Joint psoriasis is an inflammatory process that occurs in a chronic form and affects the articular surfaces. According to statistics, from 8 to 10% of patients face such a problem as psoriatic arthritis. Joint psoriasis takes second place among diseases affecting bone tissue after rheumatoid arthritis. It is worth noting the fact that the disease never affects all the joints of the body. Psoriasis is inactive - a state of remission, and active - an exacerbation.
Classification
According to the international classification of diseases, the following types of disease are distinguished:
- Oligoarthritis is an asymmetric inflammation of several joints, but not more than three.
- Distal interphalangeal psoriatic arthritis. This disease is characterized by damage to the small joints of the fingers.
- Psoriatic spondylitis. This disease affects the spinal column and spreads to any of its parts.
- Mutating arthritis. This type of joint psoriasis affects the bones and causes their complete destruction. The disease can develop both in the upper and lower extremities, while swelling of the soft tissues is observed. Due to the destruction of bones, there is a further shortening of the fingers of the limbs.
- Symmetric polyarthritis. This disease is characterized by a symmetrical lesion of both limbs.
Signs of illness
Some symptoms of joint psoriasis are similar to signs of a disease such as rheumatoid arthritis. But there are a number of signs characteristic only for this disease.
- With psoriasis, joints located directly in the heel area are sore.
- Often not one, but several joints on the fingers are affected at once.
- The localization site is painted in a crimson color and swells. This can be clearly seen in the photo of psoriasis of the joints. In addition, with this disease, the temperature in the area of the affected joint rises.
- Pain on the big toe.
The disease affects mainly the joints of the fingers. Psoriasis of the knee joint is rare, but it is much more difficult. With this type of pathology, pain prevents the patient from climbing and descending stairs normally, the joint is deformed, due to which there is a limitation in the mobility of the knee. Ultimately, all this can lead to a complete loss of motor function.
Etiology of the phenomenon
The causes of bone psoriasis are still not fully understood, but it is believed that the main ones are:
- Injury to limbs and joints.
- Infectious and viral diseases occurring in severe acute form.
- Pathology can also develop when taking high doses of such drugs as “Vazokordin”, “Egilok”, “Atenolol”.
- Frequent stresses, psychoemotional disorders, nervous strain.
- High physical activity.
Risk factors
The risk of developing joint psoriasis is significantly increased in the presence of the following factors:
- Weakened immune system.
- Intoxication of the body due to prolonged use of medications, alcohol and tobacco products, as well as drugs.
- Metabolic disease.
- Genetic predisposition.
- Human Immunodeficiency Virus and AIDS.
- Overweight - obesity, overeating.
- Inadequate rest, that is, a violation in sleep and wakefulness.
- Physical overwork and emotional exhaustion.
- Work in enterprises with a high dose of chemical radiation.
Diagnostic measures
If there is a suspicion of psoriatic joint damage, the doctor carefully examines the patient, and then sends him to take tests and undergo all necessary examinations.
- General blood analysis. With psoriasis, ESR, globulin, sialic acids and fibrinogen increase.
- Roentgenogram. This analysis helps to determine a decrease in the joint space, which indicates the development of arthrosis. In addition, using x-rays, you can find out the degree of joint damage and the severity of the disease.
- The study of synovial fluid. This analysis is carried out only with damage to large joints. The development of arthrosis is indicated by a decrease in synovial fluid viscosity and increased cytosis.
- Differential diagnosis. It is prescribed in order to clarify the presence or absence of the disease. In this case, an analysis is carried out for the rheumatoid factor. If the answer is yes, then the patient has rheumatoid arthritis. A negative result means that the patient has psoriasis of the joints.
Drug therapy
The use of drug therapy is indicated to achieve the following goals:
- Stopping the progression of the disease and partial relief of inflammation.
- Elimination of discomfort and pain.
- Strengthening and supporting the immune system.
- Bringing back the functionality of the musculoskeletal system.
The treatment of psoriasis of the joints depends on the symptoms and associated signs of the disease. For therapy, the following groups of medications are used:
- Anti-inflammatory drugs of non-steroidal origin. This group helps to eliminate pain, significantly reduce inflammation and swelling of the joint, eliminate discomfort, manifested in the form of stiffness of movements. The main drugs prescribed for joint psoriasis are Ibuprofen, Diclofenac, Nimesulide, Voltaren, Piraxicam, Movalis and Methotrexate.
- Corticosteroids. This group of drugs helps the patient get rid of all the unpleasant manifestations of psoriasis of the joints. The most effective drugs for psoriasis include Dexamethasone, Prednisolone, and Hydrocortisone. The use of hormonal ointments for a long time can cause necrosis of the skin, so these drugs are prescribed in the form of injections directly into the cavity of the joints or muscles.
