Arthropathy combines a group of pathologies with different developmental mechanisms and causes. Most often, the knee joints suffer from this ailment. Therapeutic measures are primarily aimed at eliminating the provoking factor of the disease.
Arthropathy - what is it?
This pathology is a secondary trophic change in the joint. As a rule, it occurs against the background of a recent infectious disease. Arthropathy is characterized by certain symptoms, so doctors quickly recognize it and prescribe effective therapy. This ailment appears in stages or suddenly. In addition, it may be accompanied by unexpected exacerbations and remissions. In medical terminology, the described disease is also known as reactive arthropathy. What is it, then we will consider in more detail.
Quite often, pathology is accompanied by Scheuermann's disease. It should be noted that with the development of reactive arthritis, from 2 to 5 joints, and sometimes more, can be destroyed. The named disease is almost the same in both adults and children. Although the men most often undergo knee joint changes are men aged 20-40, leading a hectic life and constantly changing sexual partners, especially HIV-infected people.
Classification of Arthropathy
The defeat of the knee joints during the development of this disease is divided into certain types:
- Dystrophic arthropathy. May appear if cartilage malnutrition has occurred. Basically, the disease occurs in old age due to general degenerative and dystrophic changes in the body.
- Reactive arthritis. With this pathology, the patient feels pain in the knee. The basis of its developmental mechanism is the reaction of tissues and cartilage to various systemic diseases: endocrine disorders, oncology, leukemia, polyneuropathy or syringomyelia.
- Pyrophosphate arthropathy. During it, the metabolism of calcium salts in the body is disrupted, due to which sediment falls on the surface of the cartilage. This process occurs due to hypocalcemia, chronic infections, or knee injuries.
- Hereditary arthropathy. The disease is transmitted genetically, and can manifest itself in childhood.
- Diabetic arthropathy. Pathology develops as a result of complications of diabetes. It worsens the patient's ability to work, in addition, often becomes a cause of disability.
- Idiopathic arthropathy. This group included the disease of the knee joints, in which they could not identify the provoking factor.
- Psoriatic arthropathy. This inflammatory joint pathology of a chronic nature is usually associated with psoriasis. But not all people with this diagnosis develop psoriatic arthritis.
The main causes of trophic changes in the joint
Arthropathy - what is it? A similar question today arises among many people. This disease belongs to the group of autoimmune joint lesions, in other words, it is close in origin to diseases of the immune system. The essence of such pathologies is that after a bacterial infection enters the body, the immune system begins to "go crazy" by attacking its own tissues.
Some genetic failures are considered to be a predisposing factor for arthropathy. If a person has a certain type of histocompatibility gene, then the likelihood of the described ailment is many times greater.
There are other causes of the disease. For example, most often arthropathy of joints develops as a result of infection with chlamydia. Moreover, this disease appears most often in men. In addition, various pathologies of the respiratory tract can lead to the development of tissue and joint damage: bronchitis, laryngitis, tracheitis and others.
Often the cause of arthropathy is intestinal infections, especially dysentery and similar ailments. Unsuccessful vaccination or treatment with immunological preparations based on antibodies sometimes leads to joint damage.
Signs of illness
Arthropathy, the symptoms of which can increase in a matter of hours or days, has an acute onset and development. In this case, deformation of the knee joint occurs, in addition, as a rule, the release of fluid into the surrounding tissue structures and into the own joint cavity is noted. Edema appears not only due to an increase in the volume of the knee, but also as a result of the growth of the ends of the bones.
It should be mentioned when speaking about the diagnosis of "arthropathy" that this is a disease that can ultimately lead to the destruction of cartilage or bone tissue. But, despite the mentioned changes, strong pain, as with other pathologies of the knee joints, is not observed. Despite the fact that in some cases fragments of cartilage and bones in the joint bag are even visible on the x-ray.
In the affected joint, the range of motion is initially limited, but later, with severe destruction, dislocations are not excluded. That is why it is so important to start timely treatment, otherwise the knee may cease to fulfill its function, leading to disability.
Sometimes with such a disease in patients, body temperature rises, and when probing the joint, pain sensations of different intensities appear, depending on the stage of the pathology. The skin in the affected area becomes hot to the touch.
The described ailment can occur in mild, moderate or severe form. In the first case, the patient practically does not suffer from stiffness of the knee, he easily moves and feels pain only with heavy loads. With more severe degrees, the stiffness of the joint increases, and in advanced cases the leg can become completely uncontrollable.
Children's knee arthropathy - what is it?
Arthropathy, unfortunately, does not have a certain age, it occurs as often in young patients as in adults. True, the causes of its occurrence are slightly different. In many cases, a change in the joint in children occurs due to certain ailments:
- allergic pathologies, especially due to medication;
- tick-borne borreliosis or brucellosis;
- viral infections - mumps, rubella or chickenpox;
- neuro-arthritic diathesis that occurs in babies with increased nervous excitability and impaired metabolism;
- blood vessel diseases.
