Disease

Arthritis of the fingers

General information

Finger arthritis is an orthopedic disease of inflammatory degenerative etiology, localized in the small joints of the hands and leading to a violation of their functionality. As a rule, this pathology is secondary, in other words, arises as a result of a person already has infectious, rheumatic, metabolic, traumatic and other health disorders. The widespread prevalence of arthritis of the hands among all age categories makes this disease socially significant, as it often becomes the cause of partial, and sometimes complete loss of patient ability to work. With rapid progression and / or the absence of adequate treatment, such inflammation of the joints of the fingers can even lead to disability over time, which puts it on a par with the most pernicious diseases of the musculoskeletal system.

According to the latest statistics, it’s precisely the fingers that affects virtually every 7th inhabitant of our planet, and recently this disease is increasingly diagnosed in childhood. In most cases (approximately 2/3 of patients), this type of arthritis persecutes women, but this is not due to gender differences. Doctors explain this feature by the specifics of female domestic and professional activities, in which hands are more often involved than men.

Pathogenesis

A joint disease such as arthritis is quite complex and diverse and therefore its pathogenesis is ambiguous. The structural features of the joint tissues, the presence of many nerve endings in them and good vascularization (the formation of new branches of blood vessels) of the synovial membrane by themselves determine the ability of the joints to respond promptly to the inflammation response to various indirect and direct effects. Depending on the nature, strength and direction of such effects, damage to the joint tissues occurs, which varies in nature, but often leads to negative consequences of the same type.

So, with specific arthritis of an infectious etiology, a toxic-allergic and bacterial-metastatic mechanism of joint damage is noted. In the latter case, the pathological pathogen through the lymphatic or hematogenous pathway directly enters the joint cavity and is found in its synovial fluid, which leads to the development of septic, tuberculosis, gonorrheal and other specific arthritis. In such cases, the most severe joint damage with destructive and proliferative tissue phenomena is observed.

With increased sensitivity, a toxic-allergic pathway for the formation of infectious arthritis is also possible, when due to exposure to toxins produced by microorganisms in the joint allergic synovitis. This type of joint damage (synovitis with dysenteric, tuberculosis, brucellosis gonorrhea and other infectious arthritis) with adequate treatment usually disappears without any residual effects.

To a lesser extent, the pathogenesis of joint inflammatory diseases has been studied, which modern medicine refers to the group of non-specific arthritis. Among them, among other things, include such widespread pathologies as: ankylosing spondylitis, rheumatoid arthritis, psoriatic polyarthritis etc.

To date, the infectious nature of their origin remains unproven, although advocates of this path of development of such pathologies still exist. According to official ideas, the process of changing the tissue and general reactivity of the body, as well as the development of allergic and autoallergic reactions, is the primary pathogenetic factor in the occurrence of these arthritis.

In this context, scientists suggest that under the influence of a still uncertain primary allergen, the source of which is possibly a chronic infectious process, primary stimulation of lymphoid immunocompetent cells occurs. At further stages of the development of pathology, a modified 7S-gamma globulin is formed, exhibiting properties autoantigento which subsequently appropriate autoantibodies.

In particular, the so-called in the medical environment belongs to them. rheumatoid factor (found in plasma in 80-90% of patients with rheumatoid arthritis 19S-immunoglobulin). Over time, the reaction according to the type of production "autoantigen - autoantibody"Becomes constant, while the formation of immune pathological complexes mainly occurs in the synovial articular membrane.

A similar mechanism for the occurrence and further progression of nonspecific arthritis is the most likely model and is not absolutely proven. Basically, this pathogenesis is typical for rheumatoid arthritisHowever, the presence of immune shifts in the overall picture of many similar pathologies at the moment does not raise any doubts. This is confirmed by the presence in the test serum of patients with rheumatoid arthritis rheumatoid factor and characteristic autoantibodies to the tissues of the joint, as well as the proliferation of plasma and lymphoid cells of the synovial membrane revealed in such patients with the nucleation of numerous cellular infiltrates.

Currently, in the pathogenetic nature of synovial inflammation observed with nonspecific arthritis, phagocytosis of the formed immune complexes with those in the synovial fluid play a huge role white blood cells. It has been reliably established that this process causes damage to the latter, which is accompanied by the release of proteolytic enzymes from their lysosomes, which in turn directly supports the course of the inflammatory reaction in the damaged joint.

