Infectious arthritis

General information about the disease

Infectious arthritis is inflammation of a joint caused by a local or general infection. The symptoms of the disease and its course largely depend on the infection that caused the infectious process.

Codes for infectious arthritis according to ICD-10:

staphylococcal - M00.0;
pneumococcal - M00.1;
streptococcal - M00.2;
caused by other specified bacterial pathogens - M00.8;
pyogenic unspecified - M00.9;
tuberculosis – M01.1;
gonococcal - M01.3;
viral – M01.5.

The disease is very common and can cause permanent impairment of joint function. A quarter of patients seeking treatment for joint diseases suffer from infectious arthritis.

1.General information

The word “ostitis” (not to be confused with otitis) in a broad sense means inflammation of the bone, or, more correctly, inflammation of bone tissue.

In fact, this is a group of heterogeneous diseases, pathological conditions and processes in relation to which much remains to be explored, clarified and clarified. In the current Tenth Revision of the International Classification of Diseases (ICD-10), such inflammatory processes are classified under the heading “Other bone diseases,” and the unifying characteristic is precisely the presence of inflammation.

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Causes of infectious arthritis

The cause of the disease is infection - a purulent infection from nearby foci (cellulitis, abscesses) or carried through the bloodstream in cholecystitis, tonsillitis, as well as general infectious diseases. When infectious pathogens enter the joint, the immune system begins to fight them, causing an inflammatory process, the course of which is directly related to the characteristics of the infectious pathogen.

Inflammation can be:

nonspecific
- that is, have general symptoms characteristic of inflammatory processes; such processes are caused by pyogenic pathogenic and conditionally pathogenic microflora - staphylococci, streptococci, Pseudomonas aeruginosa and Escherichia coli, etc.; the inflammatory processes they cause are usually of an acute purulent nature and occur acutely, especially in children;
specific
- with such inflammation, both general symptoms characteristic of all arthritis and symptoms characteristic of this infection develop; Such infections include tuberculosis, brucellosis, gonorrheal, viral, fungal, parasitic inflammatory processes.

Infectious arthritis has two development mechanisms:

bacterial-metastatic
- inflammation begins due to the presence of infection in the joint;
toxic-allergic
– inflammation develops due to general intoxication and an inadequate immune response to the introduction of infection into the body;
mixed
- both mechanisms operate.

Factors predisposing to the development of infectious arthritis: bad habits, heavy lifting, excess body weight, diabetes. Purulent joint lesions develop especially often in women suffering from rheumatoid arthritis.

What is arthritis?

Arthritis can occur in any joint. Inflammation develops in one (monoarthritis), several (oligoarthritis) or 4 or more joints (polyarthritis).

Inflammatory fluid accumulates in the joint capsule, the cartilaginous surfaces swell, and pain occurs when moving. This disease can have a different nature, including being a manifestation of more than 200 rheumatic diseases. The risk of pathology increases with injuries, metabolic disorders, genetic and immunological changes.

Treatment is aimed at controlling pain, minimizing joint damage, and improving quality of life. This includes medications, physical therapy, and patient education.

Symptoms of infectious atritis

Infectious arthritis usually begins and progresses acutely, sometimes subacutely. But with some specific infections it has an imperceptible onset and a long course.

Onset of the disease and first symptoms

With an acute onset, the main symptoms of infectious arthritis are: severe fever, chills, flying muscle-joint pain combined with severe pain in the affected joint, swelling and hyperemia of the skin over it. Infectious arthritis in children is almost always acute.

The subacute course has a less noticeable onset, the body temperature is normal or subfebrile. Swelling, hyperemia and joint pain are moderate.

The most dangerous is the hidden, imperceptible course characteristic of tuberculous arthritis. Characterized by vague pain in the joints, crunching, decreased motor activity. The disease occurs against the background of tuberculosis, a slight increase in temperature may also not attract attention, so tuberculous arthritis is rarely detected in the early stages.

Pain and swelling are characteristic of the initial stage of infectious toxic-allergic arthritis in children and adults

Obvious symptoms

Acute purulent arthritis develops very quickly, the condition worsens every day, fever, swelling, hyperemia and pain increase. It is possible that the patient will require surgical care.

