Pain in the knee joint
Diseases that cause pain in the knee joint
Pain in the knee joint is an unpleasant sensation that many people encounter when walking, performing physical exercises and even at rest.
The cause of discomfort can be trauma, as well as the following diseases:
Tendonitis of the knee joint;
of Baker Baker;
Infectious diseases of the knee joint: Lyme disease, Reiter's syndrome
It is the destruction of the cartilaginous tissue of the knee joint, as a result of which it deforms and disrupts functions. From gonarthrosis women suffer more often than men. It is also called arthrosis of the knee joint.
In accordance with the causes of the onset, two types of disease are distinguished. Factor contributing to the development of primary or idiopathic gonarthrosis is the elderly patient. Exact external causes in medicine are not established. This type of disease is two-sided, that is, it affects both legs. The second type of gonarthrosis occurs due to a knee injury or as a complication after infections. It can develop in a patient at any age and can be either unilateral or bilateral.
The main reasons for the development of gonarthrosis are fractures of the bones of the knee joint, arthritis, bone tissue tumors, arthroses and spondylitis.
The disease develops gradually and at the first stages it is practically not manifested. Among his main symptoms - acute pain in the knee joint after being in a state of rest, changes in the gait. Gradually, during the movement, discomfort passes, but after a long rest appears again. With gonarthrosis, osteophytes may appear. This is the name for the growth of bone tissue. As a result of friction of the cartilage tissues, the joint membrane becomes inflamed about these formations. The skin in this place is redder, a tumor appears, the patient's temperature rises.
Stages of gonarthrosis:
Deformation of the joint is almost imperceptible. Periodically, slight pain may occur;
Deformation is clearly visible at this stage. The pain intensifies, the attacks become longer. A crunch in the knee joint is possible;
The disease is rapidly progressing. Now the pain is felt both during movement and at rest, the gait changes.
Gonarthrosis is diagnosed on the basis of an X-ray and visual examination of the knee joint. It is recommended to perform foot massage to improve blood circulation. This will reduce pain. For the same purpose, venotonics and vasodilating agents are used. Analgesics help to get rid of pain. Chondroprotectors act on the cartilaginous tissue. At the third stage of the development of the disease, surgical intervention may be required. Endoprosthetics can replace the knee joint, completely restoring all its functions. With the help of arthroscopy, it is possible to slow down the development of gonarthrosis.
In the knee joint, there are two special cartilaginous pads that facilitate the load on the joint during active movements. They are called menisci. The medial or inner meniscus is damaged less often than the lateral, known as the outer one. Such a trauma can occur in a person regardless of age and type of activity. The development of meniscopathy is promoted by jumping, squats, skiing. At risk are those who suffer from gout or arthritis, diabetes mellitus, have weak ligaments or excess weight, increasing the load on the joints.
The main symptom for a meniscus injury is a click in the knee joint, and then a sharp pain. The younger the person, the sharper he feels. In elderly people cartilage is not saturated enough moisture, so the sensations are weaker. When severe pain occurs, the patient stops moving. Gradually, the discomfort passes, and then again a person can hardly walk. The next day the knee swells up, but it is a protective reaction aimed at restoring a clamped meniscus after an injury. Otherwise, the disease becomes chronic. The duration of the attack of pain is several weeks. During this time the swelling is gone. In the absence of the necessary treatment meniscopathy is periodically manifested by attacks of severe pain and as a result can lead to arthrosis.
The most reliable diagnostic method in this case is magnetic resonance imaging. In the course of this, the nature and degree of damage to the meniscus is determined. If it is completely torn off, surgery is necessary. The surgeon removes completely the meniscus or part of it. Therapeutic methods are effective in pinching or tearing. Restore the functions of the knee joint in this case, you can in several sessions with a traumatologist or chiropractor. Edema can remove corticosteroids and non-steroidal anti-inflammatory drugs. But first of all it is necessary to eliminate the cause of the tumor.
Arthritis is considered the most common form of knee disease. It involves the defeat of the synovial membrane, capsules, cartilage. If there is no treatment for this disease, the patient may lose his ability to work, lose the opportunity to walk and actively move.
Arthritis can be of the following types:
rheumatoid - factors contributing to its development are unknown;
post traumatic - is the result of sprains, bruises, tears, damage to the meniscus;
reactive - the cause of its appearance is considered food poisoning, infection of tissues;
deforming - occurs when circulatory disturbances occur;
gouty - is caused by malfunctions in metabolism in the body, deposits of urate sodium.
In addition, arthritis is primary when it occurs as a result of an injury and the development of an infection against it, or secondary, when inflammation occurs in other tissues, and enters the knee joint with lymph or blood.
The development of the disease contributes to overweight, increasing the load on the joints, and the elderly, as over time the cartilage and bone tissue wear out. Significant physical activity, frequent weight lifting, and immunodeficiency also lead to arthritis.
Attacks of the disease are accompanied by unpleasant sensations in the knee joint, redness, swelling. They become longer and more painful as arthritis develops. With the formation of pus in the patient, the temperature rises.
Treatment involves measures aimed at eliminating edema, discomfort, restoring the functions of the knee joint, preventing new seizures. Relief from pain is carried out with the help of non-steroidal anti-inflammatory drugs and analgesics. Effective warming and distracting ointments, as well as restorative drugs. In the period of remission, physiotherapy, massage and therapeutic gymnastics are prescribed.
If conservative treatment does not yield the necessary results, surgical intervention is performed. Folk remedies can be used after consultation with a specialist when combined with medications prescribed by a doctor.
This disease affects the periarticular tissues: muscles, ligaments, tendons, joint capsule. Periarthritis is more susceptible to places, which account for a significant load during movement, including the knee joint.
The cause of its development are chronic diseases, frequent hypothermia of the body, problems in the work of the endocrine system, peripheral vessels. Post-traumatic periarthritis occurs as a result of joint damage.
