Arthritis is an inflammatory disease of the joint.
Arthritis is characterized by pain in the joint, especially during movements, often there are restrictions on its mobility, swelling, change in shape and shape ( deformation of the joint ).
In some cases, a serous, purulent, or bloody fluid ( effusion ) is found in the joint cavity .
The skin over the joint turns red, sometimes a fever appears.
There are diseases of one joint (monoarthritis) and many joints (polyarthritis) .
Acute arthritis — begins immediately, accompanied by fever and severe pain in the joint. Chronic arthritis — develops gradually. Acute arthritis can go into subacute and chronic forms. Chronic arthritis periodically gives exacerbations, manifested in increased pain, fever, the appearance of effusion in the joint and other signs of the disease. With some forms of arthritis, significant changes can develop in the joint: in the synovial membrane lining it, cartilage, bones, capsule and ligaments. By curing movement in the joint can be fully restored; in other cases, arthritis leads to disfigurement of the joints with a limitation of its mobility or its complete immobility. Etiology.
The causes of arthritis can be common infectious diseases: tuberculosis, gonorrhea, brucellosis , dysentery , syphilis, flu, acute childhood infections (scarlet fever, etc.) and septic infections. Some Infectious Arthritis May be associated with the presence of a focal infection in the body (e.g. rheumatoid arthritis in chronic tonsil disease ). Non-infectious Arthritis resulting from metabolic disorders, more often in people after 40 years, due to various diseases of the nervous system, disorders of internal secretion, occupational diseases (A. in miners, etc.), are called Arthrosis . This group also includes arthritis associated with a lack of vitamins – Skobutic arthritis (with scurvy) and others. Traumatic arthritis develops after injuries, bruises and wounds of joints. Sometimes arthritis can occur on the basis of an increased sensitivity of the body to certain substances (e.g. to serum, medications, any food products, etc.). This is the so-called. Allergic Arthritis .
The diagnosis is based on:
- an anamnesis that establishes a relationship between joint damage with infectious diseases, focal infection, trauma, allergies, or other pathological processes;
- characteristic clinical data (“inflammatory” type of pain, swelling or deformation of the joints, progressive restriction of mobility in the joint);
- laboratory parameters of the inflammatory process;
- characteristic radiological data (narrowing of the joint space , epiphyseal osteoporosis , ankylosis);
- synovial fluid test results.
VARIETIES OF ARTHRITIS. ACUTE INFECTIOUS-ALLERGIC ARTHRITIS
This is an acute, recurring disease that occurs due to an increased sensitivity of the body to a specific infectious pathogen (most often streptococcus, staphylococcus ). Infectious-allergic polyarthritis is more common (75%) in women, mainly young women. Most scientists involved in this pathology indicate a definite relationship between the occurrence of arthritis and the acute infection of the upper respiratory tract. The mechanism of development of infectious and allergic arthritis has not yet been studied. Polyarthritis occurs only in a small number of patients who have had streptococcal or other respiratory infections. The implementation of the action of the infectious pathogen is enhanced under the conditions of a specific allergy to this pathogen, violation of immunological defense mechanisms, neurohormonal abnormalities, burdened by heredity. Symptoms Usually, 10-15 days after an acute infection (the period of the greatest allergization of the body), acute and subacute inflammation of the joints occurs. Pain, swelling, hyperemia, and an increase in local temperature increase within 2-3 days. Some patients have limited movement in the joints due to pain. But since many patients with acute respiratory infections of the upper respiratory tract take anti-inflammatory and desensitizing agents, the inflammatory process in the joints often proceeds sluggishly. In most patients, swelling of the joints is not noticeable and is mainly due to the accumulation of exudate in the joint cavity. On palpation, there is a slight or moderate increase in local temperature and the appearance of pain. Under the influence of anti-inflammatory therapy, as a rule, the reverse development of the process occurs quickly, the shape and size of the joints are completely normalized, and function is restored. After the disappearance of arthritis, any fibrotic changes are not clinically radiological detected. The duration of arthritis is 1-2 months. However, in some patients, it persists for more than 6 months. In most of them, a relapse of arthritis occurs after a repeated acute infection or hypothermia. Clinical analysis of blood during relapse rarely shows an increase in ESR to 40-50 mm / h.
For the diagnosis of infectious and allergic polyarthritis, the anamnesis is especially important: the onset of the disease after an acute respiratory infection, the development of arthritis during the period of the highest allergization of the body, the rapid increase in inflammatory signs.
TREATMENT. For the treatment of infectious and allergic arthritis, it is necessary to use antimicrobial, anti-inflammatory and desensitizing drugs. Before prescribing antibiotics, you should find out their tolerance.
- For a more active effect on streptococcus, penicillin is recommended , with poor tolerance it is replaced with erythromycin. The course of treatment is 7-8 days.
- Of the common anti-inflammatory drugs, acetylsalicylic acid 0.5 g 4 times a day or brufen 0.25 g 4 times a day, diclofenac is prescribed. The duration of medication depends on the persistence of arthritis.
- At the same time, suprastin or diphenhydramine is prescribed in the appropriate dose. It is advisable after treatment, even in the absence of relapse of arthritis, to carry out balneological treatment (hydrogen sulfide, radon, sea baths) .