based, additionally shown immobilization of the joint for some time.
Reasons
Arthritis is considered chronic if symptoms persist for more than three months. In most cases, the development of pathology is preceded by other illnesses, which means that sluggish arthritis is a disease that develops secondarily. In children and adults, inflammation of the joints is formed on the background of:
- hypovitaminosis, that is, a lack of one or more vitamins in the body;
- pyelonephritis - kidney infection caused by various bacteria;
- various kinds of allergic reactions;
- sinusitis - inflammation of the paranasal sinuses, which occurs as a complication of acute rhinitis, flu, measles and other diseases;
- tuberculosis, that is, an acute infectious disease that causes Koch's wand (today, tuberculosis, detected on time, is treatable);
- syphilis, which is characterized by a slow course, but in the later stages leads to severe lesions of the musculoskeletal system and nervous system;
- psoriasis - a chronic dermatological disease, the symptoms of which are severely flaky red spots on the skin;
- gonorrhea, characterized by lesions of the mucosa of the urogenital tract, intestines, oropharynx and conjunctiva;
- Reiter's syndrome - a complex combination of damage to the joints, conjunctiva and urinary organs, which occurs due to an autoimmune process as a result of an infectious lesion;
- Behçet's syndrome - recurrent chronic vasculitis occurring with inflammation of the mucous membranes;
- disorders of the endocrine system;
- congenital dislocation of the hip.
The list of possible causes of arthritis is very long. The disease can appear against the background of the pathological influence of bacteria, parasites and protozoa, systemic lupus erythematosus, gout, CNS pathologies, hepatitis C (but the development of the disease cannot be ruled out).against the background of other viral liver lesions), polychondritis, tonsillitis.
Chronic arthritis often develops in patients who are characterized by the following predisposing factors: unfavorable heredity, overweight, prolonged starvation or malnutrition, prolonged hypothermia, insect bites (when poison enters the joint cavity), playing sports on a professional (athletes tend to have arthritis in the knee, ankle, fingers, and wrist), alcohol abuse or long-term smoking, hormonal imbalances (in adolescence or menopause), severe emotional stress, lack of movement, constant stress on one joint.
Classification
The nature of the development of chronic arthritis can vary, but most often doctors use the following terms to formulate an accurate diagnosis: inflammatory (rheumatoid) arthritis or degenerative arthritis. The latter type occurs when there is another disease, such as osteoarthritis. The basis of the pathology in this case is damage to the cartilage in the joint and the joints of the bones. In chronic rheumatoid arthritis, the synovial membrane lining the joints from the inside is involved in the pathological process.
Distinguish between chronic psoriatic, juvenile, gouty, traumatic, reactive, infectious, gonorrheal arthritis and osteoarthritis according to the source of the disease. Chronic juvenile arthritis is expressed in disturbing symptoms infor twelve weeks or more. This is a fairly rare type of disease. Chronic juvenile arthritis occurs in children with a frequency of approximately 0.4 cases per 1000 patients. At risk are babies from two to six years old and adolescents during puberty. Girls are diagnosed with juvenile chronic arthritis more often than boys. This is confirmed by medical statistics.
Chronic rheumatoid arthritis affects people of all ages, but most often the disease is diagnosed in patients aged 30-35 years. Women among patients are approximately two to three times more than men. In total, 0.5-2% of the population suffers from this disease, in Russia - about 0.6%, but the incidence is increasing. The reasons, as a rule, are SARS, exacerbation of infectious diseases, hypothermia or severe emotional stress.
Reactive arthritis is characterized by asymmetric involvement of several joints. Most often, this is preceded by an infection of the genitourinary system or gastrointestinal tract. Before the onset of joint pain (maximum six weeks), general symptoms may appear: fever and weakness, alarming changes in the genitourinary and musculoskeletal systems, expressed respectively by atypical discharge from the urethra, painful urination, vaginitis in women and pain in the lower extremities, discomfort in the back, difficulty walking.
Chronic gouty arthritis, as a rule, occurs after gout and in the joint where several joint attacks were observed. Usually develops inpeople with a predisposition to gout, and a potential patient may not even be aware of their unfavorable heredity. If, for example, parents lead a he althy lifestyle, then the disease may not manifest itself, but it will be transmitted to the child in a latent (hidden) form. A potential patient can provoke a disease in himself if he does not lead a completely he althy lifestyle. A typical patient with this diagnosis is a fat man who abuses alcoholic beverages and consumes a lot of meat, smoked dishes, offal.