This disease is characterized by aching pain in the knee joint area, edema formation. Upon examination, the doctor can identify the presence of nodules and small seals. When you press on them, the patient experiences significant pain. When walking, there is discomfort in the knee joint.
During treatment it is recommended to limit movement and more often to be at rest. To remove inflammation and reduce the pain allow non-steroid drugs, such as diclofenac. With periarthritis, physiotherapy is performed. The most common exposure to cold is local cryotherapy, infrared laser therapy, the application of paraffin-ozocerite applications is used. It is necessary to improve the condition of the periarticular tissues.
Older women often suffer from a particular form of this disease - the periarthritis of the goose paw bag. It involves inflammation of the knee tendons from the inside. Edema, joint deformation does not occur. Pain is felt only when moving on uneven surfaces, when wearing shoes with high heels. If the disease is diagnosed on time, then in the early stages of development it can be cured quickly. For this, it is necessary to carry out physiotherapy procedures, to administer the medications prescribed by the doctor.
Tendonitis of the knee joint
It consists in inflammation of the tendon tissue in the area of its attachment to the bone or in the area of the muscle-tendon junction. This disease is known as the "knee jumper".In many ways, this is due to the fact that the cause of tendonitis is the employment of such sports as basketball, cycling, volleyball. Athletes, older people, adolescents and children - that's who is most susceptible to the disease. It affects the patellar patch, responsible for the implementation of flexion and extensor movement. Tendonitis can appear only on one leg or both at once and can be of two types: tendobursitis and tendovaginitis. In the first case, the tendon bag inflames, and in the second case, the tendon sheath.
The causes of tendonitis are:
other diseases( gout, rheumatoid polyarthritis);
injury, sprains, bruises;
constant physical activity;
fungal infections, parasites.
With tendinitis, pain often appears when weather changes. The knee joint swells, there is a restriction of its mobility, and when it moves - creaking. Attacks of pain provoke active movements. In later stages of tendonitis, a patellar ligament can be broken.
During the X-ray, the disease is detected when the cause of its occurrence is the deposition of salts, bursitis or arthritis. Laboratory tests in diagnosis are effective when tendonitis occurs as a complication after infection. Detailed information on the deformation of the tendons allows obtaining different types of tomography.
In the first stages of the disease, conservative treatment methods can be managed. It is necessary to limit the motor activity. In some cases, the immobilization of the knee joint is required, so use gypsum or a langnet. The doctor prescribes medicines( non-steroidal, anti-inflammatory) and physiotherapy. In critical situations, injections of corticosteroids and antibiotics are necessary. From physical therapy, magnetic, iontophoresis and electrophoresis are often used. Surgical removal of degenerative tissues at the last stages of tendinitis. With the accumulation of pus in the region of the knee joint, an opening and pumping is performed. Medication can be combined with the use of traditional medicine to get the best result. Under the supervision of the trainer, it is also recommended that you exercise. After recovery, you can go to normal sports. Positive influence on the condition of the knee joint with tendinitis is provided by yoga.
Rheumatoid arthritis refers to a systemic disease and manifests itself in the form of inflammation of the connective tissue. The exact reasons for its appearance are not known. There is a genetic predisposition to rheumatoid arthritis. At the moment of weakening of immunity, the disease begins to develop actively. They suffer both men and women at any age. It affects the connective tissue in the region of the joints, which account for a significant load, including the knee. The lack of timely diagnosis and treatment of rheumatoid arthritis in most cases leads to disability and even death. Death comes from infectious complications and kidney failure.
There are factors that contribute to the development of rheumatoid arthritis. This is a constant emotional tension, frequent hypothermia of the body.
In accordance with the symptoms, the following stages of development of rheumatoid arthritis are distinguished:
Swelling and swelling of the knee arises. The patient is in pain. An increase in body temperature is possible;
Inflamed cells actively divide. This causes the compaction of the synovium;
At the last stage, bone and cartilaginous tissue is affected. The knee joint deforms and does not fulfill its functions. Attacks of pain become stronger and more lasting.
Rheumatoid arthritis develops slowly. The first time can manifest only in the form of stiffness in the knee joint after being in a state of rest for a long time, for example, in the morning on waking. Pain occurs at night and with a sharp change of weather.
Diagnosis of the disease on the basis of biochemical analysis of blood, X-rays and pronounced external symptoms: redness of the skin, swelling, joint deformation, pain in it. If arthritis is caused by an infection, then antibacterial drugs are prescribed. Relieve pain in the joint and inflammation is helped by corticosteroids and non-steroidal anti-inflammatory drugs. It is also necessary to practice therapeutic gymnastics and regularly do massage.
Inflammation, which occurs inside the synovial bag, in medicine was called bursitis. Its cause is the accumulation of exudate, that is, a liquid containing dangerous microorganisms. Bursitis occurs as a result of a knee injury, significant physical exertion to it or as a complication of an infectious disease. Arthritis or gout also contribute to its development.
Bursitis can be determined from the stiffness of movements, pain in the knee joint area. Inflammation is especially noticeable after pressing movements on the skin. The patient experiences weakness, malaise, may lose appetite. If the cause of bursitis is an infectious disease, the body temperature rises. Its important difference from arthritis is the preservation of the ability to perform flexion-extensor movements.
During the diagnosis, the doctor examines the symptoms of the disease, examines the knee joint. To accurately determine the nature of the accumulated fluid, a puncture is performed. At the first stages of development of bursitis with it you can cope with the help of compresses, wraps. The patient must comply with bed rest. With chronic bursitis, a puncture is made to remove the accumulated fluid inside the bag, and then rinse the cavity.
This chronic disease is associated with deposits of sodium monoaurate, which provokes attacks of acute pain in the knee joint. Gout is more common in men than in women. The causes of its development is the violation of urinary metabolism, as a result of which the level of uric acid rises in the blood. This leads to the use of excessive amounts of products containing purines. These include meat and fish. Promotes the development of the disease and alcohol abuse.
