Rheumatoid and infectious arthritis: what are the differences from arthrosis

Rheumatoid arthritis: what is it and how is it treated?

Rheumatoid arthritis is an autoimmune-inflammatory disease. It affects more often women of different ages, and the joints of the ankles, knees, hands and ankles are affected.

It is believed that the cause of rheumatoid arthritis is a malfunction of the immune system, and provoking factors are hypothermia, stress, infection or injury. The mechanism of joint destruction can be triggered by influenza, tonsillitis or a common ARVI. Recognizing the disease is quite simple:

• the joint swells and hurts (swelling can last from several months to several years);
• joints are affected symmetrically - on both arms or legs;
• the pain intensifies at night or in the morning, subsides or goes away in the evening;
• rheumatoid nodules the size of a pea form in the joint; they are dense to the touch;
• weakness, loss of appetite, chills and a slight increase in temperature are present.

Unlike arthrosis, in which pain, on the contrary, intensifies after physical activity, with rheumatoid arthritis, warming up the joint helps get rid of discomfort.

Over time, the joints become deformed and limited in mobility. The disease affects all new joints. Pathological fluid accumulates in the knee - a Baker's cyst is formed with the risk of rupture. The cervical spine often becomes inflamed - pain appears in the neck and under the back of the head.

Sometimes people with rheumatoid arthritis lose significant weight

Symptoms of diseases

The main symptom of both diseases is pain in the affected joint or joints. With arthrosis - dull and aching, with arthritis - sharp. In addition, you should pay attention to some other signs that may indicate the development of one of the diseases.

The main symptoms of arthrosis:

• pain when walking and pressing on the joint;
• night cramping pain in the calf muscles;
• crunching and discomfort when moving;
• joint deformation.

Main symptoms of arthritis:

• limitation of joint mobility;
• redness, swelling of tissues;
• pain when pressing;
• swelling, change in joint shape;
• with infectious arthritis - increased body temperature, fever, chills.

How is rheumatoid arthritis treated?

At the initial consultation, the rheumatologist will prescribe additional examinations - a blood test, x-ray of the joint, ultrasound or MRI. It is impossible to completely cure the disease, so therapy is aimed at relieving unpleasant symptoms and preventing complications.

• Anti-inflammatory drugs relieve inflammation and pain.
• Immunomodulatory - inhibit immune reactions.

With proper treatment, remission lasts a very long time, and sometimes the disease disappears completely, but treatment will take many years. But it is strictly forbidden to massage or warm up joints affected by rheumatoid arthritis. Such manipulations lead to exacerbations.

For rheumatoid arthritis, massage and warming are contraindicated

Reasons for the development of arthrosis

The following factors may contribute to the development of arthrosis of the knee joints:

• excessive physical activity that does not meet age requirements, leading to joint damage;
• sedentary lifestyle;
• previous injuries in the area of ​​the knee joints - knee dislocations, fractures, ruptures and tears of ligaments, damage to the body of the meniscus, strong falls on the knee, bruises;
• increased body mass index, which causes increased stress on joints and meniscal tears;
• heredity;
• arthritis or other joint diseases (inflammation can lead to swelling or the accumulation of large amounts of synovial fluid in the joints, causing the destruction of cartilage tissue);
• metabolic failures leading to the removal of calcium from the body;
• diabetes mellitus of any type, hormonal imbalances and other pathologies of the endocrine system;
• chronic or past diseases of an inflammatory and infectious nature;
• blood flow disturbance;
• lupus erythematosus, rheumatoid, gouty and psoriatic pathologies, ankylosing spondylitis;
• flat feet, due to which the center of gravity shifts and the load on the joint increases;
• nervous overload and stressful situations.

What is infectious arthritis

Infectious arthritis is caused by a virus, fungus, or bacteria. Microorganisms enter the joint cavity through the blood or lymph flow from another source of infection in the body. This happens, for example, with an open joint injury, after a puncture or arthrotomy - medical intervention in the joint.

The causative agents of arthritis of an infectious nature are gonococcus, Staphylococcus aureus, streptococcus, Pseudomonas aeruginosa or Haemophilus influenzae, and also much less frequently - various fungi.

