Surgical benefits for patients with rheumatoid polyarthritis, SLE, crystalline arthritis.

Types of polyarthritis of the joints Causes and symptoms of polyarthritis Stages of polyarthritis of the joints Treatment of polyarthritis Medicines for the treatment of polyarthritis Diet for polyarthritis

Polyarthritis

is an inflammatory disease of the musculoskeletal system that simultaneously affects 2 or more joints. With polyarthritis, several joints may suddenly become painful, or one or the other may be bothered in turn. This disease does not always affect the joints symmetrically; sometimes it can be localized in completely different parts of the body.

Polyarthritis is dangerous not only because of mobility impairments, which can lead to disability, but also because of its complications. Left untreated, it increases the risk of heart attack every year and negatively affects vision and lung function. But the question of how to cure polyarthritis and whether it can be done at all can arise before a person of any age!

Polyarthritis of the joints is an inflammatory disease that affects several joints at the same time.

General information about polyarthritis

Inflammation of the joints can develop as a result of infection of joint tissue, trauma, or autoimmune damage. The acute form of the disease responds well to treatment, but as the process becomes chronic, irreversible degenerative changes in the cartilage tissue develop. PA is treated by therapists, orthopedic traumatologists, and rheumatologists, depending on the cause of the disease.

Etiology

The reasons for the development (etiology) of RA have not been definitively established. It is believed that the disease is based on two factors:

• genetic
  – hereditary predisposition to autoimmune processes, which is confirmed by frequent family diseases;
• infectious
  – past viral infections; for example, Epstein-Barr virus, which causes infectious mononucleosis.

The risk of developing RA increases under the influence of the following triggers: hypothermia, stress, hormonal imbalances, injuries, living in a cold, humid climate, etc.

The mechanism of development and causes of polyarthritis

Inflammation in the joint can be caused by:

• injuries;
• infections (bacterial, viral, fungal);
• metabolic disorders lead to the deposition of various salts in the joints (gout, amyloidosis, hemochromatosis);
• rheumatological diseases - characterized by damage to joint tissues by own antibodies (rheumatoid arthritis, lupus, dermatomyositis, etc.);
• vasculitis - inflammatory vascular diseases;
• psoriasis;
• endocrine diseases (dysfunction of the thyroid and parathyroid glands, pituitary gland).

All these factors lead to inflammatory processes in the joint capsule. As a result, swelling and redness of the surrounding tissues and pain appear. With prolonged inflammation, cartilage tissue is replaced by bone tissue, and the joint loses functionality.

Orthopedics and traumatology services at CELT

The administration of CELT JSC regularly updates the price list posted on the clinic’s website. However, in order to avoid possible misunderstandings, we ask you to clarify the cost of services by phone: +7

All services

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

Driving directions

Types of polyarthritis

Depending on the duration of the course, acute and chronic PA are distinguished.

Depending on the causes, the disease is divided into:

• rheumatoid
  ー caused by the appearance of antibodies to one’s own joint tissues, often accompanied by damage to the heart, kidneys, blood vessels and nervous system (characterized by symmetrical inflammation of the small joints of the arms and legs);
• reactive polyarthritis
  ー develops as a result of a bacterial or viral infection, caused by increased reactivity of the immune system (symptoms typically appear 2-4 weeks after an infectious disease, the lower extremities are more often affected);
• crystalline
  ー caused by the deposition of calcium salts, uric acid, affects the joints of the fingers, knees, ankles;
• psoriatic
  ー is accompanied by characteristic skin lesions (the joints are not symmetrically inflamed, the course is chronically recurrent);
• infectious specific
  ー caused by the penetration of microorganisms into the joint (syphilitic, gonorrheal, tuberculosis, brucellosis).

Our doctors

Poltavsky Dmitry Ilyich

Traumatologist-orthopedist

Experience 28 years

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Marina Vitaly Semenovich

Traumatologist-orthopedist, head of the minimally invasive traumatology and orthopedics service

Experience 36 years

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Zubikov Vladimir Sergeevich

Traumatologist-orthopedist, Doctor of Medical Sciences, doctor of the highest category, professor

44 years of experience

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Samilenko Igor Grigorievich

Traumatologist - orthopedist, doctor of the highest category

24 years of experience

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Symptoms of polyarthritis

Main manifestations of PA:

• swelling of the joints;
• pain and stiffness of movement;
• skin redness;
• the tissues over the joints are hotter than the surrounding tissues;
• in the acute period, increased body temperature, fever.

Inflammation of joints of different origins is characterized by its own localization of the lesion. Most often, small joints (hands, fingers and toes) become inflamed; later, larger joints are involved in the process.

Stages of the disease

Seropositive rheumatoid arthritis has 4 stages of development:

1. The initial stage
   is the development of the disease lasting up to 6 months; The main symptom is morning stiffness.
2. Early stage
   – from six months to a year; the symptoms of polyarthritis are more pronounced, significant swelling of the joint tissues appears.
3. Advanced stage
   – from one to two years with all clinical manifestations.
4. The late stage
   – more than two years, is accompanied by joint deformities, contractures, disability and complications from internal organs.

