Content
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1What is arthropathy: description, treatment of joints in children and adults
- 1.1The main symptoms of arthropathy
- 1.2Causes and features of the development of arthropathy
- 1.3Diagnostic Methods
- 1.4How to treat arthropathy
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2Arthropathy: Symptoms and Treatment
- 2.1Etiology
- 2.2Symptomatology
- 2.3Articular syndrome
- 2.4Urogenital syndrome
- 2.5Treatment
- 2.6Complications
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3Arthropathy - what is it? Symptoms and treatment of the disease
- 3.1Arthropathy - what is it?
- 3.2Classification of arthropathy
- 3.3The main causes of trophic joint changes
- 3.4Signs of the disease
- 3.5Pediatric arthropathy of the knee joint - what is it?
- 3.6Diagnostic measures
- 3.7Therapeutic measures
- 3.8Physiotherapy for joint damage
- 3.9Dispensary supervision
- 3.10How to avoid arthropathy
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4Types of arthropathy of joints and ways of their treatment
- 4.1Types and causes of arthropathy
- 4.2Readers often study together with this material:
- 4.3The editor has found for you two more interesting materials:
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5Arthropathy
- 5.1Allergic arthropathy
- 5.2Arthropathy with Reiter's syndrome
- 5.3Arthropathy in endocrine disorders
- 5.4Arthropathy in diseases of internal organs
What is arthropathy: description, treatment of joints in children and adults
Arthropathy of the knee joint is a disease in which a decrease in sensitivity and trophism of tissues is characteristic.
The second medical name for this pathology is the reactive type of arthropathy.
Often concomitant diseases are osteochondrosis of the spine, lesions can affect others, both large and small joints.
Since the nature of all these ailments is similar, the methods of treatment are identical. Arthropathy can affect from two to five different articular joints, and sometimes more, if in addition to the ankle, knee and hip the small joints of the extremities are affected.
Reactive arthropathy is diagnosed quite rarely, but unfortunately, both adults and children with the same frequency are affected.
According to the clinical picture and flow rate, arthropathy can be confused with arthritis, which can also be traumatic, infectious or toxic.
It is important to diagnose the disease correctly before starting therapy.
Additionally, it is difficult to diagnose what often the patient does not complain of acute pains and consult a doctor when the disease is already progressing.
The main symptoms of arthropathy
The main signs of pathology are:
- The enlargement of the joint in size, caused by swelling. Edema occurs due to the accumulation of lymphatic and synovial fluids in the joint cavity, with the development of the disease the fluid also spreads into the periarticular tissues;
- Change in the surface of the joint bones, in particular, the marginal areas. Bone tissue grows very quickly, osteophytes are formed. Thus, the body tries to fill the space on which the damaged joint was located and compensate its functions. Osteophytes also affect the shape and size of the knee, ankle or hip joints;
- Noticeable deformation of the joints. If the arthropathy of the knee is diagnosed, the affected knee is displaced inward - visually the legs resemble a cross. This is due to the pressure of the fluid in the joint cavity and changes in the structure of bone tissues;
- Pain that occurs mainly after physical exertion. Some patients generally do not feel any discomfort during the development of the disease, and therefore do not consult a doctor until the deformation is visible.
In some cases, there may be an increase in body temperature, with palpation of the affected knee or ankle, the patient feels pain of varying intensity depending on the stage disease. Skin covers in the affected joint area are hot to the touch, the mobility of the limb is limited.
The disease is of three degrees: mild, moderate and severe. With a mild form, the patient almost does not suffer from the stiffness of the joint, can move without problems and feels pain and discomfort only at high loads.
Sometimes patients feel fear when they need to step on their aching legs: they feel that when the load is in the upright position, the joint may be injured. At the second and third degree, the stiffness increases and, in a run-down form, the limb can be completely immobile and uncontrollable.
Causes and features of the development of arthropathy
Disease of both the knee and ankle joint is never primary, this ailment always develops against the backdrop of pathologies of the human nervous system. In children or in adult patients, it may appear with lesions of the spinal cord or brain. Sometimes the causes are in the pathologies of the peripheral nervous system.
Doctors do not exclude the possibility of genetic predisposition to this disease, but from the scientific point of view this theory has not yet been officially confirmed.
The most common problem among people over 60 years old. The reason lies in the age-related changes in the body - the release of free radicals of oxygen in the body, the disturbance of metabolic processes, the wear of cartilaginous and other articular tissues. It can develop as a consequence of such diseases:
- Brucellosis. The course of this disease is acute, lesions of the spine and large joints - ankle, knee or hip - are very pronounced. The bearer of brucellosis is cattle.
- Systemic vasculitis. Most often, arthropathy is caused by Kawasaki's disease, Takayasu's syndrome, Wegener's granulomatosis and angiitis caused by allergic reactions of the body.
- Diathesis of neur-arthritic etiology.
- Lyme disease - causes her bite of an insect, an ixodic tick, resulting in transmission of infection and the development of systemic allergies.
- Reiter's syndrome.
- Red lupus or a vaccination against this disease. Usually such complication of an inoculation, as arthropathy, arises, if it was made later than the due time, at an older age.
