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Arthritis of the knee

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Pain in the knee joint may be “natural” (also called functional), and, which is much more common, may be a manifestation of some kind of disease. The so-called functional pain of origin is akin to that which occurs after overloading the muscles with physical work in the country or in the gym, quickly passes. However, if there are signs of inflammation, or arthritis, the knee joint is a signal for urgent medical consultation.



What is knee arthritis?

Артрит коленного сустава The knee joint consists of bones, intra-articular structures (for example, menisci, articular cartilage), ligaments that hold this structure in a certain position, and the inner lining of the joint (synovial membrane). Inside the joint there is normally a small amount of fluid, which plays the role of a lubricant and a “nutrient solution”.

The classic signs of inflammation are dull, arching pain, enlargement of the joint and smoothing its contours (edema), reddening of the skin above the joint surface (optional), temperature increase in the knee area, inability to fully support the leg or increased pain when trying to bend or straighten the leg at the knee.

What causes arthritis?

Specialists in the treatment of diseases of the musculoskeletal system have to deal with such causes of arthritis:

- “inflammatory”, or autoimmune, rheumatological disease ( rheumatoid arthritis , spondylitis, psoriatic arthritis , gout , systemic lupus erythematosus, and some others). In these cases, inflammation inside the joint is caused by a “breakdown” in the immune system, in which the body’s own defense cells begin to attack their own cells of the articular inner lining.

- osteoarthritis in case of its exacerbation . Osteoarthritis is a disease of the musculoskeletal system, which is not very well called "degenerative." It occurs in people of physical labor, in those who often walk a lot, especially the stairs, as well as in athletes (often regardless of the sport, the heavyweight weightlifters suffer as often as track and field athletes). "Victims" of osteoarthritis are with equal frequency of men and women. Even the development of this disease is promoted by flat feet, which are not adjusted in time, the wearing of uncomfortable shoes, including high heels, in a word - any inadequate load on the legs in general and on the knee joint in particular. "Natural" load - the weight of a person's body that exceeds the norm itself is a fairly serious risk factor for osteoarthritis, the first sign of which may be inflammation of the knee joint.

- post - traumatic phenomena (if there was a dull joint injury, sprain or rupture of ligaments or intra-articular structures, which often happens, for example, when falling from alpine skis).
- in isolation, there is a Baker cyst - intra-articular fluid formation, periodically filled with synovial (articular) fluid. Such a "bag" can deliver a lot of trouble, if it increases to a large size (sometimes up to several tens of centimeters), or fester.

- infection . Several dozen microorganisms and viruses that can cause inflammation of the knee joint have been described. These include chlamydia, ureaplasma, streptococcus, herpes virus, and hepatitis ... If you can identify the pathogen and pick up the appropriate medication, arthritis disappears without a trace.
-inflammation against the background of a common disease Unfortunately, such severe conditions for the body, such as cancer, HIV infection, tuberculosis , sarcoidosis and some others, can occur with symptoms of arthritis. Such diseases are not so common, and are usually accompanied by weight loss, loss of appetite, weakness, shortness of breath on exertion, pallor, and pouring sweat. An experienced therapist, summing up all the data, without special difficulties will reveal the true "culprit" of arthritis, and, with successful treatment, pain in the joints disappear just as it appeared.

Why does the joint swell, expand, and hurt?

The main reason is the accumulation of a large amount of fluid inside the knee joint. The “bursting”, “dull”, “oppressive” nature of pain is then explained by purely mechanical reasons. The fluid presses from the inside on the walls of the joint, and, not finding a way out, causes painful sensations. In addition, the fluid formed in the knee joint during inflammation contains a huge amount of irritating intra-articular structures of substances. These substances additionally cause the production of fluid - and it turns out a vicious circle. The third cause of inflammation and pain is the settling of uric acid crystals (popularly called “sand”) in the joint. These crystals are the smallest needles that cause microdamages to the intra-articular structures, the synovial (articular) membrane, contributing to the development of arthritis.

Symptoms of Knee Arthritis

What worries a patient when it comes to the knee joint? As a rule - dull articulating pain, inability to bend or flex the leg, less often - “jamming” of the joint. Often, a crunch or a snapping sound is disturbed when flexing or extending a leg in one knee joint or both. Here it is very important to clearly formulate - when it hurts, at what time of the day, and at what load.

What is heard? Conversation with the patient.

The very history of the appearance of pain in the knee joints may already push the doctor to the idea of ​​the diagnosis.

  • First, the doctor will eliminate the post-traumatic nature of the inflammation.
  • Secondly, he will ask questions about the presence of "inflammatory" diseases among relatives. It is known that diseases such as rheumatoid arthritis, spondylitis (simultaneous damage to the joints of the extremities and the skeleton of the spine), as well as some others, can be inherited.
  • Third, clarify the condition of other joints. It often happens that the leading complaint of the patient at the reception is pain in the knees, and during questioning it turns out that in the morning it is difficult to bend or flex the fingers, or at night there is pain in the lower back, or it has become difficult to shoe because of swelling of the ankle joints. The so-called "multiple" lesion of the joints is the hallmark of some inflammatory rheumatological diseases, as well as polyarthritis in some "common" diseases, such as cancer.
  • Fourthly, it is very important to clarify the general condition and well-being of the patient. It usually does not suffer from post-traumatic arthritis and osteoarthritis.

