Reactive arthritis in children and how to cure it
Reactive arthropathy in children is a disease that occurs with a background of urogenital or intestinal infection, which is accompanied by inflammation of the joints.
The disease is more common in boys and young men. There are two main reasons for the appearance of this disease: urethritis of bacterial genesis, caused most often by chlamydia, and intestinal infection in the form of diarrhea, which is caused by salmonella, yersinia, shigella and some other pathogens.
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Symptoms of the disease
Consequences of the disease and its prevention
The exact mechanism of this disease in children is currently unknown. However, it is commonly believed that the formation of an ailment is associated with impairments in the immune system.The cell wall of chlamydia and microbes that cause intestinal infections is very similar in structure to the human cells that form the joints and mucous membranes of the body. Therefore, in some children at risk, susceptible to the formation of this disease, the immune system fails, and protective immune cells begin to attack their own cells of the joints and mucous membranes instead of microorganisms.
In addition, chlamydial infection is not always amenable to treatment - although it is relatively easy to get infected with it. Therefore, up to 80% of cases of reactive arthropathy in children are caused by chlamydia.
Depending on which bacteria caused the disease, the symptoms of reactive arthritis in children and their severity may differ, especially at the very beginning of the illness.
Symptoms of urogenital infection( chlamydia)
Usually, the disease starts subacute, 1-3 weeks after the onset of urogenital infection( as a urethritis), as a slight increase in body temperature, weakness, loss of strength, and sometimes weight loss. These and many subsequent symptoms are blurred, not pronounced in nature.
, the eye lesions occur almost always.
. After this, the child has inflammation of the eye mucosa - conjunctivitis, which can be combined with uveitis, the appearance of ulcers on the cornea of the eye, in some cases - iridocyclitis( iris damage).The latter, with inadequate treatment or even a complete absence of therapy, threatens a significant decrease in vision or even blindness!
In this case, in the clinical picture there are manifestations of urethritis, and then lesions of mucous membranes and skin. In boys, this can be expressed in the appearance of phimosis, ulcers on the skin of the glans penis. In girls, similar symptoms are manifested in the form of vulvitis, vulvovaginitis, and sometimes - cystitis.
Pretty soon, these symptoms are joined by pain in the joints and nearby muscles. Most often affects a few( up to 4-5) asymmetrical large joints of the legs - the knee, hip, and also the ankle joint and the foot joints - mainly interphalangeal joints. Hands are affected with this disease much less often.
Joint lesions of chlamydial etiology can often occur without the occurrence of severe joint pain or stiffness, or with minimal manifestations, but they are often characterized by frequent recurrence of joint inflammation.
The combination of three symptoms - urethritis, conjunctivitis and arthritis in reactive arthritis is called Reiter's syndrome.
Symptoms of intestinal infection( ursinia, shigella, etc.)
If the disease is caused by an intestinal infection, the symptoms of the onset of the disease will be slightly different. The disease begins acutely, with fever to febrile figures( 38 degrees or more), weakness, symptoms of intoxication. Soon these symptoms are joined by pains in the joints of the same localization as in chlamydia infection, but pain in the joint area is stronger.
In this case, especially pronounced swelling of the inflamed joints, the allocation of a large amount of fluid in the joint bag, and with it - greater deformation of the affected joints. In the results, the skin over the surface of the joints and the tendons becomes reddened, the temperature in this area rises, the swelling and fingers become more characteristic, shaped like a sausage.
Each second patient has endesitis, a tenderness of the tendons of the muscles adjacent to the diseased joint, with a violation of his function. Especially often Achilles tendon( located between the shin and the heel) suffers.
An accurate diagnosis of the disease is very important
Because the symptoms of this disease resemble signs of many other joint diseases, the doctor conducts a series of studies to make a diagnosis accurately.
Immunological laboratory tests - such as direct immunofluorescence analysis - detect antigens of chlamydia in the blood( if they were the cause of the disease).
And methods such as direct haemagglutination and complement reaction( RCC) allow the detection of antibodies to bacteria of the intestinal group( ursinia and shigella) in the serum of the blood.
In addition, the study of feces and urine allows you to sow the relevant bacteria and accurately identify the pathogen that caused the disease, and quite accurately put the appropriate diagnosis.
Differential diagnosis of reactive arthropathy in children is carried out with joint damage such as juvenile idiopathic arthritis, viral and tubercular arthritis, juvenile spondylitis, poststreptococcal arthritis, tick-borne borreliosis( Lyme disease), and most importantly juvenile rheumatoid arthritis( JRA).
Accurately diagnose the doctor helps to conduct serological studies( in contrast to JRA, with reactive arthropathy, this analysis will be negative), as well as carrying out X-ray, synovial and biopsy biopsies and other examinations.