There have been cases of development of arthropathy due to diseases such as infectious mononucleosis or paratitis of epidemic nature. The rapidity of the development of the disease is determined by what changes occur in the nerve tissues of a person, provoked by a disease.
Diagnostic Methods
Symptoms of this pathology of the knee joint are quite specific and easy to recognize. But the treatment is always appointed taking into account the underlying disease and the general condition of the patient, since every single case of the disease has its own peculiarities.
Cure this disease at home, using methods of alternative medicine, it is impossible. This will lead only to irreversible processes in the joint of the knee, complete destruction and immobility of the joint, and hence - to loss of efficiency and disability.
Therefore, if the knee begins to swell swiftly, the doctor should immediately show up, even if the pain syndrome is not yet available. To make an accurate diagnosis, the doctor will prescribe such procedures and tests:
- General clinical analysis of urine;
- Study for the presence of pathogenic microflora;
- Clinical blood test to determine the level of ESR;
- An expanded blood test for rheumatoid factor;
- Radiography;
- Magnetic resonance imaging;
- Electrocardiography.
With the help of these analyzes and studies, it can be established if, in the patient's body, pathogenic microorganisms that can cause an autoimmune reaction, and in addition determine the extent of the lesion nerve fibers. Until the root cause is established, which has become the impetus for the development of arthropathy, it is impossible to prescribe treatment.
How to treat arthropathy
Such a disease as arthropathy can be treated conservatively or by surgical intervention.
In any case, treatment is complex.
Conservative methods eliminate local symptoms of joint damage and the infectious component of the disease or pathology that provoked it.
The basic course of therapy necessarily includes a weekly course of taking antibiotics.
For the treatment of exacerbation of the underlying disease, appropriate drugs of systemic action are prescribed.
Virtually all diseases that can cause arthropathy are chronic, and therefore require prolonged treatment.
In the acute stage of the disease, bed rest and fixation of the affected joint is recommended - this helps prevent further damage and reduces the unpleasant symptoms of arthropathy. Complex treatment can last up to six months. Then the rehabilitation period begins.
Restorative treatment, like the therapeutic, is always selected individually, methods and procedures also depend on the nature of the disease and the degree of joint damage. Usually used are:
- Complex exercises of physical therapy. It is required not only to restore the mobility of the joint, but also gradually to return it to the correct position. Alternate active and passive movements that promote the development of muscle and joint tissues.
- Water procedures - at the initial stage of rehabilitation many patients are easier to perform exercises exactly in water. Also recommended are therapeutic baths and mud cure.
- Electrophysiology procedures - UHF, electrophoresis, shock wave therapy.
Determine in advance what will be the prognosis for such pathology, it is difficult.
Much depends on the patient's age, other chronic diseases and his willingness to work together with the doctor.
Sometimes it is possible to return completely mobility of the joint, but it also happens that limp and some stiffness, despite the treatment, remain until the end of life.
A source: http://sustav.info/bolezni/drugie/artropatiya.html
Arthropathy: Symptoms and Treatment
Category: Joints, bones, muscles 9356
- Lower abdominal pain
- Purulent discharge from the vagina
- Deformation of the joint
- Pain in the affected joint
- Prostatitis
- Immobility of the joint
- Edema of the periarticular tissues
- Stiffness in the joints
- Bleeding in the absence of menstruation
- Violation of the bladder
- Redness of the skin above the affected joint
Arthropathy is a secondary disorder that manifests itself in various degenerative-dystrophic or inflammatory manifestations in the affected joint.
In the medical literature, this condition is also called reactive arthritis. Most often the disease affects the hip, elbow and knee joints.
It is worth noting that pathology can begin to progress in both children and adults. Restrictions on sex do not have a malaise.
Etiology
Depending on the etiological factors, clinicians distinguish the following varieties of this pathological condition:
- reactive arthropathy.The mechanism of progression of this disease lies in the reaction of tissues and cartilage structures to such systemic pathologies: syringomyelia, leukemia, diseases of the endocrine system glands;
- dystrophic form.It develops as a result of a primary disruption of the nutrition of the cartilaginous structures. Usually this form of pathology is diagnosed in elderly people, when their entire body is subjected to dystrophic processes;
- pyrophosphoric arthropathy or chondrocalcinosis.Pathology develops as a result of a disturbance in the metabolism of calcium salts in the human body. As a result, they settle on the surface of the cartilage. To provoke pyrophosphate arthropathy can be traumas of the knee, hip, elbow and other joints, infectious processes, hypocalcemia. It is worth noting that pyrophosphoric arthropathy is diagnosed most often;
- idiopathic form.Its development is indicated in the case when clinicians can not accurately establish the cause that triggered the progression of the pathological process;
- psoriatic arthropathy.The disease progresses against psoriasis;
- hereditary form.The pathology of cartilage structures is transmitted at the genetic level. Usually this form begins to manifest in young children.
Symptomatology
A clinical picture of pyrophosphate arthropathy or another type of pathology is made up of two syndromes - articular and urogenital.
Articular syndrome
It is the main syndrome of arthropathy. It should be noted that often two or three joints become inflamed at the same time.
For example, with knee arthropathy in children and adults, both knees (bilateral process) are simultaneously affected simultaneously.
