Why sore and swollen joints of the hands and feet
The Ancient wisdom says: "Motion is life". In many people's lives this saying must be important. Diseases of skeletal structures, including the joints, is the main cause of persistent disability.
Recurrent pain in the joints is experiencing almost two-thirds of the population. And 25% of people has already established the diagnosis of joint pathology. With age this number is growing. In the age group above 70 years, 97% have one or other arthropathy. Often leads to disability the defeat of the carpal joints: wrist, metacarpophalangeal, interphalangeal.
The Task of true joint (and are false) is to ensure freedom of movement in certain nature. For this link is:
- the articular head;
- glenoid fossa
- the joint cavity
- joint capsule;
- auxiliary elements (intra-articular ligaments, menisci, bones optional)
The surface of the bone, friction when moving, covered with hyaline cartilage, which is washed by synovial fluid and makes movement free and painless. The normal location relative to each other (congruence), the femoral head and the acetabulum, determines the degree of freedom inherent in each separate joint. A striking example is the knee and the wrist.
If the first can only move in the frontal plane, the second joint has more degrees of freedom. The degree of movement of the articular surfaces relative to each other is called a physiological and is measured in degrees. The reason for its decline is the disease of the joint and (or) surrounding (periarticular) tissues.
In the shoulder joint a joint formed by two bones (humerus and scapula) wrist wrist bones only seven.
A General name for conditions in which the stiff joints of hands and feet – arthropathy. Each has its own causes with similar clinical picture. But the overall result is failure of the functions of the joint. That's why these diseases are combined into one group.
May be Affected in any part of the joint. Over time, decreases production of synovial fluid and articular cartilage is erased, which leads to arthritis. Inflammatory processes (infectious or aseptic) involves the connective tissue of the joint capsule, leading to bursitis.
It Happens and the transition of pathological process from adjacent bone or soft tissue. You can also reverse the process.
The body of a child has its own characteristics. The most frequent dysplasia (an abnormal development) of the hip joints. Juvenile arthritis – an acquired pathology, which affects the joints and organs of the child.
Classification and types
In the list of the most common articular pathology of the disease include:
- Reiter's syndrome
- rheumatoid arthritis
- ankylosing spondylitis
- psoriatic arthritis.
General symptoms is pain, often joints become swollen. Though there is a disease in which pain or swelling are not pronounced. The classic pentad of inflammation (local hyperthermia, redness, pain, swelling and dysfunction) occurs often, but not always.
Deformation inherent in all nosologic units. But there are nuances that are best left to the specialist. If you start to hurt the joints, in the home, you can spend only a superficial self-diagnosis.
Rate mobility. Deviations from the physiological range of motion revealed quite easily. Is there pain and stiffness? Character of pain: sharp or dull? Crepitus and crunching movements? Swelling of the joint or several? Strain?
These symptoms are enough to arrange a visit to the doctor. The specialist will be able to establish a reliable diagnosis. Although, at first glance, nothing particularly difficult, but all people, the body has its own characteristics, and this applies to every child.
A Separate nosological unit can occur with a lesion of the interphalangeal joints of the right or left hand with preservation of function of the wrist. Depending on the age of the occurrence of the same disease differs. Adult – one picture, the child is another. Without analyzing a large amount of data is very easy to make a mistake in diagnosis and to engage in useless and harmful self-treatment.
This group includes pathological conditions, the synonyms of which is osteoarthritis, osteoarthritis.
The Disease is spread quite widely. Osteoarthritis is 60-70% of all joint diseases. Often affects the knee and hip joints. In the heart of the etiology – of the joint cartilage. Lesions of small joints (hand, foot) is not relevant.
In the pathogenesis lies the failure of regeneration of hyaline cartilage. Main reasons:
- Gender (women are affected more often).
- Genetic predisposition.
- Metabolic disorders.
The breakdown Products of cartilagecause autoimmune reactions. That's why later joins synovitis.
This is a systemic disease. Is autoimmune in nature. It is based on an imbalance of b - and T-lymphocytes begins the synthesis of antibodies to proteins in the synovial membrane of the joint. While in the mechanism are involved in almost all parts of humoral immunity. In the end, there is degeneration of the joints in the connective tissue structure called a pannus. This leads to irreversible changes in the articular cartilage, then bone.
with the development of symptoms takes several weeks to several months. In 80% of patients prodromal period includes colds (sore throat, flu, sinusitis), which often occur in children. Adults may experience an exacerbation of chronic cholecystitis.
Signs of joint damage arise after 1-2 weeks. Typically symmetric involvement of small hand joints and feet. This II-III metacarpophalangeal and II-V metatarsophalangeal joints.
Rheumatoid arthritis is a wavy character. Symptoms may arbitrarily regress, repeated attacks would inevitably strike the new wrist joints, which leads to permanent deformation. Characterized by the exacerbation depending on the time of year.
Again, find the system-wide signs of the disease. This loss of muscles, skin, lungs. About heart – valve apparatus is damaged due to aseptic endocarditis. This pathology is often asymptomatic and revealed by careful examination. Often accidentally detected in a child or adolescent, although common in adults. It is therefore imperative that a comprehensive examination at the pediatrician.