Stages of exacerbation
As the disease progresses, chronic arthritis passes through several degrees of severity. The initial one is usually asymptomatic. Sometimes there may be complaints of stiffness of movements. Often the disease is diagnosed in children at this stage. Moderate is characterized by the beginning of the development of erosions on the bone. There is pain, swelling and swelling in the affected area. Severe degree is expressed in severe deformity of the joint. Its direct function is disturbed, and the patient makes any movements with great difficulty. A complicated degree is diagnosed when irreversible changes in bones and joints are detected.
For chronic rheumatoid arthritis, this classification is also used. With monoarthritis, only one joint is affected, oligoarthritis is characterized by inflammation of a maximum of three joints, polyarthritis is a condition when the inflammatory process affects many joints. Most often, the pathology is localized in the knee or ankle, jointsfingers and hands, shoulder, pelvis, often suffers from the temporomandibular joint. Chronic arthritis can affect multiple joints at once.
Symptomatics
Each of the many varieties of arthritis has its own clinical picture. For example, juvenile chronic arthritis in children is characterized by the following features:
- severe joint pain;
- deceleration of the physical development of the child;
- temperature increase;
- joint deformity;
- enlarged spleen and liver;
- shortening limbs;
- impaired functioning of the affected joint;
- skin rash at affected sites;
- deterioration of vision.
rheumatoid arthritis breathing, the symmetry of the inflammatory process and the deformity of the fingers.
For chronic arthritis (according to ICD 10 code M12) of the gouty type, prolonged attacks of gout are characteristic, quite frequent, the deformation is pronounced. Patients report manifestations of urolithiasis and other pathologies that affect the functioning of the kidneys, redness and swelling of the affected area.
In psoriatic arthritis, red spots appear on the scalp, the skin flakes and itches, fingers thicken, jointsusually affected asymmetrically, the integrity of the nail plates may be impaired. Symptoms of reactive chronic arthritis include persistent malaise and weakness, fever, frequent headaches, cracking joints, and burning sensation when urinating.
With arthritis of the TMJ (temporomandibular joint), pathological noises are heard, aching pain appears, which increases with exercise, the crunching and clicking of the joints are clearly expressed. The patient may complain of discomfort when chewing food. The doctor notes the retraction of the lips and the severity of the nasolabial folds, asymmetry towards the diseased joint and a decrease in the height of the lower part of the face. Traumatic and osteoarthritis are expressed by discomfort and crunching in the area of the damaged joint.
Diagnostic Methods
The diagnosis is confirmed during a comprehensive examination of a patient who complained of pain in the joints. Diagnosis includes the collection of complaints, a general examination, laboratory and instrumental procedures. Adequately diagnosing acute or chronic arthritis can be a general practitioner or pediatrician (but a general practitioner will still refer the patient to a narrow specialist to confirm a preliminary diagnosis and provide more qualified treatment), an infectious disease specialist, a traumatologist, a phthisiatrician, a rheumatologist and a dermatologist.
First, the specialist will study the patient's medical history and collect a life history (data on the presence of bad habits, heredity, diet and working conditions), conduct a thorough examination. Duringexamination assesses joint mobility, symptom severity, tests for rheumatism and determines the severity of the disease.
Among the laboratory diagnostic procedures, general blood and urine tests, blood biochemistry, immunological and enzyme immunoassays are prescribed. The patient will be referred for ultrasound, CT or MRI to obtain a clear picture of the lesion, X-ray in several projections, which will determine the stage of the course and the type of disease. As additional instrumental diagnostic methods, the doctor may recommend undergoing a myelography, biopsy of the synovial membrane, puncture of the affected joint, arthroscopy or arthrography to assess the condition of the cartilage tissue.
Treatment tactics
Chronic arthritis of the knee or other localization is treated differently depending on the type and severity of the disease. Symptomatic treatment is possible only in some forms, for example, in psoriatic, purulent or gouty arthritis. In other cases, the tactics of patient management is chosen purely individually. Treatment usually includes taking anti-inflammatory drugs ("Diclofenac", "Ibufen"), short-term immobilization of the joint, the introduction of glucocorticosteroids ("Dexamethasone", "Prednisolone") in the form of intra-articular injections. A course of therapeutic massage, physical education and exercise therapy exercises, spa treatment, physiotherapy procedures (balneotherapy) are recommended. Orthopedic devices are also used.
