Infectious arthritis (purulent, pyogenic, septic) - joint damage associated with the ingress of pyogenic microorganisms. Arthritis associated with infection

This article discusses infectious arthritis. We talk about the reasons for its appearance, signs and diagnosis. You will learn about the necessary therapy and possible complications.

Infectious (purulent) arthritis is a severe inflammatory lesion of the joints, which can lead to their rapid destruction. This disease is associated with the penetration of various infectious agents into the tissues of the joints, for example, in septic conditions.

Infectious arthritis is the largest group, which includes the totality of all infectious and inflammatory conditions - autoimmune, allergic, reactive, etc.
Highlight:

• Primary purulent arthritis - infectious agents act directly on the joint cavity at the time of damage to the joint.
• Secondary purulent arthritis - the impact of microorganisms occurs on the tissues surrounding the joint or in a hematogenous manner, namely, through the blood (sepsis, gonorrhea).

The risk of developing purulent arthritis increases in the following cases:

• chronic rheumatoid arthritis;
• serious systemic infections;
• homosexuality;
• some types of oncology;
• alcohol and drug addiction;
• diabetes;
• sickle cell anemia;
• systemic lupus erythematosus;
• surgery or joint injuries;
• intra-articular injections.

Types of infectious arthritis

Currently, more than a dozen types of infectious arthritis are encountered in medical practice, the main ones being seropositive rheumatoid arthritis and juvenile rheumatoid arthritis.

Seropositive rheumatoid arthritis is a chronic disease manifested by joint damage, as well as systemic changes in internal organs and blood vessels. This disease is very common among people, as it is observed in 80% of the population.

Under no circumstances should treatment for this type of arthritis be delayed, as this can lead to dire consequences. The causes of seropositive rheumatoid arthritis have not been fully identified, which negatively affects preventive measures. Presumably, the appearance of the disease is influenced by various viruses and mycoplasmas, the accompanying factors for which are: heredity, trauma, stress, toxins and age over forty years.

Rheumatoid arthritis is autoimmune in nature, that is, the immunoglobulins of the human body begin to bring harm rather than benefit to it. This type of arthritis is easily treatable if you do not delay a visit to the doctor;

Juvenile rheumatoid arthritis is an inflammatory chronic joint disease that develops in adolescents no older than sixteen years. The causes of this type of disease also remain a mystery.
The hypothetical causes of the occurrence and development of this disease are considered: bacterial and viral infections, hypothermia, injuries, protein preparations, insolation and others.

The main factor for the development of juvenile rheumatoid arthritis, according to most medical scientists, is the formation of a complex, little-studied immune response of the human body to various environmental factors, causing the development of a progressive disease.

The prognosis for this type of arthritis is not very favorable, since fifty percent of patients can count on remission. Only fifteen percent are susceptible to blindness and one third are susceptible to relapse.

Causes of infectious arthritis

As a rule, purulent arthritis is caused by viral, fungal or bacterial infections that enter the joint through the bloodstream, during surgery or other favorable routes. The appearance of pathogenic factors depends on the age group of the patient.

The disease is transmitted to newborn children from the mother if there is a gonococcal infection in her body. Children can also contract purulent arthritis during various hospital procedures, for example, during the insertion of a catheter.

The causative agents of the disease in infants are haemophilus influenzae or staphylococcus aureus. For children from two years of age and adults, streptococcus pyogenes and streptococcus viridans are the causative agents of infectious arthritis. For sexually active people, the cause of joint disease is Neisseria gonorrhoeae, and for older people - Salmonella and Pseudomonas.

Symptoms of infectious arthritis

There are reactive, infectious and post-infectious arthritis, the division of which is very arbitrary, since even modern advanced technology cannot always determine the presence of pathogenic microorganisms in the tissues of the joint. Infectious arthritis is caused by pyogenic organisms: streptococcus, staphylococcus, Proteus, pneumococcus and Pseudomonas aeruginosa.

The disease manifests itself several hours after infection and development in the form of acute pain and limitation of passive and active movements. Weakness, chills and body temperature rise. In the area of ​​the affected joint, swelling and redness of the surrounding tissues occur.

In children, this disease manifests itself in the form of subtle, erased symptoms, expressed as slight pain after prolonged physical activity. The development of the disease continues for several months, after which more serious manifestations occur.

Purulent arthritis in children poses a serious threat to health and even life, as it can lead to the destruction of cartilage and bone tissue, as well as cause septic shock, which is fatal. Symptoms of this disease in a child’s body are expressed in the form of fever, pain in damaged areas of the body, chills, as well as vomiting and nausea.

General clinical picture:

• Acute pain when moving;
• Localization of joints: knee, shoulder, wrist, small joint of the hand and foot, sacroiliac (for drug addicts);
• Signs of the inflammatory process: fever, swelling, local hyperemia;
• Dermatitis-periarthritis syndrome.

The diagnosis is based on a typical x-ray picture, a set of characteristic symptoms and the results of a microbiological study.

Which joints may be affected?

This disease is typical for all age groups, including newborns. For adults, the joints or hands that bear the main weight load are usually affected. In children, this disease usually affects the knee, hip or shoulder joints.

Since purulent arthritis can cause forced positioning of the limbs, there are certain external signs of this disease:

• Shoulder joint – the shoulder has a depressed appearance, the affected arm is in a bent position at the elbow and supported by the healthy one;
• Elbow joint - the protrusion of the elbow looks smoothed, the arm is in a slightly bent position, there may be a painful round formation on one side of the joint;
• Wrist joint - the joint is sharply deformed, which promotes bending of the hand to the side;
• Hip joint – formation of edema in the area of ​​the affected joint, inability to support the leg;
• Knee joint – a bent leg and an abnormally shaped joint impede movement;
• Ankle joint - the foot has a raised appearance, movements are limited.

Diagnostics

The final diagnosis of purulent arthritis is made by a specialist after passing all the necessary laboratory tests, studying the medical record and examining the patient. Symptoms of this type of disease are also characteristic of other diseases, so a thorough examination of the patient before treatment is mandatory.

In some cases, patients are prescribed additional consultation with a rheumatologist or orthopedist in order to avoid an erroneous diagnosis. To confirm the diagnosis, the following studies are prescribed:

• Joint puncture - examination of synovial fluid;
• Culture and biopsy - examination of the synovial tissue surrounding the affected joint;
• Blood and urine culture is a study of the biochemical and bacterial state of the body.

Hardware diagnostics of infectious arthritis in the first two weeks after the onset of the disease is inactive. That is why, at the first signs of the disease, doctors prescribe other tests, with the help of which it is possible to recognize arthritis in the early stages and begin its treatment.

Treatment of infectious arthritis

If infectious arthritis is detected, the patient is required to receive hospital treatment for several days, followed by physiotherapy sessions and medications for several months or weeks, depending on the stage of the disease.