At the same time, there are signs in the general clinical picture of all arthritis that indicate that deviations in the state of the patient’s nervous system and, above all, in its vegetative part, play an important role in the formation of diseases of this nature. This is evidenced by the often encountered symmetry of articular damage, a disorder of vascular tone and sweating, a violation of skin, bone, muscle trophism and other similar pathological problems. However, in the pathogenesis of arthritis, a specific function of the disorganization of the nervous system has not yet been determined.

Also in this regard, the role of violations by endocrine glands person. One of the pre-existing hypotheses of the occurrence of these pathologies, which puts hormonal regulation disorder at the head of the development of a number of non-specific arthritis homeostasis, and did not receive direct confirmation. However, the importance of endocrine disorders in the formation of a holistic pathological reactivity of the human body, predisposing to joint diseases, is beyond doubt. Evidence of this is a fairly frequent exacerbation of some non-specific arthritis (for example, rheumatoid arthritis hands) in women at the time menopause.

As for the arthritis of the fingers, then this pathology in the process of its progression goes through four stages of development, each of which has its own negative symptoms.

Stage One

There are no obvious external signs of the inflammatory process of the articular tissues of the hand, however, short-term pains and slight stiffness of the movements of the fingers in the morning are noted. Immediately after sleep, the patient is unable to perform the usual actions, such as unscrewing the tap, stirring sugar, etc., with former ease. Such stiffness does not last long and passes with several repeated movements. On the x-ray at this stage, you can notice a slight thinning of the bone structure of the joint.

Stage Two

Inflammation of the joints on the arm in the area of ​​her hand and / or fingers progresses, due to which the negative symptoms of the disease become more pronounced. Joint pains can be prolonged, the joints themselves look swollen and crackle when moving. At this stage, the patient experiences difficulties in performing finger manipulations not only in the morning, but throughout the day. On x-rays, erosion of bone tissue in the area of ​​the affected joints is visible.

Stage Three

Deformation of the joints on the fingers is already noticeable with the naked eye, while violations are noted, as a rule, symmetrically on both hands. Pain in the fingers becomes quite strong, aggravated by movement and can accompany the patient for a long time until the administration of pain medication. The integuments on the hands turn red, there is a local increase in temperature and significant swelling. Even simple hand manipulations are difficult. Radiography shows a progressive inflammatory process, articular deformation and impaired joint integrity.

Stage Four

The cartilaginous tissues of pathological joints grow together and for this reason the fingers and hands themselves are significantly deformed. The patient makes manipulations with his fingers with great difficulty, and sometimes can not move them at all. Even the elementary skills of a person in self-care are lost, he begins to need constant help and care. On the x-ray clearly visible irreversible curvature of bone and cartilage. At this stage, the patient is often assigned a disability group.

Classification

Taking into account the multiple root causes of the formation of arthritis of the upper limbs, today there are more than a dozen of their types, the most common of which are the following.

Infectious Arthritis

The acute and most severe form of the disease, provoked by the penetration directly into the joint tissues of various infectious pathogens. As a rule, this type of pathology rarely affects the small joints of the hands, but the possibility of its development in this section of the musculoskeletal system cannot be ruled out. Depending on the nature of the initial infection, they may be isolated brucellosis, syphilitic, tuberculous, gonorrheal and other arthritis. This type of disease is characterized by its rapid development with the occurrence of foci of inflammation, suppuration, etc.

Rheumatoid arthritis of the fingers

Unlike the previous type of disease, this pathology primarily affects the small joints of the hands, and its pathogenesis is based on autoimmune processes that force the body to produce pathological substances that destroy their own joint tissues. First symptoms rheumatoid arthritis fingers are usually found on one of them, and then extend to neighboring fingers.

In the absence of adequate treatment, more and more finger joints are involved in the pathological process, their functionality is gradually reduced and as a result, the hand is deformed and actually completely loses its purpose. Most often, the disease proceeds symmetrically, that is, it affects both hands at the same time. Negative symptoms rheumatoid arthritis are not limited only to joints and over time can lead to severe disorders in the work of many internal organs (kidneys, blood vessels, lungs, etc.).

Metabolic arthritis

The second name for this type of disease is gouty arthritis, which, in principle, is more consistent with its essence and fully reveals the main cause of the pathological process. In this case, it is the original disease gout, through the accumulation of salts (crystals) uric acid in the area of ​​the joints, causes inflammation and further destruction. Hands with gout mostly suffer in women, while men more often have problems with the big toe. Symptoms of metabolic arthritis are acute and paroxysmal, usually provoked by the intake of fatty foods, alcohol, etc.

Post Traumatic Arthritis Brush

As the name implies, this type of joint inflammation occurs as a result of injuries received by the patient, which caused damage to the bone and / or cartilage tissue in the joints of the fingers on the hand. Naturally, the development of this pathology is noted only in the field of trauma, and it itself, with proper treatment, is most often short-lived.

