Arthropathy is usually understood as a secondary damage to articular tissues that develops against the background of other diseases and pathological conditions.
The progression of such an unpleasant disease can be caused by allergic reactions, the acquisition of infections, as well as disruptions of the endocrine system, the active phase of chronic diseases and metabolic disorders.
Among the key symptoms of arthropathy, it is customary to highlight pain, asymmetry of the affected area, as well as tracing a clear dependence of the disease on the characteristics of the course of the primary disease.
Confirmation of the diagnosis is confirmed only in the absence of symptoms of gout or rheumatoid arthritis.
The treatment regimen for arthropathy is determined on an individual basis, taking into account the characteristics of the main diagnosed disorder.
Prognosis for recovery is ambiguous and depends on the time of seeking medical help and the effectiveness of the chosen treatment strategy.
General information
Arthropathy is a secondary lesion that occurs against the background of concomitant non-rheumatic diseases. Activation of pathological processes can occur in diseases of various etiologies.
The key manifestation of arthropathy is painful conditions without affecting the shape and functionality of the joint. In some cases, reactive arthritis occurs.
Localization is in the joints mainly of the lower extremities, therefore in medical practice arthropathy of the knee joint is most often diagnosed. The manifestation is inflammation, swelling, as well as rapid fatigue and difficulty in making movements.
It is important to note that the key difference between the condition under consideration is the dependence of the existing syndrome on the course of the “main” pathological process.
Severe pathologies develop extremely rarely. With a competent approach to eliminating the underlying disease, arthropathic symptoms are significantly reduced or completely disappear.
Arthropathy in Reiter's syndrome
Reiter's syndrome is a triad that includes damage to the organs of vision, joints and the genitourinary system. Most often, the cause of development is chlamydia; less commonly, the syndrome is caused by salmonella, shigella, yersinia, or occurs after enterocolitis.
Persons with a hereditary predisposition suffer. Typically, symptoms appear in the following sequence: first - acute genitourinary infection (cystitis, urethritis) or enterocolitis, soon after this - eye damage (conjunctivitis, uveitis, iridocyclitis, retinitis, keratitis, iritis) and only after 1-1.5 months - arthropathy . In this case, eye symptoms may appear within 1-2 days, be mild and go unnoticed.
Arthropathy is the leading symptom of Reiter's syndrome and is often the first reason for seeking medical help. Typically, asymmetric arthritis affects the joints of the lower extremities: ankles, knees and small joints of the foot. In this case, the joints, as a rule, are involved in the inflammatory process sequentially, from bottom to top, with an interval of several days.
A patient with arthropathy complains of pain that worsens at night and in the morning. The joints swell, local hyperemia is noted, and in some patients effusion is detected. Sometimes pain occurs in the spine, sacroiliitis develops, heel bursitis is possible with the rapid formation of a heel spur and inflammation of the Achilles tendon.
Varieties
Today, it is customary to distinguish several types of secondary diseases. Arthropathy of the knee, hip, elbow, etc. can be:
- reactive - occurs against the background of a specific tissue reaction to the development of systemic pathologies of the body. Occurs in leukemia and endocrine system disorders;
- dystrophic - progression is due to insufficient nutrition of cartilage tissue. Occurs in people over 55 years of age when natural disorders affecting the functioning of the entire body are detected;
- pyrophosphoric (chodrocalcinosis) - has a connection with metabolic disorders, namely, the exchange of salts and calcium in the tissues of the human body. Often, the provocateurs of this type of illness are injuries to large joints;
- allergic – provoked by allergic reactions;
- psoriatic – occurs with psoriasis;
- idiopathic - defined in a situation where it is impossible to establish reliable causes for the development of a pathological condition of a secondary type;
- hereditary form - transmitted at the genetic level, established on the basis of the collected anamnesis.
Reasons for development
Provocateurs of joint arthropathy are:
- diabetes;
- malignant tumors;
- disruption of hormonal levels and thyroid function;
- psoriasis;
- blood diseases;
- viral and infectious diseases;
- allergy;
- metabolic disease;
- chronic inflammation;
- gout;
- genetic factors;
- age-related changes.
Any deviation from the norm in the body can lead to the development of reactive arthropathy. The name of its types follows precisely from the source of the disease (diabetic arthropathy, arthropathy of the shoulder joint, pyrophosphate arthropathy, psoriatic arthropathy, etc.).
Symptomatic picture
Among the general symptoms of arthropathy (regardless of its type), it is customary to highlight pain of a paroxysmal nature, as well as inflammation and swelling of the affected joint, which are not accompanied by visual changes.