Medicines are used for delayed treatment, which can cause serious damage to the joints or cause other complications. For this reason, intravenous injections with antibiotics are prescribed immediately after the detection of this pathology, before accurately identifying the causative agents of the infection. After identifying the causative agent of an infectious disease, a patient with infectious arthritis is prescribed a drug that affects a specific virus or bacterium.

Anti-inflammatory non-steroidal drugs are prescribed as a course of intravenous injections for two weeks or until the inflammatory process disappears. After intravenous administration of antibiotics, a four-week course of antibacterial agents in capsules or tablets is prescribed.

Surgery is necessary in situations that require surgical drainage of infected joints. This is only used for those patients who have a certain resistance or immunity to antibiotics, or for people who have joint damage in places that are difficult to access for puncture. Penetrating injury is also the reason for surgery in the presence of purulent arthritis.

For patients with severe cartilage and bone damage, reconstructive surgery is used, which is performed only after complete recovery from infection.

Concomitant therapy and medical supervision is inpatient treatment, during which the patient is carefully monitored. A sample of synovial fluid is sent daily for culture to monitor the body's response to the effects of antibiotics.

Due to the painful symptoms of the disease, special pain-relieving procedures are provided for patients in the hospital, in the form of complex treatment: taking special medications and applying compresses to the affected joints.

In rare cases, immobilization is performed, which involves placing a splint on the leg or arm to ensure immobility of the arthritic joint. Also, therapeutic exercises are carried out for each patient on an inpatient basis, aimed at expanding the range of motion and speedy recovery.

The main goal in the treatment of purulent arthritis is to suppress the activity of the inflammatory process, acting in the most appropriate ways on the causes of its occurrence.

Complications

Infectious arthritis is a protracted disease of a unique nature, which entails the possibility of developing the following diseases: purulent tissue inflammation, sepsis. Bone inflammation, bone displacement, ligament tears, sprains and dislocations, and dehydration of the affected joint.

With timely antibacterial treatment of septic arthritis, the prognosis is favorable, which indicates the possibility of complete restoration of the affected areas of the body.

Thus, every person should understand that any disease in the early stages of its occurrence is, in most cases, treatable. You should not delay a visit to the doctor when the first signs of purulent arthritis appear, since the advanced stage of the disease can lead to adverse consequences.

Aches or pain in all joints may appear due to past infectious diseases. Joint complications usually occur as a result of the body's immune response to a viral or bacterial infection. Bacteria that enter the body penetrate the joints from a distant source of infection through the bloodstream or through direct infection of nearby tissues during surgery, injection or injury.

Etiology and pathogenesis

Infectious diseases arise due to the entry of pathogenic microbes into the body, including viruses, bacteria, fungi, etc.

It is assumed that due to the presence of antigens in microorganisms, similar to the antigens of the joint tissues of the human body, the immune system is not able to distinguish between them, and therefore attacks both microbes and joints. Pathogenic microorganisms can affect joints in different ways:

• It is possible for the infection to spread directly to the joint tissues, which can provoke severe septic arthritis with damage to nearby tissues. Risk factors:
  • joint surgery;
  • prosthesis;
  • skin infection;
  • using unsterile needles to inject drugs;
  • injuries.
• There is a risk of penetration of the pathogen into places remote from the joints (nasopharynx, genitourinary and digestive organs), causing an inflammatory process. appear as a secondary protective reaction to infection, sometimes after recovery (reactive arthritis). The following microorganisms cause joint problems:
  • Staphylococcus aureus, streptococcus and other gram-negative bacteria cause joint complications in young children;
  • bacteria that cause sexually transmitted diseases, Lyme disease, various types of staphylococcus and intestinal infections that are associated with bacteria such as salmonella, klebsiella, shigella, etc.
  • HIV, rubella virus, mumps virus, hepatitis B and C, etc.
• Sometimes, after an illness, harmless joint pain (arthralgia) or fleeting arthritis appears. Such manifestations are usually not a cause for serious concern.

Symptoms of joint complications

In septic arthritis, the joint becomes hot and red.

The infection can develop in both natural and artificial joints, causing severe pain that appears several hours or days after infection. The knees and ankles are most often affected. Sometimes the pain migrates to different parts of the body, sometimes it moves to the spine. The most characteristic symptoms of joint complications are shown in the table:

Treatment of the disease

Traditional methods

Joint disease itself is not contagious, but the infection that causes it can be dangerous to others.

Folk remedies

In addition to the main treatment, you can prepare a tincture of chestnut inflorescences.

• Purslane garden. Take 1 tbsp. spoon, add water and boil for 10 minutes, then infuse and filter. Drink 1 tbsp. spoon 3-4 times a day.
• Horse chestnut flowers. Take 20 g of raw material, infuse it with vodka (0.5 l) for 2 weeks. Use for rubbing into sore spots.

Recipes for septic arthritis:

• Prepare a mixture of coarse salt (2 tablespoons), mustard powder (1 tablespoon) and a small amount of kerosene until a viscous mass is obtained. Rub into areas of increased pain, and then wrap yourself warmly. Use once a day, preferably at night.
• Mix sunflower oil (2 tablespoons), vodka and 0.5 cups of turpentine. Use the composition for compresses at night.

Preventing joint pain due to infection

To avoid contracting an infection you must:

• Observe personal hygiene rules.
• Dress warmly in cold weather, as the culprit for pain and aching bones and joints can be the flu, sore throat or acute respiratory infections.
• Avoid promiscuity. Septic arthritis, which affects the joints, often occurs in young, sexually active people. Complications are caused by gonococcus and lead to.
• Eat nutritiously and properly, since infection of the digestive tract more often occurs in the presence of gastritis, stomach and duodenal ulcers.
• Undergo preventive examinations to detect early tuberculosis. The Mantoux test in children and routine fluorography will help avoid dangerous tuberculous arthritis.

Hardening promotes the normal functioning of the immune system.

It is important to prevent complications from viral and bacterial diseases.

Infection and joints

In the past, the role of infection in rheumatic diseases was given much more importance than it is today. At the beginning of this century, the cause of rheumatoid arthritis was considered to be a tuberculosis infection, and a kind of result of such findings was treatment with gold salts, which in some cases successfully neutralize tuberculosis bacteria. Later it turned out that tuberculosis had nothing to do with rheumatoid arthritis, and the cause of rheumatic diseases began to be considered infectious foci in the teeth, tonsils or cecum. The favorite treatment for all rheumatic diseases was the removal of infected teeth. Currently, the treatment of foci of infection in the teeth and tonsils is considered more of a general hygienic requirement than of having therapeutic value.

The infection can behave in relation to the joints in different ways:

1. The infection penetrates directly into the joint tissues and cavities, bacteria multiply there and often cause great harm.

