Arthritis

Introduction to arthritis Arthritis refers to inflammatory diseases that occur in the joints of the human body and its surrounding tissues. The clinical manifestations are redness, swelling, heat, pain, dysfunction and joint deformity of the joints. Common clinical arthritis mainly includes the following: rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gouty arthritis, reactive arthritis, infectious arthritis, traumatic arthritis, psoriatic arthritis Joint manifestations of enteropathic arthritis and other systemic diseases include systemic lupus erythematosus, tumors, and blood diseases. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: swelling

Cause of arthritis

Different arthritis has different causes, clinical manifestations, treatment and outcomes. The etiology of arthritis is complex, mainly related to inflammation, autoimmune reaction, infection, metabolic disorders, trauma, degenerative diseases and other factors. Arthritis is one of the most common manifestations of rheumatism, but arthritis does not necessarily have rheumatism, and patients with rheumatism do not necessarily develop arthritis.

Excessive joint fatigue (25%):

Excessive joint fatigue and dietary imbalance can lead to acidic constitution, which is the main cause of arthritis. When cartilage is soaked in acidic body fluids, it will degrade and the lubricating effect of synovial fluid will be worse. Lost cartilage components are present in both cartilage and bone, causing the ends of the bones to become unsmooth and form spurs (large skeletal processes). The resulting inflammation can limit the movement of the joint.

Calcium loss (10%):

Acidic people cause a lot of calcium loss, which is also the cause of arthritis. Calcium imbalance can cause calcium to accumulate in soft tissues, causing muscle pain. The bone ends of patients with rheumatoid arthritis will join and fuse together.

Cold and damp (25%):

The human body feels the wind, cold, and dampness, causing body pain or body weight, joint pain, and unfavorable diseases. Feel the many conditions caused by rheumatism. "There are various sources of disease, wind and disease": "The rheumatism is the combination of the wind and the moisture." The shape is lazy and the spirit is faint. If it lasts for a long time, it will also make the limbs slow and not follow. Tibetans are hoarse, and their tongues are not closed; or their ankles are weak and become athlete's foot."

Arthritis prevention

1. Avoid environmental factors that induce the onset of arthritis

The relationship between arthritis and the environment, especially infection, cannot be ignored. Arthritis, reactive arthritis, and infectious arthritis after streptococcal infection are directly related to infection. Pathogenic infections may also be one of the predisposing factors for autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus. Streptococcus is one of the major pathogens that cause arthritis. Other microorganisms that may be associated with the onset of arthritis include EB virus, cytomegalovirus (CMV), parvovirus B19, Shigella, Klebsiella, Mycobacterium tuberculosis, and certain mycoplasma, chlamydia, and the like. A humid environment contributes to the growth of certain pathogens and is associated with the onset of arthritis. Therefore, we should pay attention to hygiene, keep room ventilation and air well, prevent moisture and warmth, avoid the spread of pathogenic bacteria, especially streptococcus, strengthen physical exercise, improve disease resistance, and prevent it from happening.

In recent years, smoking has been significantly associated with the onset of rheumatoid arthritis. The risk of rheumatoid arthritis is significantly higher in smokers, and smoking can affect the treatment of patients with rheumatoid arthritis. Therefore, smoking cessation has become one of the preventive measures for rheumatoid arthritis.

In addition, other environmental factors such as ultraviolet light and exposure to certain chemicals may cause abnormal immune reactions in some susceptible people, leading to different arthritis.

2. Patient education, mental and psychological adjustment

The stability of the immune system is related to emotions. Many patients in clinical practice have experienced autoimmune diseases after experiencing adverse life events. Therefore, maintaining an optimistic and stable mentality is conducive to the prevention of rheumatic diseases. Deaf patients maintain an optimistic mood, eliminate depression, and fight against disease with a positive attitude, which is of great significance for the treatment of arthritis.