In this case, the appearance of such symptoms:
- pain. The pain syndrome is aching and may increase with increasing strain on the affected joint. After a restful rest, the pain may subside, but by the evening it again intensifies. In the case of progression of pyrophosphate arthropathy, pain arises from attacks;
- violation of the functioning of the affected joint. At the beginning of the progression of arthropathy, only a slight stiffness is observed when performing the usual movements. But gradually the amplitude of movements is significantly reduced, up to the point that a complete blockage of the joint may occur;
- deformation. The joint gradually changes its shape;
- edema and flushing of the skin. Usually, if these symptoms occur, the pain syndrome increases.
To reveal the presence of arthropathy of the knee, elbow, hip and other is possible even at an early stage of pathology progression. For this purpose, doctors resort to X-ray examination. In the picture, the radiologist can determine the presence of periarticular osteoporosis.
Healthy and damaged joint
Urogenital syndrome
In addition to joint damage, arthropathy often provokes the progression of other disorders in the organs and systems of the body.
Especially often, against the background of pyrophosphate arthropathy or another form of the disease, the pathologies of the genitourinary system in children and adults progress.
But it is worth noting that this manifestation of the disease is observed only in 30% of patients.
.In the fair sex can be observed intermenstrual bleeding, purulent discharge from the vagina, cervicitis, pain in the lower abdomen. In men, however, there are signs of acute prostatitis, and also the process of urine excretion may be disturbed.
.In addition, in adults and children with arthropathy, extraarticular and visceral lesions, spinal column damage, as well as a systemic inflammatory reaction are observed.
Treatment
Treatment of pathology should be started immediately, once the diagnosis was established. To be held in two directions:
- antibacterial therapy;
- therapy of joint syndrome.
Antibiotics are prescribed to destroy infectious agents that triggered the progression of pathology in children and adult patients.
The duration of treatment is 7 days. Drugs of choice:
- azithromycin;
- doxycycline;
- erythromycin;
- clarithromycin;
- ofloxacin;
- amoxicillin.
Also the standard treatment plan includes the following drugs:
- anti-inflammatory drugs (non-steroidal). Are appointed with the purpose to reduce an inflammation, and to remove a painful syndrome;
- immunosuppressors and immunomodulators. Necessary to increase the reactivity of the body;
- if the pathology proceeds very hard, the patient must be assigned glucocorticoid hormones in order to eliminate the inflammatory process in the joint.
Since the ailment develops again, it is important to treat the underlying pathology. Therefore, the main treatment plan can be supplemented:
- chemotherapy (if there are systemic blood diseases);
- to substitution therapy resorted to in the presence of ailments of the endocrine system;
- neuroprotectors.
Treatment of arthropathy is long. Usually it is carried out on an outpatient basis and only in severe cases is the patient hospitalized.
Complications
If the adequate treatment of pathology has not been performed in a timely manner, then in most cases the following complications develop:
- the transition of the acute form of the disease into a chronic one;
- recurrent course;
- impaired mobility or total blockage of affected joints.
Diseases with similar symptoms:
Rheumatoid arthrosis (coinciding symptoms: 4 of 11)
Rheumatoid arthrosis is an autoimmune lesion of articular joints, as it progresses, their deformation and destruction occur.
Degenerative processes can affect cartilage, bones and even soft tissues, which is an irreversible phenomenon and leads to severe deformations.
With severe tissue destruction, osteoarthritis is formed, characterized by impaired motor functions.
... Arthralgia (coinciding symptoms: 3 of 11)
Arthralgia is a pathological condition characterized by the appearance of a pronounced pain syndrome, both in one joint and immediately in several joints.
This ailment arises from the irritation of the nerve endings, localized in the synovial articular pouch.
It should be noted that this lesion is usually large joints (arthralgia of the knee joint is diagnosed most often).
... Endometrial cancer (coinciding symptoms: 3 of 11)
Cancer of the endometrium, or uterine precancer, occupies one of the first places in the prevalence among cancerous tumors.
Gynecologists note that this condition occurs in women over the age of fifty, and this means that the main cause of the onset of the disease can be considered such a process in the body as climacterium.
... Chlamydial arthritis (coinciding symptoms: 3 of 11)
.Chlamydial arthritis is a pathological condition of the autoimmune type, which progresses due to the penetration of chlamydia into the human body.
.The main way of transmission of the pathogen is sexual (from an infected partner to a healthy partner).
The disease is diagnosed mainly in representatives of both sexes, who are in a sexually active age - from 20 to 45 years.
... Reiter's disease (coinciding symptoms: 3 of 11)
Reiter's disease - belongs to the category of rheumatic diseases. For pathology, a combined lesion of the urogenital tract, the membrane of the eyes and joints is characteristic. Infectious-inflammatory changes can develop both simultaneously and consistently.
...
- In contact with
A source: http://SimptoMer.ru/bolezni/sustavy-kosti/1303-artropatiya-simptomy
Arthropathy - what is it? Symptoms and treatment of the disease
Arthropathy combines a group of pathologies with different mechanisms of development and causes. The knee joints most often suffer from this ailment. Therapeutic measures are primarily aimed at eliminating the provoking factor of the disease.
Arthropathy - what is it?