The main indications for surgical intervention are joint deformity, functional disorders, destructive lesions. Surgical therapy includes prosthetics, arthroscopic synovectomy, arthroplasty. To support the joints on an ongoing basis, it is shown to enrich the diet with dairy and sour-milk products, dietary meats, poultry or fish, nuts and cereals, fresh fruits and vegetables.
Arthritis in children
Children can develop and worsen arthritis. Sadly, even babies can be affected. In this case, it is quite difficult to diagnose the disease, because children cannot always objectively assess their condition. The child may remain silent about the pain, but become capricious, stop making active movements, and begin to refuse food. Notice the swelling is also not always possible. But there are signs by which arthritis can be identified in childhood. Usually the child stops making unnecessary movements, and if he is forced to move, he becomes active. Lameness or stiffness in the morning are clear signs of illness.
There are many causes of chronic arthritis in children. As a rule, pathology appears as a result of injuries, diseases of the nervous system, metabolic disorders, unfavorable heredity, lack of vitamins and nutrients, and immune system failures. The cause may be a previous infection. Effective treatment of chronic arthritis in children begins with the identification of the cause and completesurvey.
Therapy can be carried out both at home and in a hospital setting. Treatment is long, takes several years in severe cases, and with inadequate therapy or its complete absence, arthritis becomes a lifelong disease. Treatment includes medication, therapeutic massage and physical education, physiotherapy. Sanatorium-and-spa treatment is desirable to carry out during remission and with minimal activity. Therapy may include the use of splints to restrict movement. In severe cases, surgery is needed.
Arthritis is difficult to diagnose at an early stage, but it is important to know that the sooner treatment is started, the more effective and successful it will be. You need to pay attention to the child. In case of any ailments, you should immediately consult a doctor (pediatric rheumatologist). Adequate treatment will be prescribed based on the exact diagnosis, the age of the child and the general state of he alth. This will help eliminate the symptoms, and at best - achieve recovery.
The most common and severe form of arthritis in children is juvenile arthritis. This disease requires regular prevention of exacerbation and the most prolonged treatment. Traditional drugs that are used as part of drug therapy have many side effects: gastritis, stomach ulcers, and increased acidity. Today there is an alternative method: treatment by injecting homeopathic medicines into acupuncture points. This method of therapy has proven itself well in Europe, but in Russia so far onlypopularized. The introduction of homeopathy is good because it causes positive dynamics, but does not provoke the appearance of side effects, which is especially important when treating children.
Possible Complications
Chronic arthritis (ICD 10: M13 - other arthritis, M13.0 - polyarthritis, M13.1 - monoarthritis) can cause various consequences. Among the most common complications are kidney failure, vasculitis (a group of diseases associated with inflammation and destruction of the walls of blood vessels), pulmonitis (an inflammatory disease of the lungs), myocarditis (myocardial muscle damage), pericarditis, synovitis (fluid accumulation in the joint cavity), pleurisy (inflammation of the membrane surrounding the lungs), uveitis, which can cause blindness, secondary osteoarthritis. In severe cases, complete disability and limited mobility are possible.
Forecast
If the treatment of chronic arthritis is started on time, then the prognosis is favorable in most cases. The disease cannot be cured completely, but a significant duration of the remission period can be achieved. It is necessary to strictly follow all the recommendations of the doctor, which will help to avoid exacerbation and disability of the patient. From time to time it is recommended to undergo spa treatment, a course of massage and physiotherapy.
Prognosis also depends on the general he alth of the patient, the severity of the disease and the presence of concomitant diseases. In some cases, restoration of all joint functions is possible, but sometimes it is completelyis destroyed. In this case, an operation is performed, after which it is necessary to restore the soft tissues surrounding the joint.
Prevention measures
To avoid chronic arthritis (especially with unfavorable heredity), it is necessary to completely abandon addictions, engage in feasible sports and eat rationally, keep body weight within normal limits, and avoid hypothermia. It is highly recommended to carry out early diagnosis and comprehensive treatment of all possible diseases that can cause damage to the joints. Several times a year, you should undergo a preventive examination at the district clinic or private medical center. You should not refuse medosmore due to lack of time or simple unwillingness. This will help keep your joints he althy (and normal movement) for as long as possible.