With a slower course, the symptoms of infectious arthritis develop gradually, general malaise and weakness appear, joint pain becomes constant, intensifying with movement. The function of the limbs is gradually impaired: difficulties appear in their flexion or extension.

When to Seek Medical Help

You should consult a doctor if the following symptoms appear:

persistent or regularly recurring joint pain;
the appearance of fever, malaise in combination with joint pain;
swelling, hyperemia of the skin over the joint in combination with fever in patients already suffering from chronic arthritis - perhaps an infection has joined the existing chronic inflammation;
the appearance of joint pain in pulmonary tuberculosis, gonorrhea, brucellosis and other infectious diseases.

Dangers

The disease is often severe, with complications.

Stages of the disease

The course of the disease is associated with its clinical form, so the stages of development of the pathological process can have significant differences. Let's consider the stages of development of acute purulent arthritis, developed by the Research Institute named after. Vishnevsky:

Initial
– purulent process without destruction of intra-articular tissues:
V.
– with the development of purulent processes in adjacent tissues.
Expanded
– purulent arthritis with destruction of intra-articular tissues:
V.
– with purulent lesions of the surrounding soft tissues.
Launched
– with damage to bone and cartilage tissue:
V.
– with purulent lesions of these tissues;
S.
– with the release of pus to the surface of the body (fistulas).
Final
:
with proper treatment
, complete or partial restoration of limb function.

Any form of arthritis has serious complications, so you should not delay treatment.
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Possible complications

Infectious arthritis can cause early and late complications. Early complications include mainly complications of purulent arthritis:

suppuration of periarticular tissues;
generalization of infection, sepsis.

Long-term consequences include loss of limb function of varying degrees: from mild to complete immobility.

Complications can only be avoided if you consult a doctor in a timely manner.

2. Reasons

The main trigger (trigger factor) in the etiopathogenesis of osteitis is secondary infection during fractures and other injuries, which include surgical interventions on bone structures. The infection can be either nonspecific (streptococci, staphylococci and other widespread pathogenic microorganisms) or specific (mycobacterium tuberculosis, gonococcus, treponema pallidum).

Osteitis also includes Paget's osteitis deformans - a chronic, progressive disease of unknown etiology, in which the regeneration of bone tissue (normally, its renewal occurs constantly) is carried out due to the formation of tissues with an irregular, altered structure. Paget's disease usually affects the pelvic, femur, humerus bones, as well as the spinal column and skull bones.

Unfortunately, in isolated cases, the cause of the development of osteitis is non-compliance with the BCG vaccination procedure.

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Classification

The origin and symptoms of infectious arthritis of different clinical forms have both similarities and differences. Let's look at the most common forms.

Acute purulent

Acute purulent arthritis of the knee joint

This form of the disease develops when a pyogenic infection (Pseudomonas aeruginosa, staphylococci, streptococci, etc.) gets into the joint. Infection can be primary in wounds and secondary - when infection spreads from surrounding tissues or distant foci of infection. People suffering from rheumatoid arthritis, especially women, are at risk.

The disease begins acutely and progresses severely. Fever, headache, chills appear. The affected joint swells and the skin over it turns red. The pain is so severe that the patient cannot move the limb and tries to give it a position that causes the least pain.

Without timely assistance, the articular surfaces quickly collapse, limiting the mobility of the limb. With adequate treatment, complete recovery occurs.

Septic

It develops against the background of already existing sepsis - a generalized infectious process. The infection enters the joint cavity through the hematogenous route - through the bloodstream. The disease can occur in the form of:

bacterial-metastatic form with symptoms of acute purulent arthritis
- the patient’s condition can be extremely severe; the prognosis of the disease depends on timely treatment;
toxic-allergic form
- the course is not always acute, often occurs subacutely with multiple lesions of the joints of a migrating (alternating) nature; the process is non-purulent in nature and ends with recovery against the background of cure of sepsis.

Tuberculous

Arthritis in this case also occurs in the form of bacterial-metastatic and toxic-allergic forms. In the first case, the spine and large joints of the limbs are mainly affected, and the disease is called osteoarticular tuberculosis. It initially proceeds chronically with increasing pain during movement and general malaise. The main changes are visible on x-rays in the form of damage to the joint bone tissue from the appearance of a spot with loss of calcium in the bone to bone destruction. If left untreated, it leads to disability.