Radiological stages of seropositive arthritis:

1. Development of osteoporosis of the articular surfaces of bones.
2. Narrowing of the joint space, the beginning of the destruction of cartilage tissue.
3. Significant destruction of cartilage and bone tissue of articular surfaces, deep erosion; subluxations;
4. Closing of the joint space and the formation of ankylosis - immobility of the limb.

Crunching in joints - when to worry

Intra-articular injections of hyaluronic acid

Treatment of polyarthritis

An integrated approach is used to treat inflammation, treating pain, inflammation, and stimulating the regeneration of articular tissues.

Non-drug treatment

Basic recommendations for patients with PA:

• balanced diet;
• body weight control;
• moderate physical activity;
• rejection of bad habits;
• healthy sleep using an orthopedic mattress and pillow.

Drug treatment

To combat the manifestations of the disease, anti-inflammatory drugs, intra-articular and periarticular injections of hormonal anti-inflammatory drugs are prescribed. If hormonal drugs are ineffective, the use of immunosuppressants (inhibit the activity of the immune system) is indicated.

In addition to the main treatment, vitamin-mineral complexes and chondroprotectors are prescribed.

Physiotherapy

The main physiotherapeutic methods of treatment are used when the acute period of the disease has passed, these include:

• electrophoresis;
• magnetic therapy;
• physical therapy;
• massages;
• acupuncture and others.

Pathogenesis of seropositive arthritis

Pathogenesis of seropositive arthritis

The mechanism of development of seropositive arthritis (pathogenesis) is associated with a breakdown of the immune system. It develops this way:

• Normally, the body produces antibodies in response to infection; these are protein compounds - immunoglobulins (Ig), the purpose of which is to connect with an infectious pathogen (antigen) and neutralize it;
• in RA, altered Igs are produced, the immune system does not recognize them, mistakes them for foreign particles (antigen) and produces antibodies to them, which are called rheumatoid factor (RF); the resulting antigen-antibody complexes are deposited in tissues, maintaining inflammation and destroying articular surfaces;
• inflammation and tissue damage are also maintained and progressed due to the production of excess amounts of pro-inflammatory (inflammation-supporting) cytokines - molecules that normally transmit information and regulate inflammatory reactions along with anti-inflammatory cytokines.

In the seropositive form of arthritis, rheumatoid factor is detected in the blood, and in the seronegative form it is either absent or present in insignificant quantities. Why this happens has not been established.

The inflammatory process first causes swelling of the periarticular tissues, including the inner surface of the joint capsule, the synovial membrane, becoming inflamed and swollen. The next stage is the growth of connective tissue cells in it - pannus. The pannus covers the articular surfaces of the bones, destroys cartilage and bone tissue, then grows into the joint space and closes with the opposite side, making the joint immobile (ankylosis).

Prevention of relapses of seropositive arthritis

To live without exacerbations in a state of stable remission, the patient must:

• be aware of triggers and avoid them;
• lead a healthy lifestyle, engage in exercise therapy;
• eat properly regularly, monitor your weight;
• Be sure to regularly observe a doctor and, on his recommendation, take courses of anti-relapse therapy.

Well, if an exacerbation does begin, run to the doctor! At the Moscow clinic "Paramita" they know a lot about the treatment of seropositive rheumatoid arthritis!

Literature:

1. Nasonov EL, Karateev DE, Balabanova RM. Rheumatoid arthritis. In the book. : Rheumatology. National leadership. Ed. E. L. Nasonova, V. A. Nasonova. Moscow: GEOTAR-Media; 2008. pp. 290–331.
2. Nasonov E.L., Mazurov V.I., Karateev D.E. and others. Draft recommendations for the treatment of rheumatoid arthritis of the All-Russian public organization “Association of Rheumatologists of Russia” - 2014 (part 1). Scientific and Practical Rheumatology 2014;52:477–94.
3. Molina JT, Garcia FJB, Alen JC, et al. Recommendations for the use of methotrexate in rheumatoid arthritis: up and down scaling of the dose and administration routes. Rheumatol Clin 2015;11:3-8.
4. Tornero Molina J, Calvo Alen J, Ballina J, et al Recommendations for the use of parenteral methotrexate in rheumatology. Reumatol Clin 2021. pii: S1699-258X(16)30162-0.
5. Espinosa F, Fabre S, Pers YM. Remission-induction therapies for early rheumatoid arthritis: evidence to date and clinical implications. Ther Adv Musculoskelet Dis 2016;8:107-18.

Themes

Joints, Pain, Treatment without surgery Date of publication: 04/10/2020 Date of update: 11/12/2020

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Diagnostics

The diagnosis of seropositive rheumatoid arthritis is made on the basis of characteristic clinical signs and is confirmed by:

• Laboratory research:
  general clinical – acceleration of ESR, anemia is detected;
• biochemical blood test - increasing the level of C-reactive protein (CRP) - a blood plasma protein that signals the presence of inflammation;
• immunological tests:
• determining the presence of rheumatoid factor;
• detection of anti-citrullinated antibodies (ACCP) - may appear earlier than RF, at the initial stage of development, therefore they are an early diagnostic sign;
• detection of increased blood levels of pro-inflammatory cytokines interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF alpha).
• Instrumental research:
  X-ray
  - reveals the degree of destruction of articular tissues;
• MRI
  – early (pre-radiological) disorders are detected;
• Ultrasound
  reveals changes in periarticular tissues and a decrease in the volume of synovial fluid.