Joint pain and swelling are common in many different conditions. The earlier the diagnosis is made and the appropriate treatment started, the greater the success of 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.
Symptoms of arthritis are as follows: joint pain, joint swelling, stiffness of movement, local increase in temperature of the soft tissues around the joint. General symptoms such as weakness, fever, weight loss are possible. For timely diagnosis and the appointment of the appropriate treatment, the patient should consult a specialist doctor - a rheumatologist.
Unfortunately, due to the widespread publicity of unconventional treatment methods, 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 correct treatment can lead to persistent 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 that usually occurs in people over 40-45 years old. Women suffer from osteoarthritis almost twice as often as men.
The most clinically significant and disabling forms of osteoarthritis are coxarthrosis (osteoarthritis of the hip joint) and gonarthrosis (osteoarthritis of the knee joint). With 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, the patient experiences pain when walking, getting up from a chair, walking on stairs (especially going down), carrying weights. In addition to the pain, the patient is concerned about the limitation of movement of the joint, crunches during movement.
Sometimes there is a swelling (effusion) of the knee joint (it may be swollen behind, below the knee). It is a symptom of joint inflammation.
In case of effusion (synovitis), the nature of the pain changes: the pain appears at rest, not associated with stress.
Rheumatoid arthritis
Rheumatoid arthritis usually occurs in middle-aged women. The most characteristic symptoms are symmetrical arthritis (in the right and left extremities) (pain, swelling) of the joints of the wrist, the 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 in a fist, raise his hand (comb his hair), walk on his feet (due to the 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 joint syndrome, rheumatoid arthritis is characterized by general symptoms such as weakness, weight loss, weight loss, trouble sleeping, and fever.
You should know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be disabling if it is diagnosed late and poorly treated. Often the disease begins gradually, often with arthritis in one joint, and then other joints "join".
In order to use the "window of opportunity" and quickly start treatment for persistent arthritis (2-3 weeks), especially small joint arthritis, it is necessary to consult a rheumatologist. To confirm the diagnosis, immunoassays, an X-ray and an MRI are used.
Spondyloarthritis
This is a group of diseases that include ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondylitis associated with inflammatory bowel disease, reactive arthritis (associated with urogenital or intestinal infection), undifferentiated spondylitis.
This group of diseases is united by common genes and common clinical symptoms. Spondyloarthritis usually occurs in young people (up to 40 years old). Spondyloarthritis is an inflammation of the joints in the spine. Often the first symptoms of spondyloarthritis 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 part of the night or in the morning, decrease after a warm-up, do not disappear at rest, and are accompanied by morning stiffness of the spine. Spondyloarthritis often affects the hip joints (often the first symptom is groin pain).
Spondyloarthritis is characterized by the presence of asymmetric 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 when the patient has pain in the spine, but no arthritis.
These patients have long been followed by neurologists and chiropractors with a diagnosis of osteochondrosis. For a correct diagnosis, an additional examination is necessary: MRI of the sacroiliac joints, x-ray of the pelvis, blood test for the presence of a specific gene.
Drop
Men have 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 of the I (big) toe. Arthritis occurs acutely, more often at night or early in the morning, after a heavy meal, alcohol consumption, as well as after a minor injury, physical exertion.
Gouty arthritis is accompanied by severe pain (the patient cannot walk on his foot, the pain does not sleep at night, the pain intensifies even when the joint is hit with a blanket). In addition to severe pain, there is a pronounced swelling of the joint, redness of the skin on the joint, movements in the inflamed joint are almost impossible. Arthritis can be accompanied by a high fever. A gout attack goes away after a few days (at the onset of the disease - even without treatment).
In most patients, the second "attack" of gout is seen after 6 to 12 months. In the future, there is a gradual increase in the frequency of arthritis "attacks", there is a tendency to their more prolonged nature. All new joints are affected: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofus (nodules with a large accumulation of uric acid crystals).
Gout is associated with metabolic disorders, an increase in uric acid levels. In most patients, the cause of the disease is impaired renal excretion of uric acid. As a rule, patients with gout have other metabolic disorders: overweight, increased blood pressure, increased cholesterol, urolithiasis, ischemic heart disease. It requires a full examination and treatment.
Rhizomelic pseudopolyarthritis
Older people (after 50) get sick. At the height of the disease, pain and limitation of movement 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 rheumatic polymyalgia, the general condition of the patient suffers, there are often symptoms such as fever, weight loss, loss of appetite, lack of sleep and depression. There is a marked increase in ESR.
Patients usually undergo extensive screening for cancer. If the patient does not go to a rheumatologist, the appointment of the appropriate treatment is "postponed" for a long time. It should be noted that joint pain and arthritis are also a symptom of more rare 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 extra-articular soft tissue diseases called "periarthritis" (tendonitis, 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 overloads, microtraumas, overvoltages. In general, inflammatory soft tissue changes respond well to the administration of periarticular (periarticular) drugs. Inflammation of the joints can occur after injury and require surgery. These problems are treated by orthopedists.
Osteoporosis can be a complication of chronic joint disease. Densitometry is necessary to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint disease is also carried out by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatic diseases.
Arthritis occurs in tuberculosis, sarcoidosis, malignant tumors, amyloidosis, endocrine diseases, diseases of the blood 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. The treatment of joint pathology must be comprehensive and differentiated. With correct and timely diagnosis, treatment will be more effective.