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Differential diagnosis of joint syndrome and its treatment
An articular syndrome( SS) is commonly called a complex, a set of developing together signs of a disease or diseases of the musculoskeletal system.
And this syndrome is characterized not only by pain localized in the area of one of the joints or several at once, but also:
- stiffness, including in the morning or after periods of rest;
- by deformation or deformation of the joint;
- by its incorrect or unusual position.
In addition, skin color may change in the area of acute articular syndrome, wedging, presence of nodules and other functional impairments.
Articular syndrome is a common cause of people's treatment in formal medical institutions. It occurs together with 70 percent of all diseases, including those with joint and spine problems. It is painful sensations that force a person to seek help from a doctor.
What is indicated by the joint syndrome, what disease indicates should be clarified by additional signs, the patient's medical history, his predisposition, heredity and con
The most common causes of the SS
- The most common causes of the SS
- The differential diagnosis
- The infectious roots
- The clinical picture analysis
- The instrumental methods of diagnosis
- The approach to the therapy
The most common cause of the SS
The most common cause of severe pains requiring relief and hospitalization are unhealthy processes occurringin the connective tissues of the joints, as well as their disease.
The list of the most frequently diagnosed causes of OSS( acute articular syndrome):
- inflammation of the joint or adjacent tissues;
- secondary SS, which is the result of chronic, recurring autoimmune diseases;
- osteoarthritis( both primary and secondary);
- rheumatoid arthritis;
- consequences of injuries to the joints, skin and muscle tissue;
- problems in the metabolic processes of the spine;
- congenital diseases of the joints or spine.
To clarify the causes of joint syndrome requires differential diagnosis.
In the setting of such a complex diagnosis, which is associated with articular syndrome, and if there is a suspicion of rheumatic fever( rheumatoid arthritis), the process of diagnosis faces the problem of distinguishing this disease and metabolic-dystrophic disorders.
So, how best to diagnose and treat arthritis in the first year of the disease, it is in the early stages that it is important to organize the necessary examinations to establish the correct diagnosis.
In arthritis are such varieties of them:
- is infectious;
- spondylitis, including seronegative.
Also to this list it is necessary to include not verified arthritis, as well as the one that occurs together with autoimmune diseases.
In turn, obmenno-dystrophic diseases include all types of primary arthrosis, including post-traumatic. When secondary arthrosis occurs, the cause of the repeated development of the disease and its articular syndrome is usually caused by the inflammatory processes taking place in the area of the affected joint.
And, finally, two more processes can cause SS, attributable to metabolic disorders - it is gout( between attacks) and exchange-dystrophic diseases of the spine.
To help establish a correct diagnosis or to start attributing the disease to the first or second of the groups mentioned above, additional information of the following nature may be needed.
Is there any joint stiffness from morning to time, more than one hour? If yes - this is the first category of diseases - rheumatoid arthritis. Still the signs specifying on group of arthritises: symmetrical lesions of joints, often it is a metacarpophalangeal zone.
Infectious roots of
With the apparent association of pain in the joint with a previous infection, a diagnosis is made of postinfectious arthritis. It is important to make sure that there is no infection at the time of acute articular syndrome.
Otherwise, the pain syndrome will be just a direct manifestation, and a completely different disease, and not a secondary factor that appeared only after a certain time after the primary cause. What are the "roots" of the joint syndrome?
- immunodeficiency virus;
- borreliosis, etc.
When gout is a very common disease, there is a link between diet changes and the occurrence of pain in the joints.
The peculiarity of this disease is frequent asymmetry, it starts with the phalangeal part, the development manifests itself in the defeat of other joints of the body.
If suspected of having Shenllein-Henoch disease, another additional symptom is usually a small-toothed rash localized at the foot of the shin.
If arthritis occurs against a background of other diseases - for example, autoimmune, so it is called - "autoimmune arthritis".A distinctive feature of this state of affairs of the patient is the presence of a bouquet of complaints about different organs and parts of the body: the heart, kidneys, skin, muscles.