The toxic-allergic form, first described by Ponce at the beginning of the 20th century, is very similar to rheumatoid arthritis with a chronic onset and damage to the small joints of the hands and feet. Their destruction and disability are also possible. Damage to large joints sometimes occurs without consequences and resolves with anti-tuberculosis therapy.

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Joint pain at rest

Gonorrheal

Damage to joints by gonococcal infection can have bacterial-metastatic and toxic-allergic forms. In both cases, large joints are affected, most often one knee (ankle, wrist). The disease is acute, with high fever, intoxication and severe joint pain. The knee swells, turns red, and is impossible to touch because of the pain.

With timely treatment, the disease has a favorable outcome. If left untreated, complete immobility of the limb quickly sets in.

Borreliosis

Borreliosis or Lyme disease is an infection caused by spiral-shaped bacteria called Borrelia spirochetes. It is transmitted by ticks and occurs in a succession of stages:

1-2 weeks after a tick bite, an increase in body temperature, intoxication, muscle stiffness and the appearance of redness on the body at the site of the tick bite - erythema, surrounded by concentric rings, spreading to large areas of the body. With timely administration of antibacterial therapy, the disease can end at this stage.
It develops 1–3 months after the onset of the disease and manifests itself in the form of lesions of the nervous system (meningitis, neuritis with acute pain) and the heart (heart block, myocarditis, etc.).
Joint damage begins six months (sometimes 2 years) after the onset of the disease in genetically predisposed people and occurs in the form of severe joint pain, a benign recurrent inflammatory process that occurs as an infectious-allergic arthritis with asymmetric damage to 1 - 2 joints (most often the knee) and ending after a few years with recovery in most patients. But in some patients the disease can become chronic with gradual impairment of limb function.

The initial stage of borreliosis is erythema migrans and stage 3 is chronic arthritis of the knee

Viral

Develops against the background of various viral diseases:

Parvovirus infection caused by parvovirus B19
- the disease occurs with intoxication, fever, skin manifestations in the form of red spots, papules raised above the skin and pinpoint subcutaneous hemorrhages. At the same time, symmetrical damage to the joints occurs. Small joints of the hand, wrist, elbow, knee, and ankle joints may be involved. Symptoms are similar to rheumatoid lesions, but last from 3 months to a year and have a favorable outcome.
Rubella
– arthritis develops more often in adult women against the background of existing symptoms of rubella or before their appearance. Such lesions are rare in children. The periarticular tissues swell, turn red, and severe pain appears, disrupting joint function. The lesion is asymmetrical with the involvement of small joints of the hand, wrist, knee, and elbow joints. Arthritis lasts two to three weeks, after which complete recovery occurs.
Viral hepatitis B and C
- arthritis develops quite often, but has a benign course and ends with complete recovery. Small joints of the hand, elbows, ankles and, less commonly, other joints are affected. Inflammation in the joints usually begins before the appearance of jaundice and ends during its peak.

Classification and degrees of arthritis

There are many varieties of the disease. The most common are inflammatory, infectious, metabolic variants and those associated with connective tissue pathology.

Inflammatory arthritis

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The disease is accompanied by inflammation that is not caused by a reaction to any injury or infection. This process gradually destroys the joint, causing pain, stiffness and swelling in it. Often several areas of the body are affected at once.

Examples of the inflammatory variant of the disease:

rheumatoid arthritis;
reactive arthritis;
psoriatic arthritis;
juvenile rheumatoid arthritis;
ankylosing spondylitis.

Connective tissue diseases

This tissue supports and connects other organs and includes tendons, ligaments, and cartilage. When it is damaged, pain and inflammation in the joints occurs. Other organs are also affected, including skin, muscles, kidneys, and lungs. This is accompanied by signs of their damage and requires consultation with an appropriate specialist.

Examples include arthritis that occurs with systemic lupus erythematosus, scleroderma, or dermatomyositis.

Inflammation of the joint can be caused by bacteria, viruses or fungi that have entered its cavity. Main causes of pathology:

salmonella and shigella, which cause food poisoning;
chlamydia and gonococci, which cause sexually transmitted diseases;
Hepatitis C is a viral infection that affects the liver.

This disease can be treated with antibiotics or other antimicrobial drugs. However, when it becomes chronic, joint damage can become irreversible.