This pathology is a secondary trophic change in the joint. As a rule, it occurs against the background of a recently transferred infectious disease. Arthropathy is characterized by certain symptoms, so doctors quickly recognize it and prescribe effective therapy.
This disease appears in stages or suddenly. In addition, it may be accompanied by unexpected exacerbations and remissions. In medical terminology, the described disease is still known as reactive arthropathy. What is this, we will consider in more detail below.
Quite often pathology is accompanied by Sheyerman's disease. It should be noted that the development of reactive arthritis can be destroyed from 2 to 5 joints, and sometimes more.
This disease is almost the same in both adults and children.
Although most often knee joint changes occur in men 20-40 years of age, leading a disorderly lifestyle and constantly changing sexual partners, especially HIV-infected.
Classification of arthropathy
The defeat of knee joints in the development of this disease is divided into certain types:
- Dystrophic arthropathy. It may occur if there is a disturbance in cartilage supply. In general, the disease occurs in the elderly due to general degenerative and dystrophic changes in the body.
- Reactive arthritis. With this pathology, the patient feels pain in the knee. The basis of its development mechanism is the reaction of tissues and cartilage to various systemic diseases: endocrine disorders, oncology, leukemia, polyneuropathy or syringomyelia.
- Pyrophosphate arthropathy. During it, the metabolism of calcium salts in the body is disturbed, which causes a precipitate to form on the surface of the cartilage. Such a process occurs due to hypocalcemia, chronic infections, or previous knee injuries.
- Hereditary arthropathy. The disease is transmitted genetically, and it can manifest itself in childhood.
- Diabetic arthropathy. Developed pathology as a result of complications of diabetes. It worsens the patient's ability to work, and often causes disability.
- Idiopathic arthropathy. This group included the disease of the knee joints, in which it was not possible to identify a provoking factor.
- Psoriatic arthropathy. This inflammatory pathology of joints of a chronic nature is usually associated with psoriasis. But not all people with this diagnosis develop psoriatic arthritis.
The main causes of trophic joint changes
Arthropathy - what is it? A similar question now arises in many people.
This disease is referred to the group of autoimmune joint lesions, in other words, it is close in origin to the diseases of the immune system.
The essence of such pathologies is that after getting a bacterial infection into the body, the immune system begins to "go crazy attacking its own tissues.
A predisposing factor to arthropathy is considered to be some genetic malfunction. If a person has a certain type of histocompatibility gene, then the probability of occurrence of the described ailment increases many times.
There are other causes of the disease. For example, most arthropathy of the joints develops due to infection with chlamydia.
And this disease appears most often in men.
.In addition, the development of the defeat of tissues and joints can lead to various pathologies of the respiratory tract: bronchitis, laryngitis, tracheitis and others.
.Often the cause of arthropathy are intestinal infections, especially dysentery and similar ailments. To defeat joints sometimes results in an unsuccessful vaccination or treatment with immunological drugs based on antibodies.
Signs of the disease
Arthropathy, the symptoms of which can grow in a matter of hours or days, has a sharp onset and development.
In this case, deformation of the knee joint occurs, moreover, as a rule, the fluid is released into the surrounding tissue structures and into its own joint cavity.
Edema appears not only because of the increase in the volume of the knee, but also as a result of the growth of the ends of the bones.
It should be mentioned, speaking of the diagnosis of arthropathy, that this is a disease that can eventually lead to the destruction of cartilage or bone tissue.
But, despite the mentioned changes, strong pain sensations, as with the rest pathologies of the knee joints, are not observed.
While in some cases on the X-ray, even fragments of cartilage and bones in the joint bag are visible.
In the affected joint, the volume of motion is initially limited, but in the future, with severe destruction, dislocations are not excluded. That is why it is so important to begin timely treatment, otherwise the knee may stop performing its function, leading to disability.
.Sometimes with such a disease in patients the body temperature rises, and when the joint feels, pain sensations of different intensity appear, depending on the stage of pathology. The skin in the affected area becomes hot to the touch.
.The described ailment can occur in mild, moderate or severe form.
In the first case, the patient practically does not suffer from knee restraint, he easily moves and feels pain only under heavy loads.
With heavier degrees, the stiffness of the joint increases, and in advanced cases the leg may become completely uncontrollable.
Pediatric arthropathy of the knee joint - what is it?
Arthropathy, unfortunately, does not have a certain age, it occurs as often in small patients, as in adults. However, the reasons for its occurrence are slightly different. In many cases, the change in the joint in children occurs due to certain ailments:
- allergic pathologies, especially because of the intake of medicines;
- tick-borne borreliosis or brucellosis;
- viral infections - parotitis, rubella or chickenpox;
- nerve-arthritis diathesis, which occurs in children with increased nervous excitability and disturbed metabolism;
- diseases of blood vessels.
According to statistics, most arthropathy of joints appears in small patients aged 10 years and older. The disease in them proceeds almost painlessly, which makes diagnosis difficult.
As a rule, if the joints are damaged, the child's temperature rises and the general state of health worsens, the knee worries only when moving and, as a rule, passes alone at rest.
The danger of arthropathy in children is also in the fact that it can quickly deform and destroy the joint that has not been formed until the end.
