Joint pain and swelling are common in many different conditions. The sooner the diagnosis is made and the right treatment is started, the more successful the therapy will be.
Arthritis is considered "early" if diagnosed within 6 months after the first symptoms of the disease. There are early arthritis clinics in a number of European countries.
Symptoms of arthritis include: joint pain, swelling of the joints, stiffness of movement, local increase in temperature of the soft tissues around the joint. Common symptoms such as weakness, fever, weight loss are possible. In order to make a timely diagnosis and prescribe the right treatment, the patient should consult a specialist - a rheumatologist.
Unfortunately, due to the widespread advertising of non-traditional treatments, 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 lasting 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 the age of 40-45. Women suffer from osteoarthritis almost twice as often as men.
The most clinically significant and disabled forms of osteoarthritis are coxarthrosis (arthrosis of the hip joint) and gonarthrosis (arthrosis of the knee joint). With nodular osteoarthritis, there is damage (pain and deformity) to the interphalangeal joints of the hands.
The main clinical symptom of osteoarthritis is pain in the affected joint during exercise. Patients with osteoarthritis of the knee or hip joint experience pain when walking, getting up from a chair, walking up stairs (especially when descending), and carrying weights. In addition to pain, the patient is concerned about limited movement in the joint, wheezing during movement.
Sometimes there is swelling (effusion) of the knee joint (behind it, there may be swelling under the knee). This is a sign of joint inflammation.
In the case of 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 (right and left limbs) arthritis of the wrist joints (pain, swelling), small joints of the hands and feet. Joint pain in the morning is more disturbing. In the morning, it is difficult for the patient to clench his fists, raise his hand (comb his hair), press his foot (due to pain under the "pads" of the fingers). 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 articular syndrome, rheumatoid arthritis is characterized by common symptoms such as weakness, weight loss, weight loss, sleep disturbances, and fever.
You should 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 "joins" other joints.
It is necessary to use the "window of opportunity" and consult a rheumatologist to immediately begin treatment of persistent arthritis (2-3 weeks), especially arthritis of the small joints. Immunological tests, radiography and MRI are used to confirm the diagnosis.
Spondyloarthritis
This group of diseases includes 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 combines 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 hips (sometimes on one side or the other). These pains are inflammatory: 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 in the spine. Spondyloarthritis often affects the hip joints (the first symptom is often groin pain).
Spondyloarthritis is mainly characterized by asymmetric arthritis 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 pain in the spine, but no arthritis.
These patients with a diagnosis of osteochondrosis have long been monitored by neurologists and chiropractors. Additional examination is required for a correct diagnosis: MRI of the sacroiliac joints, pelvic radiography, blood test for the presence of a specific gene.
Gut
Men get gout about 20 times more often than women. Gout mainly develops in the fifth decade of life.
The "classic" symptom of gout is paroxysmal arthritis, usually of the first (big) finger. Arthritis occurs acutely, more often at night or early in the morning, after heavy meals, alcohol consumption, as well as minor injuries, physical exertion.
Gouty arthritis is accompanied by severe pain (the patient can not press 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 an open swelling of the joint, redness of the skin on 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. There is a gradual increase in the frequency of "attacks" of arthritis in the future, there is a tendency to their longer-lasting nature. All new joints are involved: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofu (nodules with 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 a violation of the excretion of uric acid by the kidneys. Patients with gout, as a rule, have other metabolic disorders: overweight, increased blood pressure, increased cholesterol levels, urolithiasis, coronary heart disease. This requires a thorough examination and treatment.
Polymyalgia rheumatism
Older people (after the age of 50) get sick. Pain and restriction of movement at the peak of the disease are characteristic of three anatomical areas: the shoulder girdle, the pelvic girdle, and the neck. It can be difficult for a patient to determine what is hurting: joints, muscles, or ligaments.
The patient with polymyalgia rheumatism suffers from a general condition, often with symptoms such as fever, weight loss, loss of appetite, poor sleep and depression. There is a significant increase in ESR.
Patients usually undergo a comprehensive cancer examination. If the patient does not go to a rheumatologist, then the appointment of the right treatment is "delayed" for a long time. Note that joint pain and arthritis are also symptoms of more rare rheumatic diseases - diffuse connective tissue diseases (systemic lupus erythematosus, systemic scleroderma, dermatomyositis, Sjogren's disease, Behçet's disease, systemic vasculitis).
There is a group of all diseases of extra-articular soft tissues, the so-called "periarthritis" (tendinitis, tendovaginitis, bursitis, entesopathy).
Soft tissue changes can be one of the manifestations of systemic diseases, but more often they occur as a result of local loads, microtraumas, overexertion. Inflammatory changes in soft tissues, as a rule, respond well to periarticular (periarticular) medication. Inflammation in the joints can occur after injuries and requires surgery. Orthopedists deal with these problems.
Osteoporosis can be a complication of chronic joint disease. Densitometry is required for accurate diagnosis of osteoporosis.
Treatment of osteoporosis associated with joint diseases is also carried out by a rheumatologist. Finally, arthritis can be a sign 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 emphasize once again that the diagnosis of joint diseases is carried out by a specialist rheumatologist. Treatment of articular pathology should be comprehensive and different. Proper, timely diagnosis and treatment will be more successful.