Among all types of arthritis, the reactive type stands out, the cause of which is not associated with joint injuries. In this case, this is a kind of response of the body to the development of infection, which is in no way connected with the musculoskeletal system.
Reactive arthritis is an inflammation of the joints that is caused by bacteria entering the body. They can get from the digestive, urinary system, as well as with damage to the eyes and nasopharynx.
Damage to the joints begins about 3-4 weeks after the penetration of the bacteria. The causative agent enters the cartilage cavity along with blood and lymph. Even at the initial stage of the course of the disease, a person begins to experience severe pain, and also there are problems with mobility in the affected cartilage tissue, the inflammatory process, swelling and redness of the skin occur.
The danger of the disease lies in the fact that reactive arthritis affects not only the musculoskeletal system, but also the internal organs, affecting also the heart and lungs.
Disease feature
Reactive arthritis is an inflammatory non-purulent process that develops with or after infection. Usually, the first symptomatology occurs approximately 2-4 weeks after the pathogen enters the body.
Often, the disease affects people aged 20-40 years. Men are much more likely to get sick than women. Reactive arthritis is mainly associated with sexually transmitted infections, as well as food poisoning. This is a kind of body reaction to infection. It is believed that the inflammatory process develops as a result of the fact that microorganisms contain certain substances that are similar to antigens of body tissues. This causes a lot of problems, as there is a significant damage to the joint.
Disease classification
Depending on the features of the clinical course of reactive arthritis of the joint, one can distinguish such forms of the disease as:
- acute;
- protracted;
- chronic;
- recurrent.
The activity of the virus is determined depending on the severity of inflammation and many other manifestations.
Causes of occurrence
Possible causes of reactive arthritis are a hereditary predisposition and the presence in the body of a gene that is completely incompatible with the antigens of the virus provoking the disease. Immunity reacts quite sharply to the presence of microorganisms, affecting its own cells. Reactive arthritis of the knee, provoked by food poisoning, can be triggered by:
- parasites;
- salmonella;
- other types of worms and bacteria.
The main provoking factors for the occurrence of this disease are considered to be diseases of the genital organs, which can include such as:
- chlamydia
- mycoplasmosis;
- ureaplasmosis.
Arthritis often develops as a result of a previous chlamydial infection. The most common methods of infection are through sexual contact, however, bacteria can enter through the household and during childbirth. Pathogens that provoke intestinal diseases are introduced into the body along with dust, food, as well as by airborne droplets.
Reactive rheumatoid arthritis can occur after the course of infectious diseases and it is provoked by flu or cardiac pathologies that form against the background of the course of angina. Thus, predisposing factors are:
- infections affecting human organs and systems;
- hereditary predisposition;
- abnormal manifestations of immunity.
Knowing the causes of reactive arthritis, symptoms can be identified by the characteristics of the course of the disease in the body. Characteristic features help determine the presence of a pathological process in the body at the initial stages, which guarantees a more successful treatment.
Symptoms of the disease
Often, symptoms of reactive arthritis begin to appear in large joints, namely:
- Knees
- hip joints;
- elbows;
- shoulders.
Symptoms may occur immediately or some time after an infectious disease. Pathology affects the joint on one side and sometimes tendons, small joints, neck, and lower back region are involved in this process. Among the main symptoms of reactive arthritis can be distinguished such as:
- significant soreness in the affected area;
- aching or shooting pain;
- pain when touching the joint;
- swelling and stiffness;
- swelling of the limb;
- discomfort during movement;
- redness of the skin;
- temperature rise.
In addition, there may be systemic manifestations of reactive rheumatoid arthritis, which manifest themselves in the form of:
- inflammation of the kidneys;
- swollen lymph nodes;
- heartache;
- nervous disorders.
Signs of the course of concomitant diseases, in particular, such as:
- prostatitis;
- cystitis;
- intestinal disorders;
- conjunctivitis;
- vaginitis;
- skin rashes;
- erosion and ulcers of the mucous membranes.
Changes in the skin are characterized by the presence of rashes, localized on the palms and soles of the feet. Legs may gradually break down and take on a slightly yellowish tint.
The first symptoms of reactive arthritis in women occur 2 weeks after infection. As a result of this, the temperature rises in the affected joints, swelling, limbs begin to swell. In addition, pain can develop, which is most manifested when walking, as well as performing other movements of the affected limb. Discomfort can be felt during palpation in the affected joint.
