So-called rheumatism or acute rheumatic fever (according to new terminology) is a systemic inflammatory disease of connective tissue, in which the pathological process has a tropism towards the membranes of the heart and joints.
Even at the beginning of the 20th century, the concept of “rheumatism” meant almost any disease of the joints - doctors did not have the need or opportunity to differentiate these ailments, especially since the range of healing procedures was not diverse. Today, a rheumatologist has a wide range of diagnostic methods in his arsenal, allowing him to distinguish rheumatism from many other rheumatological diseases, each of which has its own treatment strategy.
Rheumatism is a disease predominantly of children aged 6 to 15 years, and only 1 child in 1000 suffers in this age group.
Primary rheumatism in adult patients is observed less frequently. According to statistics, women are 2-3 times more likely to suffer from this disease than men.
Rheumatism usually begins some time after a streptococcal infection of the nasopharynx, and after a few years it can turn into a chronic, incurable disease. Fortunately, only 1-3% of patients who have an infection become victims of rheumatic fever.
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Consultation with a rheumatologist
2 Consultation with a rheumatologist
3 Consultation with a rheumatologist
Causes of rheumatism
Why do some people get rheumatism, while others under the same conditions do not? People who often suffer from ENT diseases are more likely to get rheumatism. Those at risk are those whose relatives have this disease and those who have the B-cell marker D8/17 in their blood.
So, the risk factors:
- streptococcal infection (angina, scarlet fever, pharyngitis);
- defects of the immune system, the presence of autoimmunity;
- genetic predisposition to the disease.
Causes of rheumatoid arthritis of the knee joint
Absolutely anyone can get sick, regardless of gender, age, or lifestyle. Rheumatoid arthritis is caused by a combination of several factors:
- hormonal disorders - this is why women of puberty usually become ill;
- injuries, as well as unsuccessful operations or incorrect rehabilitation after them;
- hypothermia of the body;
- smoking;
- infectious diseases;
- allergy.
The bulk of officially registered patients are men and women aged 25 to 55 years.
Clinical picture of rheumatism
The trigger for the development of rheumatism is the entry of streptococcus into the body, as a result of which the immune system begins to produce antibodies to fight the infection. However, in the body itself, namely in connective tissues and heart muscle, there are molecules of the same structure. Due to the presence of this factor, the immune system begins to “fight” its cells. As a result, connective tissue is damaged, and this is fraught with heart defects and joint deformation.
Forms of rheumatism
- cardiac form (cardiac rheumatism), when all the membranes of the heart are affected (pancarditis), myocardium (myocarditis), endocardium (endocarditis);
- articular form (rheumatism of the joints);
- cutaneous form;
- pulmonary form (pleurisy);
- rheumatic chorea (St. Vitus' dance).
Treatment of rheumatoid arthritis of the knee joint
The methods used to combat the disease are divided into non-drug and drug-based. Surgery (surgery) is used in extreme cases.
Non-drug treatments for rheumatoid arthritis of the knee:
- Pharmacopuncture. Designed to relieve inflammation and provide nutrition to the damaged joint.
- Shock wave therapy, which serves to restore normal blood supply. Returns the ability to bend the leg at the knee.
- Vacuum therapy is a type of massage based on the organization of low pressure zones in a certain area.
- Magnetotherapy. It has an analgesic and anti-inflammatory effect on affected joints.
- Laser therapy. Increases local immunity, has anti-inflammatory and sedative effects, improves blood circulation.
In contrast, some medications, in addition to the obvious effect (relieving pain, inflammation, etc.), may also have side effects:
- non-steroidal anti-inflammatory drugs;
- basic medications, the use of which begins immediately after diagnosis and can continue throughout life;
- hormonal agents.
How to treat rheumatoid arthritis of the knee joint and in what ratio to use Eastern and Western methods, the doctor must determine individually.
Symptoms of rheumatism
Rheumatism has a wide variety of manifestations: damage to the heart, joints, nervous and respiratory systems. 2-3 weeks after contracting a sore throat or pharyngitis, the first signs of rheumatism appear: fever, weakness, fatigue, headache. In some people, acute rheumatism begins 1-2 days after hypothermia, even without connection with infection.
Rheumatism of the heart
Already at the beginning of the disease, pain in the heart begins, increased heartbeat, shortness of breath even at rest.
Rheumatic arthritis
With articular rheumatism of the legs and arms, pain appears in the knee, elbow, wrist, and shoulder joints. The joints swell, active movements in them are limited. As a rule, after taking non-steroidal anti-inflammatory drugs, pain from rheumatism quickly disappears.
Skin rheumatism
With cutaneous rheumatism, vascular permeability increases. Therefore, skin rashes appear on the lower extremities.
Rheumatic pleurisy
A fairly rare manifestation of the disease. Main symptoms: body temperature remains above 38 degrees, severe pain in the chest, dry cough, shortness of breath, pleural noise can be heard on auscultation. More often the disease is limited to a fairly mild form of pleurisy.
1 ECG
2 Echocardiography with Doppler analysis
3 X-ray examination
Rheumatic manifestations of damage to the nervous system
Sometimes rheumatism can provoke damage to the meninges, subcortex and medulla. One of the manifestations of the disease is the dance of St. Vitus. With this complication, convulsive, involuntary contraction of the muscles of the face, torso of the arms and legs occurs. With a sharp contraction of the glottis, suffocation can occur, which is very dangerous for human life.
Abdominal syndrome
This type of complication is typical for children and adolescents. Accompanied by elevated body temperature, nausea, vomiting, and abdominal pain in the form of contractions.
