Arthrosis masks. What diseases can it be confused with?

Gouty arthritis is a pathology that occurs against the background of a metabolic disease such as gout. It is known for its long course and often causes severe destructive processes in the joints.

Symptoms of gouty arthritis occur due to the accumulation of uric acid crystals in the joints. These crystals not only destroy the tissue around it, but also do not bypass the hyaline cartilage. Infrequent pathologies such as:

• gouty arthritis of the ankle;
• gouty arthritis of the knee joint;
• gouty arthritis of the elbow joint.

The disease practically does not affect the pelvis and shoulders, but is fully manifested in other joints, on the fingers of the upper and lower extremities, most often on the 1st metatarsophalangeal joint of the foot. You can learn about the symptoms and undergo a course of treatment for gouty arthritis at the CELT multidisciplinary clinic.

At CELT you can get a consultation with a traumatologist-orthopedic specialist.

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Causes and mechanism of development of gouty arthritis

It has now been established that this disease is caused by metabolic disorders, and a diet high in meat only aggravates this disease, but is not the cause of its occurrence.

Predisposing factors:

• sedentary lifestyle, systematic overeating, obesity;
• unbalanced diet (predominance of protein (meat) foods, regular consumption of alcoholic beverages, absence or very little consumption of fresh vegetables and fruits);
• hereditary predisposition, diabetes mellitus;
• kidney diseases of various nature, taking certain medications (aspirin, riboxin, etc.);
• occupational hazards (for example, lead intoxication).

Gout can also be secondary, for example, in diseases of the cardiovascular system (hypertension, congenital and acquired heart defects), blood diseases (myeloid leukemia), etc.

With gouty arthritis, purine compounds and uric acid salts accumulate in the blood in large quantities, which are formed in excess, but are slowly eliminated. This leads to their deposition in the form of crystals - urates in joints, tendons, under the skin in the form of nodules (tophi), surrounded by a connective tissue capsule, as well as in the kidneys.

Most often the process is localized in one or two joints of the big toes, sometimes in the joints of the hands, and less often in the ankle, elbow and knee joints. The hip and shoulder joints are rarely involved in the process during gout.

Arthritis and arthrosis (joint diseases)

Arthritis

Arthritis is usually called inflammation of a joint (the name “arthritis” comes from the Greek word arthron, which means “joint”). Arthritis can be of traumatic, infectious and dystrophic origin.

Damage to one (arthritis) or several joints (polyarthritis) can be a symptom of other diseases. Arthritis often occurs due to repeated minor injuries, open or closed injuries to the joints. Arthritis can develop with frequent physical overexertion and hypothermia. Various infections (for example, intestinal or urinary) can also cause arthritis, called reactive arthritis. Rheumatoid arthritis also occurs, in which progressive inflammation of several joints (most often small) occurs, with the limbs affected symmetrically. Older people often suffer from this. The cause of arthritis can also be a metabolic disorder, as a result of which the nutrition of the joints deteriorates.

Arthritis in its various forms can be characterized by different combinations of symptoms. Arthritis usually causes swelling in the affected joints. In the initial stages of the disease, pain can occur both during movement and physical activity, and at certain times of the day (for example, at night or in the form of morning stiffness). If arthritis becomes chronic, the pain may become constant. In addition, the inflamed joint usually becomes red, swollen and even deformed, its function is impaired, and in severe cases of arthritis it becomes completely immobile.

Types of Arthritis

Depending on the nature of the lesion, the main types of arthritis are divided into two classes: inflammatory arthritis and degenerative arthritis.

Inflammatory arthritis includes:

• infectious arthritis
• rheumatoid arthritis
• gout
• reactive arthritis

They are associated with inflammation of the synovium - a thin film of connective tissue lining the joint from the inside.

Degenerative arthritis includes:

• osteoarthritis
• traumatic arthritis

These diseases are associated with damage to the articular cartilage that covers the ends of bones where they articulate.

Causes of arthritis

Causes of arthritis: bacterial, viral or fungal infection, injury, allergies, metabolic disorders, diseases of the nervous system, lack of vitamins. Typically, infection enters the joints through the circulatory system from another part of the body; this can occur during injury or surgery.

Arthritis symptoms

Arthritis is characterized by pain in the joint, especially when moving, there are often restrictions on its mobility, swelling, changes in shape, sometimes the skin over the joint turns red and fever appears. Symptoms of infectious arthritis are redness, swelling, pain when pressed, and common symptoms of an infectious disease are often observed - fever, chills, pain throughout the body. There is arthritis of one joint (monoarthritis) and many (polyarthritis). Arthritis can begin immediately and be accompanied by severe pain in the joint (acute arthritis) or develop gradually (chronic arthritis). Arthritis can occur suddenly or develop gradually. Some people experience a sharp, aching or dull pain. This pain is comparable to toothache. Movement in this joint is usually impaired, although stiffness is sometimes observed.