Metabolic arthritis

The main cause of the pathology is a violation of the metabolism of uric acid, which is normally excreted by the kidneys, and when this process slows down, settles in the form of crystals in the joint cavity. This leads to paroxysmal pain and swelling, and most often the first metatarsophalangeal joint (base of the big toe) is affected, and less often other joints of the limbs. Gouty arthritis develops.

With gradual wear and tear of the surface of the joint or after an injury, osteoarthritis develops, which most often affects the knee and hip joints, less often the shoulder. In this case, the signs of inflammation are weakly expressed, and deformation of the joint and limitation of its mobility come to the fore.

The severity of arthritis is determined by clinical signs, laboratory tests, and radiography of the affected organs.

Fungal

Most often, fungal infections of the joints develop with actinomycosis, but they also occur with other fungal infections. Pathogenic fungi enter the joint cavity from a nearby bone lesion or from distant lesions (carious teeth) through the bloodstream. The course is chronic, with relapses and the possible addition of a bacterial infection. Very often, fistulas occur - passages through which pus from the joint is released onto the surface of the skin. In the absence of adequate treatment, it leads to a gradual loss of joint function.

Parasitic

The cause of arthritis is usually echinococcosis, which affects the bone tissue of the vertebrae, pelvic bones and long bones of the limbs. A toxic-allergic inflammatory process usually develops in the joints. The joints of the spine, hips, knees and elbows are often involved. The course is benign, but is accompanied by severe joint pain. Recovery occurs when complete treatment of echinococcosis is prescribed.

Infectious-allergic arthritis

Infectious-allergic arthritis occurs when there is an allergy, against the background of which an inflammatory process in the joints develops under unfavorable conditions. The disease occurs in a violent form, accompanied by high fever and severe pain. Redness, swelling, and swelling are observed in the affected area. On different parts of the skin there is a ring-shaped allergic rash. Infectious-allergic arthritis is treated by a rheumatologist and an allergist.

Osteomyelitis

Manifestations of acute osteomyelitis depend on the route of infection, the general condition of the body, the extent of traumatic damage to the bone and surrounding soft tissues. On radiographs, changes are visible 2-3 weeks after the onset of the disease.

Hematogenous osteomyelitis

As a rule, it develops in childhood, with a third of patients becoming ill before the age of 1 year. Quite rare cases of the development of hematogenous osteomyelitis in adults are actually relapses of the disease suffered in childhood. Most often it affects the tibia and femur. Multiple bone lesions are possible.

From a remote source of inflammation (soft tissue abscess, phlegmon, infected wound), microbes are carried through the blood throughout the body. In long tubular bones, especially in their middle part, a wide network of vessels is well developed, in which the speed of blood flow slows down. Infectious agents settle in the cancellous bone. Under unfavorable conditions (hypothermia, decreased immunity), microbes begin to multiply rapidly, and hematogenous osteomyelitis develops. There are three forms of the disease:

Septic-pyemic form

. Characterized by an acute onset and severe intoxication. Body temperature rises to 39-40°, accompanied by chills, headache and repeated vomiting. Possible loss of consciousness, delirium, convulsions, hemolytic jaundice. The patient's face is pale, lips and mucous membranes are bluish, and the skin is dry. The pulse is increased, the pressure is reduced. The spleen and liver enlarge, and sometimes bronchopneumonia develops.

On the 1st-2nd day of the disease, precisely localized, sharp, drilling, bursting or tearing pain appears in the affected area, intensifying with the slightest movements. The soft tissues of the limb are swollen, the skin is hot, red, and tense. When it spreads to nearby joints, purulent arthritis develops.

After 1-2 weeks, a focus of fluctuation (fluid in the soft tissues) forms in the center of the lesion. Pus penetrates the muscles, intermuscular phlegmon is formed. If the phlegmon is not opened, it can open on its own with the formation of a fistula or progress, leading to the development of periarticular phlegmon, secondary purulent arthritis or sepsis.

Local form

. The general condition suffers less and sometimes remains satisfactory. Signs of local inflammation of bone and soft tissue predominate.

Adynamic (toxic) form

. Rarely seen. Characterized by lightning-fast onset. The symptoms of acute sepsis predominate: a sharp increase in temperature, severe toxicosis, convulsions, loss of consciousness, a pronounced decrease in blood pressure, acute cardiovascular failure. Signs of bone inflammation are weak and appear late, which makes diagnosis and treatment difficult.