Gout is manifested in the form of sharp pains in the knee joint and redness of the skin in this area. In soft tissues dense nodules - tofusi are formed. They are a collection of uric acid. Sometimes tofusi breaks, and it comes out. Attacks of pain with gout can last for several days or even a week.
To determine gout, you can by high content of uric acid in the blood. For this, a biochemical analysis is done. Also as part of the diagnosis, radiography is performed. To cope with the attack of gout, you should follow a diet, less to move. The patient should be provided with emotional and physical rest. The diet is combined with drug therapy.
Disturbance of the processes of bone formation leads to deformation of the skeleton, brittle bones. In medicine, this phenomenon is called Paget's disease. It affects the tubular bones of the legs and can cause pain in the knee joint. In men, Paget's disease is more common than in women. It usually occurs in people in old age.
It is difficult to determine the presence of this disease, as it may not be accompanied by any symptoms. In some cases, patients can feel pain at night, and the place of the affected bone feels warm. Diagnosis of Paget's disease is carried out using a biochemical blood test, which shows an increased content of phosphatase, biopsy and x-rays.
Relieve pain with non-steroidal anti-inflammatory drugs. In general, the treatment is aimed at preventing complications of Paget's disease: increasing the strength of bones, reducing their fragility. This is possible due to the use of bisphosphonates and preparations serving as a source of calcium. Regularly you should take tests and see a doctor. In neglected cases, rehabilitation is carried out in the clinic. With Paget's disease it is worth keeping to a diet, conducting physical education classes under the supervision of a specialist and avoiding falls and injuries. Because of the fragility of bones, the probability of fractures is high.
This disease occurs in at least 5% of the population. Fibromyalgia is expressed in the form of symmetrical musculo-skeletal pain, often appearing in the region of the knee joint. The reasons for its occurrence are poorly understood, but it is known that discomfort is not caused by inflammatory processes.
The main complaints in patients other than musculoskeletal pain are poor sleep, fatigue, loss of strength, intestinal disorders, convulsions and spasms, numbness and morning stiffness. The commonality of symptoms often becomes the cause of an incorrect diagnosis. Fibromyalgia can be confused with depression.
The cause of the disease is considered stress, emotional stress, accelerated exchange of serotonin, physical trauma. Diagnosis of fibromyalgia is carried out by various methods and is selected by the doctor individually. Often, the presence of the disease is determined even by excluding the presence of other ailments.
Treatment is medication and non-pharmacological methods. The patient in most cases necessarily prescribed antidepressants, painkillers. It is recommended to avoid stressful situations, play sports, keep to a diet, and perform massage sessions.
The diagnosis of "osteomyelitis" is made if the patient develops a purulent-necrotic process of bone and soft tissues around her. They are caused by special bacteria that produce pus. Infectious agents penetrate in various ways: endogenously - through the blood, spreading from the focus of inflammation, exogenously - as a result of fracture treatment, tooth filling. Osteomyelitis can be caused by trauma or Staphylococcus aureus.
There are 2 main types of disease: hematogenous and traumatic. In the first case, osteomyelitis for a long time does not appear externally. However, the patient may experience malaise, weakness. Then there is a sharp increase in body temperature and there is a sharp pain. Inflammatory process proceeds very quickly. Possible sepsis, leading to the death of the patient. Traumatic osteomyelitis develops when the treatment was started too late. Attacks of pain in this case alternate with a state of rest.
Treatment of osteomyelitis is medicated with antibiotics and surgically. In the course of the operation, pus, dead tissue cells are removed.
In medicine, a Baker cyst is a knee or popliteal hernia. Its size can vary, but rarely exceeds several centimeters. Most often occurs in people after 30 years and in children aged 3-7 years. Baker's cyst is formed due to damage to the knee. Also, it is caused by diseases such as arthritis and osteoarthritis.
Because of the small size of Baker's cyst, sometimes even a doctor may not be detected. The patient does not cause any anxiety, changes in his state of health are not observed. There may be pain in the knee, swelling, unpleasant sensations when performing flexion-extensor movements. In some cases, the cyst eventually passes by itself.
In the presence of severe pain, aspiration occurs. It is also necessary if the cyst is large. Good help to ease the pain of non-steroid drugs, but they can only be taken under medical supervision. Remove inflammation allows the imposition of compresses, performing physical exercises aimed at strengthening the knee.
This disease is often called dissecting osteochondrosis. The area of the cartilage can be detached along the bone and move freely in the knee joint. This makes it difficult and causes pain. This phenomenon is called König's disease. Most often it occurs precisely in the knee joint. Isolate the adult form of the disease, which is treated more difficultly, and nursery. In the course of development, König's disease passes through 4 stages.
To its symptoms include dull pain, in the joint accumulates synovial fluid. Unpleasant sensations are most strongly felt during movement. The separation of the cartilage exposes the bone, which is accompanied by inflammation, which is manifested by edema. The most informative is the radiation method of diagnosis in König disease.
At the initial stages, it is possible to cope with it with the help of conservative methods of treatment. For older patients, as well as in later stages, surgical intervention is usually required. The patient needs physical and emotional rest.
This disease manifests itself in the form of the formation of a painful cone in the region of the patella. Suffer them children and adolescents. A high risk of Osgood-Schlatter disease in those who engage in sports, for example, basketball, figure skating, ballet. The most common problems with the patella occur in boys. Doctors attribute this to the fact that they are subject to more serious physical exertion than girls.
The main symptoms of the disease are edema in the knee area, swelling, severe pain moving: running, jumping. The tuberosity is noticeable to the touch. Osgood-Schlatter disease affects, as a rule, only the knee of one leg.
It goes by itself with age. But in some cases, physical therapy or medication is required, which involves taking painkillers. You can make cold compresses on your own. It is necessary to use the patella when doing physical exercises. Therapeutic gymnastics helps to strengthen the tendons, but it must be conducted under the supervision of a doctor.