- Blood circulation improving drugs. This group of drugs includes Curantil, Drotaverin, Pentilin and Pyridoxine.
It is worth noting that the use of a drug such as Methotrexate should be used with extreme caution due to side effects that affect the functioning of the liver and kidneys.
If a bacterial infection is attached, the doctor may prescribe the use of a drug such as sulfasalazine. Due to the large list of side effects, this drug should be used with caution.
All drugs used for joint psoriasis should be prescribed only by a doctor, self-medication in this case is unacceptable. Since only a doctor can choose the optimal scheme and dosage individually for each patient.
Physiotherapeutic Activities
In combination with drug therapy for joint psoriasis, the patient is prescribed physiotherapeutic procedures. The main methods of such therapy are:
- exercises used in physiotherapy exercises;
- electrophoresis using analgesics;
- applications ozokerite;
- magnetotherapy;
- laser therapy;
- UHF and PUVA therapy.
Surgical intervention
Operations to eliminate joint psoriasis are extremely rare, since in most cases they are simply not necessary. Surgery is indicated only when no other methods of therapy bring the desired result.
One of the methods of surgical intervention is synovectomy. The main goal of this intervention is to restore the functionality of the affected joint.
In the most advanced cases, joint arthroplasty or cartilage endoprosthetics are used, in which the affected joint is replaced with an artificial one. Sometimes the patient undergoes surgical fixation of the cartilage of the wrist and ankle joint, as well as fingers on the hands and feet.
Many patients after surgery to eliminate joint damage in psoriasis experience significant relief. So, pain and discomfort disappear, joint functions are restored.
Power Features
Strict dieting is a very important factor in the treatment of joint psoriasis. From the diet should be completely excluded all pickled, smoked, spicy, salty, sweet, citrus fruits and alcohol.
The patient's daily diet should contain fermented milk products, herbs, fish, fresh vegetables, fruits, and vegetable oil. Overweight patients should follow a low-calorie diet and carefully ensure that the nutrition is necessarily fractional.
Forecast and possible complications
With untimely or improper treatment, psoriasis of the joints can lead to further disability of the patient. In addition, the disease can be fraught with the following consequences and complications:
- Ethnopathy. The inflammatory process develops at the points of attachment of the ligaments and tendons to the bone. This process is mainly observed on the feet. As a result, the functionality of the limb is significantly reduced, since when walking the patient experiences very severe pain, difficulties begin when trying to bend or straighten the toes.
- Dactylitis. Inflammation develops on the phalanges of the fingers. As a result of the pathology, the fingers greatly increase in size, pain appears, the functions of the hand are impaired, and, as a result, the patient cannot perform any finger movements. Often, dactylitis affects the toes, while the patient feels very severe pain while walking.
- Inflammation of the intervertebral joints. This type of complication leads to the fact that the patient experiences unbearable pain when trying to bend or straighten his back. The main location of the pathology is the area of convergence of the pelvis and spine.
Psoriasis is difficult to determine at the initial stage, so in most cases it is diagnosed at later stages, in which some consequences already appear. As a result, therapy is much more difficult.
The effect of joint psoriasis on internal organs
With bone psoriasis, the inflammatory process in the joints may be the only manifestation of the disease. But often this inflammation is part of such systemic diseases as pathologies of the gastrointestinal tract, kidney, liver and heart disease, polyneuritis, amyloidosis.
Diseases of this kind are difficult to determine at an early stage, since in this case the characteristic sign is only an increase in body temperature. The inflammatory process develops due to a violation of blood circulation in the vessels. In addition, antigens are deposited on the walls of blood vessels, leading to the appearance of seals and a decrease in tissue elasticity.
Preventive actions
There are no special preventive measures to prevent and prevent psoriasis of bones and joints. But doctors recommend observing a number of general measures that will help the body resist the development of the disease. The main ones are:
- Prevention of overload and injury to joints.
- Getting rid of bad habits, in particular the exclusion of alcohol and smoking.
- You need to eat only the right balanced food. Limit your intake of salt and sugar.
- Overeating and the development of obesity must be avoided.
- In the cold season, it is important not to overcool the joints, that is, to dress warmer.
- Periodically, you need to use mineral water from medicinal sources. If possible, you need to relax at sea.
It is impossible to completely get rid of psoriasis of the joints, however, following all the recommendations of the attending physician, you can bring the disease into a stable period of remission. Following the rules of preventive measures will help prevent the development of the disease.