Joint pain and swelling are common in many different conditions. The earlier the diagnosis is made and the correct treatment is initiated, 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 premier arthritis clinics in a number of European countries.
Symptoms of arthritis are: joint pain, joint swelling, stiffness of movement, local increase in soft tissue temperature around the joint. General symptoms such as weakness, fever, weight loss are possible. For timely diagnosis and the appointment of the correct treatment, the patient should consult a specialist doctor - a rheumatologist.
Unfortunately, due to the widespread publicity of unconventional treatment methods, 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 long-term remission.
Now let's talk about the symptoms of the most common rheumatological diseases.
Osteoarthritis
Osteoarthritis is the most common joint disease that usually occurs in people over the age of 40-45. Women suffer from osteoarthritis almost 2 times more often than men.
The most clinically significant and disabling forms of osteoarthritis are coxarthrosis (osteoarthritis of the hip joint) and gonarthrosis (osteoarthritis of the knee joint). With nodular osteoarthritis, there is a lesion of the interphalangeal joints of the hands (pain and deformity).
The main clinical symptom in 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 on stairs (especially when going down), when carrying weights. In addition to pain, the patient is concerned about the restriction of movement in the joint, creaking during movement.
Sometimes there is a swelling (effusion) of the knee joint (it can be swollen behind, below the knee). This is a symptom of joint inflammation.
In 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 symmetrical (right and left extremity) arthritis (pain, swelling) of the wrist joints, small joints of the hands and feet. Joint pain is most troubling in the morning. It is difficult for the patient in the morning to clench his hand into a fist, raise his hand (comb his hair), step on his feet (due to pain under the "pads" of the toes). Joint pain is accompanied by a characteristic symptom: "morning stiffness".
Patients describe morning stiffness as a feeling of "swelling, joint stiffness", "hands with tight gloves". In addition to 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 improperly. Often the disease begins gradually, often with arthritis of one joint, then other joints "stick together. "
To use the "window of opportunity" and promptly start treatment for persistent arthritis (2-3 weeks), especially for arthritis of the small joints, it is necessary to consult a rheumatologist. To confirm the diagnosis, immunoassays, x-rays and MRIs are used.
Spondyloarthritis
This is a group of diseases which 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 old). Spondylitis is 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, subside after a warm-up, do not go away at rest and are accompanied by morning stiffness of the spine. Spondyloarthritis often affects the hip joints (the first symptom is often pain in the groin).
Spondyloarthritis is characterized by the presence of asymmetrical arthritis, mainly in the joints of the lower extremities. Unfortunately, the correct diagnosis is often made 8-10 years after the onset of the disease, especially if the patient has pain in the spine, but not arthritis.
These patients have been followed for a long time by neurologists and chiropractors diagnosed with osteochondrosis. For a correct diagnosis, an additional examination is necessary: MRI of the sacroiliac joints, radiography of the pelvis, blood test for the presence of a specific gene.
Gout
Men get gout about 20 times more often than women. Gout mainly develops during the fifth decade of life.
The "classic" symptom of gout is paroxysmal arthritis, usually 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 also intensifies 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 on the joint, movements in the inflamed joint are almost impossible. Arthritis can be accompanied by a high fever. A gout attack disappears after a few days (at the beginning of the disease - even without treatment).
In most patients, the second "attack" of gout occurs after 6-12 months. In the future, there is a gradual increase in the frequency of arthritis "attacks", there is a tendency to their more prolonged nature. All new joints are involved: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofusi (nodules with a 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 thorough examination and treatment.
Polymyalgia rheumatica
Older people (after 50) get sick. At the height of the disease, pain and limitation of movement are characteristic in three anatomical areas: in the shoulder girdle, pelvic girdle and neck. It can be difficult for the patient to determine what hurts - joints, muscles or ligaments.
With polymyalgia rheumatica, the general condition of the patient suffers, often there are symptoms such as fever, weight loss, loss of appetite, poor sleep and depression. There is a marked increase in ESR.
Patients usually undergo a thorough cancer screening. If the patient does not go to a rheumatologist, the appointment 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 rheumatological 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 diseases of the extra-articular soft tissues, the so-called "periarthritis" (tendinitis, tendovaginitis, bursitis, enthesopathies).
Changes in soft tissues can be one of the manifestations of systemic diseases, but much more often they occur due to local overloads, microtrauma, overvoltage. Inflammatory changes in soft tissues, as a rule, respond well to periarticular (periarticular) drug administration. Joint inflammation can occur after injury and require surgery. These problems are faced by orthopedists.
Osteoporosis can be a complication of chronic joint disease. Densitometry is needed to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint disease is also carried out by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatological 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 emphasize once again that the diagnosis of joint diseases is carried out by a specialist rheumatologist. Treatment of joint pathology should be comprehensive and differentiated. With correct and timely diagnosis, treatment will be more successful.