Infectious diseases of the knee joint: Lyme disease, Reiter's syndrome
Lyme disease develops after the bite of an infected tick. It acquires a chronic and recurrent character as the pathogens multiply in the body. Diagnosis of the disease can be based on a biochemical blood test.
In Lyme disease, the patient experiences pain in the muscles and tendons. Most often it affects the knee joints. Possible arrhythmia, headaches, depression, weakness. When diagnosed, Lyme disease is easily confused with another disease, so at the first suspicions it is necessary to consult a doctor so that he confirms the presence of infection and prescribes antibiotics.
Reiter's syndrome is called inflammation of the urinary tract, eyes and joints, including the knee. When urinating, patients feel itching, stinging and burning. In the knee joints, severe pain is felt, and the lesion usually has an asymmetrical character. The skin in the region of the knee acquires a reddish hue, the swelling is formed. The disease can have both acute and chronic form. The cause of it becomes a genito-urinary or intestinal infection. After diagnosis, non-steroidal anti-inflammatory drugs are treated.
Article author: Muravitsky Igor Valerievich, rheumatologist
Gout - symptoms, treatment, photos, diet for gout
To the causes of the disease is also attributed to malnutrition( with a predominance in the diet saturated with purine products), excess weight, endocrine disorders in the body, certain pathologies of the circulatory system. Provoke another attack of gout can use alcohol, taking certain medications( antibiotics, diuretics), but most often the disease worsens without any specific reason, usually at night.
Symptoms of gout
Initially, the disease affects the large joints of the lower extremities, first of all the toes suffer. Gout on the legs is a common occurrence in the life of an elderly person who, in his youth, abuses alcohol and neglects his food. The disease begins with an inflammation of the joint of the big toe. The so-called gouty arthritis is accompanied by:
- increase in joint size;
- severe pain in the place of localization of the inflammatory process;
- by local body temperature increase;
- redness of covering the diseased joint of the skin.
The first attack of gout is usually short-lived, in the absence of treatment passes within a week. The second such attack can occur several years later, more rarely - decades. Such signs of gout as joint deformity, proliferation of its tissues are noted with the advanced form of the disease. To change the appearance of the joint leads to the gradual accumulation in it of salts of uric acid. In particularly neglected cases, gout becomes the cause of the patient's disability.
Treatment of gout
The basis of therapy is a special diet, aimed at reducing the ration of patients with saturated with purine products. Medications prescribed during the period of gout exacerbation help to alleviate the patient's condition, reduce the risk of complications. To eliminate the symptoms of arthritis, anti-inflammatory( nonsteroidal) drugs( Colchicine) are shown, with severe pain, pain medications.
The drugs prescribed for the treatment of gout are Uralit and Allopurinol, which help to reduce the level of uric acid in the blood by its natural elimination from the body. Regular reception of these funds helps to avoid exacerbations of the disease in the future.
Sick mud baths, applications with Dimexide are recommended for patients with exacerbation. With severe deformation of the joints, surgical intervention is performed.
Treatment of gout with folk remedies
Traditional medicine can be used as an auxiliary therapy in this case. Such therapy gives, as a rule, very good results. Elimination of severe joint pain is promoted by compresses from cabbage leaves. Leaves are thoroughly washed with warm water, dried and applied to the sore spot for the night, from above covered with bandage or gauze. Long-term use of this tool( daily, for a month) helps to reduce the risk of an attack in the future.
Also folk medicine recommends in the therapy of gout to use dogrose, garlic, ginger, baking soda, herbs of medicinal herbs( chamomile, marigold, St. John's wort, turns).Decoctions in this case can be used not only as a compress to a sore spot, but also as a drink.
Diet for gout
Patients with a similar diagnosis should take a more careful look at their diet, in particular to exclude from the diet saturated with purine products, because uric acid deposited in the joints and provoking their inflammation, is a derivative of these compounds. Nutrition for gout should be organized in such a way that the body does not suffer from the lack of some of the usual food for him. For example, fat red meat should be replaced with boiled chicken breast, white bread - bran, etc.
The diet should be observed for a long time. Otherwise, the risk of gout and progression of the disease increases.
What can not be eaten with a gout
With gout, you should stop using:
- fatty meat;
- by-products( kidney, liver, language of farm animals);
- of red fish;
- sweet carbonated water.
There are products, the use of which is acceptable, but not desirable. Chicken eggs, boiled lean meat, bread, mushrooms, cereals, peas, and beans are allowed in small quantities.
What you can eat with gout
The daily ration includes:
- vegetables. It is desirable in a boiled form, steamed, baked in the oven with a small addition of salt;
- dairy products;
- berries, mainly currants of different varieties, watermelons;
- bran, bread from bran;
- nuts, fruits and dried fruits;
- mineral water.
There are products that reduce the level of uric acid in the blood. It is primarily red and black currants, strawberries, raspberries. Also recommended for use are morsels, broths from currant leaves, dried raspberries.
Drug for gout
Drugs designed to fight gout, a lot, they all have a similar effect - reduce the level of uric acid in the blood of a person.
Traditionally, allopurinol is prescribed in the form of tablets. The drug interferes with the synthesis of uric acid in the body, contributing to the development of the enzyme xanthine oxidase, removes from it the already existing deposits of salts with urine. The drug is not contraindicated in the presence of kidney diseases, it is recommended for the prevention of gout in elderly people. Among its side effects, the greatest danger to the body is a violation of liver function and an increase in the level of sugar in the blood, but such effects in case of proper administration of the medication, as a rule, do not arise.
In the presence of significant deposits of salts of uric acid in joints, the use of drugs Solimok, Ortophen, Indomethacin( with a pronounced pain syndrome and inflammation of the joints) is indicated.