2. The infection penetrates into places remote from the joint - the ureters, digestive organs, nasopharynx and tonsils. After the healing of these organs, after some time, arthritis and other extra-articular symptoms of the disease occur as a reaction to this infection. It is not possible to detect bacteria in the joint itself, and in this case their disease is a kind of secondary protective reaction to the presence of microorganisms in foci outside the joints.

3. After suffering from the flu, in the initial stages of viral hepatitis (infectious inflammation of the liver) or infectious mononucleosis, harmless joint pain or fleeting arthritis may appear.

Infectious arthritis in the truest sense of the word is caused by microorganisms entering the joint from nearby tissues (for example, from infected bone tissue after an injury) or from the blood. Pathogenic agents can enter the joint from foci of infection, most often located in the skin or subcutaneous fat layer. Infectious arthritis is caused by a rather dangerous Staphylococcus aureus or some types of streptococci. Depending on the frequency of manifestations of sexually transmitted diseases, primarily gonorrhea, gonorrheal inflammation of the joints (gonococcal in nature) can also be observed. All this is caused by bacteria, resulting in a very intense protective reaction of the body to the inflammatory process with an influx of hundreds of millions of leukocytes into the joint. These, through the same process as rheumatoid arthritis, release enzymes that can destroy the joint in a few days. Fortunately, this is prevented by numerous protective mechanisms and timely treatment. Certain diseases such as diabetes mellitus and general fatigue of the body in bedridden people predispose the infection carrier to the joint. Joint infections have been reported among drug addicts, in whom an infection caused by an unsterile syringe is associated with a general weakening of the body. Infectious arthritis must be detected as early as possible, since only timely initiation of antibiotic treatment can stop serious changes in the joints.

A special type of joint infection is tuberculous arthritis. It was more common in times when tuberculosis was incurable. This disease occurs in people suffering from pulmonary tuberculosis. From the lungs, the tuberculosis bacillus (mycobacterium) can penetrate other organs, including the joints. Usually one or two joints are affected, and it can be very difficult to recognize joint tuberculosis. The large joints most commonly affected are the knee, hip, elbow or wrist. Arthritis develops gradually and can be difficult to distinguish from rheumatoid arthritis. After establishing a diagnosis of arthritis, it is very important to take samples of joint tissue - laboratory tests can reveal signs of the development of tuberculosis and tuberculosis bacteria in them. Sometimes they can be found in synovial fluid.

The curability of infectious arthritis, both purulent and tuberculous, today, with a large selection of antibacterial agents, is quite high, but treatment should be started on time. It should be intense, with drugs administered directly into the joint.

More often than these directly infectious arthritis, so-called reactive arthritis occurs - reactive because they are a reaction to an extra-articular infection and occur only some time after the source of infection has subsided. These include rheumatic fever, the so-called Reiter's syndrome, Lyme borreliosis, etc.

The most unstudied disease from a number of reactive arthritis is rheumatic fever. In the past, it was quite common, especially in areas with weak socio-economic development, where poverty coexisted with overpopulation. In 1925-1950 Rheumatic fever was one of the most common causes of death in children and adolescents, and a leading cause of heart disease in people under 40 years of age. Gradually, the number of cases of rheumatic fever decreased, and at the same time the mortality rate decreased. The number of people with heart muscle damage also decreased. The decrease in the incidence of rheumatic fever was caused by a number of reasons - an improvement in the quality of life, the widespread use of antibiotics for the treatment and prevention of streptococcal infections, and perhaps the streptococcus itself has changed, which has become less aggressive and has lost its ability to cause rheumatic fever. In a number of countries in Asia and Africa, the problem of rheumatic fever still exists. The cause of this disease is infection of the nasopharynx with b-hemolytic streptococcus group A (the word hemolytic means that it can destroy red blood cells). This streptococcus contains a number of protein and non-protein compounds that cause the formation of specific protective antibodies that neutralize its effect. Streptococcus produces a number of toxic substances that damage body tissues - these include the so-called streptolysin O (streptolysin is the cause of the destruction of red blood cells). To counteract this streptolysin, specific antibodies are also formed, called antistreptolysin O - abbreviated ASLO (these antibodies are used in diagnosis, since their presence in the blood indicates a streptococcal infection).

Streptococcus enters the tissue of the lymphoid ring of the pharynx (tonsils), causes a sore throat and releases toxic products - toxins. The body defends itself and produces protective antibodies to fight. After this, something interesting begins to happen. Due to a certain biological and chemical similarity of some of the constituent elements of the body of streptococcus and the connective tissue of the heart and joints, a kind of cross-reaction occurs, and antibodies designed to fight streptococcus begin to attack the tissue in which this microbe has settled. Here we can see an example of an autoimmune disease. A certain mystery is the fact that in the majority of the population, streptococcal infection of the nasopharynx passes as an uncomplicated disease, and in a minority, after some time, signs of rheumatic fever develop. Obviously, here we have an example of a certain predisposition, which, fortunately, is characteristic only of a small part of our population. Thus, with rheumatic fever, events occur in the following sequence: a sore throat, which quickly passes, after which a few days or weeks later a disease occurs with high fever, sweating, inflammation of one or more, usually large ones (knee, ankle, elbow, wrist) joints. Arthritis has a wandering nature and moves from one joint to another. Joint pain is sometimes very severe. These pains can be quite successfully treated with a number of antirheumatic drugs, and therefore have never been considered a serious disease. Another thing is heart complications. Rheumatic inflammation affects the heart muscle, the inner lining of the heart and the heart sac (pericardium). Signs of heart damage can sometimes be subtle, and only an experienced doctor can recognize them in time. The inflammatory process in the tissues of the heart does not respond to the administration of drugs as well as in the joints, in addition, it can be repeated and reappear. The result can be defects in the heart valves. The valves can grow together, causing them to become narrowed (stenosis), or due to the proliferation of connective tissue, the valve stops closing completely (insufficiency). Both of these types of heart valve lesions can significantly affect the functioning of the cardiovascular system over several years.

In addition to the heart and joints, this disease also affects the skin (the appearance of a reddish rash), and sometimes the central nervous system is affected, which is manifested by the so-called dance of St. Vitus (trochea). In this case, the muscles contract uncontrollably and uncoordinated, and sometimes chorea manifests itself only in the form of restlessness and nervousness of the child at school or uncontrollable grimaces.