In addition, in young patients there is a special form of joint disease - juvenile rheumatoid arthropathy. This disease occurs only up to 16 years.
With this ailment, the following symptoms are typical: rashes on the skin, lesions of the lymph nodes, leukemia and high fever. The reason for the appearance of this pathology is still unknown.
In some cases, this kind of arthritis in children passes independently, and in others, recovery comes only after 6-9 months of treatment.
Diagnostic measures
To make an accurate diagnosis, the history of the disease is of great importance.
It is important to find out the nature and time of the onset of pain, the presence of lesions in the anamnesis, and also associated somatic pathologies, for example gout, diabetes mellitus or rheumatoid arthritis. Moreover, the specialist will need information about surgical interventions, existing infections and common symptoms.
The physician will determine by the help of physical diagnostics the presence of a crunchy sound, local pain in the region of the knee joint, possible amplitude of movements, swelling or swelling in it. In addition, a specialist can perform functional tests to identify possible instability.
The patient will then have to undergo laboratory tests. To detect the inflammatory process, it is enough to pass a blood test.
Biochemical examination will help to identify metabolic disorders.
.And to determine whether the body has specific antibodies to its own tissues or infections, they give enzyme-linked immunosorbent assays.
.Radiography is done to identify osteophytes, subluxations, enlargement of joints, thinning of cartilaginous tissue.
Still resort to a computer tomography and a magnetic resonance diagnostics.
If there is a suspicion of differentiation of stress fractures or oncology, then a bone scan is performed using radioisotopes.
Therapeutic measures
Arthropathy, the treatment of which involves the taking of different medications, the passage of physiotherapy procedures and local therapy, requires the patient a lot of patience and strict compliance with the requirements of a specialist. When choosing the tactics of treatment, his individual approach to each patient is mandatory.
To treat arthropathy begin with medications aimed at eliminating inflammation and chlamydial infection, which could provoke the appearance of pathology.
People with the described diagnosis are prescribed non-steroid drugs to reduce pain and inflammation in the joint. The most common among these medications are Ibuprofen, Diclofenac, Piroxicam and Naklofen.
But a long uncontrolled use of these drugs can lead to the appearance of gastropathy.
If in the treatment of arthropathy, non-steroid drugs do not help, then it is better to switch to glucocorticoid drugs.
The most effective in this case are "Methylprednisolone" or "Prednisolone".
And to avoid ulcers, dyspepsia and erosions associated with taking non-steroidal medications, you must take "Misoprostol" or "Famotidine."
.Antibiotic therapy uses drugs from the group of fluoroquinols and macrolides, as well as from the tetracycline series: "Minocycline "Spiramycin "Ofloxacin" and others.
.The duration of treatment is at least a month.
But to completely get rid of chlamydia, in addition to antibiotics, it is recommended to take medications, aimed at the restoration of intestinal microflora: "Acipol "Lactobacterin "Linex" or "Beefiform."
If necessary, spend and puncture the patient joint to enter the glucocorticoid means and remove the exudate. People who suffer from reactive arthropathy of the ankle and knee joints are usually appointed for this purpose by "Diprosan".
For local therapy use of applications of dimethyl sulfoxide, as well as anti-inflammatory creams and ointments: Dolgit, Fastum gel, Diclofenac. Emerging on the mucous membranes and skin integument pathological changes, as a rule, special treatment does not require.
Physiotherapy for joint damage
If the pathology has passed to a subacute stage, then the main therapy is supplemented with physical exercises, massage and various procedures. The most effective in this situation are:
- electrophoresis;
- paraffin applications;
- laser therapy;
- magnetotherapy;
- ultraviolet irradiation.
Dispensary supervision
Patients who have suffered arthropathy are regularly observed by a rheumatologist or therapist for six months. In addition, they have to undergo clinical and laboratory monitoring every 60 days. The prognosis for reactive arthritis is in many cases quite favorable and optimistic.
Duration of the disease is usually about 3 months, but in some patients it can pass into a chronic form with characteristic clinical manifestations of lesions of mucous membranes, eyes, joints and skin.
How to avoid arthropathy
It is necessary to begin prophylaxis of the described pathology since childhood.
To prevent the emergence of reactive arthritis, the child should be treated in a timely manner all infectious diseases, you can not start the processes on their own.
And it should be done strictly under the supervision of a doctor until full recovery.
In the place of residence it is important to ensure normal air circulation and humidity, and also to keep clean. Do not forget about personal hygiene. Pets should also be constantly bathed, using special shampoos.
If there is a first suspicion of arthropathy, consult a doctor immediately.
Only after a comprehensive examination is an accurate diagnosis and effective treatment is prescribed.
If the fears are confirmed, then it is necessary to observe the rheumatologist and strictly follow all his recommendations.
A source: http://.ru/article/285111/artropatiyachto-eto-takoe-simptomyi-i-lechenie-bolezni
Types of arthropathy of joints and ways of their treatment
Recommendations of orthopedist and rheumatologist ...
Arthropathy is a common name used to describe diseases with a dystrophic lesion of joints of different origin.
Arthropathy is a secondary disease that develops on the background of injuries, joint inflammation, autoimmune diseases.
This diagnosis is made when the symptoms of the disease differ from those characteristic of rheumatoid or gouty arthritis.