Therapy of this disease is carried out immediately in several directions: the destruction of the causative agent that caused the initial infection, symptomatic treatment that alleviates the symptoms of the disease, as well as pathogenetic treatment that affects the harmful processes in the body triggered by the disease.
Treatment of the infection that caused the disease
treatment of the disease should be prescribed only by the doctor
Since most often reactive arthropathy is caused by a chlamydial infection, then in its treatment a special group of medicines is used which can influence this microorganism. These drugs include antibiotics-macrolides, fluoroquinolones and tetracyclines.
Because the second and third groups are not used in the treatment of children due to severe side effects, chlamydial infection therapy in small patients is carried out precisely by macrolides.
Assigns azithromycin. The course of treatment with this drug is 7-10 days. In addition to azithromycin, such drugs as clarithromycin, roxithromycin, josamycin may be prescribed.
Children of adolescence can already be prescribed tetracycline and fluoroquinolone formulations.
To treat an infection caused by intestinal bacteria, gentamicin or amikacin is usually used intravenously or intramuscularly for a week.
For children of adolescence, a doctor can prescribe fluoroquinolones( ciprofloxacin, ofloxacin, etc.)
Pathogenetic treatment of
If the disease becomes lingering or chronic, antibiotic prescription is no longer sufficient to treat these forms of an illness. In order to enhance the effect of treatment, drugs that improve the performance of the immune system( immunomodulators) are prescribed, such as polyoxidonium, takwitin and especially lycopide.
These drugs always necessarily apply in parallel with the appointment of antibiotics for a special treatment regimen.
Treatment aimed at reducing symptoms of the disease( symptomatic treatment)
One of the main symptoms of the disease is joint pain, so for the relief of pain, doctors prescribe non-steroidal anti-inflammatory drugs( NSAIDs), which include drugs such as naproxen, diclofenac, meloxicamand other medicines.
In situations where the inflammation of the joints and pain in them are particularly pronounced, so that drugs from the NSAID group do not help, use intra-articular injection of hormonal agents( glucocorticoids - for example, methylprednisolone) directly into the affected joint itself.
Usually this method of treatment gives very good results, but it can be used only if the synovial fluid in the joint does not contain microorganisms.
In extremely difficult situations, when the two previous methods of treatment do not give the desired effect, and the symptoms of the disease and the level of inflammation are very high, the appointment of immunosuppressive drugs is indicated, which reduces the activity of the immune system, which has failed and "attacks" the tissues of one's own organism. These drugs include metatriksat and sulfasalazine.
Consequences and prevention
As a rule, with timely access to a doctor and adequate treatment, the illness ends with a complete recovery.
However, in some children, especially those with a genetic predisposition, the disease can take a prolonged or chronic course, periodically exacerbating and recurring. In some cases, spinal joints with manifestations of spondyloarthritis may be involved in the pathological process.
Prevention of infantile reactive arthropathy consists in the early detection and treatment of chlamydial infection - both in the child itself and in all members of his family, becauseThe probability of intrafamily transmission of this disease is quite high.
Is it possible to develop arthrosis of the knee joint in children?
Disease can occur in children, starting with infancy. This creates problems for the timely diagnosis of the disease.
Young children can not tell what hurts them. Meanwhile, arthrosis requires timely treatment, without which the child can begin complications of the disease. The knee can change its shape as a result of the destruction of the joint.
Osteoarthritis of the knee joint in children is manifested by painful sensations and stiffness in the morning after a long rest. The child may not inform parents about this phenomenon. He just becomes capricious, whiny, refuses to eat.
Gradually the inflammation of the joint becomes visible to the eye: the child swells and blushes his knee. Also the baby can be lame. He becomes less active, can change his motor habits. Also, the child can have a fever, becomes flaccid, gets tired quickly, and does not eat well. If you have these symptoms, you should contact your child's doctor.
Only the physician can diagnose pathology. In addition to a routine examination, the doctor prescribes laboratory tests that determine the presence of an inflammatory process in the body.
For the examination of the child, radiography is used, with which it is difficult to detect arthrosis at an early stage. Therefore, additional modern methods of examination, such as magnetic resonance imaging and computed tomography, are used. With their help it is possible to determine the presence of pathological changes in soft tissues and to reveal bone disorders.
Treatment of arthrosis
Treatment of arthrosis should be comprehensive, conducted under the strict supervision of a physician.
In addition to drug treatment, which is mainly aimed at stopping the symptoms of the disease, a number of physiotherapeutic procedures are carried out.
The child is prescribed a rest, in especially severe cases, can recommend the application of a tire to fix the knee. Popular means of treating arthrosis are hirudotherapy and acupuncture. They give positive results.
During the period of remission, a child is recommended to have a sanatorium treatment. He also needs to constantly engage in gymnastics, which is of great importance not only during the recovery from an attack of the disease, but also to maintain the state of the child.