Post-traumatic osteomyelitis

Occurs with open bone fractures. The development of the disease is facilitated by contamination of the wound at the time of injury. The risk of developing osteomyelitis increases with comminuted fractures, extensive soft tissue damage, severe concomitant injuries, vascular insufficiency, and decreased immunity.

Post-traumatic osteomyelitis affects all parts of the bone. In linear fractures, the area of inflammation is usually limited to the fracture site; in comminuted fractures, the purulent process tends to spread. Accompanied by hectic fever, severe intoxication (weakness, weakness, headache, etc.), anemia, leukocytosis, increased ESR. The tissues in the area of the fracture are swollen, hyperemic, and sharply painful. A large amount of pus is released from the wound.

MRI of the foot. Osteomyelitis of the talus and tibia with the presence of an extensive area of bone tissue destruction.

Gunshot osteomyelitis

More often occurs with extensive lesions of bones and soft tissues. The development of osteomyelitis is promoted by psychological stress, decreased body resistance and insufficient wound treatment.

General symptoms are similar to post-traumatic osteomyelitis. Local symptoms in acute gunshot osteomyelitis are often mild. The swelling of the limb is moderate, there is no profuse purulent discharge. The development of osteomyelitis is indicated by a change in the wound surface, which becomes dull and covered with a gray coating. Subsequently, inflammation spreads to all layers of the bone.

Despite the presence of a focus of infection, with gunshot osteomyelitis, bone fusion usually occurs (the exception is significant bone fragmentation, large displacement of fragments). In this case, purulent foci end up in the callus.

Postoperative osteomyelitis

It is a type of post-traumatic osteomyelitis. Occurs after osteosynthesis operations of closed fractures, orthopedic operations, insertion of wires when applying compression-distraction devices or applying skeletal traction (wire osteomyelitis). As a rule, the development of osteomyelitis is caused by non-compliance with asepsis rules or a highly traumatic operation.

Contact osteomyelitis

Occurs due to purulent processes in the soft tissue surrounding the bone. Especially often, the infection spreads from soft tissue to the bone with panaritium, abscesses and phlegmon of the hand, and extensive wounds of the scalp. Accompanied by increased swelling, increased pain in the area of injury and the formation of fistulas.

Treatment

Only in hospital in the traumatology department. The limb is immobilized. Massive antibiotic therapy is carried out taking into account the sensitivity of microorganisms. To reduce intoxication, replenish blood volume and improve local blood circulation, plasma, hemodez, and 10% albumin solution are transfused. For sepsis, methods of extracorporeal hemocorrection are used: hemosorption and lymphosorption.

A prerequisite for successful treatment of acute osteomyelitis is drainage of the purulent focus. In the early stages, burr holes are made in the bone, followed by washing with solutions of antibiotics and proteolytic enzymes. For purulent arthritis, repeated punctures of the joint are performed to remove pus and administer antibiotics; in some cases, arthrotomy is indicated. When the process spreads to soft tissues, the resulting ulcers are opened, followed by open rinsing.

Localization of infectious arthritis

In case of infectious joint damage, the localization of the pathological process depends on the characteristics of the infection and its clinical form. In acute purulent arthritis, these are mainly large joints - knee, ankle, elbow. Small joints of the hand and foot are affected in the toxic-allergic form of tuberculosis and some viral arthritis.

Asymmetrical damage to one or two large joints is characteristic of borreliosis; most often with this infection, the knee joints are involved in the process.

Crunching in joints - when to worry

Intra-articular injections of hyaluronic acid

Diagnostics

The main task of diagnosis is to identify the causative agent of infection that is “culpable” in the development of infectious arthritis. The degree of destruction of the joint must also be determined. The following studies are being carried out:

Laboratory:
blood biochemistry – general disorders characteristic of a particular infection;
examination of synovial fluid - the nature of inflammation;
immunological studies - antibodies to various infectious agents;
PCR and microbiological studies (inoculation of biological media on nutrient media) – identification of infectious agents;
histological studies - a piece of synovial membrane tissue taken by biopsy is examined under a microscope - identifying changes characteristic of a specific infection.
Instrumental:
radiography - reveals the degree of damage to the bone tissue of the joints;
computed tomography (CT) – detailing bone destruction;
diagnostic arthroscopy – examination of the condition of the inner surface of the synovial membrane with the possibility of taking exudate or a piece of tissue for examination.

