Joint pain and swelling occur in many different conditions. The earlier the diagnosis is made and the right 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 several 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 a timely diagnosis and the appointment of the correct treatment, the patient should see a specialist - a rheumatologist.
Unfortunately, due to the widespread advertising of unconventional treatments, patients often turn to chiropractors, osteopaths, homeopaths - and time is wasted. In the treatment of rheumatoid arthritis in particular, the first 3-6 months of the disease is referred to as the "window of opportunity" - this is the time when the right treatment can lead to sustained, long-term remission.
Now let's talk about the symptoms of the most common rheumatic diseases.
arthrosis
Osteoarthritis is the most common joint disease that usually affects people over 40-45 years of age. Women are almost twice as likely to suffer from osteoarthritis as men.
The clinically most important and disabling forms of osteoarthritis are coxarthrosis (osteoarthritis of the hip joint) and gonarthrosis (osteoarthritis of the knee joint). In nodular osteoarthritis, there is a lesion of the interphalangeal joints of the hands (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 climbing stairs (especially when descending), when carrying weights. In addition to pain, the patient worries about restricted mobility in the joint and the crunching during movement.
Sometimes there is a swelling (effusion) of the knee joint (it may be swollen at the back, under the knee). This is a symptom of joint inflammation.
In the case of effusion (synovitis), the type of pain changes: pain occurs at rest, not associated with stress.
Rheumatoid arthritis
Rheumatoid arthritis usually occurs in middle-aged women. The most characteristic symptoms are symmetrical (on the right and left extremities) arthritis (pain, swelling) of the wrists, small joints of the hands and feet. Joint pain is more worrying 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 "pillows" of the toes). Joint pain becomes a characteristicAccompanied symptom - "morning stiffness".
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 general symptoms such as weakness, weight loss, weight loss, insomnia, and fever.
You need to know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can become disabling if diagnosed too late and improperly treated. Often the disease begins gradually, often with arthritis of one joint, then other joints "join".
In order to take advantage of the "window of opportunity" and to immediately start treatment with persistent arthritis (2-3 weeks), especially with arthritis of the small joints, it is necessary to see a rheumatologist. To confirm the diagnosis, immunological tests, X-ray and MRI used.
Spondyloarthritis
This is a group of diseases that includes ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondyloarthritis associated with inflammatory bowel disease, reactive arthritis (associated with urogenital or intestinal infections), and 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 of age). Spondylitis is inflammation of the joints in the spine. Often the first symptoms of spondylitis are pain in the lumbosacral area, alternating pain in the buttocks (sometimes on one side or the other). These pains are of an inflammatory nature: they intensify in the second half of the night or in the morning, decrease after warming 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 groin pain).
Spondyloarthritis is characterized by the presence of asymmetrical 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 if the patient has spinal pain but no arthritis.
These patients have long been followed up by neurologists and chiropractors diagnosed with osteochondrosis. For a correct diagnosis, an additional examination is required: MRI of the sacroiliac joints, X-ray of the pelvis, blood test for the presence of a specific gene.
gout
Men are about 20 times more likely to get gout than women. Gout mainly develops in the fifth decade of life.
The "classic" symptom of gout is paroxysmal arthritis, usually of the I (big) toe. Arthritis occurs acutely, more often at night or early in the morning, after a heavy meal, alcohol consumption and after a slight injury or 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 intensifies even if the joint is touched with a blanket). In addition to severe pain, there is pronounced swelling of the joint, reddening of the skin over the joint, movements in the inflamed joint are almost impossible. Arthritis can be accompanied by a high fever. An attack of gout disappears after a few days (if the disease breaks out - even without treatment).
In most patients, the second "attack" of gout is seen after 6-12 months. In the future, the frequency of "attacks" of arthritis gradually increases, there is a tendency for its protracted nature. All new joints are affected: knees, ankles, elbows. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofus (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 uric acid excretion through the kidneys. Patients with gout usually have other metabolic disorders: obesity, increased blood pressure, increased cholesterol, urolithiasis, ischemic heart disease. This requires extensive examination and treatment.
Polymyalgia rheumatica
Older people (after 50 years of age) get sick. At the peak of the disease, pain and restricted mobility are characteristic in three anatomical areas: in the shoulder girdle, pelvic girdle and neck. It can be difficult for the patient to determine what is hurting: joints, muscles, or ligaments.
With polymyalgia rheumatica, the general condition of the patient suffers, symptoms such as fever, weight loss, loss of appetite, sleep disorders and depression often occur. There is a significant increase in ESR.
Patients typically undergo thorough cancer screening. If the patient does not go to a rheumatologist, then the appointment of the right treatment is "postponed" for a long time. It should be noted that joint pain and arthritis are also a symptom of less common 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, enthesopathy).
Changes in the soft tissues can be one of the manifestations of systemic diseases, but they occur much more often as a result of local overloads, micro-traumas and overvoltages. Inflammatory changes in the soft tissues usually respond well to periarticular (periarticular) drug administration. Inflammation in the joints can occur after injury and require surgical intervention. These problems are treated by orthopedic surgeons.
Osteoporosis can be a complication of chronic joint disease. Densitometry is needed to accurately diagnose osteoporosis.
Treatment for osteoporosis related to joint disease is also performed by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatic diseases.
Arthritis occurs with tuberculosis, sarcoid, malignant neoplasms, amyloidosis, endocrine diseases, diseases of the blood system and other pathologies.
Finally, I would like to point out once again that the diagnosis of joint diseases is carried out by a specialized rheumatologist. Treatment of joint pathology should be comprehensive and differentiated. With the correct and timely diagnosis, treatment will be more successful.