Rheumatism should not be left to chance or treated by relying on the advice of friends and relatives, even those familiar with this disease. Loss of time leads to progression of the disease and dangerous complications in rheumatism. There is a threat of developing atrial fibrillation and myocardiosclerosis. Possible damage to the lungs and kidneys. And the most dangerous thing is thromboembolism (blockage of the pulmonary artery by a blood clot), which can suddenly end the patient’s life.
Symptoms
Signs of rheumatoid arthritis appear approximately 1-2 weeks after illness caused by acute streptococcal infection. Rheumatitis of the extremities is just one of the syndromes inherent in rheumatism. In the acute course of this disease, the following pathological conditions are possible:
- rheumatoid arthritis (inflammation of the joints);
- rheumatic carditis (inflammation of heart tissue);
- rheumatic chorea (damage to the nervous system);
- skin lesions (erythema, rheumatic nodes);
- rheumatic pleurisy (inflammation of the lining of the lungs).
Rheumatoid arthritis affects mainly the large joints of the extremities (elbows, knees and ankles), and somewhat less commonly it affects the small joints of the hands and feet. Since rheumatoid arthritis is a syndrome of post-streptococcal infection, the patient feels general weakness, shortness of breath, and body temperature rises to 38-39 °C.
A distinctive feature of rheumatoid arthritis is symmetrical damage to the joints, and it is benign in nature, that is, it does not lead to joint deformation. The patient feels pain in the joints, their mobility is lost, swelling and redness of the skin in areas of inflammation are possible.
Diagnosis of rheumatism
When diagnosing the disease, the following methods are used:
- ECG;
- Ultrasound of the heart;
- X-ray examination (helps to see changes in the size and shape of the heart);
- general blood test (can show ESR level, anemia, etc.);
- immunological blood test (appearance of C-reactive protein, presence of streptococcal infection).
1 General blood test
2 Immunological blood test
3 Diagnostics of rheumatism in MedicCity
Symptoms of rheumatoid arthritis of the knee joint
Characteristic manifestations of the disease can be detected without the use of special diagnostic equipment:
- decreased mobility of the knee, which manifests itself at the initial stage of the disease only after an overnight rest;
- sharp or aching pain that intensifies with movement; may spread to the entire leg;
- inflammation, signs of which are swelling of the knee, local changes in body temperature;
- effusion in the affected area;
- fever;
- increased fatigue.
As the disease progresses, the symptoms of rheumatoid arthrosis of the knee joint will intensify, and its deformation will be visible even to a non-specialist. Start treatment without waiting for the problem to become disabling! At the initial stage, the destruction of the knee can still be stopped.
Proper nutrition for rheumatoid arthritis of the knee joint
The diet for rheumatoid arthritis is based on several principles:
- you need to eat in small portions, at least 4 times a day;
- You should avoid cold dishes and limit the consumption of highly heated foods;
- it is necessary to reduce salt intake to the amount indicated by the doctor;
- drink about 2 liters of liquid per day.
Healthy foods that should form the basis of your diet:
- fruits and vegetables;
- bread - rye or bran;
- cereals;
- fresh greens are a source of vitamin C, iron, calcium;
- lean meat;
- sea fish;
- dairy products;
- green tea, natural juices.
You should limit yourself to sour, salty, spicy foods, coffee and alcohol, and avoid fatty foods.
Diagnosis of arthritis
As soon as symptoms of arthritis appear, namely joint pain, you should consult a doctor. A number of diagnostic tests may be required for diagnosis:
- A physical examination that allows you to see the presence of swelling of the joint, pain on palpation, and limited mobility in the joint.
- Determining the intensity of pain and nature.
- Blood tests - general, blood fractions, rheumatic tests, presence of antibodies, etc.
- X-ray examination of the affected joint
- MRI or CT of the joint
- Densitometry
- Ultrasound of the joint
- Arthroscopy (a procedure in which an endoscope equipped with a video camera is inserted into the joint cavity in order to visualize the pathology)
- Joint puncture with laboratory testing of punctate
Not all tests can be used for diagnosis, but only a combination that allows for the most accurate diagnosis. If test results are positive, you may need to consult a rheumatologist.
Given that arthritis is different, diagnosis will require a different amount of research and different time. For example, diagnosing osteoarthritis is straightforward, whereas diagnosing rheumatoid arthritis requires imaging and blood tests, and only a combination of tests can make the diagnosis (similar to putting together a puzzle). For other joint lesions, additional research methods may be required. For example, psoriatic arthritis, as a complication of a disease called psoriasis, or reactive arthritis, which accompanies infectious diseases. In some cases, the underlying disease dominates the clinical picture and interferes with the diagnosis of arthritis. For example, with polymyalgia rheumatica or with ankylosing spondylitis (ankylosing spondylitis).
Gymnastics for rheumatoid arthritis of the knee
Physical exercise will help keep muscles toned and maintain joint mobility. The intensity of the exercises is determined by the doctor, who can supplement the list of basic exercises:
- lying on your back, bend your leg at the knee joint, without lifting the sole off the floor;
- bending your knees, make rotational movements, as when riding a bicycle;
- bending your knees, spread them apart and bring them back;
- swing your legs without bending them at the knee (lying and standing);
- make circular movements with the leg bent at the knee;
- spreading straight legs to the sides in a lying position.
When prescribing gymnastics for rheumatoid arthritis of the knee, the doctor takes into account the presence of concomitant diseases and the degree of damage to the joint.