Treatment of infectious arthritis

Basic principles of treatment of infectious arthritis:

suppression of infection that caused joint damage;
detoxification therapy – removal of toxic inflammatory products from the body;
prevention of relapse of the disease and further destruction of the joints.

Different clinical forms of infectious arthritis require different approaches to treatment. Thus, acute purulent and other severe arthritis are treated only inpatiently. In case of chronic course, outpatient treatment or its combination with inpatient treatment during an exacerbation is possible. At this stage, the main methods of treating infectious arthritis are surgery and medication in combination with immobilization (creating immobility) of the affected joints.

Later, at the recovery stage, non-drug methods are added: therapeutic exercises, massage, physiotherapeutic procedures, reflexology courses.

Surgical treatment of acute purulent arthritis

When there is a suppurative process in the joints, the following surgical procedures and operations are performed:

arthrocentesis
- joint puncture (puncture with a needle and syringe) followed by removal of purulent exudate, washing (lavage) of the joint cavity with a disinfectant solution and administration of antibiotics;
therapeutic arthroscopy
– the same procedure, but performed using endoscopic equipment (arthroscope); during arthroscopy, it is possible to remove not only pus, but also pieces of necrotic tissue and bone sequestration;
arthrotomy with flow-aspiration drainage
– performed when there is a large accumulation of pus and destruction of the joint; The joint cavity is opened in a traditional surgical way, after which the pus is removed and the joint cavity is regularly washed with disinfectant solutions and antibiotics are introduced into it.

Immobilization

To reduce the pain of acute arthritis, the affected joints must be kept motionless. Immobilization is carried out using splints, orthoses and other special devices for a short period until the acute period of inflammation passes. Prolonged immobilization may interfere with the recovery of joint function.

Immobilization for infectious arthritis

Drug treatment

This is the main type of treatment. Even acute purulent arthritis in the initial stages is treated conservatively.

Infection suppression:

When viral, fungal or parasitic arthritis is complicated by a laboratory-confirmed bacterial infection, courses of antibacterial therapy are also prescribed.
Viral arthritis is one of the symptoms of an underlying viral infection. Treatment of this infection leads to elimination of inflammation in the joints. Antiviral drugs: Interferon alpha is prescribed for any viral arthritis; for hepatitis B and C, Entecavir and Telbuvidin are used. But all antiviral drugs have many side effects, so they are not always used.
Fungal infections of the joints are treated with antifungal drugs with laboratory-confirmed sensitivity of the fungal infection to them.
Parasitic arthritis - treatment is carried out after identifying the causative agent of the infection. For echinococcal (ascariasis, trichuriasis) arthritis, Albendazole or Mebendazole is prescribed.

Elimination of intoxication and inflammation:

To relieve intoxication, intravenous drip solutions of 5% glucose, 0.9% sodium chloride (saline) with vitamins C, group B are prescribed;
Inflammation, swelling and pain in the joints are eliminated by prescribing orally, intramuscularly and externally such medications (ointments, gels) as Diclofenac, Ibuprofen, Ketolac, Nemisulide, etc. Menovazin solution, used for rubbing, relieves pain well. If pain and inflammation are not relieved, short courses of glucocorticoids (GCS) are prescribed - Prednisolone, Dexamethasone, etc. But in infectious processes this is dangerous, since GCS reduce immunity.

If there is a risk of the inflammatory process becoming chronic, treatment of arthritis is carried out by a rheumatologist together with another specialist (surgeon, infectious disease specialist, dermatovenerologist). Basic drugs are prescribed that suppress inflammatory processes that develop during immune failure (Methotrexate, Sulfasalazine).

To restore the cartilage tissue of the joints, chondroprotectors are prescribed: Structum, Donu, Chondroitin.

Antibiotics for infectious arthritis

Antibiotic treatment of infectious arthritis is carried out for all types of bacterial inflammation. But their effectiveness depends on how accurately the pathogen is identified and its sensitivity to antibiotics is established. Only selective use of antibiotics will be beneficial. For tuberculous arthritis, anti-tuberculosis drugs are prescribed - Streptomycin, Rifampicin, etc.

