Joint pain and swelling are common in many different situations. The sooner the diagnosis is made and the correct treatment is started, the higher the success rate of treatment.
If the diagnosis is made within 6 months after the first symptoms of the disease appear, arthritis is considered "early". Many European countries have early arthritis clinics.
The symptoms of arthritis are: joint pain, joint swelling, exercise stiffness, and local increase in the temperature of the soft tissue around the joint. Systemic symptoms may occur, such as weakness, fever, and weight loss. In order to make a timely diagnosis and make an appointment for the correct treatment, the patient should consult a specialist-a rheumatologist.
Unfortunately, due to the widespread publicity of unconventional treatments, patients often turn to chiropractors, osteopaths, and homeopaths-and time is wasted. Especially in the treatment of rheumatoid arthritis, the first 3-6 months of the disease is called the "window of opportunity"-this is the period when the correct treatment can lead to lasting and long-term relief.
Now let us talk about the most common symptoms of rheumatism.
Osteoarthritis
Osteoarthritis is the most common joint disease and usually occurs in people over 40-45 years of age. Women suffer from osteoarthritis almost twice as frequently as men.
The most clinically significant and disabling forms of osteoarthritis are hip arthropathy (hip arthropathy) and knee arthropathy (knee arthropathy). With nodular osteoarthritis, there are lesions (pain and deformity) in the interphalangeal joints of the hands.
The main clinical symptom of osteoarthritis is pain in the affected joints during exercise. For arthropathy of the knee or hip, the patient will feel pain when walking, getting up from a chair, walking up stairs (especially when going down stairs), and bearing weights. In addition to pain, patients also worry about limited joint movement and crunching noises when moving.
Sometimes the knee joint will swell (ooze) (maybe swelling below the knee). This is a symptom of joint inflammation.
In the case of effusion (synovitis), the nature of the pain changes: the pain occurs at rest and is not related to stress.
Rheumatoid Arthritis
Rheumatoid arthritis usually occurs in middle-aged women. The most typical symptom is symmetrical (left and right limb) arthritis (pain, swelling) of the wrist joints and small joints of the hands and feet. The joint pain is even more disturbing when I wake up in the morning. In the morning, the patient has difficulty making fists, raising hands (brushing hair), and stepping on feet (due to pain under the "pad" of toes). Joint pain is accompanied by a characteristic symptom-"morning stiffness".
The patient described morning stiffness as "joint swelling and stiffness", "hands wearing tight gloves" sensation. In addition to joint syndrome, rheumatoid arthritis is characterized by general symptoms such as weakness, weight loss, weight loss, sleep disturbance, and fever.
You need to know that rheumatoid arthritis is a chronic disease. If diagnosed late and treated improperly, rheumatoid arthritis may become disabled. This disease usually starts gradually, usually arthritis of one joint, and then the other joints "join in".
In order to use the "window of opportunity" to promptly start the treatment of persistent arthritis (2-3 weeks), especially arthritis of the small joints, it is necessary to consult a rheumatologist. To confirm the diagnosis, immunological examinations, radiological examinations, and MRI can be used.
Spondyloarthritis
This is a group of diseases, including ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondyloarthritis related to inflammatory bowel disease, reactive arthritis (related to genitourinary system or intestinal infection), Undifferentiated spondyloarthritis.
This group of diseases is combined by common genes and common clinical symptoms. Spondyloarthritis usually occurs in young people (up to 40 years old). Spondylitis is inflammation of the joints of the spine. Usually, the first symptoms of spondylitis are lumbosacral pain, alternating hip pain (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, and are relieved after warming up, do not disappear during rest, and are accompanied by morning stiffness of the spine. Spondyloarthritis often affects the hip joint (the first symptom is usually pain in the groin).
Spondyloarthritis is characterized by asymmetric arthritis, which mainly occurs in the joints of the lower limbs. Unfortunately, the correct diagnosis is usually made 8-10 years after the onset of the disease, especially if the patient has spinal pain but does not have arthritis.
These patients received long-term follow-up by neurologists and chiropractors and were diagnosed with osteochondrosis. In order to make a correct diagnosis, additional tests are needed: MRI of the sacroiliac joint, X-ray of the pelvis, and blood testing for the presence of specific genes.
gout
Men are 20 times more likely to suffer from gout than women. Gout mainly occurs in the fifth decade of life.
The "typical" symptom of gout is paroxysmal arthritis, usually my (big) toe. Acute attacks of arthritis occur more often at night or early in the morning, after a large meal, after drinking, and after minor injuries and physical exertion.
Gouty arthritis is accompanied by severe pain (patients cannot step on their feet, the pain cannot fall asleep at night, even if they touch the joints with a blanket, the pain will increase). In addition to severe pain, there are obvious swelling of the joints, redness of the joint skin, and inflamed joints that are almost impossible to move. Arthritis can be accompanied by high fever. The gout attack will disappear after a few days (at the time of the onset of the disease-even without treatment).
In most patients, the second "onset" of gout is observed 6-12 months later. In the future, the frequency of "flares" of arthritis will gradually increase, and there will be a more persistent trend. All new joints are involved: knees, ankles, elbows. Without treatment, the patient will develop chronic gout: chronic arthritis, kidney damage, tofu (nodules with large amounts of uric acid crystals) under the skin.
Gout is related to metabolic disorders and elevated uric acid levels. In most patients, the cause of the disease is impaired renal excretion of uric acid. Patients with gout usually have other metabolic disorders: overweight, elevated blood pressure, elevated cholesterol levels, urolithiasis, and ischemic heart disease. This requires comprehensive examination and treatment.
Polymyalgia rheumatica
Older people (after the age of 50) can get sick. At the peak of the disease, pain and restricted movement are characteristic of three anatomical areas: the shoulder girdle, the pelvic girdle, and the neck. It may be difficult for patients to determine what was injured: joints, muscles or ligaments.
The general condition of patients with polymyalgia rheumatica often has symptoms such as fever, weight loss, loss of appetite, poor sleep, and depression. ESR increased significantly.
Patients usually undergo a thorough cancer screening. If the patient does not see a rheumatologist, the appointment for the correct treatment will be "postponed" for a long time. It should be noted that joint pain and arthritis are also rarer rheumatism-diffuse connective tissue diseases (systemic lupus erythematosus, systemic scleroderma, dermatomyositis, Sjogren’s disease, Behcet’s disease, systemic vasculitis)) Symptoms.
There is a whole set of extra-articular soft tissue diseases, the so-called "periarthritis" (tendinitis, tenosynovitis, bursitis, enthesal disease).
Changes in soft tissue may be one of the manifestations of systemic diseases, but more common are due to local overload, microtrauma, and overvoltage. Inflammatory changes in soft tissues usually respond well to drug administration around the joints (peri-articular). Inflammation of the joint may occur after injury and requires surgical intervention. These problems are handled by orthopedic surgeons.
Osteoporosis may be a complication of chronic joint disease. Densitometry is needed to accurately diagnose osteoporosis.
The treatment of osteoporosis associated with joint diseases is also performed by rheumatologists. Finally, arthritis may be a symptom of other non-rheumatic diseases.
Arthritis occurs in tuberculosis, sarcoidosis, malignant tumors, amyloidosis, endocrine diseases, blood system diseases and other pathologies.
Finally, I want to point out again that the diagnosis of joint disease is done by a rheumatologist. The treatment of joint disease should be integrated and differentiated. Through correct and timely diagnosis, treatment will be more successful.