Laboratory tests play an important role in the diagnosis of rheumatic fever. First of all, we are talking about the sedimentation of red blood cells, the number of which increases significantly in the initial stages. The tests are carried out in such a way that the patient's venous blood is mixed with an anticoagulation solution to prevent it from clotting, after which the blood is poured into a vertically installed glass tube. After an hour and after two hours, the sedimentation of red blood cells in the uncoagulated blood plasma is calculated. Normally, a few millimeters of pure plasma is formed from the blood cells at the top of the dark column. Due to changes in blood proteins in the presence of an inflammatory process, this figure increases to several tens of millimeters (maximum - 100-120 mm in 1 hour). The sedimentation of red blood cells tells us how intense the inflammatory process is in the body. In the future, the already mentioned antistreptolysin antibodies are analyzed.

Rheumatic fever should be treated promptly and vigorously. The basis of the treatment program is bed rest, especially if the heart has been affected. Bed rest may not be so strict if test results (erythrocyte sedimentation) improve and depending on the degree of heart damage. With rheumatic fever, which is not accompanied by complications, the recovery process is rapid, although it may take up to two months for the manifestations of this disease to completely disappear. Heart complications also cause longer-term disability.

Among the medications used in treatment, increased doses of acetylsalicylic acid (aspirin) are used, which are prescribed by a doctor or non-steroidal antirheumatic drugs in the appropriate dosage (see the section on pharmacotherapy of rheumatic diseases). If we are talking only about the articular form of rheumatic fever, such treatment may be sufficient. If there are signs of heart complications, it is necessary to take corticosteroids in higher dosages, which is also determined by the doctor. This treatment should continue until signs of recovery appear. After this, the doses of corticosteroids taken are reduced, and therapy ends only after the manifestations of this disease have completely disappeared. For some time, backup drug therapy is used. At the beginning of the treatment of rheumatic fever, penicillin is also used to remove living and “harmful” streptococci from the body, and if the patient does not tolerate it well, it can be replaced with another antibiotic.

Patients whose disease has left traces of heart damage are given preventive treatment with penicillin for several years. In this case, we are talking about either taking small doses daily, or taking a long-acting dosage of penicillin once every few weeks. It is important to carefully treat each sore throat with antibiotics.

In conclusion, an important circumstance should be pointed out. Although, thanks to all the above factors, rheumatic fever was virtually eliminated by the 1970s and doctors gradually began to forget about it, since 1986 there have been reports of a beginning increase in incidence in the United States. We are talking about diseases of children living in families with a good quality of life and in healthy rural areas. In addition, as already happened during the Second World War, young recruits get sick. It turns out that the social factor is not decisive for defeating rheumatic fever. Scientists who immediately undertook research on streptococci from the nasopharynx and tonsils of patients discovered that this streptococcus had changed, and now the disease was caused by a new, modified type of this microorganism.

The first symptoms of the disease are arthritis, most often of the ankle or knee joints. They appear 1-3 weeks after infection of the urethra. Sometimes the patient may only vaguely remember a burning sensation during urination or frequent urination, which some time ago bothered him a little. Often, along with the joints, the patient has pain in the sacral spine or pain in the heel area (the junction of the tendon and the heel bone). Less commonly, the mucous membrane of the eye becomes inflamed (conjunctivitis), and a scaly rash may appear on the skin of the feet. This disease does not last long; only in exceptional cases can it last for several months. In the initial period, it responds well to treatment with antibiotics; later, non-steroidal antirheumatic drugs and treatment with sulfasalazine are needed to relieve pain (see the section on pharmacotherapy of rheumatic diseases).

Acquired immunodeficiency syndrome (AIDS) can also have an impact on joints. The virus that causes this disease attacks human lymphocytes, which are involved in the body's defense against infection, and impairs their normal functioning. Thus, in those infected with it, access to the body of infection is facilitated and the likelihood of developing tumor diseases increases. Infectious arthritis secondary to bacteria may occur in the joints and bones of patients. Sometimes symptoms characteristic of Reiter's syndrome and spinal injuries may develop.

A special type of arthritis, which has much in common with infectious and reactive arthritis, is Lyme borreliosis. This is a complex disease that affects, in addition to joints, the skin, heart and nervous system. As for its joint manifestations, it resembles the symptoms of infectious arthritis, since the tissues are affected by bacteria. On the other hand, this disease is also of the nature of reactive arthritis, since the disease, especially in the joints, appears only a few months after infection.

The discovery of Lyme borreliosis occurred in the United States in 1975, when a small “epidemic” of arthritis arose among children in the town of Old Lyme in Connecticut. Two American rheumatologists Star and Malavista, as a result of careful research, discovered that in this case we are talking about infection with an unknown spiral-shaped microorganism, which was later, in 1982, identified by the microbiologist of the US National Institute of Medicine Burgdorfer and named it Borrelia Burgdorferi ). In the following years, cases of Lyme borreliosis were observed in all areas of the United States and in many countries in Europe and Asia.

The first signs of the disease appear on the skin; at the site of infection (after a tick bite), red spots appear, which increase in size and gradually fade in the center. The skin can also be affected in later stages of Lyme borreliosis in the form of inflammatory processes and simultaneous thinning (atrophy).

After the discovery of each new disease, scientists sought to find out whether this disease had already been described previously in the literature. It turned out that in Europe these skin manifestations had been known for more than 100 years, and when penicillin was invented, some doctors tried to treat them purely intuitively with penicillin (this was brilliant, since the bacteria were sensitive to this antibiotic). Thus, we can talk about the “rediscovery of an old disease”, but, of course, this time with an explanation of its cause and the introduction of new treatment methods.

The bacteria that causes Lyme borreliosis is transmitted primarily by ticks. The risk of contracting borreliosis is proportional to the level of tick infestation in a given area. In the Czech Republic this level is quite high - about 30%, while in Slovakia it is 9%. This tick overwinters in the ground, and from May to August lives in the grass and bushes. From there it gets to its “master”, which can be different types of animals, as well as humans. The likelihood of disease increases with the number of ticks attached and the time they remain on the skin. The most dangerous are the so-called nymphs, which represent one of the stages of tick development (the transitional stage between the larva and the adult tick).

This disease goes through three stages. At the initial stage, it manifests itself (about a month after the tick bite) in the form of skin rashes, vague flu-like conditions, fatigue, loss of appetite, and mild pain in muscles and joints. After another 2-3 months, symptoms of nervous diseases may appear in the form of irritation of the lining of the brain, poliomyelitis and disorders of the nervous system - from lability to neurosis. This includes heart damage and joint inflammation. Joint inflammation may appear several years after infection. In most cases, the inflammation goes away, but sometimes it becomes chronic. In the final stage, chronic, atrophic skin changes appear, most often on the lower extremities. Diagnosis of this disease consists of identifying specific antibodies, the action of which in the initial stage is often not very reliable. Later, without proof of the presence of antibodies, the diagnosis of Lyme borreliosis can no longer be confirmed.