If diagnosis is difficult, the temporary determination of the disease - non-differentiated arthritis - is stopped. After a certain number of observations, a rheumatologist can make a more accurate diagnosis.
When arthrosis affects one joint, OSS is localized in one place and is called a disease: "coxarthrosis" for the hip joint, "gonarthrosis" for the knee. If several joints get sick at once, this is polyosteoarthrosis.
Analysis of the clinical picture of
For each disease characteristic of the joint syndrome, there are a number of clinical manifestations, according to which the course of the disease differs, albeit not always:
- As already noted above, arthritis differs by such symptoms as"Morning stiffness" of the joints, lasting from thirty minutes to an hour.
- With rheumatic polyarthritis after the transferred diseases( pharyngitis, for example), its symptoms appear only after two and a half, three weeks. When carrying out research, there are violations in the structure of the extreme parts of the epiphyses or their deformation.
- For reactive arthritis , the onset may come from an infection of a urological( urogenital), tonsilogenic or anerogenic nature.
- Reiter's syndrome is characterized by a whole triad of characteristic features.
- As for the spine lesions, the spondyloarthritis is observed without imparting to its disks immobility or disability.
- From diseases such as gonorrhea and tuberculosis, specific infectious arthritis can develop.
- If the deforming osteoarthrosis of is observed, large joints of the body are also affected mainly.
In addition to the external condition and analyzes, as well as their medical interpretation, they interpret the results of the studies together with the complaints and the nature of the pain and joint syndrome. Goniometry is also done, visualizing and indicator methods are used.
Instrumental diagnostic methods
Goniometry is a painless diagnostic method that is implemented by measuring angles that can be rotated by limbs or body parts due to their joints and discs. This diagnostics of the functions and capabilities of the joints is carried out with the help of specially designed tools for this purpose.
What is meant by "indicator" research methods? These are procedures that are designed to display in any convenient way information regarding the state of health of an organ or organism.
Indicator methods include studies for the presence of an inflammatory process and general factors of its course. In this physician, laboratory research helps. For example, a blood test and disease-relevant substances and particles that by their presence, absence or quantity indicate what is happening in the body.
Assessment of the external condition by visual inspection is called arthroscopy. This process of careful detailed research with the help of the visual apparatus also adds a large amount of information to the anamnesis of the sick person.
Early diagnosis of the inflammatory process, as one of the most frequent factors of the joint syndrome, is one of the main steps towards a correct diagnosis and recovery.
It is not uncommon to perform a joint synovial fluid test in a comprehensive study. This allows us to say what is included in this important element of the healthy normal existence of the human body. When observing in the pictures during the medical diagnosis of calcification of ligaments, this speaks of Bekhterev's disease.
Sometimes thermal imaging( thermography), a method of examining tissues by infrared radiation, can be used when remote temperature measurement is performed inside the joint or in its inaccessible place.
On the skeleton of the map, made up of a set of temperature indicators placed on special paper, draw conclusions about the course of the disease or make adjustments, clarifications in the diagnosis.
Approach to therapy
Of the variety of methods for the treatment of joint syndrome, two large groups are distinguished:
- symptomatic treatment.
The latter group includes anti-inflammatory drugs, analgesics, both in tablets and injections, to which is used in cases of acute need to stop the syndrome. The first include such: Meloksikam, Celecoxib, Ibuprofen, Aceklofinak, Diklovit, Ketoprofen.
When a strong pain syndrome is also used, specific drugs that can be used for other diseases and conditions, analgesics of different nature.
Glucocosteroid preparations used for articular syndrome: Prednisolone, Dexamethasone, Triamcialon.
When a doctor prescribes a drug, the patient must definitely be observed for some time with a specialist and undergo all necessary studies, including analysis and instrumental studies.