In the acute period, arthritis of an infectious nature has the following symptoms:

• increased body temperature to 39 °C;
• severe pain that increases with movement;
• swelling of the joint, increased local temperature, redness of the skin;
• general intoxication of the body - headache, nausea, lethargy.

Sometimes infectious arthritis becomes chronic, and the symptoms change:

• body temperature remains at 37-37.5 °C;
• the pain becomes less intense;
• swelling is almost invisible;
• joint movements are possible in a limited manner;
• signs of intoxication include weakness, sweating, loss of appetite.

Infectious arthritis affects one large joint

Treatment of knee arthritis

To achieve maximum therapeutic effect, you should follow an integrated approach to the treatment of arthritis.

Medication link:

1. NSAIDs. With their help, it is possible to relieve pain, especially at night. Among the many drugs, none showed specific benefits, which means that any NSAID drug is suitable for use.
2. Glucocorticosteroids (GCS). Usually not prescribed, only in short courses, if the course of arthritis affects the activity of the cardiovascular system.
3. Antibiotics. Short courses (1-2 weeks) against a specific pathogen.
4. Chondroprotectors. Prescribed to restore the integrity of articular cartilage. However, numerous studies (for example, data from 10 large studies in the British Medical Journal) show no effect even compared to placebo!
5. Hyaluronic acid. An important element of cartilage tissue. It is injected into the joint cavity, creating a protective effect and preventing the joint from further damage. However, the therapy does not involve stimulation of one’s own acid, so it seems very expensive (from 30 to 250 thousand rubles annually).

What are the differences in the treatment of arthritis and arthrosis?

Arthrosis is not an inflammatory, but a degenerative disease of the joints, or wear and tear of cartilage. The disease ranks third in the world in terms of prevalence after oncology and cardiovascular pathologies. The symptoms of the disease are somewhat reminiscent of arthritis, but an experienced orthopedist or rheumatologist can easily differentiate them:

• The pain is sharp, occurs with movement and stops at rest.
• The joint crunches as the bones, unprotected by cartilage, rub against each other.
• Mobility in the joint is limited - in the later stages, bone growths (osteophytes) form, making movement difficult.
• The joint is deformed.

Since acute inflammation is usually absent, therapy for osteoarthritis is aimed at controlling pain and increasing mobility. The treatment regimen does not include antibiotics, antifungal or immunomodulatory drugs. It consists of the following medications and therapeutic methods:

• short course non-steroidal anti-inflammatory drugs;
• hormonal corticosteroids;
• chondroprotectors;
• synovial fluid prostheses, synthetic or based on hyaluronic acid;
• physiotherapy and massage;
• Spa treatment.

With arthrosis, your daily routine is very important.

Despite similar symptoms, arthrosis and arthritis are treated completely differently. Therefore, when joint pain appears, you should never engage in self-diagnosis, much less self-medication, and you should not try traditional methods on yourself. On the one hand, you risk starting the disease and bringing it to a deep chronic stage. On the other hand, you can harm yourself and endanger other organs, such as the heart or kidneys.

Arthritis

About 350 million people worldwide have arthritis. For example, in the United States it is noted that almost 22 percent of the population (40 million, including 250 thousand children) have some form of arthritis and often other terms are used to refer to the inflammatory process in the joints, such as arthralgia, arthropathy or arthrosis .

Data

• Arthritis is inflammation of one or more joints.
• Symptoms of arthritis include pain and limited joint function.
• Arthritis can affect both men and women, adults and children.
• Arthritis is treated by a rheumatologist.
• Early diagnosis can help prevent permanent damage and disability.

The disease is often accompanied by joint pain (arthralgia). There are many different reasons for the development of inflammation in the joints. These may be trauma (osteoarthritis), metabolic disorders (for example, gout or pseudogout), hereditary factors, direct and indirect effects of infections (bacterial or viral), disorders of the immune system with an autoimmune component (for example, rheumatoid arthritis and systemic lupus erythematosus) . Common to all types of arthritis are that both joints and tendons, muscles, ligaments, cartilage are affected, and internal organs are often affected. With some types of arthritis, especially of autoimmune origin, internal organs (heart, lungs, kidneys) are affected and the patient may have general symptoms, such as fever, chronic fatigue, weight loss, and swollen lymph nodes.