Arthritis treatment

Treatment for arthritis depends on the form of the disease. First of all, it is necessary to eliminate its underlying cause (excessive exercise, poor diet, alcohol abuse). Treatment of arthritis involves taking antibiotics; non-steroidal anti-inflammatory drugs administered intra-articularly are also used. When treating arthritis, specialists also pay great attention to physiotherapeutic procedures and therapeutic exercises necessary to maintain joint mobility and preserve muscle mass.

Arthrosis

What is the difference between arthrosis and arthritis?

Arthrosis (from the Greek arthron - joint), a chronic metabolic disease of the joints, accompanied by changes in the articulating surfaces of the bones. The more correct name for arthrosis is osteoarthritis. The main symptoms of arthrosis: severe pain in the joint, decreased joint mobility. If arthrosis is neglected, joint immobility occurs. The main difference between arthrosis and arthritis: with arthrosis, the main destructive activity is performed not by inflammatory, but by degenerative processes in the articular cartilage. Arthrosis is not an inflammatory disease and therefore has nothing in common with arthritis or chronic polyarthritis, in which joint inflammation is based on a reactive pathological change in the joint fluid. The same can be said about acute arthritis - inflammation of the joints caused by various infectious agents. Characteristic symptoms of arthrosis are pain during exertion, subsiding with rest, limited mobility and crunching in the joint, muscle tension in the joint area, possible periodic swelling, gradual deformation of the joint.

Unlike arthritis, arthrosis is a joint disease accompanied by the destruction of cartilage, and inflammation occurs later and may not be permanent.

Arthrosis causes pathological changes in joint tissue, and the causes of the disease are still not fully understood. Arthrosis develops under the influence of various genetic (arthrosis most often affects women, as well as people with congenital diseases of bones and joints) and acquired (old age, excess weight, previous joint surgeries) factors. Osteoarthritis can also occur as a result of excessive stress on the joints or their injuries. It is customary to distinguish between primary and secondary arthrosis. Primary arthrosis is the result of a disruption in the regeneration processes of cartilage cells, which can occur due to poor blood supply and nutrition of joint tissues. It is believed that secondary arthrosis develops in an already affected joint, but it is difficult to draw a clear boundary between these two forms.

In the initial stages, arthrosis manifests itself in the form of unpleasant sensations and crunching when bending the joints. When arthrosis begins to progress, pain appears during movement and physical activity, intensifying towards the end of the day (it usually subsides during the night, and a person suffering from arthrosis may not pay attention to the disease for a long time). In the later stages of arthrosis, the mobility of the joints is completely impaired, and pain torments the person more and more often. Arthrosis is very dangerous, and if degenerative tissue changes have gone too far, the doctor will not be able to restore the joint. Usually it is only possible to slow down the progression of the disease, relieve inflammation (through the use of non-steroidal anti-inflammatory drugs) and reduce pain. To prevent arthrosis from leading to disability, the patient should try to reduce the load on the affected joint and get rid of excess weight, which is facilitated by physical therapy and physiotherapeutic procedures. Severe arthrosis may require surgical intervention.

Classification of arthrosis

• Primary arthrosis accounts for approximately 40-50% of all cases of arthrosis. In this case, the disease occurs on a previously healthy joint, and its cause is not damage to the joint, but, for example, heavy physical work.
• Secondary arthrosis accounts for approximately 50-60% of cases. In this case, the joint susceptible to arthrosis was deformed even before the disease - for example, as a result of injury.

Arthrosis affects 10 to 15% of the world's population. With age, the risk of arthrosis increases significantly. Symptoms of arthrosis are often detected as early as 30-40 years of age. 27% of people over 50 years old suffer from arthrosis. And after 60 years, almost everyone suffers from this disease. The incidence of arthrosis is the same among men and women. An exception is arthrosis of the interphalangeal joints - this type of arthrosis occurs most often in women.

The causes and nature of the disease may vary. Arthrosis can develop due to rheumatic conditions. This applies to people with chronic rheumatism. Diseases sometimes occur in whole “sets”: arthrosis is accompanied by rheumatism, varicose veins with thrombosis, vascular sclerosis, stroke, etc. Everything in the body is interconnected. Arthrosis can also be an autoimmune disease. This means that the immune system, whose purpose is to protect you from viruses and bacteria, suddenly begins to attack healthy cells. The mystery of why the body begins to attack itself has not yet been solved.

