Chronic arthritis: symptoms and treatment


Chronic arthritis is a pathological process of inflammatory nature that affects joints. This disease can arise as a complication from an earlier infectious or inflammatory process or be an independent pathological process, the development of which was provoked by certain etiological factors.

There are several forms of development of this ailment of the musculoskeletal system, however clinicians isolated two forms of this ailment into separate nosological units — juvenile and chronic arthritis of the TMJ.

There are no restrictions on age and sex, why this disease can be diagnosed in childhood and adolescence.

Diagnostics includes a comprehensive examination of the patient, using laboratory-instrumental methods of investigation. Treatment is carried out conservatively, using physiotherapy procedures during periods of persistent remission. Complete elimination of the disease is impossible.

Etiology

The etiological factors that can cause this disease include:


  • hepatitis C
  • tonsillitis;
  • pyelonephritis;
  • sinusitis;
  • Tuberculosis
  • psoriasis
  • systemic lupus erythematosus
  • sarcoidosis
  • Behcet’s disease
  • reactive arthritis;
  • gout;
  • recurrent polychondritis
  • arthritis of the knee joint

In general, any infection of a specific or non-specific nature can provoke the development of chronic arthritis. However, it is noted that such aetiology has not yet been proven with regard to rheumatoid arthritis.

Separately, there are predisposing factors for the development of such a disease:


  1. the course of diabetes;
  2. Complications after vaccination
  3. Thyroid disease;
  4. Pregnancy
  5. long static load on the same joint
  6. Frequent hypothermia
  7. Hyperinsolation
  8. physically inactive lifestyle
  9. previous diseases of rheumatic origin
  10. weak immune system, against which there is frequent infection of the body with various diseases

Based on the foregoing, we can say that any infection process in the body can provoke the development of chronic reactive arthritis or any other form of this dangerous disease.

Classification

The following clinical forms of the disease are distinguished:


  • Juvenile chronic arthritis in children — does not occur in adults, is characterized by the involvement of small joints of the extremities in the inflammatory process. Inflammation of the cervical spine, temporomandibular joint is less common. It should be noted that this form of pathology is distinguished by a pronounced clinical picture with intensive course, subsequent development of deformities, contractures and limb shortening
  • Chronic arthritic arthritis . With this form of a person’s illness, frequent, severe pain, sometimes up to several weeks, will be disturbed. After about 3-4 years, deformities of the affected joints develop, limb in the movements, the formation of tofus. This form of the disease can affect the internal organs, with the corresponding diseases;
  • Chronic psoriatic arthritis . Most often it is a complication of psoriasis, it is diagnosed in about a third of patients with this systemic disease. Characterized by a thickening of the fingers, limited mobility of the feet, there may be a flexural contracture.
  • Rheumatoid arthritis . Affected small joints, which, in the end, leads to the complete immobility of the lower or upper limbs.

It should be noted that every form of the disease is characterized by its clinical picture.

Symptoms

In this case, it is difficult to identify the general symptom complex, as the nature of the manifestation of pathology will depend on its shape.

The juvenile form of the pathological process is characterized by the following clinical signs:


  1. Insufficient development of the lower jaw, which causes the so-called «bird’s jaw» syndrome;
  2. limb shortening
  3. impaired motor function
  4. affection of the upper limbs leads to the fact that the child has problems with holding small items in his hands
  5. periarticular muscle atrophy
  6. lag in physical development is possible

It is noted that this form of the disease is three times more common in girls, but the exact causes of this predisposition have not yet been established.

The rheumatoid form manifests itself in the form of the following clinical picture:


  • Three or more small joints are involved in the pathological process
  • the patient feels the stiffness of movements in the morning, which disappears during the day;
  • decrease in body weight, for no apparent reason;
  • increased sweating, especially at night;
  • recurrent fever attacks
  • S-shaped deformation of joints.

If the treatment of rheumatoid arthritis is not started in time, the disease can lead to complete immobility of the joints and, as a consequence, disability of the person.

In the chronic form of gouty arthritis, the following clinical picture takes place:


  1. The patient may be troubled by severe, frequent pain, which may last up to several weeks;
  2. The inflammatory process affects the knee, wrist, ankle joint
  3. the formation of tofus — yellow-white plaques, which consist of tissue clusters of urates. Localization of such formations — joints, auricles, sclera and cornea.

It should be noted that this form of pathology is fraught with the development of serious complications, which will be expressed in the defeat of internal organs, most often related to the genitourinary system.

In the psoriatic form of this disease there is no pronounced pain syndrome, and the disease itself is characterized by external deformities — limited mobility of the upper or lower extremities, thickening of the fingers.





Diagnostics

If you suspect a rheumatoid arthritis or any other form of this ailment, it may be necessary to consult the following highly qualified specialists:


  • rheumatologist;
  • Surgeon
  • orthopedist
  • pediatrician
  • The otolaryngologist
  • dermatologist
  • Ophthalmologist

Diagnosis is determined by physical examination and necessary diagnostic measures.

The diagnostic program may include the following:


  1. general clinical analysis of blood and urine
  2. detailed biochemical and immunological analysis of blood
  3. blood sugar test
  4. ELISA;
  5. CT, MRI of affected joints
  6. arthroscopy
  7. puncture of the affected joint
  8. Ultrasound of affected joints
  9. X-ray examination

Based on the results of the study, an accurate diagnosis is determined and the most effective treatment tactic is selected.

Treatment

As a rule, the treatment of such diseases is carried out in a complex way — medical therapy is combined with physiotherapy procedures and exercise therapy.

Therapeutic measures may include taking the following medicines:


  • antibiotics
  • Non-steroidal and steroidal anti-inflammatory drugs
  • Glucocorticosteroid — preparations of this group are administered intravenously
  • pain relievers
  • vitamin-mineral complexes.

In the psoriatic form of the disease, anti-inflammatory therapy is carried out separately.

In addition to medical treatment, the doctor can appoint:


  1. Exercise exercises for exercise therapy
  2. course of manual therapy;
  3. physiotherapy procedures
  4. wearing special compression dressings
  5. use of special orthopedic devices that reduce the load on the affected joint.

Also, as a prevention of recurrence of the disease and for the maximum extension of the phase of persistent remission, after the course of active therapy, the patient may be referred to a sanatorium-resort treatment.

The indications for the operation can be the following:


  • with obvious functional disorders of the musculoskeletal system
  • with destructive joint damage

We need to understand that it is impossible to completely eliminate chronic arthritis. By fulfilling the prescriptions of the doctor, one can only extend the phase of a stable remission.

Possible complications

If the prescribed treatment is not observed or if it is completely absent, the following complications may develop:


  1. diseases of the urogenital system;
  2. Bone or fibrotic ankylosis
  3. myocarditis, pleurisy
  4. synovitis of the knee joint

In addition to individual pathological processes, any form of arthritis can lead to complete immobility of the joint, which leads to disability.

Prevention

There are no effective prevention methods for this ailment, as there are no exact etiological factors. It is advisable to adhere to a generally healthy lifestyle and seek medical help in a timely manner.