Symptoms

Symptoms of arthritis include pain and limited mobility in the joints. Joint inflammation is characterized by stiffness, swelling, redness and a local increase in temperature in the joint area. There may also be pain in the joint area. With many types of arthritis, symptoms occur in other organs that are not directly related to the joints. Thus, patients with arthritis may have symptoms such as fever, swollen lymph nodes, weight loss, and symptoms of dysfunction of organs such as the lungs, heart, or kidneys.

Diagnostics

The first step in diagnosing arthritis is to consult a rheumatologist. The doctor analyzes the history of the disease, symptoms, examines the joints, determines the presence of inflammation in the joint area, the presence of deformity, and also checks for the presence of somatic problems that may cause the development of joint inflammation. Various methods are used to diagnose arthritis, such as laboratory tests, radiography, and ultrasound. In some cases, diagnosing the type of arthritis requires multiple visits to a rheumatologist, who is a specialist who deals directly with arthritis. Timely diagnosis allows you to prescribe adequate treatment and avoid serious complications, both from the joints and often from internal organs.

It should be noted that both before and especially after a diagnosis of arthritis, maintaining contact with a doctor is of great importance, as it allows you to monitor both changes in the course of the disease and the possibility of adjusting treatment and safe use of medication (some drugs have a number of side effects ).

Treatment

Treatment for arthritis depends on the specific type of arthritis. As a rule, an integrated approach is used, including both medicinal treatment methods (NSAID painkillers to influence the immune system) and non-drug treatment methods (physiotherapy, exercise therapy).

For most forms of arthritis, diet plays little or no role in treatment, but omega-3 fatty acids found in fish have been shown to have a beneficial role. At the same time, with some types of arthritis (for example, gout), eating a number of foods high in purines (red meat, shellfish) or foods such as beer can trigger an exacerbation of the disease. With the same disease as celiac disease, taking foods containing gluten (wheat, barley, rye) can lead to increased joint pain.

The prognosis for patients with arthritis depends on the severity of the inflammatory processes, the presence of complications, and the presence of concomitant lesions of internal organs. For example, rheumatoid arthritis often leads to damage to the lungs, kidneys, eyes, etc. Chronic joint inflammation can lead to permanent joint damage and loss of joint function, making joint movement difficult or impossible.

Since most forms of arthritis are genetically determined, there are no real methods of prevention. But it is possible to prevent arthritis associated with injury or arthritis caused by infection (for example, septic arthritis, reactive arthritis, Whipple's disease).

Symptoms and diagnosis of arthrosis of the knee joints

The disease can be distinguished by the following characteristics:

• Pain syndrome. Pain usually occurs suddenly, but most often during physical activity, even minor ones. The pain can be of different types. At first these will be weak shots (unfortunately, few people pay attention to them). Mild pain that occurs only periodically can continue for months, or even years, until the disease develops into a more severe stage.
• Noticeable deformity of the knee. A similar symptom is characteristic of the later stages. And at the beginning of the development of arthrosis, the knee swells and swells a little.
• The appearance of dense formations in the area of ​​the back wall of the knee joints. Accumulation of a large amount of joint fluid in the cavity of a Baker's cyst or in the joint itself.
• A sharp crunching of the joints, which is accompanied by pain.
• Decreased joint mobility. This is especially pronounced in the last stages of arthrosis. In this case, bending and straightening the knee causes severe pain, and in the final stages, movement becomes almost impossible.

REFERENCE! A patient with arthrosis changes his gait: it is characterized by wobbly legs and limping.

Arthrosis

Arthrosis refers to degenerative-inflammatory processes and develops due to age-related changes in the structure of cartilage tissue.

It affects the moving joints of large bones, and less commonly, the joints of the fingers.

Read also:  Turmeric for joint pain - the best recipes

Appearance of a joint with arthrosis

The main cause of pathological changes is metabolic disorders in the cartilage. Violation of cartilage trophism leads to irreversible loss of proteoglycans and loss of tissue elasticity.

Dystrophic changes in cartilage entail pathological changes in the structure of the articular surfaces of bones. Over time, the degeneration process spreads to the periarticular tissues.

Types of arthrosis

Based on their origin, they distinguish between primary and secondary arthrosis.

