Joint pain and swelling are common in many different conditions. The earlier the diagnosis and the start of appropriate treatment, 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 many European countries.
Symptoms of arthritis: joint pain, joint swelling, stiffness of movement, local increase in the temperature of the soft areas around the joint. General symptoms such as weakness, fever, weight loss are possible. The patient should consult a rheumatologist for a timely diagnosis and appropriate treatment.
Unfortunately, due to the widespread advertising of non-standard treatment methods, patients often turn to chiropractors, chiropractors, homeopaths - and time is wasted. In the treatment of rheumatoid arthritis in particular, the first 3-6 months of the disease are called the "window of opportunity" - the period when proper treatment can lead to lasting and long-term remission.
Now let’s talk about the symptoms of the most common rheumatological diseases.
Osteoarthritis
Osteoarthritis is the most common joint disease, usually occurring in people over 40-45 years. Women suffer from osteoarthritis nearly 2 times more often than men.
The most clinically significant and disabling forms of osteoarthritis are coxarthrosis (hip arthrosis) and gonarthrosis (knee arthrosis). In nodular osteoarthritis, changes in the interphalangeal joints of the hands (pain and deformity).
The main clinical symptom of osteoarthritis is pain in the affected joint during exercise. In the case of arthrosis of the knee or hip, the patient feels pain when walking, getting up from a chair, walking up stairs (especially when descending), and when carrying weights. In addition to the pain, the patient is worried about restricting joint movement, crackling during movement.
Sometimes swelling (effusion) of the knee joint occurs (swelling behind and below the knee). This is a symptom of arthritis.
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 common symptoms are symmetrical (right and left limb) arthritis (pain, swelling) in the wrists, small joints in the hands and feet. Joint pain is more worrying in the morning. The patient has difficulty in the morning clenching his fists, raising his hands (combing), stepping on his 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, joint stiffness, " a "tight gloved hand. "In addition to joint syndrome, rheumatoid arthritis is also characterized by common symptoms such as weakness, weight loss, weight loss, and fever.
You should know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can cause disability if diagnosed late and treated improperly. The disease often begins gradually, often with arthritis in one joint and then "joins" other joints.
A rheumatologist should be consulted to take advantage of the "window of opportunity" and to begin treatment for persistent arthritis (2-3 weeks) immediately, especially for arthritis of the small joints. Immunological tests, radiography, and MRI are used to confirm the diagnosis.
Spondyloarthritis
This group of diseases includes ankylosing spondylitis (spondylitis ankylopoetica), psoriatic arthritis, spondyloarthritis associated with inflammatory bowel disease, reactive arthritis (associated with urogenital or intestinal infections), undifferentiated arthritis.
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 an inflammation of the joints of 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, subside after warming up, do not go away at rest, and are accompanied by stiffness in the morning. Spondyloarthritis often affects the hip joints (the first symptom is often lumbar 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 to 10 years after the onset of the disease, especially if the patient has spinal pain but no arthritis.
These patients have long been followed by neurologists and chiropractors with a diagnosis of osteochondrosis. Further examination is needed for a correct diagnosis: 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 mainly develops in the fifth decade of life.
The "classic" symptom of gout is paroxysmal arthritis, usually the I (big) toe. Arthritis occurs acutely, more often at night or early in the morning, after eating plenty of food, drinking alcohol, and minor injuries and exercise.
Gouty arthritis is accompanied by severe pain (the patient cannot step on his leg, the pain does not sleep at night, the pain intensifies even when the joint is touched). In addition to severe pain, marked swelling of the joint, redness of the skin above the joint, and 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 onset of the disease - even without treatment).
In most patients, a second "attack" of gout occurs after 6-12 months. The frequency of "attacks" of arthritis will gradually increase in the future and tend to be protracted. All new joints are affected: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, formation of subcutaneous tofus (nodules with significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders and increased 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, high blood pressure, high cholesterol, urolithiasis, ischemic heart disease. This requires comprehensive examination and treatment.
Polymyalgia rheumatica
Older people (after 50 years) get sick. At the culmination of the disease, pain and restraint 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 polymyalgia rheumatica, the patient's general condition worsens, 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 thorough cancer screening. If the patient does not go to a rheumatologist, the appointment of appropriate treatment will be "postponed" for a long time. It should be noted that joint pain and arthritis are less common symptoms of 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 extracorporeal soft tissues called "periarthritis" (tendinitis, tendovaginitis, bursitis, enthesopathy).
Soft tissue lesions may be a manifestation of systemic disease, but are much more common due to local overloads, microtraumas, and overexertion. Inflammatory changes in soft tissues generally respond well to periarticular (periarticular) drug administration. Arthritis can occur after injuries and requires surgery. These problems are dealt with by the orthopedist.
Osteoporosis can be a complication of chronic joint disease. Densitometry is required for accurate diagnosis of osteoporosis.
Osteoporosis associated with joint disease is also treated by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatological diseases.
Arthritis occurs in tuberculosis, sarcoidosis, malignancies, amyloidosis, endocrine diseases, vascular diseases, and other pathologies.
In conclusion, I would like to point out once again that the diagnosis of joint disease is made by a rheumatologist. Treatment of joint pathology should be comprehensive and differentiated. With the right timely diagnosis, treatment will be more successful.