One day hospital 3rd KO
Malykhin
Sergey Aleksandrovich
11 years of experience
First qualification category
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Polyarthritis means multiple inflammation of the joints. It can develop in different parts of the body at the same time. The disease disrupts the functioning of cartilage, tendons and ligaments, and also provokes unbearable pain and inflammation in the muscles.
The disease can exist in chronic or acute form. In the acute form, the disease progresses rapidly and is characterized by severe symptoms. In the second case, the picture is more blurred, but the patient runs a high risk of remaining disabled. How not to miss the first symptoms of this disease and what to do if they are detected?
Symptoms of polyarthritis
Signs of polyarthritis of the joints manifest themselves through:
- constriction, internal stiffness;
- multiple swellings (in the area of three or more joints);
- thickening of the limbs;
- the appearance of pain when trying to squeeze or squeeze the affected area of the body;
- shortness of breath, development of bronchitis, difficulty swallowing food (with affected laryngeal joints);
- hyperthermia;
- malaise;
- redness;
- swelling;
- small dislocations of the cervical vertebrae, pinching blood vessels, nerve roots, and spinal cord.
Symptoms of polyarthritis are typical not only for adults, but also for children. In this case, not only the child’s joints begin to suffer, but also poorly formed internal organs.
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Clinical manifestations of shoulder arthropathy
A typical patient with glenohumeral periarthritis has degenerative-dystrophic lesions of the intervertebral discs of the lower cervical vertebrae with narrowing of the intervertebral canal. The clinical picture is determined by the form and stage of the disease.
The simple form of periarthritis is manifested by barely noticeable pain in the shoulder during normal movements (dressing, washing, combing). If the patient prefers to sleep on the affected shoulder, the pain is bothersome at night. Most patients do not indicate the cause and do not remember the onset of the disease; sometimes it is associated with hypothermia or injury.
Acute periarthritis is characterized by acute pain, which can radiate to the neck, outer surface of the shoulder and sharply intensifies with palpation, abduction and extension. Bending is less painful. The pain intensifies sharply at night and is often not relieved by painkillers.
General health suffers; low-grade body temperature, weakness, and malaise are typical. To avoid movements in the shoulder, patients bend the affected limb at the elbow joint and fix it with their healthy arm.
Reference!
As a rule, acute periarthritis is complicated by tendobursitis with the deposition of calcifications in the ligaments and tendons.
Chronic glenohumeral periarthritis occurs with moderate pain and increasing limitation of shoulder mobility, the range of movements decreases gradually. The pain is localized in the area of degenerative-dystrophic changes, sometimes radiates to the neck and is successfully relieved by taking analgesics.
Acute untreated bursitis often takes a chronic course. However, a primarily chronic form of the disease occurs against the background of fibrous bursitis. The final sad result of the chronic course in the absence of treatment is ankylosis (immobility) of the shoulder joint.
Humeral periarthrosis due to tendon rupture in athletes and heavy physical labor workers is manifested by severe pain, hematoma, and a sharp limitation of active movements. In this case, passive movements (with external help) are not limited.
Reference!
Dowborn's symptom - the appearance of pain when extending (raising the arm) by 45-60 degrees and disappearing with further elevation to 120 degrees is characteristic of damage to the tendons of the supraspinatus, infraspinatus and biceps muscles.
Risk factors
A common cause of polyarthritis of the hands or other parts of the body is a genetic factor. That is, the disease is inherited. At a certain point, the immune system begins to attack the cartilage, destroying it and surrounding tissue. As a result, inflammation and further irreversible processes occur.
It should be clarified that even if there is a genetic predisposition, not all people become victims of such an unpleasant disease. For its “launch” to occur, a confluence of certain circumstances is necessary. They may be:
- injuries;
- lack of vital vitamins;
- obesity;
- diseases of the endocrine system;
- stress;
- exposure to toxins and allergens;
- respiratory tract infections.
Classification
There are several types of polyarthritis:
- rheumatoid;
- infectious;
- crystal;
- psoriatic;
- reactive;
- destructive.
Rheumatic arthritis occurs most often among other types of disease. It is extremely dangerous and can lead to disability. Women are more susceptible to it. The disease occurs against the background of a severe weakening of the immune system. It attacks the hands, feet, destroys blood vessels, heart, kidneys. The synovial cavity with fluid accumulation becomes larger. The patient feels pain, fever and stiffness of movement.
Infectious polyarthritis occurs against the background of a pathogenic microorganism that enters the joints through the blood. With this disease, pus often forms. If measures are not taken in time, the patient will completely lose mobility of the affected joints.
Psoriatic polyarthritis appears against the background of the underlying cause - psoriasis - no earlier than six months later. Most often, this type of disease affects the feet of patients over 45 years of age. The peak of pain occurs in the morning. All movements become constrained, especially after prolonged sleep or rest.
Polyarthritis of the shoulder joint, fingers, and hands is also common. It can be triggered by severe hypothermia, domestic or industrial injuries, as well as tight, uncomfortable shoes or clothing. The bones in the legs and arms literally begin to stick out, taking on an unnatural appearance.
Types of shoulder arthrosis
According to different criteria, the disease is divided into separate types.
For reasons of illness
In accordance with this criterion, primary and secondary osteoarthritis are distinguished. Primary shoulder arthrosis is mainly the result of age-related changes and develops after 50 years. But sometimes the disease begins at a young age, but the cause of its onset cannot be determined. In this case, they speak of primary idiopathic arthrosis of the shoulder. Hereditary predisposition plays an important role in its development: the presence of a similar disease in one of the close relatives.