3. Functional exercise and lifestyle adjustment

Long-term joint disease can lead to limited joint activity and muscle atrophy. Functional exercise is an important method for recovery and maintenance of joint function. Pay attention to the timing, type and intensity of exercise during functional exercise. The acute phase of joint swelling should limit joint activity, raise the affected limb to reduce edema, and rest in bed until the joint swelling and pain improve. After the swelling and pain is improved, the flexion and extension of the joint and the rotational movement are performed without increasing the pain to increase the joint activity. Arthritis of weight-bearing joints such as knee arthritis and hip arthritis need to avoid weight-bearing exercise. The types of joint movements are not the same. Patients with knee arthritis can choose swimming, walking and other sports to avoid walking too much and going down the stairs. Patients with lumbar and neck arthritis can choose the rotation of local joints to avoid long-term desk and head. For patients with ankylosing spondylitis, swimming is the best body exercise. For patients with small arthritis, you can choose to weave, braid, plasticine, paper-cut, calligraphy, typing, gardening, etc. No matter what kind of exercise you choose, you need to start from a small amount, step by step, and it is better to not cause joint pain after exercise. Otherwise, you need to adjust the exercise intensity and reduce the exercise time. In conditional hospitals, the above functional exercise should be carried out under the guidance of a rheumatology specialist and a rehabilitation specialist. In addition, patients should pay attention to lifestyle adjustments, such as ankylosing spondylitis patients need to stand upright when standing, sleep more hard bed, maintain supine position to avoid flexion contracture, pillows should be low, once the upper thoracic and cervical spine involved should stop using the pillow. Patients with knee arthritis should avoid wearing high heels.

Arthritis complications Complications swelling

Osteoarthritis complicated by joint movement disorder of the limbs, in severe cases, limbs and flexion contracture deformities, and finally joint disability.

Arthritis Symptoms Common Symptoms Joint Swelling Pain Shoulder Joint Activity Restricted Joint Local Stinging Pain After Knee Swelling Pain,... Joint Joints Swelling Joints Irregular Joint Hardening Joint Effusion Calves Lack of Post-Knee Pain

1. Pain: It is the most important manifestation of arthritis.

2. Swelling: Swelling is a common manifestation of joint inflammation and is not necessarily related to the degree of joint pain.

3. Dysfunction: joint edema caused by joint pain and inflammation, resulting in limited joint activity. Chronic arthritis patients may have permanent joint function loss due to limited long-term joint activity.

In addition, acute infection with arthritis can also cause joint swelling.

Arthritis examination

No specific laboratory indicators. ESR is mostly normal, C-reactive protein is not high, RF (rheumatoid factor) and autoantibodies are negative. The joint fluid was yellow or yellowish, the viscosity was normal, the coagulation test was normal, the white blood cell count was less than 2×10 ⁶ /L, and the glucose content was rarely lower than half of the blood glucose level.

Typical X-ray findings are stenosis of the affected joint space, subchondral bone sclerosis and cystic changes, and osteophyte formation at the edge of the joint. Severe joint surface collapse, deformation or subluxation.

Magnetic resonance imaging can show abnormalities in joint structures such as early cartilage lesions, meniscus, and ligaments, which is beneficial for early diagnosis.

Arthritis diagnosis

diagnosis

According to the history, examination, clinical manifestations can be diagnosed.

Differential diagnosis

Because of the wide variety of arthritis, complex etiology, and different treatment principles, it is important to identify arthritis.

1. Rheumatoid arthritis: This disease is one of the most common types of chronic arthritis. It is associated with genetic, bacterial and viral infections, environmental factors including smoking. Can occur at any age, but women 40-60 years old are more common. It is more common to have small joints (finger joints, wrist joints) of both hands, and it is manifested as bilateral involvement. The patient was also accompanied by morning joint stiffness for more than 1 hour and limited joint activity. Systemic organ involvement can occur when the condition is severe. The anti-cyclic citrullinated peptide antibody is a specific antibody. The vast majority of patients were positive for rheumatoid factor, but there was no absolute correlation between the level of rheumatoid factor and the activity of the disease.

