Methods and standards for the diagnosis of arthritis, symptoms and treatment

Arthritis is an inflammatory disease of the whole body, in particular joints. The disease causes severe pain, which is significantly worse at night. The disease begins to develop in his youth from 30 years and older. Most often, women suffer from pathology, since they are transmitted a genetic problem, so early diagnosis of arthritis is very important.

Definition

The joint consists of a capsule, articular surfaces and a cavity with fluid, all covered with cartilage. With arthritis, inflammation occurs in its synovial membrane. Further, this process goes to other elements of the joint: capsule, cartilage, tendons and ligaments. At the time of the examination, a change in all parts is observed. In severe cases, there is complete deformation. Photos of the symptoms, treatment and diagnosis of arthritis are described below, so you can fully understand the clinic of this disease.

Locations

The skeleton is an integral system of flexible joints that allows a person to easily perform various movements. After the first signs of an ailment, this or that part begins to malfunction.

At the place of localization, the disease can be divided into the following categories:

1. Arthritis of the hands - such inflammation occurs in the elbow joint, shoulder, hand or individual fingers. The common cold and flu, as well as diabetes, tuberculosis and genital infections can affect the formation of the ailment.
2. Arthritis of the feet - covers the defeat of the knee joints, hip area and foot with finger grip. The reasons for the development are the same as in the previous version. Among the main symptoms, severe pain can be distinguished, which becomes greater at the time of movement, swelling and redness in this area, as well as the stiffness of movements. The diagnosis of finger arthritis is quite important, since the problem appears due to a hereditary factor, so if it is possible to prevent the disease, then it is better to do it.
3. And also the disease affects the cervical spine, such a pathology is found even in young people. The reason for this is a genetic predisposition, poor posture, bad habits, hypothermia, heavy loads and the presence of injuries and wounds in this department.

Symptoms

The methods for diagnosing arthritis are different, but in order to decide which ones to choose, you need to know the main factors that indicate the presence of the disease.
A pathology clinic develops with a general malaise, which is initially regarded as overwork or fatigue. However, all feelings gradually increase and soon affect daily functioning and activity.

The main sign of the disease is arthralgia, in which there is a steady wave-like character, significantly amplified in the second half of the night. Its intensity varies from minor pains to severe and severely limiting mobility.

A typical clinic for the diagnosis of rheumatoid arthritis and its other types is supplemented by local hyperemia and hyperthermia, feelings of stiffness, swelling and limited mobility. Palpation can determine the soreness of the entire plane of the joint and joint space. Further, deformation, as well as joint disruption, alteration of the skin and the formation of exostosis, join the listed symptoms.

If an infectious form is present, then chills and fever will appear.

Causes

The following factors of the onset of the disease are distinguished:

• bruises, repeated injuries, closed and open joint injuries;
• metabolic problems and lack of vitamins;
• fungal, infectious and viruses: colds, SARS, tuberculosis;
• diseases of the nervous system;
• physical overload;
• hereditary predisposition;
• immune disorders.

Very often, the ailment can occur due to hypothermia, excess weight, allergies, smoking and a sedentary lifestyle. Diagnosis of finger arthritis is most often performed by persons of such professions: seamstresses, hairdressers and masseurs. Problems with the spine are often found in loaders and builders.

Kinds

Arthritis is a very extensive disease, and therefore has many forms. It affects many parts of the body - both soft tissues and joints.

1. If you conduct differential diagnosis of reactive arthritis, you can determine that this disease develops under the influence of infections:

• intestinal, due to the use of low-quality foods;
• airway inflammation (tracheitis, pneumonia and bronchitis);
• Salmonella bacillus and other dangerous microbes that penetrate the joints with blood flow, causing inflammation;
• chlamydia, provoking the development of an infection of the genitourinary system.

Reactive arthritis has another subspecies - aseptic, which appears when the immune system forms antibodies that affect the cells of its own body, as it takes them for bacteria. As a therapy, Leflunomide, Sulfasalazine, ASD and monoclinal drugs are used.

2. Diagnosis of rheumatoid arthritis most often occurs in the later stages, since this disease is called "long-playing", it develops slowly and does not appear immediately. Most often, lesions form symmetrically and are localized in the limbs: ankles, knees, from the shoulders to the hands. The main reason is the failure of the immune system due to hormonal abnormalities or the virus. The walls of blood vessels begin to be perceived as harmful bacteria, and they are destroyed. In this case, it is recommended to use the “ASD” immunomodulator, the sulfasalazine antimicrobial drug, and Paracetamol as an anesthetic.