What can be seen during the examination?

On examination, the presence of skin defects - bruises, scratches, injections - will strengthen the doctor in the opinion that he has a patient with post-traumatic arthritis. It also happens that the injury only “launched” the autoimmune process, but this happens much less often. The doctor registers the presence of signs of inflammation (in detail, we stopped at them at the beginning of the article), signs of arthrosis. The latter are determined by the presence or absence of pain when you press on certain "pain" points and samples with "passive" movements.

Surveys Which specialist to contact?

  • Orthopedic surgeon . Most often, patients with diseases of the musculoskeletal system, patients turn to surgeons or traumatologists. Or to traumatologists-orthopedists, if available in the clinic. This is where the first diagnostic search and the first diagnostic errors occur. Orthopedists are rarely well trained in rheumatology, their task is to diagnose and treat post-traumatic changes in the joint.
  • Therapist . This is the doctor to whom the patient turns, if in addition to pain in the knee joint there are so-called “general” complaints: increased body temperature, weakness, weight loss, morning stiffness in the body or individual joints. The therapist is the person who can (and should) suspect the presence of an "inflammatory" rheumatological disease and prescribe at least a blood test. Further along the chain, the patient is usually sent to a rheumatologist.
  • Rheumatologist . The best option for the patient. Narrow-specialization allows rheumatologists at the stage of examination and questioning to come as close as possible to the cause of the problem, prescribe the necessary follow-up examination and select the right treatment as soon as possible. Often, the prescribed drugs determine the patient's prognosis for work capacity, physical activity, and sometimes for life just in time.
  • Infectionist . Solves a fairly narrow range of problems, but is necessary when it comes to arthritis associated with infection. To be sure that the pathogen is removed from the body permanently and arthritis does not recur, regular control is needed, which is carried out by an infectious disease specialist.

Diagnosis of Knee Arthritis

To clarify the diagnosis, in addition to laboratory methods, the so-called instrumental are widely used. Well, when we have the whole arsenal of diagnostic procedures at our disposal, we can choose the most informative ones that are most suitable for the clinical situation.

- X - ray . The cheapest, but not sufficiently informative method. It will allow to evaluate the structure of the bone: are there any gross bone destruction, excessive bone proliferation (this is called “proliferation” and is similar to the formation of growths or spines). In some cases, the gap between the large bones will be narrowed, in other cases - widened. All of these are indirect signs by which an experienced radiologist may suggest, for example, the presence of osteoarthritis.

- Ultrasound (ultrasound) . This method of research is highly respected by surgeons, because, unlike X-ray, ultrasound allows us to understand what is happening with the soft structures of the joint - ligaments, tendons, meniscuses - suffering primarily from injuries. With this method, it is possible to identify articular "bags" filled with fluid (Baker's cyst), due to which the joint can "wedge". Many devices now have the opportunity to see deposits of uric acid crystals, which in most cases confirms the diagnosis of gout.

- MRI (magnetic resonance imaging) . An expensive, fairly informative method that serves to detect a small amount of fluid, the initial signs of destruction of bone tissue, tears of the meniscus, in general, those changes that are not visible on the X-ray or ultrasound.

- Arthroscopy . The only method that allows "live" to see the joint from the inside. Through special punctures a video camera is inserted into the flexible conductor, which allows the doctor to assess the situation as accurately as possible. The disadvantages of this procedure are the need for anesthesia, a rehabilitation period of several days long, and possible complications (including suppuration of the joint).

- Laboratory methods . Using a blood test, you can determine whether the occurrence of arthritis is a symptom of an autoimmune disease, or is it a manifestation of inflammation in the joint area, which does not apply to the entire body. The second situation is much more comforting for both the doctor and the patient.

Common signs, or rheumatologists, of systemic inflammation include:

  • increased ESR (erythrocyte sedimentation rate)
  • inflammatory changes in the body "will confirm" an increase in the level of leukocytes and lymphocytes (these indicators will also be increased in infectious (reactive) arthritis).

Biochemical analysis of blood will be useful, first of all, to determine the level of uric acid in the blood (this is primarily a sign of gout), as well as to determine possible contraindications to the prescription of drugs (increased liver enzymes).

Immunological analyzes are the most expensive, but also the most informative studies. Without going into particular details, we just say that a single immunoassay may be enough to make a diagnosis.

And what if all the test results are negative, there is no inflammation, but the phenomenon of arthritis is pain, swelling is there?

In this case, a complex treatment of osteoarthritis or post-traumatic phenomena is prescribed (the diagnosis is clarified using instrumental methods of research).