Ointment from gout
Local preparations for gout give a good therapeutic effect, their use helps to eliminate the pain symptom, reduce the inflammatory process in the patient's joint, facilitate the general condition of the patient.
In the treatment of inflammatory diseases of the joints, a 2% Diclofenac ointment based on the active ingredient diclofenac sodium is widely used. The product has a slight anti-inflammatory effect, quickly eliminates pain, is recommended for use in exacerbating gout.
A similar action is possessed by the ointment Fullflex. It is worth remembering that such drugs are struggling with the manifestations of gout, but in no way hamper the progression of the disease, and therefore, as the main remedy can not be appointed.
Prevention of gout
Prevention of disease can be considered correct nutrition in youth, not abuse of alcohol, especially after 40 years. Individuals who have already been diagnosed with the same condition must be constantly under the control of specialists, regularly undergo an examination of the body. In half the cases, the neglected form of the disease leads to complications from the excretory system( renal dysfunction) and disability.
The main causes of pain in the knees: what diseases cause them? Notes by the therapist
why there are pains in the knees
Pain in the knees is a common symptom of various leg diseases. About some of them you can find out in this article. Some causes of painful symptoms in the knee area may not even be directly related to the knee joints, but to be symptoms of diseases of very different joints. And since the treatment of coxarthrosis of the hip joint is not an easy task, it is worth taking a closer look at your health, and if you have pain in your legs, consult a competent doctor. But first things first.
Knee joint rupture
A rupture of the ligaments of the knee joint is a common phenomenon in road accidents, falls from a height, with strong actions directly attached to the shin area. Sometimes it is not the rupture that is diagnosed, but the tension( tear) of the ligaments. Classify the gaps for the following subspecies:
- rupture of lateral ligaments: significant lateral motor activity of the tibia with violent abnormalities;
- rupture of cruciate ligament: the appearance of hemarthrosis, which makes diagnostics difficult;
- rupture of the patellar ligament: a sharp gait disturbance, the affected limb seems to be bent at support, no hemarthrosis.
Treatment: application of gypsum tutor to the thigh and lower leg, immobilization period about a month, then a course of exercise therapy, massage, and various physiotherapeutic procedures are also useful.
Fractures( closed, that is, with intact skin surface, open - fractures with soft tissue damage) of the knee joint: marginal, longitudinal, transverse, oblique, helical and comminuted.
Symptoms: almost absolute limitation in movements and unbearable pain, increasing gradually. Treatment conservative: fixation with plaster bandage, use of skeletal traction.
Knee joint bursitis
Knee joint bursitis is a disease accompanied by an inflammatory process in the synovial bag, while fluid accumulates in it. Clinic: swelling, swelling, reddening of the skin in the affected area, all symptoms are accompanied by severe pain.
If the bursitis is in the region of the bone of the patella, then there may be a febrile condition. Treatment: it is necessary to undergo an X-ray examination, then the doctor will suggest a puncture for pumping out excess fluid. The next days you need to take drugs of the NSAID group.
Osteoarthritis of the knee joint is degenerative arthritis, in other words, the condition of the joint's wear, namely, cartilaginous formations. Clinic: due to the fact that this disease develops gradually over time, the symptoms have an unstable tendency - discomfort increases in the morning, pain, then subsides, then increases, the joint swells especially during periods of sharp weather changes.
Other symptoms of this disease are tenderness of the joint, knee deformation leading to restriction of movement, stiffness in the morning hours.
Treatment combines physiotherapeutic and pharmacological methods, the latter is the use of anti-inflammatory drugs, strength exercises and aerobics are very useful.
Knee Gland Knock
Knee Gout is a chronic disease caused by an impaired metabolism. Clinic: redness of the affected area, swelling, intense pain in the knee, which occurs suddenly. Pain in the joint lasts an average of a week and subsides, after two weeks of discomfort.
Also characteristic is the formation of nodules of different sizes( tofusi - the region of uric acid concentration), which are localized in the soft periarticular tissues.
Tendonitis of the knee joint
Tendonitis of the knee joint or knee tendonitis is a disease accompanied by inflammation of the joint or tendon, which on the outside cause severe swelling and redness of the skin. Treatment: anesthesia, inflammation with the help of preparations of the NSAID group, as well as the use of stretching exercises and muscle strengthening.
It should be noted that pain does not always cause complications in the knee, but this is not a reason not to seek qualified help from a doctor. Because the pain that appeared one day in the region of the knee joint may appear again, but with a stronger intensity.
To relieve the knee of pain and discomfort, you must first remove the inflammation and swelling, which are formed, usually after an injury. The first help in such cases is simple measures that you can do yourself before calling a doctor:
- protection of the knee joint by applying bandages;
- rest and rest of the affected joint;
- applying ice to the affected area, which prevents the formation of a tumor( 15 minutes every 4 hours);
- compresses, which prevent accumulation of fluid and edema;
- position of raised legs if possible, which will additionally help to avoid swelling of the joint.
Pain in any area is a signal of an incident of a negative phenomenon in it. The knee joint is the basis of the human musculoskeletal system, and the appearance of pain in it is a sign of serious violations, which should be disposed of together with a medical specialist.
On other causes of pain in the knees, you can find out on the site "Arthrosis - no."
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Gout, gouty arthritis: symptoms, signs and treatment
Gout , or gouty arthritis is a disease in which metabolic disorders occur in the body and joints are deposited in the jointsuric acid. This is a very unpleasant, but easily amenable to treatment of disease.
occurs with the gout relatively infrequently. Although the very word "gout" I hear almost every day. For example, most grandmothers call "gout" arthrosis of the big toe. Usually they say: "My leg has grown gout."
Actually, gout, although it affects all the same big toes, is most often the lot of men. In women, gout( real, true gout) is several times less common.
Earlier, some 100 years ago, gout was generally considered exclusively a male disease. But in our time, due to the fact that women began to eat better, there are more meat and sausages, gout began to occur more often than, for example, a century ago.
