Reactive or allergic arthritis occurs as a manifestation of the body’s general reaction to a pathogen. The disease affects the joints (acute, subacute inflammation), being benign.
The risk group includes children prone to allergies, or those who have suffered food poisoning or infectious diseases. Common allergens include medications, food, pollen, and animal dander.
But not all children, even those at risk, develop reactive arthritis. An additional important factor is genetic predisposition.
The main distinguishing feature of this arthritis is that it is reversible. However, relapses are possible, and when the body is repeatedly exposed to the same allergen, the severity of the symptoms increases.
Why does reactive arthritis occur?
The main reason is pathogens that have entered the body. But if you examine the joint fluid in the acute period, you will not be able to detect bacteria or antibodies in it. This fact is explained by the following phenomenon: blood leukocytes, aimed at fighting bacteria, begin to combine with them, forming immune complexes that mistake joint cells for foreign bodies that need to be destroyed. Thus, a malfunction in the immune system leads to inflammation of the joints.
The causative agents of the disease are transmitted by airborne droplets and airborne dust, during birth from the mother. Domestic animals are also carriers.
Causes of arthritis of the lower extremities
The disease is based on the following deviations:
- The spread of a viral or bacterial infection in the tissues forming the joint.
- Consequences of an infectious disease. This type of arthritis is called reactive.
- Autoimmune disorder in the body. In this case, the cells of the immune system - antigens begin to attack the body's own cells, identifying them as foreign. This type includes rheumatoid arthritis.
- Patients suffering from psoriasis are often diagnosed with psoriatic arthritis.
- The juvenile rheumatoid form of the pathology almost always takes a chronic course.
- Ankylosing spondylitis. Despite all the efforts of scientists, it has not yet been possible to establish the cause of this form of arthritis.
- Patients with gout develop gouty arthritis due to metabolic disorders.
The disease may occur as a result of:
- surgery performed on the joint;
- severe bruise;
- disturbances in the functioning of the immune system;
- due to an infection with high pathogenicity;
- excessive loads on the joints, for example, when performing heavy physical work.
Bad heredity plays a role. The likelihood of inflammation in the joints of the legs is higher in patients whose relatives already have patients suffering from a similar illness.
How does the disease manifest itself?
Reactive arthritis makes itself felt 1-3 weeks after the pathogen enters the body. Common precursors are acute respiratory, intestinal and urogenital infections.
General symptoms:
- Severe pain appears in the joint.
- The patient begins to limp sharply or cannot use the affected joint at all.
- Swelling, often redness and a local increase in temperature occur in the affected area.
- The general temperature rises.
- Weakness and loss of appetite are observed.
The appearance of more specific symptoms depends on the bacteria that have entered the body. Based on them, the main pathogen is determined.
For example:
- Urogenital infection is often accompanied by chlamydial infection. Clinical signs of cystitis and urethritis appear in boys, vulvovaginitis and vulvitis in girls.
- Intestinal bacteria aggravate common symptoms. Thus, the body temperature rises to 38 degrees or more, all joints begin to ache, the accumulation of a large amount of fluid in the joint area leads to its pronounced deformation, which leads to impaired mobility, and the adjacent tendons also hurt.
Clinical picture.
The course of arthritis can be acute, subacute and chronic. General clinical symptoms are joint pain, deformation, dysfunction, changes in temperature and color of their skin.
Pain in arthritis is spontaneous, most intense in the second half of the night and in the morning, and decreases after movement.
Joint deformation is a consequence of changes in soft tissues, subluxations and contractures.
Joint dysfunction can be caused by both pain and morphological changes in articular tissues. It can be expressed in varying degrees - from mild, which does not deprive patients of their ability to work, to complete immobility of the joint due to fibrous or bone ankylosis.
In acute arthritis, the limitation of mobility is usually reversible. Chronic forms are characterized by progressive limitation of mobility, first caused by pain, then by the development of proliferative and fibrotic processes. In rare cases, due to osteolytic processes, subluxations, on the contrary, the development of pathological joint mobility is noted. Changes in the temperature of the skin of the joint are a fairly common symptom of arthritis. An increase in temperature can be observed with acute, subacute arthritis and exacerbation of chronic ones.
Patients usually complain of pain, changes in shape and limited joint mobility. The nature of the complaints may indicate the presence of an inflammatory process in the joint (severe spontaneous pain, progressive deterioration of joint function, rapidly occurring deformity, etc.).
In acute arthritis, the pain in the joint is usually very severe and constant. Characterized by significant pain restriction of joint function. Upon examination, changes in the skin and an increase in the size of the joint may be observed.
In subacute arthritis, all the above-described manifestations are less pronounced.
In chronic arthritis, pain occurs mainly when moving the joint; upon examination, a change in the shape of the joints is detected, caused not so much by inflammatory swelling of the tissues as by proliferative fibrous changes, contractures, subluxations, ankylosis, and shows the presence of dense painful swelling of the soft tissues. Laboratory indicators indicate a lesser severity of the inflammatory process.
Chronic forms often lead to disability of patients.
Treatment.