A characteristic sign is stiffness of movements, provoked by a violation of the outflow of intraarticular fluid. A sick person cannot move normally or perform physical exercises. At the initial stage of the course of the disease, patients show signs of damage to the spine, diseases of the kidneys, heart, nervous system. In addition, there may be symptoms of malaise and sudden weight loss.
Reactive arthritis develops against the background of previously transmitted infectious diseases. Some of them are already passing by the time of joint damage, and many are transitioning to the chronic stage. In this case, in addition to the signs of arthritis, the patient also has the symptoms of infectious diseases.
Skin manifestations are quite rare. Usually they occur along with the articular manifestations of the disease. Such signs can be very different, from reddening of individual sections of the skin to the formation of small erosions. They may resemble skin lesions as in psoriasis.
In some cases, an autoimmune process can affect the functioning of other organs and systems, causing tissue inflammation. Damage to organs and tissues such as:
- kidney damage
- heart muscle;
- pericardium;
- nerves.
Symptoms can be very different, however, in any case, there are signs of joint damage. Other manifestations of the disease can occur only in some cases.
Diagnostics
Knowing the causes and symptoms of reactive arthritis, treatment should be carried out as early as possible, and for this, a comprehensive diagnosis is required to determine the characteristics of the course of the disease in the body. Diagnosis involves visual inspection of the patient to assess the potential threat to joint damage.
Often the disease is found in men of reproductive age. The doctor assesses the condition of the skin and mucous membranes, determines the presence of inflammation in the limbs. In addition, he must have an idea regarding previously transferred bacterial diseases of the genital area, as well as the intestines and stomach.
If you suspect a reactive course of arthritis, a specialist can prescribe additional studies, namely:
- blood and urine tests;
- analysis of feces for the presence of parasites;
- research on gonococci and chlamydia;
- determination of rheumatoid factor.
In some cases, a joint puncture is prescribed . In addition, radiography of the affected part of the body is required. If there are complaints of impaired activity of the heart muscle, echocardiography can be prescribed.
Joint radiography can be done even during pregnancy, if there is an urgent need. Modern devices make it possible to minimize the radiation dose and direct the rays into the joint area. Ultrasound examination consists in the study of limbs using sound waves. It allows you to identify a number of pathologies that can be completely invisible in an x-ray. Ultrasound can identify such signs of the disease as:
- tendonitis;
- bursitis;
- tenosynovitis.
In addition, this allows you to get complete information regarding damage to the kidneys and heart muscle, if the inflammation is too intense. Arthroscopy is a new research technique. It consists in introducing a small chamber into the joint cavity, which makes it possible to assess the state of tissues within the joint.
Treatment features
Treatment of reactive arthritis should be purely individual, and it is carried out in a hospital, as its course may be associated with the presence of infections. The goal of therapy is to eliminate the infection, as well as to reduce the progression of the disease. If there is a symptom of an infectious lesion, then antibacterial drugs are prescribed to eliminate the bacteria and the cause of the inflammation.
In addition, anti-inflammatory drugs are prescribed to treat reactive arthritis, which can reduce pain and joint inflammation. In severe stages of the lesion, injections of glucocorticosteroids directly into the articular region are sometimes prescribed. Since taking antibacterial drugs adversely affects the beneficial intestinal microflora, a course of probiotics is prescribed in parallel. Vitamins support the body's defenses.
Depending on whether the underlying cause of the infectious disease was conjunctivitis or urogenital infection, topical creams and ointments are prescribed. They contribute to the restoration of physiotherapy due to more active microcirculation of the fluid inside the joint cavity, enhancing the flow of nutrients and blood flow.
During the course of the active inflammatory process, significant loads should be avoided. However, after stopping the acute stage of the disease, it is recommended to gradually restore physical activity.
Depending on the symptoms of reactive arthritis, treatment is prescribed individually, taking into account the presence of concomitant pathologies and possible complications. Timely diagnosis is very important for the treatment. It is worth remembering that in the initial stages, the pathogen is more susceptible to the effects of medications.
Features of the disease in children
Reactive arthritis can occur at a very early age, when the baby is exposed to the harmful effects of bacteria and viruses, since it does not fully form immunity. Often, boys suffer from this disease.