In addition, gout in women began to occur more often due to the use of certain drugs, primarily - drugs for high blood pressure. Some drugs to reduce high blood pressure with prolonged use lead to an increase in the concentration in the body of uric acid. But all the same in men gout shows itself much sharper and "more aggressive", because the concentration of uric acid is significantly influenced by male sex hormones.
Below I will tell you about symptoms of , signs of and treatment of gout , and about which diet to adhere to in this disease.
Symptoms of gout
"Classic" gout refers to a group of arthritis. It develops in people who have a hereditary predisposition to this disease. And a potential patient may not even suspect about his heredity.
Say, if his parents or relatives lead a healthy lifestyle, do not abuse alcohol and eat right, the disease may not manifest themselves and will last a lifetime only in a latent, latent form. And our potential patient, who is predisposed to this disease, will provoke a disease only if he leads a lifestyle that is not quite healthy( from the point of view of the propensity to gout).
For example, a typical gout is often( but not always) a full man who abuses either alcohol or so-called "purine food": meat, meat soups, smoked foods, fish-salted foods, by-products( liver, kidneys), beans,beans, chocolate, grape wine.
Abuse of these products leads to an increased formation of uric acid in the blood, which in turn forms a poorly soluble salt of sodium urate. When the concentration of uric acid in the blood reaches the limit level, its salts in the form of microcrystals are deposited in the joint cavity, forming there a kind of "depot".
The presence of sodium urate microcrystals in the joint cavity is a serious irritant for it. But nevertheless, crystals can be asymptomatic for a long time in the joint - until any provocation( physical overload, stress, prolonged fasting or, on the contrary, search of "purine products" and alcohol) provokes an acute gouty attack, that is,a gout attack. It is regular acute attacks of gout - the main sign of this disease.
Symptoms of gout
The first attacks of gouty arthritis are almost always short-term. The attack usually begins suddenly, most often at night. Most joints are inflamed( sometimes one, sometimes both).Less commonly, the thumbs on the hands, knee, ankle, elbow joints, calcaneal tendons and rarely - wrist joints are inflamed.
The pain is such that, according to the stories of my patients, I want to literally "climb on the wall" from her. The affected joint swells, reddens, the skin above it becomes bright red or purplish and hot to the touch. Even a slight touch to the inflamed joint or the slightest movement in it causes unbearable pain.3-4 days the patient is suffering, when suddenly the attack passes, as if nothing happened.
However, after a while, the pain also repeats itself suddenly. And, if at the beginning of the disease intervals between attacks are long enough, from one to eight months, and the seizures themselves are short, then everything changes with time. Attacks are becoming more durable, and the intervals between them are shorter.
Eventually, there comes a time when the pain in the joints becomes permanent, and the intervals between attacks are practically absent. This condition is called "gouty status", or chronic gouty arthritis. In chronic gouty arthritis, the articular cartilage is destroyed, and special defects are formed in the bones adjacent to the joint - piercers, which are a cavity filled with sodium urate microcrystals.
In addition, sodium urate crystals can be deposited even under the skin, forming whitish solid nodules, filled with a gritty mass. Such nodules are called tofus, and most often they are located on the auricles or near the joints. Sometimes tofusi break through and through the formed fistula crystals of uric acid are allocated. Fortunately, usually within a few days after the tofus breakthrough, the wound heals without consequences.
In addition to the above troubles, gout, especially neglected, is almost always accompanied by the deposition of urate in the kidneys, which leads to urolithiasis, and sometimes to inflammation of the kidneys( pyelonephritis).
It's important to know! Female gout options usually flow much softer. Women rarely have acute gouty attacks, far toffee and punching in bones are much less common. Most often, female gout shows itself as blurred chronic pain in the knee or ankle. And to guess that this is not an arthrosis, an experienced doctor can only by the strong puffiness of the inflamed joint, uncharacteristic for arthrosis.
Diagnosis of gout
Assuming the presence of gouty arthritis in the patient( and in classical cases it is quite easy), a competent rheumatologist or arthrologist will send the patient to the x-ray of the hands and feet, as well as a biochemical blood test.
When the gout is started, the doctor will easily detect on the X-ray images of the hands and feet the characteristic gouty "piercers" in the periarticular bones. A blood test will show an increase in the level of uric acid. If this increase is clearly expressed and is combined with the presence of "piercers" in the bones and characteristic gouty symptoms, the diagnosis is considered reliable, and then we only need to choose the right treatment.
The problem, however, is that if you do uric acid analysis at the time of the attack( and it is usually at this time that the patient consults the doctor), then such an analysis may not record any deviations. That is, at the time of an attack, the level of uric acid in the blood can turn out to be normal( because at the time of an attack the maximum amount of uric acid goes to the inflamed joint).
Therefore, it is necessary to measure the level of uric acid in the blood several times, including interictal periods. But this is often not enough patience for patients with gout. As soon as the next attack "comes to naught," they often again completely stop thinking about their health.
Meanwhile, without proper diagnosis and without proper treatment, gout can lead to very undesirable consequences not only for the joints, but also for the kidneys.
Continuing the topic, I want to note that, despite the frequent mention of the term "gout" in literature and in conversations, in fact it turns out that the correct diagnosis of patients with gout is not always and often with great delay. Sometimes you have to deal with monstrous diagnostic errors.
For example, one of my patients at the time of the attack, surgeons managed to diagnose "gangrene of the big toe," and amputated a gouty finger with a gout. Literally in 3 weeks he had a big thumb on the other leg, and the patient was going to amputate him too! Fortunately, the man guessed that this time it would be necessary to consult another doctor, and turned to me for help. On examination, it became immediately clear that the patient did not have gangrene, but classical gout. I prescribed a colpicine for the patient, and the attack was eliminated literally in one day! From the imaginary gangrene, the next day there was no trace left.