According to statistics, most often arthropathy of joints appears in young patients aged 10 years and older. Their disease is almost painless, which makes diagnosis difficult. As a rule, in case of damage to the joints, the child's temperature rises and overall health worsens, while the knee only bothers when moving and, as a rule, passes independently at rest.
The danger of arthropathy in children is also that it can quickly deform and destroy a joint that has not been fully formed. In addition, in young patients there is a special form of joint disease - juvenile rheumatoid arthropathy. This disease occurs only until the age of 16. With such an ailment, the following symptoms are characteristic: rashes on the skin, lesions of the lymph nodes, leukemia and high fever. The reason for the appearance of the named pathology is still not known.
In some cases, this type of arthritis in babies passes on its own, and in the rest, recovery occurs only after 6-9 months of treatment procedures.
Diagnostic measures
To make an accurate diagnosis, the medical history is of great importance. It is important to find out the nature and time of the onset of pain, the presence of damage in the anamnesis, as well as concomitant somatic pathologies, such as gout, diabetes mellitus or rheumatoid arthritis. Moreover, the specialist will need information about surgical interventions, existing infections and general symptoms.
Using a physical diagnosis, the doctor will determine the presence of a crisp sound, local pain in the area of the knee joint, possible range of motion, swelling or swelling in it. In addition, a specialist can conduct functional tests to identify possible instability.
Then the patient will have to undergo laboratory tests. To detect an inflammatory process, it is enough to take a blood test. A biochemical examination will help identify metabolic disorders. And in order to determine whether there are specific antibodies in the body to their own tissues or infections, enzyme immunoassays are performed.
Radiography is done to identify osteophytes, subluxations, enlargement of joints, thinning of cartilage. They also resort to computed tomography and magnetic resonance diagnostics. If there is a suspicion of differentiation of stress fractures or oncology, then bone scans using radioisotopes are performed.
Therapeutic measures
Arthropathy, the treatment of which involves taking various medicines, undergoing physiotherapeutic procedures and local therapy, requires a lot of patience and strict observance of the specialist’s prescriptions from the patient. When choosing treatment tactics, his individual approach to each patient is required.
They begin to treat arthropathy with medications aimed at eliminating inflammation and chlamydial infection, which could provoke the appearance of pathology. Non-steroidal drugs are prescribed to people with the described diagnosis to reduce pain and inflammation in the joint. The most common of these medications are Ibuprofen, Diclofenac, Piroxicam, and Naklofen. But a long uncontrolled use of these drugs can lead to the appearance of gastropathy.
If non-steroid drugs do not help in the treatment of arthropathy, it is better to switch to glucocorticoid drugs. The most effective in this case are "Methylprednisolone" or "Prednisolone". And to avoid ulcers, dyspepsia and erosion associated with the use of non-steroidal drugs, it is necessary to take "Misoprostol" or "Famotidine".
When antibiotic therapy is used, drugs from the group of fluoroquinols and macrolides, as well as from the tetracycline series: "Minocycline", "Spiramycin", "Ofloxacin" and others. The duration of treatment is at least a month. But in order to completely get rid of chlamydia, in addition to antibiotics, it is recommended to take medications aimed at restoring the intestinal microflora: Acipol, Lactobacterin, Linex or Bifiform.
If necessary, a puncture of the diseased joint is also carried out in order to introduce glucocorticoid drugs inside and remove exudate. People suffering from reactive arthropathy of the ankle and knee joints are usually prescribed Diprosan for this.
For local therapy, applications from dimethyl sulfoxide are used, as well as anti-inflammatory creams and ointments: Dolgit, Fastum Gel, and Diclofenac. Pathological changes that occur on the mucous membranes and skin integuments, as a rule, do not require special treatment.
Physiotherapy for joint damage
If the pathology has passed into the subacute stage, then physical therapy exercises, massage and various procedures are added to the main therapy. The most effective in this situation are:
- electrophoresis;
- paraffin baths;
- laser therapy;
- magnetotherapy;
- ultraviolet radiation.
Dispensary observation
Patients who have undergone arthropathy are regularly monitored by a rheumatologist or therapist for six months. In addition, they must undergo clinical and laboratory monitoring every 60 days. The prognosis for reactive arthritis in many cases is quite favorable and optimistic.
The duration of the disease is usually about 3 months, but in some patients it can become chronic with characteristic clinical manifestations of damage to the mucous membranes, eyes, joints and skin.
How to avoid arthropathy
It is necessary to begin the prevention of the described pathology from childhood. In order to prevent the appearance of reactive arthritis, the child must be treated in a timely manner all infectious diseases, you can not let the processes go by their own accord. Moreover, this should be done strictly under the supervision of a doctor until complete recovery.
In the place of residence, it is important to ensure normal air circulation and humidity, as well as to maintain cleanliness. Do not forget about personal hygiene. Pets also need to constantly bathe, using special shampoos.
If you experience first suspicions of arthropathy, consult a doctor immediately. Only after a comprehensive examination is an accurate diagnosis made and effective treatment prescribed. If the fears are confirmed, then you will have to be observed by a rheumatologist and strictly follow all his recommendations.