The discovery of Lyme borreliosis attracted much attention from doctors, and its high incidence in the Czech Republic (up to several thousand patients) caused certain concerns. Since Lyme borreliosis has a very variable and diverse nature, a number of disorders have begun to be explained by the presence of this particular disease. The situation is complicated by the relatively high presence of antibodies against Borrelia among residents of the Czech Republic, which is due to their relatively frequent contacts with the carrier of this disease. Only a small percentage of them get sick.

Early treatment with antibiotics can cure the disease and prevent it from progressing to further stages. Antibiotics of the penicillin and tetracycline groups are used, sometimes in significant doses. Later stages are less responsive to treatment, and therefore large doses of antibiotics are injected directly into a vein, and sometimes the most modern cephalosporin antibiotics are used.

It is still not very clear how Borrelia causes such a complex disease. In the initial stages they are present alive in tissues, and later die under the influence of antibiotics. Dead borrelia cause cross-type immune reactions. This means that antibodies attack not only Borrelia, but also the tissues of the body itself. Thus, Lyme borreliosis is indeed partly infectious and partly a reactive disease.

Prevention of borreliosis consists of preventing the carrier of this disease from entering the body. When staying in a deciduous forest, you should wear suitable clothing that covers all parts of your body and appropriate footwear. It is also necessary to use means to repel midges and insects (repellents). Ticks should be removed carefully, using tweezers, after smearing with alcohol, vegetable oil or nail polish. The wound should be immediately disinfected with iodine solution.

Infectious arthritis is an inflammatory disease caused by various microbes. Anatomically, a human joint is protected by special tissue barriers that separate its cavity from the bloodstream. But the pathogen does not necessarily need to penetrate inside - inflammation develops in the small vessels of the articular membranes.

Externally, infectious arthritis, which has different origins, is very similar, since the basis of the disease in all forms is the inflammatory process. Therefore, to accurately determine the causative agent, diagnostic methods are required that make it possible to accurately name the cause of the disease. It also allows you to separate infectious joint damage from pathology that has similar symptoms.

It is usually necessary to separate the infectious and rheumatoid nature of the disease, since the symptoms in both forms are very similar. The final diagnosis can only be established based on the results of laboratory diagnostics, which confirm the autoimmune nature of rheumatoid arthritis. Therefore, infectious arthritis is a truly complex and extensive disease that requires a responsible approach to diagnosis and treatment.

Infectious arthritis

The severity and variety of symptoms depends entirely on the type of microbe causing joint damage. Therefore, the inflammatory process can occur through the following two mechanisms:

• Septic arthritis is characterized by pathogens entering only the vessels of the joint membranes, where they come into conflict with the immune system. It can be caused either by the bacteria themselves or by particles of their toxins that penetrate through the bloodstream. The symptoms in this case are caused by the reaction of all parts of the joint to the processes occurring in its membranes.
• In another case, microbes penetrate into the joint cavity, leading to infection of the synovial fluid. Then they talk about pyogenic, viral or fungal arthritis - depending on the pathogen identified during diagnosis. The symptoms of this disease and septic arthritis may not differ, but the outcome can be very different.

Septic arthritis always has a more favorable prognosis than pyogenic arthritis, since the synovial fluid remains relatively clean. But the purulent nature of the inflammation increases the risk of scar tissue formation in the joint, which leads to the formation of mobility impairments.

Septic

This variant of the disease always develops against the background of an ongoing infectious pathology, which is accompanied by the entry of microbes into the blood. In their entirety or destroyed form, they penetrate into the vessels of the joint membranes, causing the development of the following symptoms:

1. Typically, signs of the disease appear a week after the onset of the main illness, and sometimes during recovery.
2. Septic arthritis affects the large joints of the lower extremities - the knee, hip joint.
3. Symptoms appear suddenly - the temperature rises again, fever appears. Intense bursting pain is felt in the joint, and the range of movements decreases.
4. Gradually, the skin around the knee or hip joint turns red and takes on a shiny appearance. It is hot to the touch - the pain intensifies when palpated.
5. Septic arthritis is unilateral and, if left untreated, easily moves to other joints. Moreover, the previously inflamed knee and hip joints are completely relieved of symptoms.

If antibiotics have already been used in the treatment of the underlying disease, then the developed infectious arthritis serves as an indication for the prescription of additional antibacterial drugs.

Pyogenic

The development of this variant of inflammation is characterized by the penetration of bacteria into the joint cavity, where they form a purulent focus. Its development is indicated by slightly different symptoms and mechanisms:

1. Pyogenic arthritis is caused by prolonged inflammation or trauma, which leads to damage to the joint membranes. This allows microbes to enter the synovial fluid and multiply there quietly.
2. Their detection by the immune system provokes the onset of violent inflammation, accompanied by the formation of pus.
3. Symptoms—pain, swelling, and stiffness—can occur in any joint that becomes infected.
4. But the general symptoms caused by the formation of a purulent focus always come to the fore. From it, a huge amount of toxins enter the blood, which creates high fever and severe chills.
5. Without appropriate antibiotic treatment, inflammation moves to surrounding tissues, which is accompanied by the development of sepsis - “blood poisoning”.

Since pyogenic lesions are usually a consequence of injury, its treatment must necessarily include prevention of the development of inflammation with the help of broad-spectrum antibiotics.

Viral

Some viruses (for example, influenza pathogens) are able to actively move through the bloodstream, settling in small vessels. They penetrate the membranes of the joint, causing the following symptoms there:

1. Arthritis due to influenza is characterized by the appearance of manifestations in the initial period of the disease, when viral particles intensively penetrate the blood.
2. Large joints of the lower extremities (knee, hip), as well as the spine, are affected.
3. There is the appearance of severe, “aching” pain in the joint, which intensifies with movement. But the stiffness is slightly expressed, which allows you to freely perform them in full.
4. There are no changes in the skin in the projection of the joints, since inflammation is only accompanied by an increase in the secretion of synovial fluid. Its excess, caused by dilation of the vessels of the membrane, leads to pain in the joints.
5. The pain is usually bilateral and symmetrical, affecting the area of ​​both knee or hip joints.

Since viral infectious arthritis develops against the background of cold symptoms, its diagnosis is usually not difficult.

Fungal

The development of this lesion is observed in people with weakened immune systems, since normally the body is well protected from such pathogens. Therefore, its occurrence is typical for patients with HIV infection, in whom infectious arthritis acquires specific features:

1. The immune system in such patients almost does not work, which allows them to endure infectious arthritis for a long time without significant symptoms.
2. Fungi, when ingested, are instantly destroyed by immune cells in a healthy person. And in this case, they spread unhindered with the bloodstream, populating any tissue.
3. There will no longer be any clear inflammatory signs, since the body is not able to give an adequate response to the microbe.
4. Fungi will continuously maintain sluggish inflammation, which will be characterized by mild pain and decreased mobility in the joint.
5. Gradually, rough scar changes form inside the joint, with which the body tries to limit microbes. They will cause persistent impairment of mobility, leading to closure of the joint cavity.