Special attention is given juvenile rheumatoid arthritis. The main criterion is the development of the child up to 16 years. First monoartrit (usually the knee joint), accompanied by involvement of the eye (iridocyclitis, keratitis) and skin manifestations (rashes on the type of erythematous, dermatitis appears as macular). This variant of RA has a favorable course and rarely leads to serious health problems of the child. The defeat of the hands when adequate treatment does not occur.
One of the severe cases of JRA – still's disease. Clinical manifestations intense. Polyarthritis with loss of large and small joints, sometimes the wrist with one of the parties. Violated the General condition: fever, malaise, skin symptoms. Changes in the internal organs – enlargement of the liver and spleen, and in the future – endocarditis, pericarditis, other serosity. A recurrent, short-term remission. In 30% of cases leads to ankylosis.
Comparative characteristics of the most common arthropathy (table 1)
|Criteria||Osteoarthritis||Rheumatoid arthritis||Reiter's Syndrome||Gout||Ankylosing spondylitis (Bekhterev's disease)|
|Etiology||Destruction of articular cartilage||Nonspecific inflammatory process||infection process||A metabolic uric acid||Autoimmune mechanism|
|Characteristics in the population||More common in women||No gender dependencies||Most males||Most males||Often affects young men|
|Reasons||Injury. The decreased production or increased reabsorption of the synovial fluid. Degenerative changes of articular cartilage||Autoimmune conditions. Inflammation of the connective tissue components of the joint with the transition to the articular surface||Chronic intoxication by microbial antigens||Hyperuricemia||the Formation of ankylosis of the joints due to an autoimmune process|
|Symptoms||1. Sick, then later |
some time swollen.
2. The most loaded in
life (hip, knee). Wrist are not affected.
3. Severe pain and violation of
functions caused by the friction of the head of the bone about the articular fossa.
4. Often develops in
age patients with excessive body weight.
5. By the end of the day increases the pain
and stiffness in the joint.
6. Is an independent
|1. Swelling and pain occur |
almost at the same time.
2. Affected joints
upper extremities (hands, elbow, interphalangeal).
3. Pain and dysfunction
caused by edema of the periarticular tissues, ligaments brushes.
4. More common in young
people. For the first time can be diagnosed in a child.
5. Stiffness in
affected joints in the morning.
6. Can be a symptom of
|1. Accompanies |
urinary tract infection.
genitourinary organs and the organs of sight.
3. Most often suffer
the joints of the foot and the tendon calcaneus. Wrist intact.
4. Frequently detected in
5. The arthritis is in the nature of
acute diseases with inflammation pintados.
the infectious process.
|1. The beginning is sudden, |
2. Severe pain in
phalanx of one foot.
onemetatarsophalangeal joint, often the right. Wrist intact.
4. Age over 40 years.
5. Picture of acute
6. The manifestation of
|1. The beginning is sudden,
2. Severe pain in
phalanx of one foot.
the loss of one metatarsophalangeal joint and is more often right. Wrist intact.
4. Age over 40 years.
5. Picture of acute
6. The manifestation of
hyperuricemia. 1. Gradual hidden
2. The increase in pain and
stiffness in one side of the back.
spine, lumbosacral articulation. Wrist intact.
4. Often in the beginning
5. The main manifestation
– increasing stiffness.
6. The result
the autoimmune process.
|Instrumental and laboratory data||1. Blood tests do not have significant deviations.|
2. X-ray picture depends on the stage, changes are detected in the initial stages.
|1. In the blood – the inflammatory changes of acute-phase reaction.|
2. X-ray picture in the initial stages of specific signs has not.
|1. In the blood – inflammatory response. Informative studies on chlamydial antigens.|
2. X-ray picture when adequate treatment is not changed.
|1. Biochemical |
a blood test reveals high uric acid content.
osteolysis of the epiphysis of the bone.
the study of histocompatibility antigen HLA B27.
the existence of increasing ankylosis.
|Exodus||Steady progression, deformation of joints and bone tissue, the need for prosthetics.||Relapsing course with periods of remission. Bone lesions are rare.||Recovery with adequate treatment of the underlying pathology.||Permanent cure of uric acid metabolism provides favorable course.||a Steady progression. Treatment and exercises are distancing disability.|
- Treatment of arthropathy should be carried out only on the basis of a thorough examination of the patient. Despite the apparent commonality of symptoms, it is clear that the causes of arthropathy are very different. Thus the treatment every time you need to pick up adequate.
- treat Osteoarthritis by restoring tissue trophism, reducing body weight. In the treatment of arthritis in the first place are cytostatics. Reiter's syndrome is generally treated with antimicrobial agents. Gout – diet and "Allopurinol". Bekhterev's disease – indication for polypragmasie, prescribers from several groups.
- recreational gymnastics also need to know how to use, so as not to hurt. Therefore it is important and timely appeal to the specialist.
- It will guarantee the preservation of the quality of life on the usual level.
- Rheumatology: national manual/ edited by E. L. Nasonov, V. A. Nasonova, 2008
- Clinical diagnosis of joint disease/ D. M. Doherty Doherty, 1993
- Lectures on internal diseases/ V. I. Vishnevsky, 2012