In the most severe cases, if the treatment has not produced a result, surgical intervention is recommended for the purpose of stenting( endoprosthetics).Share this article with your friends:( 1 votes, average: 5.00 of 5) Loading. ..
All about knee arthrosis - causes, symptoms, treatment. ..
Knee pain is one of the most common complaintsa man that can not be ignored. Knee joints can be affected with quite serious diseases, with severe consequences, with lifelong preventive procedures and with limited mobility. For example, knee arthrosis. Do not know what this is? Then we will understand together: what does it mean, how it manifests itself, why it arises and how to cure the knee arthrosis? So, let's get started:
Knee arthrosis is a devastating affection of the knee joints, which leads to the destruction of articular cartilages, to the deformation of the knee itself and to the limitation of its mobility. In medicine, knee arthrosis is called gonarthrosis.
Causes of Knee Arthrosis
Knee arthrosis can occur for several reasons. Depending on the form of the disease, the following situations that affect the appearance of the knee arthrosis:
- Primary arthrosis - the main cause is a congenital joint defect. This form of arthrosis occurs in children with the incorrect formation and development of the ligamentous apparatus or the surfaces of the joints.then leads to an overload of the joint and, as a consequence, to the degenerative processes in it.
- Secondary arthrosis - occurs due to other diseases and injuries, such as:
- arthritis( or inflammation of the joints) - often prolonged arthritis leads to the formation of fluid in the joint cavity and to the occurrence of secondary arthrosis,
- trauma - dislocation, knee injury, a fracture of the bones of the lower extremities with damage to the ligamentous apparatus of the joint and its cartilaginous, bone parts;in this case, knee arthrosis is called posttraumatic,
- metabolic disorder - which leads to salt deposition,
- meniscus removal surgery - disrupts the integrity of the knee structure and provokes its rapid wear,
- other surgical interventions,
- excessive foot load whenexercise or because of excess body weight. ..
- a disease with prolonged spasms of vessels or leg muscles. ..
The most common knee arthrosis occurs in women aged 40 years and overweightand with varicose veins!
Knee arthrosis can develop both in one knee and in two at once, that is, it is one-sided or two-sided. For example, excess body weight is likely to affect the development of bilateral arthrosis, and trauma - to unilateral.
Symptoms of knee arthrosis
Knee arthrosis is characterized by a fairly long period of development, its initial stage can last as one year, and several years. At the same time, the disease does not manifest itself with severe symptoms, it does not cause severe pain, knee deformities. ...The only thing that can bother the patient, so it's easy discomfort in the knees, which occurs from time to time, and sometimes not at all noticeable.
In general, the knee arthrosis develops in three stages:
The initial stage of - as we have said, last for months, years. .. It manifests periodic pains in the knees. There is always a pain when climbing / descending the stairs, as well as when rising from bed in the morning.
The second stage of - pain intensifies, accompanied by a crunch, and is already felt in any movement, the articular cavity can contain liquid, the knee begins to deform, the volume of movements decreases.
The third stage of - painful sensations intensify, become durable and do not decrease even at rest of the knee. Deformity of knees is strongly pronounced, legs are bent in X or O-shaped. Joints do not perform their functions - the legs almost do not bend at the knees and do not fully extend to the end. The walk becomes either half-bent or waddling.
In this case, with post-traumatic knee arthrosis, signs develop much faster. The disease can develop in just a few months! First, the patient feels pain in the knee, there is some swelling. With physical exertion, pain intensifies, "stiffness", "tightness" of the knee appears. Well, then the disease is greatly progressing, also greatly deforming the legs and causing severe long-term pain.
How to treat knee arthrosis?
Treatment of knee arthrosis depends on two factors - the stage of the disease and the severity of the lesions. The main objectives of the treatment of arthrosis of the joints are to eliminate pain, in the restoration of the cartilaginous tissue, the ligamentous apparatus of the joint and in increasing the volume of movements of the affected knee. But the earlier you start the treatment of knee arthrosis, the better! After all, knee arthrosis is a chronic disease. If at the initial stages of development it is possible to eliminate its cause and completely cure the patient( to reduce body weight. ..), then in the 2-3 stages only remission, rest, with minimal manifestations of the disease is possible.
Various methods of treatment are used for the treatment of knee arthrosis. They are prescribed only by a doctor! !!The main ones are:
- medical treatment aimed at anesthetizing, on the removal of inflammation, on the activation of blood circulation in the affected joint and on the restoration of cartilage;
- manual therapy, massage with knee arthrosis - to relieve pain, spasms, to correct the position of bones, increase mobility and increase blood flow in the affected area of the joint;
- physiotherapy, exercise therapy, therapeutic gymnastics;
- surgical intervention, to be exact - prosthetics, replacement of a sick joint with a metal implant. The method is quite effective and provides full recovery, but there is one big "but" high price for the operation and limited rows of endoprosthesis operation, they require replacement;
- use of orthopedic devices for unloading the affected knee - orthoses, canes. ..