Antibiotics for the treatment of infectious arthritis

Non-drug methods

Used mainly after eliminating acute inflammation:

physical therapy (physical therapy) - individual exercises with minimal muscle tension are prescribed at the end of the acute period; then the volume of loads is gradually increased; Exercise therapy helps improve blood circulation, strengthen muscles and quickly restore limb function;
acupressure – the principle of purpose and mechanism of action is the same as for exercise therapy;
physiotherapeutic procedures - sometimes prescribed in the acute period, for example, electrophoresis with painkillers and anti-inflammatory drugs; during the rehabilitation period, thermal procedures (paraffin, ozokerite), magneto- and laser therapy are prescribed; during the period of stable remission - mud applications.

Traditional methods

Traditional methods are also often included in complex treatment:

warming compress: take half a glass of turpentine and vodka, 3 tablespoons of vegetable oil; mix the ingredients, moisten a napkin, apply to the sore joint, cover with plastic, wrap and leave overnight; repeat three times a week for a month;
tincture of elecampane roots: 2 tablespoons of crushed dry raw material, pour 200 ml of vodka, leave for a week, strain and use as a rub at night.

It should be remembered: traditional methods of treatment should only be prescribed by a doctor. Self-treatment of infectious arthritis can cause irreparable harm to the body.

Arthritis

About 350 million people worldwide have arthritis. For example, in the United States it is noted that almost 22 percent of the population (40 million, including 250 thousand children) have some form of arthritis and often other terms are used to refer to the inflammatory process in the joints, such as arthralgia, arthropathy or arthrosis .

Data

Arthritis is inflammation of one or more joints.
Symptoms of arthritis include pain and limited joint function.
Arthritis can affect both men and women, adults and children.
Arthritis is treated by a rheumatologist.
Early diagnosis can help prevent permanent damage and disability.

The disease is often accompanied by joint pain (arthralgia). There are many different reasons for the development of inflammation in the joints. These may be trauma (osteoarthritis), metabolic disorders (for example, gout or pseudogout), hereditary factors, direct and indirect effects of infections (bacterial or viral), disorders of the immune system with an autoimmune component (for example, rheumatoid arthritis and systemic lupus erythematosus) . Common to all types of arthritis are that both joints and tendons, muscles, ligaments, cartilage are affected, and internal organs are often affected. With some types of arthritis, especially of autoimmune origin, internal organs (heart, lungs, kidneys) are affected and the patient may have general symptoms, such as fever, chronic fatigue, weight loss, and swollen lymph nodes.

Symptoms

Symptoms of arthritis include pain and limited mobility in the joints. Joint inflammation is characterized by stiffness, swelling, redness and a local increase in temperature in the joint area. There may also be pain in the joint area. With many types of arthritis, symptoms occur in other organs that are not directly related to the joints. Thus, patients with arthritis may have symptoms such as fever, swollen lymph nodes, weight loss, and symptoms of dysfunction of organs such as the lungs, heart, or kidneys.

Diagnostics

The first step in diagnosing arthritis is to consult a rheumatologist. The doctor analyzes the history of the disease, symptoms, examines the joints, determines the presence of inflammation in the joint area, the presence of deformity, and also checks for the presence of somatic problems that may cause the development of joint inflammation. Various methods are used to diagnose arthritis, such as laboratory tests, radiography, and ultrasound. In some cases, diagnosing the type of arthritis requires multiple visits to a rheumatologist, who is a specialist who deals directly with arthritis. Timely diagnosis allows you to prescribe adequate treatment and avoid serious complications, both from the joints and often from internal organs.

It should be noted that both before and especially after a diagnosis of arthritis, maintaining contact with a doctor is of great importance, as it allows you to monitor both changes in the course of the disease and the possibility of adjusting treatment and safe use of medication (some drugs have a number of side effects ).

Treatment

Treatment for arthritis depends on the specific type of arthritis. As a rule, an integrated approach is used, including both medicinal treatment methods (NSAID painkillers to influence the immune system) and non-drug treatment methods (physiotherapy, exercise therapy).

