Arthritis of the shoulder joint: symptoms, treatment
Inflammatory process in the humeral articulation - a pathology rare enough. In the human body, the small joints of the upper and lower extremities, as well as the spine, are most vulnerable and subject to inflammatory changes. The shoulder joint is a fairly large joint, the inflammatory process enters it only in the case of a serious disease. However, the defeat of this particular articulation introduces significant inconveniences and suffering to the patient, chronic arthritis is the cause of a person's severe disability. When the shoulder joint is damaged, the lower limb sections can not function properly, so the mobility and other functional capabilities of the elbow joint and hand are limited. In addition, the diseases of the shoulder joint can be accompanied by a pronounced pain syndrome, which causes the limitation of movements in the thoracic and cervical spine.
Causes and features of inflammation of the humerus
The causes of arthritis of the brachial articulation are as follows:
- purulent microbial agents (staphylococcus, proteus, streptococcus, Pseudomonas aeruginosa) that enter the articular cavity as a result of the generalized septic process;
- Tuberculosis bacillus, which affects the joint in severe forms of infection;
- causative agent of brucellosis;
Brief description of selected types of shoulder arthritis
Purulent arthritis of the shoulder joint
The inflammatory process in the humeral articulation develops as a result of a purulent microbial flora entering the joint capsule with blood flow. The first clinical signs of a septic condition are high fever, severe weakness, severe pallor of the skin, disruption of the cardiovascular system. Actually arthritis of the shoulder joint is manifested by reddening and swelling of the skin and soft tissues around the joint, painfulness when feeling. Pain in the joint, as a rule, is quite intense, increases with movement, in connection with this, the mobility of the upper limb is severely restricted. When puncturing the joint from the cavity, purulent contents flow out. The treatment of purulent arthritis of the shoulder joint involves the use of powerful antibiotics with a wide range of effects, as well as detoxification therapy. During rehabilitation, various physiotherapeutic procedures are shown: UHF, magnetotherapy, electro-ionophoresis.
Rheumatic arthritis of the shoulder joint
This disease is allergic-infectious nature. It is caused by hemolytic streptococcus, in the future, allergic and autoimmune processes are of primary importance. Rheumatism is characterized by the symmetry of the affected joints. In the case of rheumatoid arthritis of the shoulder joint, pain and limited movement are observed. A person, as a rule, complains not only of pain in the shoulder, but also of the morning stiffness in the humeral joint. The treatment uses a combination of steroid hormones and NSAIDs.
Tuberculous arthritis of the shoulder joint
Tuberculosis infection, encompassing bone tissue, can be observed at any age, but is more typical for children of childhood. Often, bone tuberculosis develops in the body, extremely weakened by other diseases or in the case of a serious untreated or incorrectly treated infectious process.
The initial signs of the tuberculosis process are not so much local changes in the joint as symptoms of general malaise. A person for a long time worried:
- elevated temperature (often subfebrile, rarely - high);
- unmotivated sweating, especially at night;
- increasing general weakness;
- fatigue and a general decline in strength, which do not disappear even after a long rest.
In the joint itself, the tuberculosis process passes through several stages, which replace one another and can be quite long. At the stage of pre-dentritic general signs of tuberculosis infection dominate, changes in the shoulder joint are little pronounced or absent.
The next stage of tuberculous arthritis is actually arthritic, when bone and cartilaginous tissues of the shoulder joint are involved in the process. There is pain in the shoulder, usually moderately intense and increasing with movement, giving back to the shoulder blade or back. There is a limitation of mobility of the shoulder: a person with difficulty lifts and lowers his arm, can not hold his hand for a long time in the raised position. In the humerus (tubular part or more often the head of the bone), the formation of sequestrants (cavities) and the phenomenon of caseous decay (within the cavity the curdled masses of the destroyed cells are detected).
In the absence of proper treatment in the shoulder joint, dystrophic and deformational changes begin to dominate. On the radiographic image (in the lateral and direct projection) there is a narrowing of the joint gap, osteoporosis of the bone (decrease in density as a result of calcium reduction), the formation of pathological bony outgrowths, the presence of tuberculosis cavities, the structure of the humerus (trabeculae) of the humerus.
In the future there is a shortening of the upper limb, a fusion of the joint gap, that is, ankylosis of the joint develops. This makes it almost impossible for a full movement in the shoulder joint and the whole limb as well. The phenomenon of osteoporosis and the presence of tuberculosis sequesters lead to increased fragility of the bones, which in turn leads to an increased risk of fractures.
Treatment of tuberculous arthritis of the shoulder joint is very long and not always successful. Therapy provides for the hospitalization of a patient in a specialized medical institution. An important aspect of successful treatment is the immobility of the shoulder joint until the inflammatory process subsides. For this, a special plaster bandage is applied, which fixes not only the shoulder joint itself, but the entire limb as well as the upper part of the trunk. The second important point is the appointment of a long-term course of a combination of 3-4 antituberculous drugs.
In the acute period of the tuberculosis process, physiotherapeutic procedures and local remedies are categorically counter-indicative. A person with tuberculous arthritis is recommended to have high-calorie, enriched with minerals, vitamins and microelements of nutrition, in the absence of other open forms of tuberculosis (for example, infiltrative pulmonary tuberculosis) - staying in fresh air in the conditions of specialized sanatoriums in a certain resort climatic zone.
After the abating of active tubercular inflammation, it becomes possible to perform an operation to replace the shoulder joint - replacing the deformed structures with an artificial joint.
Brucellosis arthritis of the shoulder joint
This is a specific inflammation of the humeral joint, which is most common in the countries of Central Asia, as well as in the Mediterranean basin (Maltese or Mediterranean fever is one of the names of this infection). For this infectious disease, a professional character is typical: people who work with large and small cattle (livestock keepers, veterinarians, meat-packing plant workers) suffer from this disease. Frequent cases of brucellosis among people who like to eat milk and dairy products that are not subjected to heat treatment (cottage cheese, brynza).
One of the manifestations of brucellosis is a specific lesion of the musculoskeletal system, in particular, of the shoulder joint. Characteristic changes in several large joints, which develop against the background of other manifestations of the disease.
Among the common signs of brucellosis are elevated body temperature, an increase in all groups of lymph nodes, as well as the liver and spleen. At the initial stages of the disease, the joints were changed little: there was a slight soreness, a moderate limitation of mobility. The joint itself is not externally changed. When the chronic form of brucellosis is formed, the damage to the joints begins to gradually prevail in the clinical picture. For example, in the shoulder joint inflammation of not only the articular surfaces, but also the articular bag, as well as the tendons, develops. Gradually, the shoulder joint completely loses its functional abilities, the upper limb can not perform the necessary movements. An irreversible ankylosis of the joint, contracture of muscles and their subsequent atrophy are formed.
A sad feature of brucellosis arthritis is the complexity of the treatment and its low effectiveness. The appointment of a combination of several antibiotics (tetracycline and aminoglycoside group) does not always bring the desired positive effect. The chronic form of brucellar arthritis of the shoulder joint with the phenomena of deformation treatment is not amenable. Prosthesis of the joint with chronic brucellosis is not shown. A person with this kind of shoulder arthritis gets lifelong disability.
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