In addition, there are:
- soreness;
- disorders of the genitourinary system;
- noticeable stiffness of movement;
- increase in body temperature.
There are also specific symptoms that are observed exclusively in women. For example, nagging pain in the lower abdomen, intermenstrual bleeding, purulent discharge, etc.
It is also important to pay attention to the fact that symptoms of arthropathy may also include signs of secondary damage, which usually include:
- pain of varying intensity (dull/aching);
- limited mobility;
- painful palpation.
Etiology and list of the most likely causes of joint arthropathy
Arthropathy of the knee joint or other joints of the musculoskeletal system (MSA) of the human body can be diagnosed in people of different ages, in particular in children.
Considering the stages of the course of secondary pathology, we can distinguish:
- acute period, the duration of which can reach two months;
- a protracted form is observed throughout the year;
- The chronic form involves a long course with remission and the occurrence of periodic relapses.
It is important to note that regardless of the type or form of the disease being considered, there is a list of the most likely causes of its development. Each cause has certain consequences, which largely determine the form of the disease being diagnosed.
Among the most common causes of secondary pathology of this type are:
- allergic reactions;
- associated painful conditions;
- infectious and parasitic lesions;
- inflammation of blood vessels;
- overweight;
- disruption of internal organs.
Symptoms and signs
Joint arthropathy may not make itself felt for a long time. The patient already suffers from an illness, but is not even aware of his illness. More than a month may pass after the illness. And only then the patient begins to notice:
- joint pain at rest and/or with movement;
- edema;
- redness;
- local temperature increase;
- restriction of movements after a long rest.
In each case, the disease manifests itself differently. For example, in children aged 1.5 to 6 years, an acute condition is manifested by severe fever, enlarged lymph nodes, and sometimes a skin rash. At the same time, arthritis is already actively destroying even children’s joints that are not yet fully formed. That is why it is recommended to visit a specialist at the slightest suspicion of joint problems.
Risk factors for joint arthropathy
There are certain factors that indicate an increased risk of secondary pathological disease. These include:
- autoimmune diseases;
- hemophilia;
- excessive stress on the joints;
- genetic predisposition;
- alcohol abuse;
- tendency to allergic reactions;
- chlamydia infection;
- impaired metabolism;
- accumulation of uric acid in joint tissues.
When is it time to seek medical help?
Despite the extensive symptomatic picture and seemingly obvious signs of a secondary disease, identifying it in the initial stages is not an easy task.
Only over time does a feeling of a sharp deterioration in health begin, which makes it possible to track vivid symptoms.
You should visit a traumatologist or orthopedist in a situation where:
- swelling of the periarticular tissues is observed;
- body temperature rises “unreasonably”;
- there is a feeling of extreme fatigue, weakness is present;
- lymph nodes increase in size;
- movements are severely limited or completely impossible.
Self-medication in such a situation is not the best solution. Wasting time reduces your chances of recovery.
Preparing to visit the doctor
To identify inflammatory arthropathy, it is necessary to undergo tests, undergo diagnostics and visit an orthopedic traumatologist. This is a specialized specialist who will help determine the root cause, select appropriate therapy and overcome the disease.
No special preparation is required before visiting a doctor. You just need to call and make an appointment at JSC “Medicine” (clinic of Academician Roitberg). Our clinic is located at 2nd Tverskoy-Yamskaya lane, 10 (TsAO, not far from the Mayakovskaya, Belorusskaya, Tverskaya, Chekhovskaya, Novoslobodskaya metro stations).
You must have extracts and certificates of previous and chronic diseases with you.
Main events
In order to make a correct diagnosis, everyone who seeks medical help must be prepared for such manipulations as:
Additionally, if signs of inflammation in the joints are detected, the patient is referred for examination to an ophthalmologist.
As a result of passing all diagnostic measures, the attending physician determines further treatment, taking into account the degree of damage, the presence of concomitant diseases, age and other characteristics.
Features of arthropathy treatment
Treatment of arthropathy is determined individually based on the characteristics of the existing disease and the results of the diagnosis.
In order to achieve the most effective result, a complex of physiotherapeutic and medicinal methods is used. At the rehabilitation stage, therapeutic physical education (PT) is used.
In case of severe inflammation, as well as a recurrent course of the pathology, transfer of the patient to inpatient treatment is allowed.
Strategy
The entire treatment strategy consists of following the simplest rules:
- Rejection of bad habits
- Eating balanced food.
- Maintaining optimal body weight.
- Following the instructions of the attending physician (compliance with the intended plan and features of drug therapy).
The effectiveness of a particular treatment regimen for arthropathy is determined by the onset of recovery or positive dynamics of the clinical picture of a particular case. The use of therapeutic methods should help reduce pain and restore functionality.