Another patient for seven years was treated for arthrosis, despite the fact that his joints were inflamed with attacks, alternately, about once a month, and the inflammation never stayed longer than 5-7 days. The most surprising thing in this story was that the patient in numerous blood tests taken from a vein, uric acid just off scale. She was above the norm more than 2 times! But the doctors over and over managed not to pay attention to this. And they continued to bend their line. In one of the attacks, a man even managed to operate his knee and removed a completely healthy meniscus. But the operation, of course, did not bring any relief to the patient. The knee periodically continued to become inflamed along with other joints.
Only after the man came to see me and put in front of me a pile of tests, where the constant increase in the level of uric acid was clearly read, the patient was finally picked up adequate anti-gouty treatment. And already a month after the beginning of treatment, gout attacks, for the first time in all past years, began to come to naught. And then stopped at all.
Treatment of gout
Having diagnosed the patient, I usually without any irony say: "Congratulations, you have gout."I really do not sneer, because of all the possible diagnoses this one is one of the most favorable. Gout is very easy to treat and does not represent a particular difficulty for a competent specialist.
Although here, as often happens, there is a "spoon of tar in a barrel of honey".Yes, gout is treated very well, but many patients with gout do not want to accept the conditions that are necessary for recovery - as "conditions" is the rejection of those foods( and alcohol) that caused metabolic disorders. And when I tell patients that to get rid of the disease, I must give up my favorite foods and alcohol, I often just do not want to hear. Because every time I have to patiently explain that without a diet there can be no question of recovery - no matter what "steep" drugs are not used. Another thing is that in many cases the diet is a temporary measure, and if certain conditions are met, after a year or two severe restrictions can be canceled.
Drug therapy gouty arthritis consists of two components: treatment of an acute attack and therapy of the actual gout.
Non-steroidal anti-inflammatory drugs( voltaren, ibuprofen, movalis, nimulide, etc.) are successfully used to stop acute gouty attacks, or a short-acting special antidotal agent called colchicine. Locally on the affected joint, you can put a vodka compress.
Preparations for arresting an acute attack do not last long, with a short three to seven-day course. And directly for the therapy of gout, in the absence of contraindications, for several months or years, use the drug that reduces the formation of uric acid in the body - purinol, the same allopurinol .
Compliance with the diet and the use of purinol( allopurinol) leads to the normalization of patients during the first month of therapy. Although the first week, against the background of therapy with purinol or allopurinol, there may even be an exacerbation of the disease. But then the attacks become weaker and happen less and less, and eventually stop at all.
And after about a year, with the well-being of my ward, I allow some indulgence in his regime. I ask the patient what he would like to cancel - a diet or taking medication, because we can limit ourselves to something else. If the patient is already accustomed to a diet, then there is no point in breaking it. In this case, it is better to reduce the dose of medications taken or to abolish them altogether.
If the patient with difficulty endures restrictions in nutrition, then you can abandon the diet, but continue to take medication. However, the use of drugs will take several years - which, in general, is not terrible, since purinol( allopurinol) rarely causes any side effects and is generally well tolerated by patients.
Article of Dr. Evdokimenko © for the book "Arthritis", published in 2004.Edited in 2011. All rights reserved.
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Gouty arthritis: symptoms, photos, folk remedies and diet
- Treatment by popular methods
The process, which results in the deposition of urate salts in bones, joints, tendons and other components of the body, is called gouty arthritis. The disease usually occurs because of improper metabolism. It is accompanied by a defeat of tissues and organs, attacks of acute, most often nocturnal painful sensations. In advanced cases, deformation of the affected area occurs.IMPORTANT TO KNOW!A new means of restoring joints in 99% of subjects. The pain goes away 100%!Read more here - & gt;
In gouty arthritis, excess uric acid and purine compounds accumulate in the blood. Postponed in the tendons, joints, kidneys, they acquire the form of crystals - urate. Often with gouty arthritis are formed and small nodules, usually with a diameter of up to 1 centimeter. Names are called from urate salts, and capsules formed by connective tissue - tofus.
The defeat of the joints of the big toes or hands is the most common manifestation of gouty arthritis. Rarely does the ailment extend to the shoulder and hip zones. Sometimes gouty arthritis of the ankle, knee or ulnar cartilage is diagnosed.
Causes of gouty arthritis
Until now, the factors contributing to the formation of gout have not been fully studied. However, scientists have clearly determined that in many cases hereditary factors lead to the development of arthritis, and they are manifested mainly in men.
It is established that the disease is closely associated with a metabolic disorder in the body. Thus, the use of excess meat in a person aggravates the course of the disease. Predisposing factors of gouty arthritis are:
- weighed down;
- overweight, sedentary lifestyle;
- taking certain medications;
- systematic overeating;
If a person has some diseases, gouty arthritis can have a secondary nature. Perhaps the development of the disease in patients who had to undergo chemotherapeutic treatment to destroy malignant neoplasms. Under such circumstances, the massive disintegration of cells causes metabolic disorders, which in turn lead to gouty arthritis.
Symptoms and periods of the disease
Gout is affected by two systems - urinary and musculoskeletal. At the initial stage of the ailment, pain can be disturbed irregularly, manifesting itself every 2-3 months. The affected area swells, the skin over it becomes crimson. After the first attack, the symptoms usually disappear within 4 days, but tissue destruction continues. Over time, pain intensifies, and breaks between attacks - are reduced.
With the development of gouty arthritis, the accumulation of urate in the kidneys is continuously increasing. Mass accumulation of these crystals leads to the development of renal failure and urolithiasis.
The first period of the disease
Acute gouty arthritis is formed for several years without manifestation of obvious signs of elevated uric acid in the blood. Symptoms of ailment in the form of pain can be disturbed at night or early morning immediately after getting up from bed.
The disease is characterized by rapid growth of extremely intense unpleasant sensations. There are swelling of the joint and redness of the skin, fever.