But still, most often arthrosis is a sign of rheumatoid arthritis, and represents destructive changes in cartilage and bone tissue that occur with age as a result of natural aging. Statistics are also eloquent. Upon reaching 60-70 years of age, the disease arthrosis is diagnosed in 60-70% of people. The words “arthrosis” and arthritis are similar only phonetically, but the causes are completely different and, accordingly, the treatment as well. When highlighting the differences between arthrosis and arthritis, it is important to realize the different direction in which the destructive and deforming process occurs. If you have arthrosis, then the metabolism in the joint is disrupted, its elasticity is lost, the cartilage becomes thinner and every movement causes pain. If you have arthritis, then your immune system has attacked the joint, your body works against its tissue and this causes inflammation, pain and changes that are deforming in nature. Understanding this is important because it determines treatment. While autoimmune processes will be suppressed in arthritis, mechanical restoration of the joint is the main goal for treating patients with arthrosis.

The first blow is taken by the knee joints, elbow joints, and arms. Thus, arthrosis of the knee joint is the most common. Over time, deforming arthrosis occurs, the joints begin to deform, and due to curvature, the affected areas can take on bizarre shapes. There are, in particular, terms such as “swan neck”, “button loop”. If a person has arthrosis deformans and the fingers are affected, then in appearance they may become shorter.

Deforming arthrosis is a disease of our time; a sedentary lifestyle has led us to it. Nature destined us to live differently, but by automating processes, man “earned” a lot of sores with which people pay for all the benefits they receive. Deforming arthrosis usually affects the supporting joints. Osteoarthritis of the knee joint is explainable because its peculiarity, unlike other joints, is the heavy loads it bears. Nature did not take much care in feeding such overworked places. And since the cartilage of the knee joint does not have its own vessels, it can atrophy as a result of aging or under the influence of infections or injuries.

Which joints are affected by arthrosis?

The most common diseases are arthrosis of the joints of the lower half of the body (hip, knee, first metatarsophalangeal). Most often, osteoarthritis affects the knee (gonarthrosis) and hip (coxarthrosis) joints. One of the earliest symptoms of arthrosis is pain in the knee joints. At the beginning of the disease, it is practically absent at rest, but appears when the joint is loaded. For arthrosis of the knee joints, massage of the lower extremities can be useful, but direct impact on the diseased joint should be avoided, as this can increase the inflammatory reaction in it.

In the hands, the joints of the phalanges of the fingers are most often affected by arthrosis. Arthrosis usually occurs first on one joint, and then on the second - symmetrical to the first.

Arthrosis of the spine

Ankylosing spondylosis (Bechterew's disease) leads to limitation of the motor capabilities of the spine - due to the connection, i.e. fusion of some joints. The results of an X-ray examination reveal that the spine, subject to arthrosis, looks like a bamboo stick.

There are five forms of spinal arthrosis:

• Central - only the spine is susceptible to arthrosis
• Arthrosis affects not only the spine, but also the shoulder or hip joints.
• Peripheral - the spine and peripheral joints are susceptible to arthrosis
• Scandinavian - arthrosis damage occurs in the spine and small joints of the hands and feet
• Ankylosing spondylitis with extra-articular manifestations: damage to the eyes, cardiovascular system, kidneys, lungs in the form of fibrosis.

An assessment of how much arthrosis has damaged the spine, or more precisely, how much it has limited mobility, is carried out using the following tests:

It is necessary to tilt your torso forward as far as possible without bending your knees. The distance to the floor in the absence of arthrosis is within 5 millimeters.

You need to stand with your back to the wall and press your heels, buttocks and the back of your head against it. Most often, patients with arthrosis cannot touch the back of their heads.

You need to stand up straight, without bending your spine, and then try to reach the shoulder joint with your ear.

Patients with arthrosis cannot do this.

Causes of arthrosis

Arthrosis can occur as a result of intoxication, infectious diseases (for example, typhus, syphilis, etc.). Arthrosis can also occur due to joint injuries (fracture of the articular ends of bones, damage to articular cartilage), with significant functional overload of the joint (for example, ballet dancers, loaders and etc.). Colds are of known importance (for example, arthrosis in workers in hot shops).