Knee arthritis treatment

The main thing that bothers the patient with knee arthritis is how to relieve pain. For the first time confronted with such a problem, they start to take uncontrolledly tablets of nonsteroidal anti-inflammatory drugs, or, even worse, to inject them intramuscularly. These drugs are randomly sold in the pharmacy network, like vitamins or cosmetics! But after all, every medicine except indications (pain, inflammation) has its own contraindications. This pharmacists usually do not know, or do not consider it necessary to remind.

For example, that nonsteroidal anti-inflammatory drugs should not be taken for gastritis and ulcers of the stomach and intestines, as well as for hemorrhoids and coronary heart disease.

However,

  • Non-steroidal anti-inflammatory drugs are drugs that usually start the treatment of arthritis of the knee joint.
  • "Local" treatment - a variety of gels, creams and ointments containing the same non-steroidal means - can be applied quite freely if there is no skin reaction to the medication used (redness, itching, peeling). In case of intolerance of the gel or ointment, it should be canceled, and later, after the skin condition is normalized, local treatment can be resumed by another means.

Treatment of autoimmune diseases is carried out only by a rheumatologist under strict control.

Special preparations are used, which suppress the "raging" immune cells exactly where it is needed.

  • Preparations from the group of chondroprotectors require patient patience, perseverance in achieving the intended goal and a clear understanding of the meaning of treatment: slow (otherwise it will not work) and a gradual improvement in the structure and, therefore, the function of articular cartilage.
  • Physiotherapy treatment. It is used for osteoarthritis, post-traumatic arthritis, gouty arthritis. These are the procedures so much loved by “spa visitors,” based on the effects of magnetic, ultrasonic waves, weak laser radiation, and local application of cold. When autoimmune diseases can cause even more aggravation.
  • Fixation, or orthotics of the joint. The purpose of this treatment is to give rest to the inflamed joint, to unload it. Bandages, orthoses, elastic bandaging are used.
  • Intra-articular and periarticular steroids - the rapid achievement of anti-inflammatory effect. This method of treatment should not be confused with the surgeon’s favorite “blockade” when novocaine solution is injected at certain points around the joint for pain relief (this procedure is performed, for example, by football players during a match when there is no possibility to rest the injured leg). Steroid or glucocorticosteroid drugs can not be administered more often than 1 time in 3 months, in addition, they can cause quite serious side effects.
  • Hyaluronic acid preparations. They are prescribed for osteoarthritis and are a “prosthesis” of synovial fluid. In the classical course of osteoarthritis, synovial fluid in the knee joints is small, it is viscous and does not adequately fulfill its role of damping and cartilage feeding. The introduction of these drugs directly into the joint with a syringe allows you to achieve a long-term analgesic and, most importantly, improving the very structure of the joint effect.

Recommendations for patients with osteoarthritis of the knee

1. Power. When the disease of the musculoskeletal system of any special diet, except in the case of gout, is not required. If gout is detected, it imposes certain restrictions on the patient: it is necessary to exclude from the diet “red” meat (beef, veal, mutton), tomatoes, smoked meats, spices, fresh leafy greens, alcohol.

2. Treatment of the underlying disease, the manifestation of which was arthritis of the knee joint. It is necessary to tune in for quite a long, perhaps for several months or even years, treatment with repeated courses. But the walk is worth it, isn't it?

3. Fighting overweight is the cornerstone for most patients with osteoarthritis. It must be remembered that human joints are “calculated” by nature for a certain weight, and not for the one we like.

4. Physical therapy, swimming, cycling. Sufficient physical activity is vital for those who are faced with the problem of osteoarthritis.

5. When walking on foot, it is strongly not recommended to make ascents and descents along stairs, this increases the "wear" of the knee joints.

6. You should not be stingy and buy good quality, if possible orthopedic shoes or order orthopedic insoles for an individual impression. Как и физкультура, занятия в бассейне или прием назначенных лекарственных препаратов – это финансовое вложения в собственный организм, который ответит взаимностью в ответ на заботу!


15 Январь 2014 | 13 853 | Uncategorized
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Rheumatoid Arthritis Eliminators: Doctors who focus on killing mycoplasma bacteria to help stop rheumatoid arthritis pain, here on YouTube: https://www.youtube.com/watch?v=t50KMb2CfDE

DNA Leguillou: And nobody understands it unless they have it. I've lost family because they think I have too much drama, when the drama is really that I'm going handicap quickly and I have nobody to help me 😥. Mine is severe. Those meds don't work for some of us who have it really bad btw

RXU Entertainment: Yesterday I Was At The Fin Throw Ball Match In My School And Our Team Was One Score Away From Winning, Same As The Other. But While Catching The Ball, My Nail Spanned Inside My Finger. I Don't Know How To Explain But Like The Ring Finger Of The Right Hand Bended And My Finger Hone Broke, Sadly, We Lost The Match. But My Team Members And Coach Was Not Disappointed At All. They Said *"We'll Do Better Next Time"* And My Coach Said *"Even If You're Hurt, You're Still Strong My Child"*

Bryan Boria: Anyone figure out a solution? I have pain in every single one of my fingers And it hurts to even grip or flex my fingers & the muscle feels super tight.

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