Treatment of infectious arthritis caused by fungi must necessarily include therapy for HIV infection, supplemented by prophylactic courses of antibiotics.

Diagnostics

Based on the listed signs, it is noticeable that individual forms of the disease do not allow one to determine what kind of arthritis it is - the infectious agent can only be isolated through research. When the diagnosis is final, there are usually no difficulties in prescribing treatment. And if the right medications are chosen, the symptoms of the disease will go away very quickly.

Infectious inflammation is mainly differentiated from rheumatoid arthritis, which appeared for the first time. Clinically, these diseases are very similar in the early stages, since rheumatoid arthritis can affect only one or two joints. But a thorough analysis of the patient’s complaints and symptoms even before laboratory diagnosis can alert the doctor. And conducting research will make it possible to clearly distinguish between these two diseases, which have different natures.

Laboratory

In these methods, the object of analysis is the patient's blood obtained from a finger or vein. It identifies characteristic signs that indicate the development of an acute inflammatory process:

• In a general blood test, the number of white blood cells - leukocytes - is determined. With inflammation, it necessarily increases, which indicates the body's resistance to microbes.
• With the bacterial or fungal nature of arthritis, neutrophils increase, immediately responding to the pathogen. When the cause of the disease is a virus, an increase in lymphocytes is observed.
• With any nature of arthritis, the erythrocyte sedimentation rate (ESR) increases.
• Biochemical analysis examines protein indicators - during inflammation, the ratio of albumin and globulins changes.
• Specific antibodies are also determined there, which exclude the autoimmune nature of inflammation. The most accessible indicators are rheumatoid factor and antibodies to cell nuclei. Their increase indicates an autoimmune process that occurs in the body.

Therefore, it is not necessary to undergo many expensive tests - these blood tests are enough to confirm the infectious nature of arthritis.

Instrumental

Sometimes difficulties arise in determining the diagnosis, which requires obtaining joint fluid for analysis. It is then subjected to various manipulations to assess its character and components:

• You can evaluate the liquid by its appearance - normally it is transparent and yellowish in color. With the development of an inflammatory process of a bacterial or fungal nature, its cloudiness and the appearance of small particles of tissue or pus are noted. Viral infection does not lead to a change in transparency - only a slight lightening is observed.
• A small amount of material is examined using a microscope or automated analyzer to evaluate the cellular composition. In pyogenic and fungal arthritis, a large number of neutrophils are found in combination with destroyed membrane cells. A viral infection is characterized by an increase in the number of lymphocytes.
• The remaining liquid is then left for inoculation to grow a culture of microbes. The isolated pathogen is tested for sensitivity to antibiotics to improve the effectiveness of treatment.

As a nonspecific study, magnetic resonance imaging can be used, which will only confirm the presence of an inflammatory process in the joint.

Treatment

Certain forms of the disease require different approaches to drug administration, but the general principles of treatment are similar. They are aimed at removing the pathogen from the joint tissues and reducing inflammatory symptoms:

1. Treatment of infectious arthritis of any origin necessarily involves the prescription of anti-inflammatory drugs. Powerful drugs (Diclofenac, Ketoprofen) are administered in the form of a course of injections, which allows you to suppress the main symptoms of inflammation.
2. For bacterial and fungal arthritis, antimicrobial drugs with a wide spectrum of action are prescribed. A narrowly targeted medicine is used only after receiving culture results, which will determine the type of pathogen.
3. Antibiotics are selected based on two factors - breadth of action and possibility of administration using syringes. Usually a group of protected penicillins is used - Amoxiclav, or cephalosporins (Cefazolin, Cefotaxime).
4. Several antibiotics from different groups are often combined to completely block the possibility of microbes from multiplying. But this option is only possible in a hospital setting to avoid mutual side effects.
5. To destroy fungi, drugs with a broad spectrum of action are also prescribed - Amphotericin B, Nystatin.
6. Viral arthritis does not require specific medications - treatment of the cold itself will lead to a reduction in symptoms. To do this, use plenty of fluids and restorative drugs - vitamins.

But it often happens that conservative therapy becomes ineffective - this is due to shortcomings in diagnosis or choice of medication. Then you have to use artificial interventions - therapeutic punctures of the joint. With their help, inflammatory fluid with microbes is removed, after which repeated rinsing of the joint cavity is performed. This allows you to mechanically remove most of the pathogen, reducing the intensity of inflammation.

Arthritis in children

In children, the symptoms of the disease are almost no different from adults, but their severity often alarms parents. The child’s body is still “training” the functioning of the immune system, which often causes an unusual course of the simplest diseases:

• Infectious arthritis in children often occurs after an illness, which is associated with the easy spread of the pathogen throughout the body.
• General symptoms always come to the fore - fever, sweating, chills. They can easily disguise themselves as any other inflammatory process.
• Joint damage is always migratory in nature - even within one day, arthritis easily moves between different joints.
• On one joint, symptoms do not last longer than three days - without treatment, they spread to other joints, leaving no traces behind.
• The lesion is always one-sided - most often the disease occurs in the knee joints.
• If you have a repeated sore throat or cold, arthritis may occur again, which is associated with the next introduction of microbes.

There are not many reasons for the development of “wandering” inflammation in children, so difficulties in diagnosing and treating the pathology rarely arise.

Pathogens

Migratory arthritis in children is usually caused by bacteria from the group of streptococci - thanks to special substances, they easily penetrate the bloodstream. There they are quickly destroyed, but their particles are carried into small vessels, including joints. Therefore, the following childhood streptococcal infections lead to the development of the disease:

• Most often, the source of bacteria is a common sore throat or pharyngitis - they affect the mucous membrane of the pharynx and tonsils. From such a vast surface, rich in blood vessels, microbes easily penetrate into the blood.
• A type of streptococcus, pneumococcus, causes the development of pneumonia, which has now become common in children. Therefore, after suffering from pneumonia, you can expect the development of reactive arthritis within a few weeks.
• Penetration of skin streptococci through small wounds is less common. If the child’s body has good immunity, then this path for microbes will be firmly blocked.

Inflammation in the joints is caused not by the bacteria themselves, but by fragments of their cell wall, which contains aggressive substances. They are very similar in structure to the joint membranes, which leads to errors in the functioning of the immune system. Its cells simultaneously begin to destroy not only parts of the microbes, but also the joint capsule, causing the development of inflammation.