Physiotherapy
Physiotherapy is a special branch of medicine that involves the use of a methodological complex that can have a beneficial effect on human health. The methods used differ in the influence of natural or artificial factors (light, water, etc.) on the body.
In the treatment of arthropathy, radon baths, climatotherapy, exposure to electric current, etc. are actively practiced.
The intensity and duration of therapy is determined solely by the attending physician and depends on a large number of factors (features of drug therapy, general health, age and much more).
Drug therapy
Drug treatment of arthropathy involves taking such pharmacological groups of drugs as:
- antibiotics - used to eliminate agents that provoke the progression of the disease;
- non-steroidal anti-inflammatory drugs (NSAIDs) – relieve inflammation, eliminating visual manifestations;
- chondroprotectors – activate tissue regeneration, thanks to the enrichment of articular tissues with building material.
The most important role is played by chondroprotectors, which largely help the body overcome diseases of the musculoskeletal system. Artracam is considered to be one of the best drugs of this pharmacological group.
In order to improve the effectiveness of the prescribed therapy, a combination of medication and physiotherapeutic treatment is used, which makes it possible to significantly speed up recovery and achieve such positive results as:
- relieving inflammation;
- reduction in intensity or complete relief of pain;
- improving blood circulation in the affected joint.
Surgical intervention
Like any other pathology of the musculoskeletal system, arthropathy can lead to the need for complex surgical intervention.
The main goal of the radical method is to eliminate the consequences of the progression of pathologies and restore the functionality of the site of its localization.
Exercise therapy as a method of rehabilitation
Exercise therapy is an excellent way to speed up the restoration of the previous level of health and consolidate the results of treatment of pathological conditions of the musculoskeletal system.
A set of exercises is selected individually for each patient, which allows for targeted action and activation of the full functioning of the muscle frame, which in turn has a positive effect on the stability and functionality of the bone joint.
Complications and prognosis
Delayed consultation with a doctor, self-medication, as well as violation of the established regimen for taking medications or visiting physical therapy can lead to a number of complications, for example:
- limitation or complete loss of joint mobility;
- infection;
- the need for surgical intervention;
- disability.
With a timely, high-quality approach, we can talk about positive forecasts. Despite the impossibility of completely getting rid of the disease, there is an elimination of unpleasant sensations and the ability to control the existing disease.
Prevention of joint arthropathy
According to available data, arthropathy is a secondary pathology and develops against the background of other diseases. The main goal of prevention is to prevent the development of any pathological processes or at least their timely elimination.
To significantly reduce the risk of developing joint arthropathy, it is recommended:
- systematically monitor your general health;
- maintain at least a minimal level of physical activity;
- adhere to the basics of proper, nutritious nutrition;
- monitor body weight and prevent obesity;
- give up bad habits;
- reduce the likelihood of infection;
- attend preventive examinations with your doctor;
- promptly seek medical help and treat pathologies, infections and other diseases in accordance with the scheme approved by the doctor;
- carry out prophylactic administration of drugs from the pharmacological group of chondroprotectors (Artracam, etc.) in order to maintain the quality of joint tissues.
Health is something that cannot be bought, but can be maintained. Maintain an optimal level of quality of life by following simple recommendations for the prevention of various diseases.
Arthropathy in other infectious and parasitic diseases
Arthropathy often appears against the background of various pathologies that are associated with infections and parasites. When a person has suffered from Lyme pathology, brucellosis and trichinella, he develops flying arthralgia. Rubella occurs in combination with symmetric polyarthritis. And arthropathy in combination with mumps is similar to rheumatoid arthritis. The following signs are observed:
- unstable inflammation in the joints;
- the character is migratory;
- inflammation of the pericardium occurs.
From chicken pox, mononucleosis with infections, arthropathy appears, which is an unstable arthritis. It quickly disappears if the symptoms of the main pathology disappear.
Artopathy accompanied by meningococcal infection is observed a week after the development of the pathology. Most often this is accompanied by monoarthritis of the knee joint, but sometimes polyarthritis of large joints appears. Viral hepatitis also provokes the appearance of arthropathy, while the pathology manifests itself as arthralgia or volatile arthritis, joint damage occurs symmetrically. Artopathies make themselves felt at the beginning of the development of the disease, when there is not even jaundice.
HIV infections are accompanied by various signs of joint disorders:
- It could be arthritis, arthralgia.
- AIDS arthritis of the lower leg and knee joints may also occur. In this case, the function of the limbs is noticeably impaired, and pain is felt.
If the underlying disease is treated, then the signs of the affected joints disappear.