Secondary arthrosis of the shoulder joint develops after injuries and illnesses, but aggravated heredity is also important here: in one person, even a minor injury or acute arthritis can lead to the development of arthrosis, while in another, more significant injuries end without consequences.
According to the characteristics of the flow
There is deforming arthrosis of the shoulder, characterized by rapid progression of bone deformities. A feature of this type of disease is a change in the shape of the joint and frequent infringement of nearby blood vessels and nerves. Compression of blood vessels leads to impaired circulation and rapid progression of degenerative disorders, and compression of nerves leads to impaired sensitivity of the limb and severe pain along the peripheral nerves.
By origin
Post-traumatic arthrosis of the shoulder - the symptoms and treatment of this disease have their own characteristics associated with traumatic damage to certain articular structures. Metabolic-dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ruptures of ligaments, tendons and simply bruises. Injuries occur from a blow to the joint or from falling on the side with the arm adducted. Rupture of the joint capsule with dislocation usually occurs when falling on an abducted arm.
Often, after a minor injury, a person does not notice the first signs of arthrosis for a long time and seeks medical help already at the second stage of the disease. Significant injuries require long-term rehabilitation treatment and arthrosis, as a rule, begins to be treated in the early stages.
Shoulder arthrosis after inflammatory diseases - the symptoms and course of this pathology depend on the underlying disease. The glenohumeral joint is often affected by psoriatic arthritis; in this case, arthrosis develops in one joint, forms slowly, but is difficult to treat. With rheumatoid arthritis, both shoulders are affected, arthrosis develops in waves with frequent alternation of metabolic-dystrophic and inflammatory processes.
By distribution
Only one left or right joint can be affected and then they speak of monoarthrosis. Simultaneous damage to two (left and right) humeroscapular joints is called oligoarthrosis.
Arthrosis of other joints of the shoulder complex
Acromioclavicular arthrosis is most often of post-traumatic origin. Develops against the backdrop of lifting weights with your arms above the horizontal. Accompanied by pain when raising the arm. When osteophytes grow on the articular surfaces, impingement syndrome may appear - pinching of the tendons and muscles of the shoulder between the head of the humerus and the acromion of the scapula during rotation and abduction of the shoulder. This accelerates the progression of arthrosis and decline in hand function.
Crunching in joints - when to worry
Intra-articular injections of hyaluronic acid
Diagnostics
To make sure that the patient really has polyarthritis of the joints, and not a disease with similar symptoms, the doctor prescribes a differential diagnosis. During it, those diseases that can be confused with polyarthritis are gradually eliminated.
Diagnosis consists of a medical examination, as well as:
- x-ray;
- MRI or CT;
- general blood test;
- general urine analysis;
- histological examination of joint tissue samples;
- arthrography.
Based on the data obtained, treatment for polyarthritis is prescribed.
Causes
Unlike the knee, ankle and hip joints, the shoulder does not experience significant stress when walking, which is why this form of arthrosis occurs much less frequently. Pathology can be caused by:
- regular excessive physical activity: heavy lifting, professional sports, vibration;
- congenital pathologies of the structure of the shoulder joint and adjacent structures;
- rheumatoid arthritis, systemic lupus erythematosus and other autoimmune diseases;
- congenital weakness of connective tissue, accompanied by joint hypermobility;
- injuries: dislocations, sprains and ruptures of ligaments, intra-articular bone fractures;
- hormonal changes and disruptions (including pregnancy, menopause);
- inflammatory diseases of the joint and periarticular structures (arthritis, bursitis, etc.);
- metabolic disorders, including gout, diabetes.
Heredity plays an important role in predisposition to arthrosis.
Treatment
How to treat polyarthritis? First you need to understand and eliminate the disease that caused the disease. It could be psoriasis, a viral infection or gout, for example. Treatment of polyarthritis of the joints also necessarily includes anti-inflammatory therapy, against the background of which severe pain should disappear. In addition, the patient needs to strengthen his immunity and the body’s resistance to infections and viruses.
Physiotherapy has a good effect on the affected areas:
- acupuncture;
- acupressure;
- manual sessions;
- pharmacopuncture.
Symptoms of arthrosis of the shoulder joint
- Pain at rest or during movement.
- Discomfort during changing weather conditions.
- Pain after prolonged exercise that lasts a day or longer.
- Crunching.
- Stiffness in movement due to pain.
- Swelling of the joint area.
- A feeling of increased temperature in the area (a sign of an inflammatory process).
- Problems with sleep due to the inability to lie for a long time on the side of pain.
Symptoms can vary greatly from patient to patient. Much depends on the cause of the disease and its course. We talked about the main signs that should prompt you to visit a doctor at the beginning: pain and stiffness. If you notice these symptoms, you should definitely visit a specialist. A doctor's intervention with such serious symptoms is required, even if it is not arthrosis, but something else.
Home treatment methods
When treating polyarthritis, a diet is prescribed. Every extra kilogram of weight increases the load on the joints, causing the disease to actively progress. To eliminate the disease it is necessary:
- take medications;
- perform therapeutic exercises;
- take massage courses;
- use traditional medicine recipes.
Nonsteroidal anti-inflammatory tablets are used as medications. They eliminate fever, pain, swelling and redness. Anti-inflammatory drugs can also be injected and applied in the form of ointments.
If the infection spreads and pus forms, an additional course of antibiotics is added. They can be administered intravenously, intramuscularly or directly into the joint cavity.
Chondroprotectors, immunomodulators, and preparations with calcium D3 are used in treatment.