Treatment

Treatment of infectious arthritis in children is often difficult, due to restrictions in the use of certain drugs. But in such cases, they try to weigh the benefits and risks of their use:

1. Treatment of the suspected source of bacteria is mandatory - antibiotics from the penicillin group, effective against streptococci, are used for this. They are prescribed in the form of injections to eliminate the negative effect of the medicine on the child’s intestines.
2. General strengthening procedures are used - increasing the amount of food and liquid consumed, additional vitamins. This ensures the rapid removal of germs and toxins from the bloodstream.
3. Anti-inflammatory drugs are rarely prescribed to children, so they are usually replaced by physical therapy procedures. UHF or laser provides a thermal effect on the source of inflammation, allowing it to accelerate its resorption.
4. Since arthritis is of immune origin, the child is given antihistamines to reduce allergic reactions. The drugs are given in tablet form so as not to overload the baby with unnecessary injections.

Many parents deliberately refuse treatment for this disease, hoping to eliminate it on their own. This is true - without treatment, the signs of arthritis will go away after a while. But the child will continue to have an allergic reaction, which will manifest itself with every infection associated with streptococcus entering the body.

IT IS IMPORTANT TO KNOW!

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Bursitis of the knee joint: symptoms, treatment and photos

Knee bursitis is a very unpleasant disease. It occurs as a result of the development of inflammatory processes in the joint capsule. The most common cause of this disease is injury or heavy physical activity, which results in the release of large amounts of intra-articular fluid from the synovial membrane of the knee joints.

• Bursitis of the knee joint: photos, causes
• Diagnosis of knee bursitis treatment
• • Local treatment
  • Traditional methods to alleviate the condition
  • Surgery
• Further recovery
• Prevention measures
• Conclusion

In this way, the body reacts to remove too much tension in the joint and minimize the negative effect of the resulting injury. But there comes a time when the volume of intra-articular fluid exceeds the permissible limit, as a result the body is no longer able to process it. This leads to its accumulation in the cavities of the synovial membrane. The consequence of this is the development of bursitis of the knee joint, which is characterized by its own symptoms and certain treatment methods are used.

Bursitis of the knee joint: photos, causes

Not in every case it is possible to detect the causes of bursitis. There are patients who develop this disease without serious reasons. The most common factors that cause the development of this disease are:

• Injuries and damage to the knee joint.
• Sprain of a joint caused by excessive tension;
• Significant physical activity exceeding the permissible limit.
• Inflammation of the joints, leading to the development of characteristic diseases, such as gout.
• Penetration of infection.

The location of the inflammatory processes largely determines the type of bursitis:

1. Patellar or suprapatellar bursitis. It is most often found in patients who complain of inflammation of the patellar bursa.
2. Popliteal or infrapatellar bursitis. A condition in which inflammatory processes affect the popliteal bursa.
3. Baker's cyst. A situation that results in damage to the synovial bursa located in the lower inner part of the knee joint.

There are also two additional types of this disease:

• Serous bursitis. A condition in which inflammation of the synovial bursa is noted, not associated with the activity of microbes. As a rule, it is caused by injury or sprains.
• Purulent. In this case, the cause of the disease is the penetration of pathogenic microorganisms into the cavity of the bursa, as a result of which pus begins to form. Most often, the path to the synovial bursa for bacteria opens through wounds and cracks in the skin.

Depending on the nature of the disease, acute and chronic bursitis are distinguished. This, in turn, determines the symptoms of the disease, as well as the method of its treatment.

Knee bursitis can be identified by its pronounced symptoms.

If the bursa is subjected to prolonged mechanical stress, chronic knee bursitis may develop against this background. During the course of the acute form of the disease, the main symptoms will be associated with inflammatory processes in the walls of the bursa.

Diagnosis of knee bursitis treatment

The specialist chooses treatment based on the results of the examination, but first he has to find out the cause of the disease. When prescribing various diagnostic procedures, the doctor needs to make sure of the aseptic nature of the inflammation of the disease. This can be done by puncturing the bursa.

1. If the test results revealed a clear liquid, then it follows that aseptic inflammation occurs.
2. If pus is detected, it can be assumed that bursitis was caused by pathogens.
3. It is not difficult to identify a Baker's cyst, since it usually occurs in a characteristic place - the popliteal fossa.
4. If there are signs of popliteal bursitis, it is often necessary to resort to a group of instrumental diagnostic methods - ultrasound, arthrography, radiography of the knee joint.

In principle, identifying this disease is quite simple. If an experienced doctor is involved in this, then you can get a picture of the disease based on the results of a general examination and palpation examination.

Treatment of knee bursitis

When confirming the diagnosis of knee bursitis, the doctor is required to propose a program of therapeutic measures that should remove all causes of inflammation and reduce its severity. This problem can be solved by including the following activities in the treatment program:

1. Rest for the joint;
2. Treatment with medications;
3. Physiotherapeutic procedures.

When choosing the most effective treatment methods for knee bursitis, it is necessary to proceed from the nature of the disease. If an aseptic form of inflammation of the synovial bursa has been identified, then during treatment it is necessary to follow a number of recommendations:

If the diagnostic results revealed a septic form of the disease, then treatment is reduced to taking antibiotics. At the same time, it is necessary to remove the bursa pus using the aspiration method; also in this form, drainage of the joint capsule is indicated.

Local treatment

To eliminate unpleasant symptoms, you can use a wide variety of anti-inflammatory ointments:

• voltaren emulgel;
• traumeel;
• diklak;
• DIP relief;
• chondroxide;

For external use, compresses prepared from dimexide and 0.5% novocaine solution are indicated. These components are taken in a ratio of 1:3:

• A gauze napkin must be dipped into the prepared mixture, and then a compress is applied to the affected area;
• You need to put a film on a napkin, and wrap the area with a scarf or towel on top.

It is necessary to keep these compresses on the joint for no more than half an hour, otherwise there is a danger of severe burns.

Traditional methods to alleviate the condition

During the time that doctors have known about this disease, many traditional medicine recipes have been accumulated that can effectively relieve the symptoms of knee bursitis. Among them, we can distinguish a group of folk methods that best help alleviate the patient’s condition:

Surgery

It’s not often that doctors have to resort to surgery for bursitis. If such a decision has to be made, then specialists take this step only as a last resort, when traditional treatment has failed to achieve the desired result.

Surgical treatment of bursitis is indicated for patients with the following symptoms:

• purulent process;
• chronic course without effect from conservative therapy;
• fistula form;
• injuries with penetration into the bursa cavity.

The main task of the operation is to remove the inflamed joint capsule. But the patient needs to keep in mind that this will make him disabled.

Further recovery

It may take varying amounts of time for your knee to regain mobility. Here you need to take into account what efforts the patient himself will make for this. This process can be accelerated if drug treatment is combined with exercise and sports.

During treatment, it is necessary to avoid activities that can cause microtrauma to the joint. It is very useful for quick recovery to use folk remedies in the form of infusions and compresses that will help remove swelling.