Psoriatic arthritis

It is formed against the background of such a serious disease as psoriasis and in its essence is one of its negative manifestations. With the defeat of the hands in this case, as a rule, their distal joints or all the joints of one finger at a time suffer. A typical symptom of this type of pathology is a crimson-cyanotic shade of the skin over problem areas and severe swelling. At the same time, damaged fingers look like boiled sausages, and the joints themselves become like a radish.

Secondary arthritis

This group of orthopedic diseases includes arthritis, the appearance of which was preceded by other most often systemic pathologies of the human body (immune, allergic, somatic).

In addition to the classification due to the formation of arthritis, categorization of this disease by the localization of the pathological process can be used, which divides the damage to the distal hands (the interphalangeal finger joints suffer), the middle (the joints between the right metacarpus and the fingers are affected) and the proximal (the hand itself is damaged). Also in clinical practice, arthritic lesion of only the thumb on one or both hands, which is called - risartrosis.

Causes

According to the ideas of modern medicine, the emergence and further development of arthritis of the hands is caused by some internal and external factors or their combination, which are the trigger of this pathology.

Genetic predisposition

Many of the observations and studies that have been carried out prove the presence of a certain gene in the human genome, the transmission of which to the future generation significantly increases the risk of formation of articular pathologies in it. This in no way means that every person with a similar heredity will suffer from arthritis, however, when other adverse factors are connected, the probability of this is quite high.

Bacterial and viral diseases

In some cases, the immediate onset of arthritis may be preceded by previous diseases of a bacterial or viral etiology. Most often, such joint pathology develops against the background flu, scarlet fever, syphilis, measles, gonorrhea, tonsillitis, herpes, hepatitis B, mumps etc. The chance of joining an arthritic lesion increases with inadequate treatment of these diseases or not brought to the logical end of therapy. The category of painful conditions that contribute to the formation of acute arthritis can also include hypothermia, stressful situations and the recent past. vaccination (with increased sensitivity).

Injuries

The injuries of the hands received by a person during his life, including fractures, sprains, and even bruises in this area, quite often leave some kind of damage on the bone and cartilage tissues of the joints. Such defects over time can cause intra-articular inflammation and develop into arthritis.

Working and living conditions

Quite often, the root cause of arthritis-type joint disorders is certain conditions of work and human life that somehow keep the joints of the hand in constant tension or cause regular internal microtrauma of their tissues (any work related to fine motor skills of hands, dampness, etc. ) This category of risk of arthritis formation also includes athletes who use excessive loads on the hands in training and competitions (tennis, bowling, weightlifting and athletics, etc.).

Age-related changes

In the process of growing up, the joints of a person’s hand themselves undergo age-related changes. In the structure of their tissues, there is a gradual decrease in metabolic transformations, cartilage begins to coarsen, the volume of synovial fluid decreases. All these negative transformations often trigger a pathological mechanism leading to arthritis and similar articular pathologies.

Hormonal changes

Some hormonal pathologies or a natural physiological rearrangement of the body, in which sex and other hormones are involved, can lead to the development of arthritis of small joints. Thus, the risk of joint inflammation is substantially increased during the onset menopause, in the moment puberty, during the period of pregnancy etc.

Decreased immunity

Any painful condition that occurs with a decrease in function the immune system or its pathological transformation (autoimmune processes), are able to negatively affect the joints (especially small ones), which with a high degree of probability can cause the development of many joint diseases, including arthritis of the hands.

Allergic reactions

Finger arthritis may well form due to serious allergic reactions, especially with previously damaged cartilage and / or bone tissues of the joint.

Systemic diseases

Arthritic damage to small joints, including carpal joints, is often just one of the symptoms of more serious systemic pathologies, among which are: psoriasis, rheumatism, lupus erythematosus, gout, tuberculosis, diabetes, scleroderma.

Symptoms of arthritis of the fingers

The negative signs of arthritis of the fingers may vary depending on the underlying cause of this pathology, however, there are a number of symptoms that will be characteristic of any type of such joint inflammation.