Symptoms of arthrosis

The basis of the disease is a malnutrition of the articular (epiphyseal) ends of the bones. Due to changes in patency or damage to the vessels supplying the bone, aseptic necrosis occurs, aggravating lesions in the joint. Thus, arthrosis is progressive. Initially, painful changes appear in the inner (so-called synovial) membrane of the joint capsule, then they capture the cartilage covering the articular surfaces of the articulating bones; the cartilage gradually breaks down, exposing the bone; The bone tissue is thinned out in places, thickened in places, bone spike-like outgrowths are formed - a picture of deforming arthrosis develops. More often, arthrosis develops in the hip, knee and first metatarsophalangeal joints. Typically, middle-aged and elderly people suffer from arthrosis. Arthrosis is manifested by pain that appears gradually, occurs periodically, worsens after sudden physical exertion or, conversely, after a long period of rest. Due to pain, mobility in the joint is limited. Arthrosis is accompanied by inflammation of the tissues surrounding the joint and nerve trunks; joint function also suffers due to protective muscle tension.

Treatment of arthrosis

Treatment of arthrosis is outpatient and in sanatorium-resort conditions. Prescribe painkillers, hormonal drugs (adrenocorticotropic), physiotherapy (thermal procedures, ultrasound), therapeutic exercises, massage. In severe cases, surgery (arthrodesis, arthroplasty) is used to treat arthrosis. If the wear and tear of cartilage has not yet progressed too far, medications containing glucosamine sulfate, a natural substance obtained from the shells of marine animals, can help. It has a positive effect on cartilage metabolism and improves joint mobility.

Main symptoms and treatment of gouty arthritis

Patients are bothered by severe pain in the joints: even the slightest touch to them becomes unbearable, while the joints become very swollen, the skin over them acquires a purple tint and its temperature is increased. Often the patient’s body temperature rises, chills appear, and blood tests reveal an increased level of uric acid.

An exacerbation very often occurs suddenly, often at night, and lasts on average from two to five days, sometimes going away even without treatment. However, after some time the pain may return again. The intervals between attacks become shorter, and the attacks themselves become longer.

In 10% of patients, after the first attack of the disease, remission occurs (it can last up to 10 years or more). In other patients, relapses may occur two to three times a year. With each subsequent attack, the number of joints involved increases, and relapses become more severe and prolonged.

The presence of tophi nodules on the hands, feet, as well as under the skin on the ears and on the back surface of the elbow joints is a manifestation of the chronic form of gout, since they usually appear no earlier than three or more years after the first gouty attack and their number can vary. Sometimes tophi nodules form not only under the skin, but also in the kidneys and other internal organs (this is usually detected by ultrasound, CT).

Very often, gouty arthritis of the joints is combined with diabetes mellitus, obesity and hypertension, and atherosclerosis. In 1/3 of patients with gout, urolithiasis develops, and sometimes renal failure develops. All these diseases mutually aggravate each other. But in some patients, an attack of urolithiasis is the first manifestation of gout, which is detected after examining the patient for urolithiasis.

Clinical manifestations

The first clinical manifestations of gouty arthritis are pronounced:

• pain localized in the area of ​​the affected joint;
• redness of the skin;
• increased pain during movement;
• increase in body temperature.

After a few days, the above symptoms practically disappear, but others appear:

• subcutaneous formations in the area of ​​the affected joint, which sometimes burst;
• increasing the duration of attacks and decreasing the time period between them.

At this stage, cartilage is destroyed and the disease becomes chronic. If treatment for gouty arthritis is not started at this stage, the following symptoms are observed:

• roughening of the skin in the area of ​​the affected joints;
• restriction of movements of the arm or leg;
• deformations of bones and cartilage.

Examination for gouty arthritis:

• general blood test (possible leukocytosis, accelerated ESR);
• biochemical blood test (determination of C-reactive protein, fibrinogen, uric acid, etc.);
• urine analysis to determine the concentration of uric acid;
• detection of uric acid crystals in synovial fluid or tophi contents;
• X-ray examination of the osteoarticular system to identify bone defects - “punches”
• Ultrasound of joints - reveals the presence of inflammatory fluid in the joint, unevenness of bone structures due to the presence of marginal osteophytes, uneven thickness of bone structures due to the presence of tophi, visualization of uric acid crystals in the synovial fluid in the form of a “blizzard”;

IMPORTANT: It is more advisable to take tests during the interictal period and several times because A test for uric acid at the time of an attack will usually be negative, due to the fact that large amounts of uric acid accumulate in the joints!

The most important thing about arthrosis

Arthrosis is a progressive disease that affects the articular surfaces. It develops gradually and leads to deformation and destruction of cartilage tissue. Various reasons lead to the disease: heredity, abnormalities in the structure of the joints, injuries, high loads. The pathology affects only the joints.