Prevention measures

To avoid further recurrence of the disease, it is necessary to monitor the level of stress during work or training. It is also necessary to develop the ligamentous apparatus so that it can withstand the expected forces without consequences, create safe conditions for the joints, and prevent situations in which injuries may occur.

Those who have already been diagnosed with knee bursitis need to be especially careful. To avoid the occurrence of unpleasant symptoms, it is necessary to use elastic knee pads from time to time. They will serve as support for the knee, providing a compression effect, as a result of which the knee joint will be subject to less stress.

Conclusion

Knee bursitis is dangerous for the health of any person who has to subject their body to high stress. Up to a certain point, a person may not feel changes in his condition, but if the loads are high and constant, disproportionate to the capabilities of the joint, then this will ultimately lead to the appearance of unpleasant symptoms. Knee bursitis can negatively affect your mobility, which can significantly disrupt your normal lifestyle.

Any symptoms, be it pain or others, must be attended to when they first appear. But even if the disease was noticed too late, even in this case it can be cured. After passing the examination, the doctor can prescribe effective therapy, which cannot be supplemented with folk remedies. This combination of techniques will help enhance the therapeutic effect and speed up the healing process.

• general information
• Symptoms
• Diagnosis of the disease
• Treatment

Arthritis is a chronic inflammatory disease of the joints. There are several types of arthritis - reactive, rheumatoid arthritis, also gouty, osteoarthritis, septic and juvenile arthritis, spondylitis. In this case, let's talk about rheumatoid arthritis.

general information

Rheumatoid arthritis in most cases affects the knees, feet, hips, shoulders, arms, wrists and elbows, and the inflammation is symmetrical. Inflammation of the joints occurs due to damage to the membrane that lines the surface of the joints. As the disease progresses, the cartilaginous bone is affected, joint deformation and bone erosion occur.

In rare cases, rheumatoid arthritis affects the lungs, heart, and nervous system.

The causes of the disease are not fully understood; it is believed that genetic inheritance plays a major role here. It is reliably known that this is an autoimmune disease when the body synthesizes antibodies against its own membrane membrane.

According to the International Classification of Diseases, 10th revision (ICD-10), there is the following differentiation of the disease:

• M05 - Seropositive RA;
• M06 - Other RA;
• M05.0 - Felty's syndrome;
• M05.1 – Rheumatoid lung disease;
• M05.2 - vasculitis;
• M05.3 – RA with damage to a number of organs;
• M06.0 - Seronegative RA;
• M06.1 - Still's disease in adults;
• M06.9 - RA of unknown origin.

This disease affects about 2% of the population, regardless of race. Moreover, arthritis occurs 3-4 times more often in women than in men. At any age, there is a risk of getting rheumatoid arthritis, no matter what the cause, and it is quite common in young people and children. The disease is very complex, with disability affecting 70% of all patients, and due to a number of complications such as infections and kidney failure, it can be fatal.

Symptoms

Rheumatoid arthritis is inseparable from chronic polyarthritis, i.e. inflammation of several joints at the same time. Gradually, patients begin to experience fatigue and muscle weakness. The first signs can be observed for several weeks until the inflammation becomes more obvious. Symptoms increase gradually as inflammation increases. What could be the main signs?

Rheumatoid arthritis can be distinguished by joint stiffness, especially due to prolonged immobility of the body. This condition usually occurs after sleep and goes away after an hour or more. As long as the stiffness continues, a serious degree of inflammation is present. When the joints are inflamed, pain, swelling of the joint, and increased temperature in the area of ​​inflammation may be felt.

If any of the above symptoms occur, you must consult a doctor to make a diagnosis; the doctor will determine the prognosis for the further course of the disease and treatment methods. So, let's summarize the main signs: you feel tired, lack of appetite, unusual pain in the joints, general weakness of the body. Pay special attention to these symptoms if anyone in your family has or has previously had this disease. If you know that you have arthritis, but notice pain, swelling of the joints, or discomfort in the stomach, immediately consult a doctor for treatment adjustments.

Diagnosis of the disease

To make a correct diagnosis, it is necessary to present the whole picture of the disease as a whole, taking into account the patient’s medical history. Laboratory methods cannot reliably establish signs of rheumatoid arthritis. The mere presence of rheumatoid factor in the blood does not indicate the presence of this disease, but may indicate the presence of another serious disease. As a result of a blood test, we can say that rheumatoid arthritis is directly related to the presence of anemia in the patient.

X-ray signs of rheumatoid arthritis are not always obvious and it is not possible to make an accurate diagnosis. X-rays will help identify swelling of the tissue near the joint, as well as the presence of fluid. Detection of bone erosion at an early stage indicates the progression of rheumatoid arthritis and requires immediate treatment. As the disease progresses, abnormalities in the structure of the joints become more noticeable, the space between the joints narrows and bone tissue is destroyed.

Treatment

Treatment for rheumatoid arthritis is aimed at suppressing the activity of the process, relieving pain, reducing stiffness in the joints and preventing complications. To make it easier to overcome the disease, considerable attention should be paid to nutrition. It has been proven that some foods contribute to the complication of the disease. Therefore, the diet should exclude the consumption of fatty meat, milk, citrus fruits, oat and rye cereals, and corn. There will be a positive effect from eating vegetarian low-calorie foods.

A doctor knows how to cure arthritis with medications; you should not prescribe any medications for yourself if they became known only on the recommendation of people without medical education, or from reviews on some forum or website.

Basic therapy includes taking non-steroidal anti-inflammatory drugs: Meloxicam, Diclofenac, Nimesulide, Dexalgin. They have anti-inflammatory and analgesic effects. In addition, glucocorticoids, such as prednisolone, are used. These drugs should be used with caution, as the risk of developing undesirable effects is quite high. Thus, NSAIDs negatively affect the gastrointestinal tract and the occurrence of ulcers. Glucocorticoids negatively affect the immune system, triggering autoimmune processes, destroying bones, causing diabetes and obesity, and exacerbating existing chronic diseases.

To reduce the activity of the rheumatoid process, it is recommended to take the following medications: Methotrexate, D-penicillamine, Azathioprine, Sulfasalazine, Cyclophosphamide. They work to suppress the immune system, thereby slowing down the destruction of bones by their own protective potential. Therefore, patients taking these drugs are extremely susceptible to various types of infections. It must be said that drugs in this group are very toxic, affect the blood, and affect a number of internal organs. They should be taken with extreme caution and only after a doctor’s prescription if it is really necessary.

Modern treatment of rheumatoid arthritis is still not complete without physiotherapeutic procedures. The patient is prescribed ultraviolet irradiation, magnetic therapy, electrophoresis with anti-inflammatory drugs. When the acute stage of the disease subsides, it is recommended to supplement treatment with massage and exercise therapy.