When treating arthritis, complex pathogenetic therapy should be used aimed at:
a) change in the general and immunological reactivity of the patient (impact on the focus of chronic infection, normalization of metabolism, vitamin balance, etc.);
b) reduction of general and local inflammatory reactions (use of hormonal, physiotherapeutic agents, spa treatment);
c) restoration of impaired joint function (therapeutic exercises, massage, occupational therapy);
d) treatment of the underlying pathological process (for arthritis associated with other diseases).
The most important principle of the treatment of chronic arthritis is long-term staged treatment (hospital - clinic - resort), varying depending on the nature of the arthritis, its form, etc.
- Physiotherapy.
Therapeutic exercise for arthritis is an obligatory component of complex treatment, but is contraindicated in the acute period. In the subacute period, active, mainly lightweight, elementary exercises are used on the main axes of movement in the joints in combination with general strengthening and breathing exercises with a gradually increasing load in a lying position, and then sitting and standing. Along with active exercises, careful passive movements are used to relax the limb being exercised as completely as possible, taking into account pain sensations.
In the treatment of chronic arthritis, physical therapy occupies an important place in clinical, outpatient and sanatorium-resort practice. When the joints of the upper extremities are affected, exercises are performed mainly in a sitting or standing position. In case of pathology of the joints of the lower extremities, the supporting function of the legs is trained in a lying, sitting and standing position. For diseases of the spine, unloading positions for the spine are also recommended, for example, on all fours. Active exercises are used: free, with effort, with the wide use of various apparatus, objects and mechanotherapeutic devices. Patients are recommended to perform independent exercises with repetition of tasks during the day up to 4-6 times, lasting 5-7 minutes each, in order to train the affected joints. In addition, morning hygienic exercises and walks are useful. It is advisable to carry out physical therapy in combination with massage and mud therapy.
Good results are obtained from therapeutic exercises in water.
In the surgical treatment of rheumatoid arthritis, therapeutic exercises are used before surgery to increase the overall tone and resistance of the body.
Difficulty of diagnosis
It lies in the fact that the general symptoms are very similar to those of other types of arthritis. And at an appointment with a rheumatologist at our clinic, many patients and their parents forget to say that shortly before they suffered an infectious disease or had an allergy. Therefore, the primary task of our specialists is to find out a complete and accurate picture of the diseases that the child has been suffering from for 1-2 months in order to prescribe the correct tests and carry out treatment.
The main diagnostic methods are:
- Visual inspection of the affected joint.
- Blood and urine analysis. The disease is determined by leukocytes, antibodies to urogenital infections, the number of which exceeds the norm.
- Stool analysis is necessary to identify/exclude infections in the intestines.
- In some cases, an analysis of synovial fluid and a biopsy of the synovial membrane of the joint are prescribed.
- To confirm the diagnosis, the doctor may prescribe an X-ray examination or magnetic resonance imaging.
Prognosis and prevention
A qualified physician can slow the progression of ankle arthritis and relieve pain. The doctor will give effective recommendations for preventing damage. Patients at high risk of inflammatory processes are advised to:
- Maintain normal body weight.
- Quit alcoholic beverages and smoking.
- Stick to a healthy diet.
- Maintain normal physical activity.
- Treat infectious lesions in a timely manner.
- Regularly undergo preventive examinations.
Features of treatment
The treatment process for reactive arthritis in our clinic takes place simultaneously in three directions:
- Painful symptoms are relieved. Non-steroidal anti-inflammatory drugs are used to relieve pain. When the pain is severe and the prescribed medications do not help, intra-articular administration of hormonal medication is permissible. They act quickly, but they can be used no more than once a month and in the absence of bacteria in the synovial fluid.
- Treatment of infections that provoked the onset of the disease. The selection of medications, dosage and duration of treatment is carried out depending on what pathogen was detected.
- Elimination of consequences caused by the disease. To stop the harmful processes that were started by reactive arthritis, pathogenetic treatment is used, and immunomodulators are prescribed. This therapy is necessary only when the disease becomes protracted.
For the most effective treatment, we recommend contacting our clinic when the first signs or suspicions of reactive arthritis appear.
Prevention of arthritis
Prevention of arthritis comes down to avoiding and eliminating all possible triggering factors. A healthy lifestyle, weight control, a balanced diet, avoidance of excessive alcohol consumption and regular preventive examinations with a doctor will significantly reduce the likelihood of developing arthritis, and following all the doctor’s recommendations in the early stages of the disease will significantly increase the likelihood of recovery or significantly reduce the likelihood of relapses.
Up to contents
The information in this article is for reference only and does not replace professional advice from a doctor. To make a diagnosis and prescribe treatment, consult a qualified specialist.
Prevention
To avoid arthritis, you should follow a few simple but very important rules for prevention purposes:
Careful monitoring of the condition of the feet and comfort when using shoes will avoid compression of joints and cartilage, which can result in deformation processes.
It is important to protect your legs from injury and excessive stress.
It is necessary to fully treat chronic and, in particular, viral diseases.
It is important to monitor your weight, since excessive weight gain leads to increased stress on the joints, which is fraught with many unpleasant consequences.
It is recommended to carry out therapeutic exercises to normalize the blood flow system in the joint and cartilage tissue.