For most forms of arthritis, diet plays little or no role in treatment, but omega-3 fatty acids found in fish have been shown to have a beneficial role. At the same time, with some types of arthritis (for example, gout), eating a number of foods high in purines (red meat, shellfish) or foods such as beer can trigger an exacerbation of the disease. With the same disease as celiac disease, taking foods containing gluten (wheat, barley, rye) can lead to increased joint pain.

The prognosis for patients with arthritis depends on the severity of the inflammatory processes, the presence of complications, and the presence of concomitant lesions of internal organs. For example, rheumatoid arthritis often leads to damage to the lungs, kidneys, eyes, etc. Chronic joint inflammation can lead to permanent joint damage and loss of joint function, making joint movement difficult or impossible.

Since most forms of arthritis are genetically determined, there are no real methods of prevention. But it is possible to prevent arthritis associated with injury or arthritis caused by infection (for example, septic arthritis, reactive arthritis, Whipple's disease).

Approach to treating the disease in our clinic

Medical doctors in Moscow have developed their own approach to the treatment of infectious arthritis. It includes:

thorough identification of the causes (infectious factor) of the disease;
suppression of infection using modern medicinal methods developed in the most advanced clinics in the world;
restoration of joint function using modern medicinal and non-medicinal methods, as well as using traditional methods of treatment of ancient Chinese medicine, which considers the human body as a whole.

As a result of the complex treatment, our patients forget about pain and lead their usual lifestyle. To prevent exacerbations, our clinic conducts courses of anti-relapse treatment.

Arthritis symptoms

Symptoms of arthritis include pain and limited joint function. Inflammation is characterized by joint stiffness, swelling, redness, pain and a feeling of heat. Arthritis of the knee joint is often accompanied by loss of cartilage with limited movement. Arthritis of the fingers can lead to loss of hand strength.

Many forms of arthritis that accompany rheumatic diseases may be accompanied by symptoms of damage to other organs. These may include fever, swollen lymph nodes, weight loss, fatigue, feeling unwell, and even signs of damage to the lungs, kidneys, or heart.

General clinical recommendations

Persons who have had acute infectious arthritis or suffer from chronic infectious arthritis must:

lead an active healthy lifestyle, quit smoking and alcohol abuse;
eat properly and fully;
exclude heavy physical activity and injuries;
engage in therapeutic exercises, swimming and feasible sports;
treat infections promptly;
carry out doctor's orders; in the chronic course of the disease, conduct courses of anti-relapse treatment.

Prevention

Infectious arthritis can be prevented by doing hardening, sports without heavy physical activity, eating right and treating all infections in a timely manner.

We combine proven techniques of the East and innovative methods of Western medicine.
Read more about our unique method of treating arthritis

Frequently asked questions about the disease

What is the difference between infectious and reactive arthritis?

An infectious inflammatory process develops when an infection enters a joint, and a reactive inflammatory process develops against the background of some kind of general infection in the absence of a pathogen in the joint cavity. Read more about reactive arthritis in this article.

Which doctor treats you?

Nonspecific infectious processes - a surgeon or traumatologist, specific ones - a surgeon and another specialist - an infectious disease specialist, a dermatovenerologist, a phthisiatrician. When transitioning to a chronic course, a rheumatologist.

What is the prognosis for treatment of infectious arthritis?

Depends on the infection that caused the disease. Most acute arthritis ends in recovery. The outcome of specific infections depends on the course of the underlying disease: viral arthritis ends in complete recovery, while tuberculosis arthritis does not always have a favorable outcome.

Infectious arthritis can be severe with unpredictable consequences. Therefore, it is very important to treat it promptly and correctly. They know how to do this.

Bibliography:

Belov B. S. // Bacterial (septic) arthritis and infection of the prosthetic joint: modern aspects. — [b.m.]: Modern rheumatology., 2010.
Parvizi J Jacovides C, Antoci V, et all, // Diagnosis of periprosthetic joint infection:. — [b.m.]: J Bone Joint Surg AM, 2012..
Isaacs J. Oxford textbook of rheumatology. – Oxford University Press, 2013.
Slobodin G. et al. Acute sacroiliitis //Clinical rheumatology. – 2021. – T. 35. – No. 4. – pp. 851-856.

Themes

Arthritis, Joints, Pain, Treatment without surgery Date of publication: 03/04/2021 Date of update: 03/15/2021

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