3. The differential diagnosis of psoriatic arthritis is very detailed, since this ailment belongs to genetic diseases, with it there are skin lesions in almost all representatives of the same family. In order for the disease to move from the outside to the inside, exposure to injuries and bruises, operations, wounds, childhood illnesses (scarlet fever, chickenpox), as well as shingles, hepatitis and even flu, is required. For therapy, it is recommended to take Sulfasalazine and Paracetamol as an anesthetic.

4. The treatment and diagnosis of symptoms of gouty arthritis is difficult, as this ailment appears due to the ingress of uric acid into the blood. The crystals settle in various tissues, thereby causing a lot of inconvenience. The main factor that provokes the disease is the problem with the kidneys, but often the development is observed with metabolic disorders. For treatment, it is recommended to use the above drugs.

Palpation and general examination

Diagnosis of arthritis begins with a general examination, which helps to see external abnormalities. Most often manifested by swelling in the area of ​​the joints. At the time of the examination, the doctor often asks the patient to make certain movements in order to recognize the nature of the pain and the area of ​​its spread.

Another and the most important method is feeling or palpation. With a touch, the doctor can evaluate the external signs of joint disease. Thus, rheumatoid or rheumatic nodules are easily found, and it is also determined where discomfort is observed during movements, the state of the joint capsule and the temperature are determined.

Diagnosis of arthritis with these methods is the most affordable, but it is carried out without the use of technical means, so it is difficult to imagine the full clinical picture of the disease.

Goniometry

This version of the examination is carried out using a goniometer - a device that allows you to identify the amplitude of joint mobility. It resembles a protractor and helps to calculate the angle of mobility. The patient performs a number of necessary manipulations (extension, bending, lowering, lifting), and the doctor fixes the measurements and compares them with the norm.

Laboratory methods

Such standards for the diagnosis of rheumatoid arthritis and other types of disease are more accurate, since detailed information about the patient's condition can be obtained.

1. Blood test - during a biochemical examination, the doctor will pay attention to the amount of c-reactive protein in the blood serum, to the diphenylamine reaction, as well as other indicators. A serious sign is to consider an increase in ROE (erythrocyte sedimentation reaction), since it indicates an inflammatory process. In the presence of pathology, immunological analysis shows antinuclear antibodies (ANA). And also it should be noted that the level of urea rises significantly.
   
2. Urinalysis - it should be noted that this indicator will be overestimated only with severe forms of the disease. In healthy individuals, protein in urine and blood should be absent altogether. Its appearance indicates the presence of the disease.

Radiation diagnostics

Clinic treatment for rheumatoid arthritis is impossible without such an examination. Allows you to study the condition and structure of joints in detail. No prior preparation required.

1. X-ray examination - an indication for the use of this technique is considered pain in the joints, difficulty in mobility and swelling. During the examination, the image of the joint is provoked onto a special film using rays. At the time of diagnosis, they are covered with a lead apron to protect all other organs. An x-ray will help to consider the pathology and deformation of the joints. Results will be presented after 15 minutes as a snapshot. This method of diagnosing arthritis is not suitable for pregnant women, since minimal radiation does occur.
   
2. Arthrography is more accurate than conventional x-rays. It is used for meniscus damage and at the time of suspicion of rupture of the joint capsule. Before the procedure, the joints begin to artificially contrast. For this, a special substance is introduced into the cavity, after which they ask the patient to perform several movements. At this point, the image is captured by targeted radiography. The outcome of the examination, depending on the apparatus, can be obtained on film or a monitor. The procedure takes literally 10 minutes, and there are no contraindications, with the exception of iodine allergy.
3. Computed tomography (CT) is performed to diagnose seronegative arthritis, and not only because it is very effective. The method allows you to evaluate the structure to a millimeter and take a picture in any plane. Such a diagnosis greatly facilitates the ability to make a diagnosis. At the time of the procedure, the patient is placed on the couch, which during the examination moves, and then a special tube amplifies and transmits the rays in the necessary sequence. Everything takes 2-3 minutes, and the degree of exposure is minimal. The result can be obtained both in the picture and in digital format.

Radionuclide methods

The study helps to identify pathology with the help of radiopharmaceuticals. The most popular method for diagnosing rheumatoid arthritis in the early stages is scintigraphy. During the procedure, radioactive isotopes are introduced into the body, and good images are obtained due to the radiation emitted by them. The procedure is performed using a tomograph.