Primary

the form affects previously healthy joints and is a consequence of age-related changes and inadequate physical activity. The timing of the appearance of the first symptoms of arthrosis depends on hereditary predisposition, characteristics of professional activity, and lifestyle.

Traditionally, people over 45 years of age are considered at risk, but now there is a steady trend towards early incidence. The disease affects mainly women, but with age, the dependence on gender gradually smoothes out.

Secondary arthrosis

develops against the background of a previous injury or certain diseases of different nature, including:

• autoimmune processes;
• metabolic disorders;
• endocrine dysfunction;
• pathologies of the structure of bone joints;
• genetic diseases;
• inflammatory processes.

Secondary arthrosis is not associated with the aging process and can occur at any age.

There are three stages in the development of the disease.

At the first stage, changes in the joint fluid occur. The nutrition of the cartilage is disrupted, and its resistance to stress decreases. Roughness appears on the surface of the cartilage, and inflammation develops, accompanied by pain.

As the disease progresses to the second stage, the pain becomes habitual, and the course of the accompanying inflammation becomes wave-like. The cartilage begins to deteriorate, and compensatory bone growths form at the edges of the articular area. Periarticular muscles are involved in pathological processes.

The third stage is characterized by severe depletion of articular cartilage with areas of complete tissue destruction. Degenerative processes lead to irreversible anatomical changes, including changes in the axis of the limb. The function of the ligamentous apparatus is disrupted, abnormal mobility appears in the affected joint against the background of limited natural mobility.

According to the location of the lesion, they are distinguished:

• gonarthrosis,
• coxarthrosis,
• spondyloarthrosis,
• arthrosis of the interphalangeal joints of the hands.

Other localizations of pathology are relatively rare.

Coxathrosis, arthrosis of the hip joint

With this disease, a classic clinical picture of arthrosis is observed. The first symptom of coxarthrosis is discomfort in the hip joint after physical activity.

With progressive coxarthrosis, pain increases, stiffness and limited mobility appear. Patients with a severe form of coxarthrosis spare the affected limb, avoiding stepping on it, and while stationary, choose positions in which the pain is felt the least.

Treatment of arthrosis

It is impossible to cure arthrosis completely with modern medicine. However, timely diagnosis and complex therapy aimed at preventing further destruction of cartilage tissue help stabilize the condition of the affected joint and significantly improve the patient’s quality of life.

First of all, it is necessary to reduce the load on the musculoskeletal system. Doctors recommend avoiding carrying heavy objects, staying in one position for a long time, and limiting time on your feet. For overweight patients, it is vital to lose weight.

In the drug treatment of arthrosis, the following is used:

• non-steroidal anti-inflammatory drugs, such as diclofenac, nimesulide, ibuprofen, internally in the form of injections or tablets and externally as part of ointments. The form and regimen of use are prescribed depending on the patient’s condition;
• drugs from the group of chondroprotectors to maintain the condition of cartilage tissue;
• steroidal anti-inflammatory drugs in the form of intra-articular injections. Prescribed in severe cases;
• hyaluronic acid preparations to improve joint mobility.

Additionally, warming compresses and ointments, drugs that activate blood microcirculation and metabolic processes, antioxidants and microelement-vitamin complexes with selenium are used, and physiotherapeutic treatment is prescribed. In severe cases, it is necessary to resort to surgical intervention.

During the period of remission, the patient is recommended a course of exercise therapy, selected in accordance with the characteristics of the course of the disease.

For more information about treatment methods, see:

• surgical treatment of arthrosis
• joint replacement

How does arthritis differ from arthrosis of the joints when diagnosed?

The primary diagnosis of arthritis and arthrosis involves visual examination and palpation of the joints that have become the source of complaints. Previous illnesses and injuries can also provide a clue.

A comprehensive blood and urine test can determine the difference between arthritis and arthrosis. It can determine the presence of bacterial pathogens, elevated white blood cell counts, rapid erythrocyte sedimentation, and other markers of inflammation (for example, rheumatoid factor. If the result is “clean,” other tests are prescribed.

An x-ray for arthrosis shows a narrowing of the joint space, thinning of the cartilage layer, and also, depending on the stage of the disease, the presence of osteophytes. With arthritis, no visible changes are noted.

Diagnosis can use hardware research methods (ultrasound, CT, MRI) and minimally invasive interventions (arthroscopy).