In addition, there are folk methods of treatment, there are a lot of them. But here you can not do without a doctor - not all methods can be useful and safe! Than to treat a knee arthrosis, what national recipes, the doctor should advise!
Prevention of Knee Arthrosis
To prevent the development of arthrosis in the knee joint, the following preventive measures are recommended:
- correct lifestyle( less to sit at the computer, more movements, exercise, gymnastics. ..)
- no bad habits,
- balanced nutrition( vitamins,proteins. ..),
- normal body weight,
- prevention of injuries when lifting weights, in sports classes. ..
And, of course, the most important thing is not to run knee arthrosis! At the first symptoms, contact a specialist doctor and begin treatment! As they say, everything is in your hands! Be healthy!
Symptoms of arthrosis in adults and children: crunching, obstruction, deformation
Most often, hip and knee joints suffer from arthrosis. Slightly less ankles and fingers. Other arthrosis joints are practically unaffected. Each of the types of arthrosis has its own individual characteristic symptoms, but in general the disease has the most common symptoms.
- Pain - the joint affected by arthrosis has its distinct painful sensations. First, the pain most often occurs during the period of movement. For example, while running, the patient experienced pain in the knee joint, but when he finished the exercise and immersed the joint in a calm state, the pain disappeared. This behavior of pain should alert and immediately seek medical advice.
Another type of arthrosis pain is night pain. Pain in the joints at night occurs as a consequence of inflammation. If the pain occurs more than one night in a row, then it can be characterized as rheumatoid and, of course, it is worth immediately contacting doctors for help. In this case, 2 degrees of arthrosis is assumed, and only the use of anti-inflammatory drugs can help.
- Joint crunch - the joint affected by arthrosis has its own tonality during crunching. It happens that the joint has become numb from a long, monotonous position and with a sharp movement crunched. This should not be feared, there is a poorly developed ligamentous apparatus, which in no way can indicate the presence of the disease. In the case of a crunch with arthrosis, one can distinguish its dry and coarse sound. The more the joint itself collapses, the sharper becomes the crunch.
- Difficulty in the movements of - since the 2nd degree of arthrosis, the amplitude of the joints is markedly reduced. In the affected joint, there are osteophytes( bone spines) that affect the decrease in the gap in the damaged joint, and thus cause spasms in the muscles.
- Joint deformation - changes in the appearance of the joint affected by arthrosis can be observed at grade 3.At this stage, osteophytes already fully expand around the joint. Also, with inflammation( synovitis of the joint), an excess fluid accumulates in its cavity, which has no outlet and this opens the affected joint.
The photo below shows how and how the osteophytes of
grow in the joint affected by arthrosis. If we perform X-ray examinations at different stages of arthrosis development, we will see the following symptoms:
With arthrosis 1 degree , no visible traces of the presence of arthrosis are observed, possibly narrowing the joint gap.
For arthrosis of the 2nd degree osteophytes begin to grow, the joint gap decreases 3-4 times( if to compare with the norm), cystic formations appear.
For arthrosis of grade 3 , complete destruction of the cartilaginous tissue of the joint, as well as ruptures of intraarticular ligaments and menisci, can be seen.
Symptoms of arthrosis in children
Even 10 years ago, arthrosis was considered a disease of the elderly. However, in our time it can be found even among children. Symptoms of developing arthrosis in children are similar to adults, but they have their own individual characteristics.
The main symptom of developing arthrosis in a child is pain. But in children during the period of growth there is also another pain, which is called pain of growth. It is important not to confuse pain with arthrosis with pain when developing a child's growth. When the pain grows, the child can become aggressive, as often can not understand and explain what is happening to him. In this case, the psychological aspect is very important. The child should not be scolded, but help to understand the problem.
The second symptom after pain, maybe joint deformity. Usually children are very restless and this often leads to minor injuries. In case of injury, the cartilaginous joint that has not yet matured is easily deformed. If you do not take the necessary measures in time, the disease progresses( during the growth of the child this happens much faster than in the adult).The most recent stage is when the joint becomes completely immobile.
It is necessary to monitor the baby's nutrition. Since often childhood obesity is a sign that indicates the development of arthrosis. At excess weight the child is difficult to move and more often to be in a sitting state, which in turn leads to stagnation of metabolism not only in the whole body, but also in the joints in particular.
There are no special preventive measures to prevent signs of arthrosis in children. It is necessary to strengthen the muscles and joints of the child from a small age, doing some sports or developing physical training of the child with classes.
At the first symptoms of arthrosis in children, it is important to immediately seek advice from pediatricians.