2. Osteoarthritis: also known as degenerative joint disease, osteoarthrosis, commonly known as bone hyperplasia. The occurrence of osteoarthritis is closely related to age and obesity. The prevalence of osteoarthritis in people under 45 years old is only 2%, and the prevalence rate in people over 65 years old is as high as 68%. In short, people from old to old age have varying degrees of osteoarthritis. All joints can be affected. However, when the small joints of the hands are involved, they are mostly the interphalangeal joints of the hands. Clinically, the patient has a bony prominence in the distal interphalangeal joint. Patients can also have morning stiffness, but the time is less than half an hour. The blood rheumatoid factor in these patients is often negative.

3. Gouty arthritis: The disease is associated with excessive and/or reduced uric acid production in the body. Excessive uric acid deposits locally in the joint causing arthritis. Its incidence is very urgent, often caused by excessive diet or stress, manifested as joint swelling and heat pain. Single joint involvement is more common, the most common site of infection is the bony prominence around the big toe. Acute gouty arthritis is also relieved quickly. Symptoms can be relieved after one or two weeks of treatment or after drug treatment, but it is easy to relapse. Chronic gouty arthritis can be seen without recurrent episodes of arthritis.

4. Ankylosing spondylitis: Young males have multiple occurrences and have a significant family-like onset. Mainly involving the spine, ankle joint, but also peripheral joint involvement. Spine stiffness may occur when the lesion is severe, and the cervical vertebrae, lumbar vertebrae, and thoracic vertebrae are restricted in activity, and "humpback" occurs, which seriously affects the daily life of the patient. More than 90% of patients have HLA-B27 positive, while rheumatoid factor is negative.

5. Psoriatic arthritis: also known as psoriatic arthritis. Patients often have skin manifestations of psoriasis. Psoriasis arthritis joint disease is partially characterized by rheumatoid arthritis and may therefore be confused with rheumatoid arthritis. However, when the small joints of the hands are involved, the joints are often pointed at the end of the finger. However, the ankle and spine are rare in rheumatoid arthritis. Some patients may have no skin lesions when arthritis occurs, and such patients are easily misdiagnosed. The patient's serum was negative for rheumatoid factor.

6. Reactive arthritis: acute onset, often with a history of intestinal or urinary infection before onset. Asymmetric involvement of large peripheral joints (especially lower limbs). The ankle and spine can also be involved. Out of the joint can be expressed as ophthalmitis, urethritis, balanitis, more than 80% of patients with HLA-B27 positive, rheumatoid factor negative.

7. Enteropathic arthritis: patients with ulcerative ulcers may have arthritis. The joint symptoms are mild and often have other parenteral manifestations including ophthalmia and rash.

8. Infectious arthritis: related to bacterial infections. Common pathogens include Staphylococcus aureus, Pneumococci, meningococcus, Neisseria gonorrhoeae, Streptococcus, Mycobacterium tuberculosis. The pathogenesis includes direct bacterial infection and bacterial release of toxins or metabolites during infection, including subacute bacterial endocarditis and post-sex red fever arthritis. Arthritis caused by direct bacterial infection is characterized by redness and swelling of the joints and joint dysfunction. The lower limb weight bearing joint is asymmetrical. Large joints are more common, such as the hip and knee joints. Joint cavity puncture fluid often shows suppurative changes. Bacteria can be found by smear or culture. Mycobacterium tuberculosis-infected arthritis occurs in young people, and evidence of tuberculosis in other areas includes lung or lymph node tuberculosis. There may be nodular erythema and serum rheumatoid factor is negative. Tuberculin test was positive. Arthritis caused by bacterial metabolites or toxins can heal itself in 1-2 weeks, and joint symptoms are migratory.

9. Traumatic arthritis: related to joint trauma.

10. Autoimmune diseases involve the joints: autoimmune diseases such as systemic lupus erythematosus, Sjogren's syndrome, scleroderma and tumors often occur in the development and progression of arthritis. Most of these arthritis are non-erosive arthritis, and some arthritis can be relieved after the primary disease is controlled. More than leaving joint dysfunction.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.