Arthropathy - a set of diseases characterized by the same type of lesion of the musculoskeletal system
In medicine, this disease has another name - reactive arthritis. It affects most often the knee, elbow and hip joints. There are no age limitations in the disease.
Types and causes of arthropathy
information for reading
Depending on the clinic of the disease and the factors that caused it, these types of illness are distinguished:
- Reactive arthropathy. Its development is associated with the reaction of tissues and cartilage to systemic abnormalities: endocrine gland diseases, leukemia, syringomyelia.
- Dystrophic form. It occurs as a result of a deterioration in cartilage nutrition. Diagnose more often in elderly people, when the entire body is already experiencing dystrophic changes.
- Pyrophosphate arthropathy (chondrocalcinosis). Appears against the background of an incorrect exchange of calcium salts in the body, as a result of which their settling on the cartilage occurs. It occurs after joint injuries or infectious diseases. This form is diagnosed most often.
- Idiopathic form. Diagnosed when it is not possible to identify the causes of arthropathy, which caused the development of the pathological process.
- Psoriatic arthropathy. The disease develops against the background of psoriasis.
- Hereditary form. Disorders in the diet of cartilage structures are laid down at the level of genes. The disease begins to appear usually in childhood.
- Diabetic arthropathy. Damage to the joints on the background of diabetes mellitus. It develops mainly in young women.
Psoriatic arthropathy appears on the background of psoriasis
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In reactive arthritis (arthropathy), the patient exhibits the following symptoms:
- articular syndrome;
- clinic of urogenital disease;
- extraarticular inflammation (skin and mucous membranes);
- lesions of the spine;
- visceral lesions;
- systemic inflammatory reaction.
Articular syndrome is the main symptom of the disease. It manifests as a simultaneous inflammation of two or more joints.Pain in the joint is aching, intensifying with loads.
After rest, the pain may subside, but by evening it resumes. In the affected joint begins to appear stiffness and limited movements.
With the progression of the disease, joint blockage can occur.
Over time, the deformation of the joint begins to manifest. There is swelling (edema), which is due to the accumulation of fluid in the cavity of the joint bag.
Especially brightly, the edema appears on the knee, elbow, wrist joints
There is an increase in the temperature of the joint and its redness. When these symptoms appear, the pain sensations usually increase.
Diagnosis of arthropathy of the knee, elbow and hip is usually possible in the early stages.The doctor prescribes an x-ray study. The pictures clearly reveal violations in the cartilaginous tissue of the joint - signs of osteoporosis, an increase in the joint gap.
On an x-ray, the doctor will unmistakably identify the signs of periarticular osteoporosis
In addition to damage to the joints, arthropathy often causes disturbances in the work of other organs and systems.Most often progressing disorders in the genitourinary system (urogenital syndrome). Such violations are detected in about 30-40% of patients.
.In women, they are detected in the form of violations of the menstrual cycle, vaginal discharge with pus, cervicitis, pain in the lower abdomen. In men, symptoms of prostatitis often appear, the process of urination may be disturbed.
.Extra-articular lesions are manifested in the form of eye diseases (conjunctivitis), psoriasis, stomatitis and the appearance of ulcers in the oral cavity, inflammation of the mucous membranes on the genital organs.
Visceral lesions in patients are manifested by diseases and inflammatory processes in the kidney and excretory system. Rarely begins to progress ischemic heart disease, there is tachycardia, as well as disorders in the work of the nervous system.
Systemic inflammatory reaction is observed only in 10-15% of patients. They complain of general malaise, fatigue, there is fever, fever.
With arthropathy, almost all patients in the blood increase the rate of erythrocyte sedimentation (ESR)
Reactive arthropathy in children is a consequence of urogenital or intestinal infection.It is observed more often in boys than in girls.
Called chlamydia, salmonella, iersiniyami and some other pathogens. There is a disease in children with Reiter's syndrome, which includes conjunctivitis, arthritis and urethritis.
Symptoms of diseases in a child can be observed both collectively and separately. There is also a general deterioration in well-being.
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To treat the disease must start immediately after it is diagnosed. Therapy is carried out in two directions: treatment of the underlying disease and antibiotic therapy.
Antibiotics are prescribed for the destruction of infectious agents that caused a pathological reaction. The course lasts 7 days. The drug is prescribed by the doctor individually to each patient.
Almost always adequate therapy of the underlying disease makes it possible to minimize the painful manifestations on the part of the joints. The standard treatment plan includes the use of:
- anti-inflammatory drugs (non-steroidal) to relieve pain and inflammation in the joints;
- chondroprotectors, whose action is aimed at stopping degenerative changes in the joints;
- immunomodulators for the maintenance of the immune system;
- vitamin complexes to maintain joint health.
In addition to the use of drugs, it is mandatory to have a course of physiotherapeutic procedures to normalize blood circulation in the joints and periarticular bags, as well as to relieve inflammation.
Physiotherapy exercises with correctly selected loads help restore muscle tone and improve the stability of the supporting function of the joints
Sometimes treatment is supplemented with chemotherapy (if systemic blood diseases are observed) or with substitution therapy (if endocrine system diseases are present).
