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.
Symptoms of arthritis are: joint pain, joint swelling, stiffness of movement, local increase in soft tissue temperature around the joint. General symptoms such as weakness, fever, weight loss are possible. For a timely diagnosis and the appointment of the correct treatment, the patient should consult a specialist doctor - a rheumatologist.
Unfortunately, due to the widespread advertising of unconventional methods of treatment, patients often turn to chiropractors, osteopaths, homeopaths - and time is lost. 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 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). With nodular osteoarthritis, there is a lesion of the interphalangeal joints of the hands (pain and deformity).
The main clinical symptom in osteoarthritis is pain in the affected joint during exercise. With arthrosis of the knee or hip joint, the patient experiences pain when walking, when getting up from a chair, when walking on stairs (especially when descending), when carrying weights. In addition to pain, the patient is worried about limitation of movement in the joint, crunching during movement.
Sometimes there is a swelling (effusion) of the knee joint (it can be swollen behind, under the knee). This is a symptom of joint inflammation.
In the case of effusion (synovitis), the nature of the pain changes: pain appears at rest, not associated with stress.
Rheumatoid arthritis
Rheumatoid arthritis usually occurs in middle-aged women. The most characteristic symptoms are symmetrical (on the right and left extremities) arthritis (pain, swelling) of the wrist joints, small joints of the hands and feet. Joint pains are more troubling in the morning. It is difficult for the patient in the morning to clench his hand into a fist, raise his hand (comb his hair), step on his feet (due to pain under the "pads" of the toes). Joint pains are 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 such general symptoms as weakness, weight loss, weight loss, sleep disturbance, and fever.
You need to know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be disabling if diagnosed late and improperly treated. Often the disease begins gradually, often with arthritis of one joint, then other joints "join".
In order to use the "window of opportunity" and promptly start treatment for persistent arthritis (2-3 weeks), especially with arthritis of small joints, it is necessary to consult a rheumatologist. To confirm the diagnosis, immunological tests, radiography, and MRI are used.
Spondyloarthritis
This is a group of diseases that include ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondyloarthritis associated with inflammatory bowel diseases, 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 old). 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 of an inflammatory nature: they intensify in the second half of the night or in the morning, decrease after a warm-up, do not go away 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 the case when the patient has pain in the spine, but no arthritis.
These patients have been followed up by neurologists and chiropractors for a long time with a diagnosis of osteochondrosis. For a correct diagnosis, an additional examination is required: 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 during 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, drinking alcohol, as well as after a minor injury, physical exertion.
Gouty arthritis is accompanied by severe pain (the patient cannot step on his foot, does not sleep at night because of the pain, the pain intensifies even when the joint is touched with a blanket). In addition to severe pain, there is a pronounced swelling of the joint, redness of the skin over the joint, movements in the inflamed joint are almost impossible. Arthritis can be accompanied by a high fever. A gout attack disappears after a few days (at the onset of the disease - even without treatment).
In most patients, the second "attack" of gout is observed 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 more protracted nature. All new joints are involved: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofuses (nodules with a significant accumulation of uric acid crystals).
Gout is associated with metabolic disorders, increased levels of uric acid. In most patients, the cause of the disease is impaired renal excretion of uric acid. Patients with gout, as a rule, have other metabolic disorders: overweight, increased blood pressure, increased cholesterol levels, urolithiasis, ischemic heart disease. This requires a comprehensive examination and treatment.
Polymyalgia rheumatica
Persons of older age (after 50 years) get sick. At the peak 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 polymyalgia rheumatica, the patient's general condition suffers, often symptoms such as fever, weight loss, loss of appetite, poor sleep, and depression are common. There is a marked increase in ESR.
Patients usually undergo a thorough cancer screening. If the patient does not consult a rheumatologist, then the appointment of the correct treatment is "postponed" for a long time. It should be noted that joint pain and arthritis are also a symptom of more rare 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 extra-articular soft tissues, the so-called "periarthritis" (tendinitis, tendovaginitis, bursitis, enthesopathy).
Changes in soft tissues can be one of the manifestations of systemic diseases, but much more often they arise as a result of local overloads, microtraumas, overvoltage. Inflammatory changes in soft tissues, as a rule, respond well to periarticular (periarticular) drug administration. Inflammation in the joints can occur after injuries and require surgical intervention. These problems are dealt with by orthopedists.
Osteoporosis can be a complication of chronic joint diseases. Densitometry is required to accurately diagnose osteoporosis.
Treatment of osteoporosis associated with joint diseases is also carried out by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatologic diseases.
Arthritis occurs in tuberculosis, sarcoidosis, malignant neoplasms, amyloidosis, endocrine diseases, diseases of the blood system and other pathologies.
In conclusion, I would like to note once again that the diagnosis of joint diseases is carried out by a specialist rheumatologist. Treatment of articular pathology should be comprehensive and differentiated. With the correct, timely diagnosis, treatment will be more successful.