Visualization is formed at the cellular level, this contributes to the visualization of functional changes that begin to occur in the body earlier than the anatomical ones. The procedure is completely safe, since gamma-emitting radionuclides with a short half-life are used. The main contraindication is pregnancy and lactation.

Joint MRI

Magnetic resonance imaging (MRI) is often used to diagnose rheumatoid arthritis in the early stages. It is carried out using strong magnetic radiation and radio waves. This all allows you to get a more accurate picture of the fabric. The patient fits inside the “tube” of the device and the main requirement for it is immobility, since the quality of the image will depend on this.

The technique allows you to examine in detail the clinical picture of injuries and degenerative ailments. The procedure takes 10-20 minutes, and the patient receives a conclusion after 20-30 minutes. MRI is considered non-hazardous, since the applied magnetic field does not pose a threat to the human body, so there are no serious restrictions.

Ultrasound diagnostics

Very often, ultrasound waves are used in the treatment and diagnosis of a rheumatoid arthritis clinic. A special apparatus provides the necessary frequency, which interacts with soft tissues and enters the examination area. Very often, ultrasound (ultrasound) is prescribed for injuries and rheumatic pathologies that are accompanied by inflammatory processes.

Sound vibrations are recorded by a special scanner, and the image is immediately displayed on the monitor, if necessary, it can be printed. In order to prevent air from appearing between the scanner and the examination site, the plane is lubricated with a special gel. The doctor passes the sensor through the body, and this does not bring the patient even minimal discomfort. Ultrasound is the safest procedure that can be performed during pregnancy.

International standards for ICD-10

In order for any doctor to find out about a patient’s illness in the event of going to a foreign hospital or center located in another city without a special examination, there is an international classification, which is presented below:

• M00 - pyogenic arthritis.
• M01 - direct infection of the joint in parasitic and infectious diseases.
• M02 - reactive arthropathies.
• M03 - reactive and post-infectious arthropathies, which are classified in other groups.
• M05-M14 - inflammatory polyarthropathies.
• M05 - seropositive rheumatoid arthritis.
• M06 - other rheumatoid arthritis.
• M07 - enteropathic and psoriatic arthropathies.
• M08 - juvenile arthritis.
• M10 - Gout.
• M11 - other crystalline arthropathies.
• M12 - other specific arthropathies.
• M13 - other arthritis.
• M14 - Arthropathies for other diseases classified elsewhere.

There are a lot of international standards for the diagnosis of rheumatoid arthritis, but thanks to such a classification, a doctor can always know in any situation what his patient is sick with.

Treatment

The etiological treatment of arthritis is performed only with certain forms of it - gouty, infectious and allergic.

1. Ailments with a chronic and subacute course are subject to a single pharmacotherapy with the use of anti-inflammatory steroid ("Methylprednisolone", "Prednisolone") and non-steroidal ("Ibuprofen", "Naproxen", "Diclofenac") drugs. Synthetic steroids are often used for implementation in the deepening of the joint (medical puncture).
2. As the acute inflammatory process subsides, physiotherapy (erythrocyte ultraviolet irradiation) in erythema doses, phonophoresis with hydrocortisone, electrophoresis with analgesics, amplipulse therapy), which has anti-inflammatory and analgesic effects, prevents joint dysfunction and is actively connected to drug therapy.
3. It is also recommended to use massage and physiotherapy exercises, as these procedures for arthritis are aimed at preventing the development of functional disorders and contracture in the joints.
   
4. As a rehabilitation complex, balneotherapy, mud therapy, spa and sanitary therapy can be used.
5. The use of efferent therapy techniques (cryophoresis, plasmapheresis, cascade fixation of blood plasma), focused on extracorporeal absorption of antibodies in autoimmune arthritis, urate and gouty flow. When using extracorporeal pharmacotherapy, the patient’s personal blood cells (red blood cells, white blood cells, platelets) are used to correctly deliver the drug components to the focus of inflammation.
6. As a treatment for severe forms of arthritis, stem cell insertion is often used. Such treatment helps to improve the nutrition of the tissues of the joint, resume metabolism, subside inflammation and increase immunity to infections, which very often cause the disease. The incredible value of stem cells can be traced in the stimulation of cartilage regeneration, as well as the restoration of its structure.
7. In some cases, surgical intervention is required - synovectomy, resection of the joint, arthromy, arthrodesis, hailectomy, atroscopic dislocation.
8. If there are destructive changes in the joint that are caused due to arthritis, endoprosthetics, as well as reconstructive arthroplastic surgery, are indicated.