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 early arthritis clinics in a number of European countries.
The symptoms of arthritis are: joint pain, swelling of the joints, stiffness of movements, local increase in the temperature of the soft tissues around the joint. Common 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 mass advertising of non-traditional 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 "window of opportunity" - this is the time when proper treatment can lead to permanent 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, commonly found 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 (arthrosis of the hip joint) and gonarthrosis (arthrosis 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. In osteoarthritis of the knee or hip joint, the patient experiences pain when walking, when getting up from a chair, when walking up stairs (especially when going down), when carrying weights. In addition to the pain, the patient is worried about restricting movement in the joint, crunching while moving.
Sometimes there is swelling (effusion) of the knee joint (it can be swollen at the back, below the knee). This is a symptom of inflammation of the joints.
In the case of an effusion (synovitis), the nature of the pain changes: the pain appears at rest, 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 limb) arthritis (pain, swelling) of the wrist joints, small joints of the hands and feet. Joint pain is more bothersome in the morning. In the morning, the patient finds it difficult to clench his 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, stiffness in the joints", "hands with tight gloves". In addition to the joint syndrome, rheumatoid arthritis is characterized by such common 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 incorrectly. Often the disease begins gradually, often with arthritis of one joint, then other joints "join".
In order to use the "window of opportunity" and start treatment of persistent arthritis in a timely manner (2-3 weeks), especially in arthritis of the small joints, 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). 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 disappear at rest and are accompanied by morning stiffness in 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 in the joints of the lower extremities. Unfortunately, the correct diagnosis is often made 8-10 years after the onset of the disease, especially in cases where the patient has pain in the spine but no arthritis.
These patients have long been followed by neurologists and chiropractors diagnosed with osteochondrosis. For a correct diagnosis, additional examination is needed: MRI of the sacroiliac joints, X-ray of the pelvis, blood test for the presence of a specific gene.
gout
Men get gout about 20 times more often than women. Gout develops mainly in the fifth decade of life.
The "classic" symptom of gout is paroxysmal arthritis, usually on the first (big) toe. .
Gout is accompanied by severe pain (the patient cannot stand on his feet, the pain does not sleep at night, the pain intensifies even when touching the joint with a blanket). In addition to severe pain there is a pronounced swelling of the joint, redness of the skin above the joint, movements in the inflamed joint are almost impossible. Arthritis may be accompanied by fever. Gout 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 "attacks" of arthritis, there is a tendency for their longer nature. All new joints are affected: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous tofu (nodules with a significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders, elevated 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, high blood pressure, elevated cholesterol levels, urolithiasis, ischemic heart disease. This requires a thorough 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 of three anatomical areas: the shoulder girdle, the pelvic girdle, and the neck. It can be difficult for the patient to determine what is hurting: joints, muscles or ligaments.
In rheumatic polymyalgia, the patient's general condition 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 in-depth cancer screening. 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 rarer 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 diseases of the extraarticular soft tissues, the 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, overexertion. Inflammatory changes in soft tissues, as a rule, respond well to periarticular (periarticular) administration of drugs. Inflammation in the joints can occur after injuries and require surgery. Orthopedists deal with these problems.
Osteoporosis can be a complication of chronic joint disease. Densitometry is required to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint disease 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 circulatory system and other pathologies.
In conclusion, I would like to note once again that the diagnosis of joint diseases is made by a specialist rheumatologist. The treatment of joint pathology should be comprehensive and differentiated. With the correct and timely diagnosis, the treatment will be more successful.