Typically, the disease affects mature and elderly people. It is also susceptible to those who, due to their occupation, place a lot of stress on the joints of the wrists, hands, and legs. You can sometimes hear arthrosis referred to as “pianists’ disease” or “athletes’ disease.”

Symptoms of arthrosis

Arthrosis appears gradually as it progresses. At the very beginning there are often no symptoms. Because of this, patients seek medical help in late stages, which makes treatment difficult.

First symptoms:

• crunching and clicking in joints;
• immobility of the joint after a long period of rest, quickly disappearing with movement;
• pain during exercise and movement.

As the disease progresses, the symptoms become more pronounced: immobility and pain intensify, and soft cartilage tissue is replaced by bone growths (the so-called hard joint syndrome). In later stages, patients may lose the ability to move the affected joints.

Treatment and prevention

If you “catch” arthrosis in the initial stage, then it responds well to therapy. Another important factor for prognosis is age. The younger the patient, the easier it is to rid him of the disease. What is the treatment?

In our center, shock wave therapy shows excellent results, when the restoration of joints is promoted by short-term exposure to low-frequency acoustic impulses. In addition, drug therapy that activates regeneration, electrophoresis with drugs, and carboxytherapy can be used. The load on sore joints is necessarily reduced.

Advanced disease and arthrosis in elderly patients cannot be completely cured. But with the help of regular, competent therapy, you can keep the disease under control, provide the patient with a high quality of life, and greatly slow down the destruction of the joint.

Basic principles of primary prevention, which helps prevent the development of arthrosis:

• maintain a normal weight - extra pounds increase the load on the joints;
• move - regular physical activity is good for joints;
• wear good and comfortable shoes - improper load distribution provokes increased pressure on the joints;
• strengthen immunity;
• don't get too cold.

Basic principles of treatment of gouty arthritis of the joints

Treatment of gout in men and women should be carried out under the supervision of a doctor and with periodic urine and blood tests. It must be comprehensive and aimed at suppressing the level of uric acid, accelerating its removal from the body, and must include:

You can find out more about the symptoms and treatment methods for joint arthritis, prices, and make an appointment with our specialists by calling the numbers in the Contacts section Call! We will be happy to assist you!

• during an exacerbation of gout, rest is necessary, especially for the affected limb, dry heat, vodka compresses, but warming compresses, visiting the bathhouse and sauna are not recommended;
• a diet with a decrease in protein in the diet to 0.8-1 g / kg of the patient’s weight, drinking plenty of fluids;
• drug therapy:
• painkillers and drugs - NSAIDs in combination with colchicine, are prescribed as early as possible at the first signs of an acute attack of arthritis;
• taking medications that normalize salt metabolism, as well as for the prevention and/or treatment of kidney damage;
• urate-lowering drugs are indicated for persistent hyperuricemia and acute attacks of arthritis, chronic arthritis and the presence of tophi. And also to prevent the formation and dissolution of existing uric acid crystals. Allopurinol is usually the drug of first choice in urate-lowering therapy;
• local therapy - in the presence of inflammatory fluid in the joint, a joint puncture is performed to remove it and followed by intra-articular administration of glucocorticosteroids;
• a necessary condition is weight control, as well as limiting the intake of certain medications (at the discretion of the attending physician) that adversely affect protein metabolism in the body;
• During the period of remission, in addition to nutritional therapy, physical therapy, physiotherapeutic procedures, light physical labor and exercise, long walks, osteopathic, acupuncture, and massage are recommended.

You can find out more about the symptoms and treatment methods for joint arthritis, prices, and make an appointment with our specialists by calling us in the Contacts section.

Call! We will be happy to assist you!

Osteoporosis

Source of the problem . Osteoporosis is a systemic disease associated with a decrease in bone density, which often leads to fractures (including the femoral neck), disability and even death of the patient. Moreover, arthrosis and osteoporosis are often combined with each other in older people.

Symptoms . For the time being, osteoporosis may not manifest itself in any way. A person can consider himself healthy for decades and not even be aware of the problem. An indirect manifestation of the disease are fractures with a low level of injury (falling from your height, awkward movement) and a decrease in height by more than 2 cm per year or by 4 cm compared to the height you had in your youth, which may indicate compression fracture of the vertebral bodies, which most often goes unnoticed by the patient.

Treatment . With osteoporosis, as a rule, there is a deficiency of calcium and vitamin D, which is necessary for its absorption. This deficiency can be compensated by taking vitamin D, as well as by eating a diet high in dairy products, fish, organ meats, nuts, cabbage, raisins, and prunes.

When osteoporosis is combined with osteoarthritis, you cannot do without taking chondroprotectors.

Question answer

Why is gout a disease of kings?