.The principles of treatment of psoriatic arthropathy are based on the reduction of the pain symptom, the prevention of the development of pathology and the destruction of new joints.
.The main task in this case is the rapid cure of the patient, in order to prevent a transition psoriatic arthropathy in disability, which is observed when untimely or incorrect treatment.
Timely call for advice to a doctor will help to avoid serious health problems
The prognosis for the treatment of arthropathy largely depends on the degree of the disease that caused it, and the timeliness of the treatment.
With the early application for qualified medical care, a complete cure for the disease is possible. Even a little pain can be the beginning of a serious illness.
Therefore, never ignore the signals of your body.
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A source: http://SustavInfo.com/bolezni/artrit/simptomy-i-lechenii-artropatii-sustavov/
Arthropathy
Arthropathy- secondary damage to the joints on the background of other diseases and pathological conditions.
It can develop with allergies, certain infectious diseases, endocrine disorders, chronic diseases of internal organs, metabolic disorders and disorders of nervous regulation. Clinic of arthropathies can vary significantly.
Common features are pain, asymmetry of the lesion, dependence of the joint syndrome on the course the main disease and poorly expressed changes in the results of instrumental studies (radiography, CT, MRI).
The diagnosis of arthropathy is made if the joint and extra-articular symptoms do not match the diagnostic criteria of gouty or rheumatoid arthritis. Treatment is carried out taking into account the underlying disease.
Arthropathy - joint damage caused by non-rheumatic diseases. It can occur in diseases of different etiologies. It flows in the form of arthralgia (pain without disrupting the form and function of the joint) or in the form of reactive arthritis.
The main characteristic of arthropathies is the dependence of the joint syndrome on the course of the underlying disease.
Severe pathological changes in the joints usually do not develop, in most cases the joint symptomatology completely disappears or decreases significantly with adequate treatment of the underlying disease.
Allergic arthropathy
Pain in the joints occur against the background of an allergic reaction. Arthropathy can develop as soon as possible after contact with the allergen, and several days later.
The diagnosis is made on the basis of characteristic allergic symptoms: the presence of fever, skin rash, lymphadenopathy, bronchial obstruction syndrome, etc.
Blood tests reveal hypergammaglobulinemia, eosinophilia, plasma cells and antibodies of IgG class. The phenomena of arthropathy disappear after desensitizing therapy.
Arthropathy with Reiter's syndrome
Reiter's syndrome is a triad involving damage to the organs of vision, joints and the genitourinary system.
Most often the cause of development is chlamydia, less often the syndrome is caused by salmonella, shigella, iersinia or occurs after enterocolitis. Suffer persons who have hereditary predisposition.
Usually the symptoms appear in the following sequence: first - an acute urinary infection (cystitis, urethritis) or enterocolitis, shortly thereafter, the defeat of the eyes (conjunctivitis, uveitis, iridocyclitis, retinitis, keratitis, iritis), and only after 1 month, arthropathy. In this case, the symptoms from the eyes may appear within 1-2 days, be weakly expressed and remain unnoticed.
.Arthropathy is the leading sign of Reuters syndrome and often becomes the first reason for seeking medical help.
.Usually asymmetric arthritis with lesion of the joints of the lower extremities is observed: ankle, knee and small joints of the foot.
Thus joints, as a rule, are involved in inflammatory process consistently, from below upwards, with an interval in some days. A patient with arthropathy complains of pains that intensify at night and in the morning.
Joints are edematic, local hyperemia is noted, in some patients effusion is detected. Sometimes there are pains in the spine, sakroileitis develops, heel bursitis with a rapid formation of the calcaneal spur and inflammation of the Achilles tendon is possible.
The diagnosis is made on the basis of medical history, symptoms, laboratory and instrumental research data.
If there is a history of enteritis or urinary infection, patients with arthropathy are referred for consultations to the appropriate specialists: gastroenterologist, urologist and venereologist.
In case of eye damage, consultation with an ophthalmologist is necessary.
In blood tests, signs of inflammation are revealed, in urine tests - an insignificant or moderate amount of leukocytes. To detect chlamydia, a scraping from the cervical canal, urethra and conjunctiva is performed.
When carrying out the X-ray of the knee and ankle joint, there is a certain narrowing of joint cracks and foci of periarticular osteoporosis. Radiography of the calcaneus usually confirms the presence of the calcaneal spur.
Radiography of the foot indicates the presence of periostitis, erosion and spur of metatarsal bones and bones of phalanges of fingers.
.Treatment is aimed at combating the underlying infection and eliminating the symptoms of the disease. Patients with arthropathy are prescribed antichlamydia drugs, if necessary - analgesics and NSAIDs.
.In 50% of cases, arthropathy completely disappears, in 30% of patients there are relapses of arthritis, in 20% of cases there is a chronic course of arthropathy with further aggravation of symptoms and impaired function joints.
Arthropathy can occur with a number of parasitic and a variety of infectious diseases. Trichinosis, brucellosis and Lyme disease are characterized by volatile arthralgia, sometimes in combination with myalgia.
When rubella appears unstable symmetrical polyarthritis.
Arthropathies in epidemic parotitis resemble a picture of rheumatoid arthritis: inflammation in the joints is unstable, has a migratory nature and is sometimes accompanied by inflammation of the pericardium.
