Joint pain and swelling are common in many different conditions. The earlier the diagnosis is made and proper 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 early arthritis clinics in a number of European countries.
Symptoms of arthritis are: joint pain, swelling of the joints, stiffness of movement, local increase in temperature of the soft tissues around the joint. General symptoms like weakness, fever, weight loss are possible. For a timely diagnosis and appointment of correct treatment, the patient should consult a specialist - rheumatologist.
Unfortunately, due to the widespread advertising 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 correct treatment can lead to ongoing and long-term remission.
Now let’s talk about the symptoms of the most common rheumatic diseases.
Osteoarthritis
Osteoarthritis is the most common joint disease that usually occurs in people over 40-45 years old. Women suffer from osteoarthritis almost 2 times more often than men.
The most clinically important and disabling forms of osteoarthritis are coxarthrosis (osteoarthritis of the thigh 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 experiences pain when walking, when getting up from a chair, when walking on stairs (especially when descending), when carrying weights. In addition to pain, the patient is concerned about restriction of movement in the joints, cracking during movement.
Sometimes there is a swelling (shedding) of the knee joint (may be swollen back, below the knee). This is a symptom of joint inflammation.
In the case of effusion (synovitis), the nature of the pain changes: the pain appears at rest, which is not accompanied by stress.
Rheumatoid arthritis
Rheumatoid arthritis usually occurs in middle-aged women. The most characteristic symptoms are symmetrical arthritis (in the right and left extremities) (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 shake hands, raise the hand (comb the hair), step on the feet (due to pain under the "pillows" of the toes). Joint pain is accompanied by a characteristic symptom - "morning stiffness".
Patients describe morning stiffness as a feeling of "swelling, stiffness in the wrists, " "hands with tight gloves. "In addition to articular syndrome, rheumatoid arthritis is characterized by such general symptoms as weakness, weight loss, weight loss, sleep disturbance, and fever.
You should 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 the other joints "join".
To take advantage of the "window of opportunity" and immediately begin treatment for persistent arthritis (2-3 weeks), especially for small joint arthritis, it is necessary to consult a rheumatologist. Immunological tests, radiography and MRI 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 old). 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 of inflammatory nature: they intensify in the second half of the night or in the morning, diminish after heating, do not leave at rest and are accompanied by morning stiffness in the spine. Spondyloarthritis often affects the hip joints (the first symptom is often pain in the groin).
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 where the patient has pain in the spine but not arthritis.
These patients have been followed by neurologists and chiropractors for a long time with the diagnosis of osteochondrosis. For an accurate diagnosis, an additional examination is required: MRI of the sacroiliac joints, pelvic radiography, 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 of the first (thumb). Arthritis appears acutely, most often at night or early in the morning, after a heavy meal, drinking alcohol, and after a minor injury, physical exertion.
Gout arthritis is accompanied by severe pain (the patient can not step on the foot, the pain does not sleep at night, the pain intensifies even when the wrist is touched with a blanket). In addition to severe pain, a pronounced swelling of the joint is observed, redness of the skin over the joints, movements in the inflamed joint are almost impossible. Arthritis can be associated with high fever. The gout attack disappears after a few days (at the beginning of the disease - even without treatment).
In most patients, the second "attack" of gout is observed after 6-12 months. In the future, there is a gradual increase in the frequency of arthritis "attacks", there is a tendency for their more prolonged nature. All new joints are included: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofu (nodules with a considerable 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 uric acid excretion. Patients with gout, as a rule, have other metabolic disorders: overweight, increased blood pressure, increased cholesterol levels, urolithiasis, ischemic heart disease. This requires a comprehensive examination and treatment.
Rheumatic polymyalgia
Older people (after 50 years) get sick. At the peak of the disease, pain and restriction of movement are characteristic in three anatomical areas: in the shoulder girdle, the pelvic girdle, and the neck. It can be difficult for the patient to determine what hurts: the joints, muscles or ligaments.
With rheumatic polymyalgia, 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 noticeable increase in ESR.
Patients usually undergo a complete cancer screening. If the patient does not go to the rheumatologist, then the appointment of the correct treatment is "postponed" for a long time. It should be noted that joint pain and arthritis are also symptoms of the rarest rheumatic 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 extra-articular soft tissue diseases, so-called "periarthritis" (tendinitis, tendovaginitis, bursitis, enthesopathy).
Soft tissue changes can be one of the manifestations of systemic diseases, but much more often they occur as a result of local overload, microtrauma, hypertension. Inflammatory changes in soft tissues, as a rule, respond well to the administration of periarticular (periarticular) drug. Inflammation in the joints can occur after injuries and requires surgical intervention. These problems are treated by orthopedists.
Osteoporosis can be a complication of chronic joint disease. Densitometry is needed to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint diseases is also performed 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 emphasize once again that the diagnosis of joint diseases is made by a specialist rheumatologist. Treatment of joint pathology should be comprehensive and differentiated. With accurate and timely diagnosis, treatment will be more successful.