Joint pain and swelling are common in many different conditions. The earlier the diagnosis is made and the correct treatment is started, the greater the success of the therapy.
Arthritis is considered "early" if the diagnosis is made within 6 months of the first symptoms of the disease. There are clinics for early arthritis in many European countries.
Symptoms of arthritis are: joint pain, swelling of the joints, stiffness of movement, local increase in the temperature of the soft tissue around the joint. General symptoms such as weakness, fever, weight loss are possible. For timely diagnosis and appointment of proper treatment, the patient should consult a specialist - rheumatologist.
Unfortunately, due to the widespread advertising of unconventional methods of treatment, patients often turn to chiropractors, osteopaths, homeopaths - and time is wasted. In particular, in the treatment of rheumatoid arthritis, the first 3-6 months of the disease are called the "window of opportunity" - this is the time when proper treatment can lead to persistent and prolonged remission.
Let us now discuss the symptoms of the most common rheumatic diseases.
Osteoarthritis
Osteoarthritis is the most common joint disease that usually occurs in people aged 40-45. Women suffer from osteoarthritis almost 2 times more often than men.
The most clinically significant and disabling forms of osteoarthritis are coxarthrosis (arthrosis of the hip joint) and gonarthrosis (arthrosis of the knee joint). In nodular osteoarthritis, the interphalangeal joints of the hands are damaged (pain and deformity).
The main clinical symptom of osteoarthritis is pain in the affected joint during exercise. With osteoarthritis of the knee or hip joint, the patient feels pain when walking, when getting up from a chair, when walking up stairs (especially when descending), when carrying weights. In addition to pain, the patient is worried about the restriction of movement in the joint, creaking during movement.
Sometimes there is swelling (effusion) of the knee joint (it may be swollen behind, below the knee). This is a symptom of arthritis.
In the case of an eruption (synovitis), the nature of the pain changes: the pain occurs at rest, it is not related to stress.
Rheumatoid arthritis
Rheumatoid arthritis usually occurs in middle-aged women. The most characteristic symptoms are symmetrical (on the right and left extremity) arthritis (pain, swelling) of the wrists, small wrists and feet. Joint pain is more bothersome in the morning. In the morning, it is difficult for the patient to squeeze his hand into his fist, raise his hand (comb his hair), stand on his feet (due to pain under the "pads" of the toes).
Patients describe morning stiffness as a feeling of "swelling, stiffness in the joints", "hands with tight gloves". In addition to joint syndrome, rheumatoid arthritis is characterized by such general symptoms as weakness, weight loss, weight loss, sleep disturbance, and fever.
You need to know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be disabled if diagnosed late and not treated properly. Often the disease begins gradually, often with arthritis of one joint, and then the other joints "join".
In order to use the "window of opportunity" and start the treatment of persistent arthritis as soon as possible (2-3 weeks), especially arthritis of the small joints, it is necessary to consult a rheumatologist. Immunoassays, radiography and MR are used to confirm the diagnosis.
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 united by common genes and common clinical symptoms. Spondyloarthritis usually occurs in young people (up to 40 years). 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, decrease after warming up, do not pass at rest, and are accompanied by morning stiffness of the spine. Spondyloarthritis often affects the hip joints (the first symptom is often groin pain).
Spondyloarthritis is characterized by the presence of asymmetric arthritis, mainly of the joints of the lower extremities. Unfortunately, the correct diagnosis is often made 8-10 years after the onset of the disease, especially in the case when the patient has back pain, but no arthritis.
These patients have been monitored for a long time by neurologists and chiropractors diagnosed with osteochondrosis. For the correct diagnosis, an additional examination is needed: MR of the sacroiliac joints, X-ray of the pelvis, blood analysis for the presence of a certain gene.
Gout
Men get gout about 20 times more often 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, more often at night or early in the morning, after a large meal, alcohol consumption, as well as after a minor injury, physical exertion.
Gouty arthritis is accompanied by severe pain (the patient cannot stand on his feet, the pain does not sleep at night, the pain intensifies even when the joint is touched with a blanket). In addition to severe pain, there is a pronounced swelling of the joint, redness of the skin over the joint, movements in the inflamed joint are almost impossible. Arthritis can be accompanied by high fever. The gout attack disappears after a few days (at the beginning of the disease - even without treatment).
In most patients, a second "attack" of gout is observed after 6-12 months. In the future, the frequency of "attacks" of arthritis will gradually increase, there is a tendency of their longer-lasting nature. All new joints are affected: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous tofu formation (nodules with a significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders, increased levels of uric acid. In most patients, the cause of the disease is impaired excretion of uric acid through the kidneys. Patients with gout, as a rule, have other metabolic disorders: overweight, high blood pressure, elevated cholesterol levels, urolithiasis, ischemic heart disease. This requires a comprehensive examination and treatment.
Polyumalgia rheumatica
Older people (after the age of 50) get sick. At the peak of the disease, pain and restriction of movement are characteristic in three anatomical areas: in the shoulder, pelvic girdle and neck. It can be difficult for the patient to determine what is hurting: joints, muscles or ligaments.
In rheumatic polymyalgia, the general condition of the patient suffers, and symptoms such as fever, weight loss, loss of appetite, poor sleep, and depression often occur. There is a significant increase in ESR.
Patients usually undergo a detailed examination of the cancer. If the patient does not go to a rheumatologist, then the appointment of proper treatment is "delayed" for a long time. It should be noted that joint pain and arthritis are also a symptom of rare rheumatic diseases - diffuse connective tissue diseases, Behcet's disease, systemic vasculitis).
There is a whole group of diseases of extraarticular soft tissues, the so-called"periarthritis" (tendinitis, tendovaginitis, bursitis, enthesopathy).
Soft tissue changes can be one of the manifestations of systemic diseases, but they occur much more often as a consequence of local overload, microtrauma, and overstrain. Inflammatory changes in soft tissues, as a rule, respond well to periarticular (periarticular) drug administration. Inflammation in the joints can occur after an injury and require surgery. These problems are dealt with by orthopedists.
Osteoporosis can be a complication of chronic joint disease. Densitometry is required for an accurate diagnosis of osteoporosis.
Treatment of osteoporosis associated with joint diseases is also carried out by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatic diseases.
Arthritis occurs in tuberculosis, sarcoidosis, malignant neoplasms, amyloidosis, endocrine diseases, diseases of the blood system and other pathologies.
In conclusion, I would like to mention once again that the diagnosis of joint disease is made by a specialist rheumatologist. Treatment of joint pathology should be comprehensive and differentiated. With a proper, timely diagnosis, treatment will be more successful.