Infectious mononucleosis and chickenpox are accompanied by arthropathy in the form of unstable arthritis, rapidly passing with the extinction of the symptoms of the underlying disease.
Arthropathy with meningococcal infection develops about a week after the onset of the disease; usually monoarthritis of the knee joint, and rarely - polyarthritis of several large joints.
With viral hepatitis, arthropathy is possible in the form of arthralgia or volatile arthritis with symmetrical lesion mainly knee joints and small joints of the hand; Arthropathy usually occurs at the very beginning of the disease, even before the appearance of jaundice.
For HIV infection, there is a wide variety of articular symptoms: both arthritis and arthralgia are possible, in a number of cases, AIDS-associated arthritis of the ankles and knee joints, accompanied by a pronounced impairment of limb function and intense pain syndrome.
.In all these cases, the joint symptomatology quickly disappears when treating the underlying disease.
.With nodular periarteritis, Takayasu's syndrome and Cherge-Strauss granulomatosis, arthropathies usually take the form of arthralgias.
With Kawasaki's disease, both arthralgia and arthritis are possible.
With Shenlen-Henoch disease and Wegener's granulomatosis, a symmetrical lesion of large joints is observed, a non-permanent pain syndrome against the background of swelling of the periarticular tissues.
Arthropathy in endocrine disorders
The most common joint damage in cases of hormonal imbalance is climacteric or ovariogenic arthropathy.
Articular syndrome develops in the background of menopause or a decrease in ovarian function, due to other causes (surgical removal, irradiation for malignant neoplasm).
Arthropathy often affects women with excess weight. Usually the small joints of the feet are affected, and more rarely the knee joints. There are pains, stiffness, crunch and swelling.
The configuration of joints is broken - first due to edema, then due to dystrophic processes.
At the initial stages, the radiographic picture is normal, on the MRI of the joints or during arthroscopy of the knee joint, a certain thickening of the synovial membrane is revealed. In the subsequent, gonarthrosis and arthrosis of the foot joints are detected. After selecting effective replacement therapy, arthropathies decrease or disappear.
Diabetic arthropathy develops mainly in young women with Type I diabetes mellitus for 6 or more years, especially with irregular and inadequate treatment. The lesion is usually one-sided, the joints of the foot suffer.
Less often the knee and ankle joint are involved in the process, even more rarely - the spine and joints of the upper limbs. For diabetic arthropathies, a clinic of rapidly progressing arthrosis is characteristic.
The roentgenograms reveal foci of osteolysis, osteoporosis and osteosclerosis, flattening of the joint surfaces and osteophytes.
.Treatment of diabetes mellitus leads to a reduction of arthropathy, but with severe arthrosis, therapy is needed to eliminate pain syndrome and restore cartilage.
.Hyperparathyroidism causes the resorption and subsequent restoration of bone tissue, while in the articular cartilage there are calcareous deposits, articular chondrocalcinosis develops.
Arthropathy manifests itself in the form of volatile pain in the joints, acute mono- and polyarthritis. After correction of hyperfunction or removal of parathyroid adenoma articular symptoms usually disappear.
Hyperthyroidism, especially its severe forms, can also be accompanied by arthropathy. Both arthritis and arthralgia are possible, sometimes in combination with muscle pain.
The radiological picture is scant, only the phenomena of widespread osteoporosis are revealed. Diagnosis is made on the basis of clinical manifestations.
Therapy of the underlying disease leads to a decrease or disappearance of arthropathy.
For hypothyroidism is characterized by the defeat of large joints, often knee. There are also pains in the hip joints. Arthropathies are combined with myalgia, stiffness and muscle weakness.
Radiological picture without changes. With the development of hypothyroidism in childhood, rotation and displacement of the femoral head can occur with the development of the flexural contracture of the hip joint.
When the pituitary gland is damaged, spinal cord and distal joints of the limbs are sometimes damaged.
.In severe cases kyphosis of the cervicothoracic region develops in combination with decalcification of the sternum and ribs. Deformities of limbs and joint looseness are possible.
.Arthropathy is manifested by pain in the back and joints of the limbs. Contractures are uncharacteristic.
Arthropathy in diseases of internal organs
The most famous arthropathy for diseases of internal organs is Marie-Bamberger syndrome - deformation of fingers in the form of tympanic sticks and nails in the form of hourglasses.
The cause of deformation is ossifying periostosis of the distal sections of the tubular bones, resulting from the reaction of the bone tissue to the disturbances of the acid-base balance and the lack of oxygen.
The syndrome most often occurs with lung diseases (lung cancer, cavernous tuberculosis, suppurative diseases). It can also occur with cirrhosis of the liver, prolonged septic endocarditis and some congenital heart defects.
Arthropathy is manifested in the form of severe pain in the joints. Minor edema is possible.
Crohn's disease and ulcerative colitis are characterized by arthropathies in the form of acute migrating arthritis. Usually the ankle and knee joints are affected.
With nonspecific ulcerative colitis arthritis of the hip joints and pain in the spine are possible.
All manifestations of arthropathy disappear on their own within 1-2 months.
A source: http://www.krasotaimedicina.ru/diseases/traumatology/arthropathy