When arthritis begins, the duration of attacks of a painful syndrome in mild cases varies from 1 day to 7-10 days. A characteristic feature of this period of ailment is the complete spontaneous recovery of a person. In the intervals between attacks there is a complete absence of symptoms of the disease, up to the time of the formation of chronic gouty arthritis.
The second period of the disease
In the next stage of the progression of joint damage, the intervals between attacks begin to vary widely. Sometimes signs of the disease are found in a year, and sometimes in ten years. In any case, seizures become more severe, and are combined with pronounced systemic manifestations. Pathology begins to affect other cartilages, adjacent tissues and an articular bag.
Progressing, gouty arthritis symptoms manifest a migrating nature. People feel chills, fever, weakness in the body, general malaise. Often observed the formation of single painless tophi. In some cases, for example, in older women who take special drugs - diuretics, tofus formation occurs before the development of gouty arthritis.
The third period of
The first symptoms of a chronic course of an ailment are a crunch during movement and a feeling of stiffness of the cartilage that appears after a period of rest. In the future, moderate pain during exercise is observed.
In the third stage, the stiffness increases and becomes permanent. Deformation of the affected joint becomes pronounced. The periods of remission of the disease become quite insignificant - from a year or less.
Chronic gout is accompanied by the appearance of such signs:
- a lot of tofus;
- kidney damage;
In the third stage, tofuses are formed on the hands, feet, elbows, knees, sometimes on the auricles. In elderly women, they can be located in the area of Heberden's nodules. In some cases, there is ulceration of the skin over tofus. Of these, the content can be spontaneously isolated as a white paste-like mass. Visualize gouty arthritis photos with tofus images will help without error.
Traditional methods of treatment of gouty arthritis
Therapy of gouty arthritis is a complex and multi-structural process in which the use of medicines is not enough. For sustained and speedy recovery, auxiliary methods are needed.
This is an ultraviolet irradiation of cartilage, therapeutic exercise and soft massage, reflexotherapy. With the combination of these methods there will be no relapse, if you pay attention to the diet.
How to treat arthritic arthritis correctly knows an experienced specialist. He can immediately warn the patient against the use of aspirin and other salicylates. Such drugs delay uric acid in the body and reduce the effectiveness of antidiagnostic drugs.
In medicine, gouty arthritis therapy is usually presented in the form of three stages: stopping inflammation, reducing the concentration of uric acid and maintaining a remission with diet. Effective removal of pain and inflammation helps the use of a special drug colchicine. It is recommended to use it in parallel with treatment with nonsteroidal anti-inflammatory drugs.
Colchicine perfectly copes with attacks of gouty arthritis in a few days. However, it is quite toxic, which requires short-course therapy and constant monitoring of the doctor. Only a specialist can be prescribed and the necessary non-steroid painkillers: naproxen( sanaprox, aliv, nalgezin-forte), indomethacin( inddeene, indotard, methindole, indocid) and others.
If the treatment of an acute attack of gouty arthritis with colchicine or NSAIDs does not lead to the desired result, hormonal medications are prescribed. Glucocorticoid hormones the doctor can use in the form of single injections or short courses. Among the drugs in this category, betamethasone and methylprednisolone are especially popular. They will probably remove the main symptoms of the ailment.
To defeat directly gouty arthritis, prescribe medications to eliminate the cause of its occurrence. To reduce the level of uric acid, the following 3 categories of drugs help:
- uricolitic - drugs that break down urates( uricosim, magurlite, blemaren, uralit);
- uricosuric - drugs that enhance the excretion of urates( probenecid Grufibrate, nofibal, allomaron);
- uricodepressive - drugs that reduce the production of uric acid( allopurinol, allopurinol-egis, allupol, purinol, etc.).
In comparison with other rheumatic diseases, the diet for gouty arthritis is much more important. It involves reducing the consumption of high-calorie food. It is recommended to reduce the intake of animal fats and special nutrients - exogenous purines. Extremely careful use any alcoholic beverages, including beer and red wine.
Better completely eliminate from the diet of a patient with gouty arthritis liver, fatty meats, kidneys, meat broths, smoked products, herring, sprats. From vegetable food, peas, lentils, beans, spinach, cauliflower are undesirable. A small intake of meat in a boiled form is allowed up to 2-3 times a week. Effectively defeat gouty arthritis diet will only help in conjunction with taking medication.
Treatment by folk methods
When a patient is diagnosed with gouty arthritis - folk remedies therapy can significantly reduce the symptoms of ailment. Nowadays recipes of compresses, herbal baths and infusions have gained popularity. Some patients are treated with activated charcoal or iodine.
Others consume 50 ml of a scrambled mass of 4 lemons and 3 heads of garlic, filled with boiling water and infused during the day.
Treatment of gouty arthritis with folk remedies can be performed using such infusions:
- 10 pods of bitter pepper, boiled over low heat in 300 ml of liquid for 10 minutes, is insisted for 5 hours. Next, the broth is filtered and a similar amount of honey is added. Take a natural medicine on a teaspoon twice a day;
- 20 g of dried pansy grass, filled with 200 ml of water and stewed in a water bath for 15 minutes, insist ¾ hours. Then the broth is filtered, squeezed and diluted with boiled water to form 200 ml of medicinal infusion. Take inwards on a tablespoon 3 times a day;
- a tablespoon of chopped celandine, filled with 200 ml of boiling water, is kept in a warm place for about an hour. Take after filtering 2 or 3 tablespoons of the present 3 times a day. Use fresh grass celandine is also recommended for rubbing affected areas, taking baths.
People with a diagnosis of gouty arthritis treatment of folk remedies will have a positive effect if carried out in a complex way. Therapy with folk remedies is very effective and demonstrates relatively good results. The main thing is the systematization of medicines and natural recipes. Consultation with a doctor will help to take into account the side effects of medications and strictly observe the dosage.