The defeat of the musculoskeletal system is mainly associated with a hereditary predisposition and autoimmune pathologies. Symptoms of the disease in children can be less pronounced than in an adult. Often the child does not feel much discomfort during games and during the period of mobility. Soreness can occur only with pressure on the inflamed joint. Symptoms and treatment of reactive arthritis in children can be very different, however, among the main signs of the disease can be distinguished:
- swelling and redness of the skin in the affected area;
- urethritis;
- frequent conjunctivitis.
In this case, treatment must necessarily be comprehensive and qualified, as this will allow you to quickly get rid of the disease. Serious pathologies can develop without well-conducted therapy, leading to joint destruction.
Traditional Medicine Methods
Regardless of the cause, treatment for reactive arthritis in a child should be comprehensive. The goal of therapy is to eliminate the infection, complete recovery or achieve remission. The use of medications is necessarily indicated.
Basically, treatment is carried out in a hospital setting. For this, antibacterial drugs, anti-inflammatory drugs are prescribed. To eliminate chlamydia in children over 8 years of age, the use of fluoroquinolones and tetracyclines is indicated. A younger child is prescribed macrolides.
In addition, the use of immunomodulators is required that stimulate the body's resistance to various infections.
Therapy of arthritis, provoked by an intestinal infection, is carried out using aminoglycosides, and immunosuppressive drugs are also shown. With a continuous exacerbation, sulfasalazine is prescribed. The course of therapy and medicines is prescribed exclusively by the attending doctor. Treatment requires special care, since the child's body can respond to drugs completely unpredictably, up to an increase in inflammation.
Alternative treatment
Together with drug therapy, the use of alternative therapy methods is indicated. This implies the external use of compresses, ointments, applications. Usually, ointments are made on the basis of fat and an anti-inflammatory component, for example, honey or plant materials. Instead of fat, alcohol or vodka can be used for a higher concentration of the drug.
Hot pads with steamed herbs, in particular, such as:
- chamomile;
- hop;
- clover;
- elder.
You can apply herbs individually or in a mixture. To prepare the medicine, you need to heat the raw materials in a container with a small amount of water almost to a boil. Then fill the mixture with small linen bags and apply to the affected area for 15-20 minutes.
An effective means is a slightly heated leaf of cabbage. It must be smeared with honey, applied to a sore joint, wound tightly with plastic wrap and secured with a bandage. Wrap a warm scarf on top. It is advisable to do such a procedure at night.
You can apply a compress prepared on the basis of ammonia, bile, honey, iodine and glycerin, taken in equal proportions. The finished mixture should be left for 10 days in a dark place. Then take the required amount of the mixture, heat it in a water bath, moisten gauze in a solution and apply it to the affected area. Wrap on top and wrap with a woolen scarf. Such a procedure should be carried out daily until the symptoms are eliminated.
Dieting
Proper nutrition will help maintain health and restore strength. During this period of illness, the child should receive the most rich in vitamins and minerals food. It is recommended to exclude spicy and fatty dishes from your usual diet, replacing them with stewed and more lean ones. It is important to consume as much sea fish as possible, as the acids contained in its composition have a good effect on cartilage.
Some vegetables can trigger exacerbation of arthritis. Therefore, it is not recommended to consume eggplant, bell peppers, potatoes and tomatoes. Preference should be given to a salt-free diet with the mandatory inclusion of products containing calcium. It is important to follow a diet that helps lower acidity, therefore, the diet must include:
- poultry and fish;
- milk products;
- fish fat.
It is also important to eat a lot of vegetables and fruits, as they contain vitamins and antioxidants in their composition, which protect against negative external influences.
Prognosis after treatment
The prognosis after treatment is often quite good. Full recovery occurs literally in 6-12 months. Only in a few patients can symptoms return again or the disease progresses to a chronic stage.
Possible complications
The effects of reactive arthritis in childhood can lead to juvenile spondylitis. This pathology is a complex inflammatory process that affects larger joints. Sometimes patients may experience joint deformities or curvature of the foot.
In the absence of treatment or its complete absence, the disease can provoke joint ankylosis. In complex cases, myocarditis or glomerulonephritis occurs, which often lead to the death of the patient.
Prophylaxis
Knowing what causes, symptoms, treatment and consequences of reactive arthritis, it is important to prevent the occurrence of infectious diseases that provoke the formation of arthropathy. Preventive measures include:
- maintaining a healthy lifestyle;
- compliance with hygiene rules;
- consumption of fresh and quality food;
- the exclusion of hypothermia;
- timely vaccination.
In addition, it is important to use contraceptive methods during sexual intercourse, as well as timely contact a doctor for infectious diseases.