  • For all types of arthritis of the hands, the first symptoms are expressed in pain that a person begins to experience when his hands perform previously familiar actions. At the initial stage of the formation of the disease, such pain can be weak, short-term and felt only in the morning for about half an hour after sleep. In the future, the severity and duration of the pain syndrome will increase until its constant presence. Quite often, patients with arthritis of the fingers on their hands describe such pain with the word “aches”, which in itself clearly confirms its nature. In some patients, it is accompanied by an unpleasant tingling and burning sensation in the fingers. At the last stage of the disease, pain often disappears only with the use of painkillers.
  • Following the inflammatory lesion of one or more finger joints on one hand, in most cases a similar pathological process occurs on the second hand. Such symmetrical negative symptoms are characteristic mainly for rheumatoid arthritis, however, patients with other types of the disease are often persecuted.
  • In almost all patients with arthritis, there is a painful response from the affected joints to changing weather conditions. Many of them also react to dampness and pressure drops in the surrounding atmosphere.
  • As a rule, with arthritis of the fingers, the so-called stiffness of the hands (mainly in the morning) is observed, when attempts to move fingers are given to a person with great difficulty. It feels like this condition is like wearing very tight gloves and is invariably accompanied by a feeling of soreness. Often, the patient, in order to begin to perform the most basic actions with his hands, first has to somehow develop the fingers and the brush itself.
  • Finger joints damaged by arthritis in almost all cases swell and / or swell, which sometimes makes the fingers on the hands remotely look like churchkhela. In addition, the skin around the knuckles of damaged fingers redden, stretch and become hot to the touch.
  • Body temperature usually rises locally only in the area of ​​an active inflammatory process in the diseased joint, but in some cases (for example, in severe rheumatoid or infectious arthritis), a general fever.
  • From the second stage of the disease, many patients begin to feel crepitus in the affected joints of the fingers, in other words, when they move, specific bone-cartilaginous creak and clicks accompanied by soreness are heard. At the same time, peculiar nodules can form under the skin in pathological areas.
  • Another common symptom of arthritis of the hands is the rapid fatigue of the hands during work, in many cases developing into general weakness. These manifestations of the disease increase as it progresses together with pain and other negative phenomena.
  • One of the main signs of arthritis of the hand along with pain is considered to be a gradual restriction of the mobility of the fingers and the amplitude of their movements. If you ignore the treatment, this can lead to internal and external changes in the structure of the hand itself, giving it a wide variety of inorganic forms and completely leveling its function.

Tests and diagnostics

The main concept for diagnosing finger arthritis is a directed study of the affected hand (or two), as well as a comprehensive study of the patient’s health status using a variety of diagnostic methods. Only a competent arthrologist or rheumatologist can correctly make such a diagnosis and confidently determine the etiological background of arthritis based on the following information:

  • a general history of the history, which reveals the features of the onset of arthritis, and helps to establish a connection between the joint damage and the root cause of its occurrence, including infectious diseases, focal infections, allergic reactions, previous injuries, or other pathological processes;
  • specific clinical information that reveals the inflammatory nature of pain, the situation of progression of limited mobility of the finger joints, their deformation due to proliferative or exudative phenomena that occur directly in the articular structure or periarticular tissues, etc .;
  • characteristic data of x-ray studies that can detect pathological changes such as: thinning of the joint space, present ankylosesepiphyseal osteoporosis, usuratsii bone surfaces of affected joints, etc .;
  • unambiguous laboratory indicators indicating the development or growth of the inflammatory process;
  • research results aimed at studying the morphological composition of biopsy synovial fluid and membrane (presence synovitis proliferative in nature).

In the diagnosis of arthritis, one of the main roles is played by a correctly collected medical history, which helps the doctor to find out many primary issues related to the initial etiology of the occurrence of inflammatory pathology in the joints, the type of disease in relation to its primary or secondary nature, associated pathological processes, and many others.

In itself, the inflammatory nature of this disease is presumably determined by the doctor during the initial physical examination of the affected joints of the hand. In this case, the actively occurring inflammation is virtually guaranteed to be indicated by the local swelling of the periarticular region, its pain on palpation, the presence of effusion, a local change in temperature, and densification of adjacent soft tissues.

In order to confirm the existing intra-articular inflammatory process and determine its intensity, puncture of the problem joint is carried out with the extraction and further laboratory study of synovial fluid. Loose mucin clot structure, reduced viscosity and increased number white blood cells with indicators up to 50,000 in 1 mm³ indicate the inflammatory configuration of the synovial fluid. Distinctive characteristic cytosis (with tuberculous arthritis prevail lymphocyteswith rheumatoid neutrophils etc.), the presence of excessive crystallization (for example, with gouty arthritis crystals uric acid), the presence of infectious pathogens in the synovial fluid and other qualitative indicators allow the doctor to establish a reliable diagnosis regarding the type of disease.

Valuable information about the pathological process provides the diagnostician with a morphological study directly synovial membranebiopsy by microscopic excision or puncture. In order to more thoroughly diagnose arthritis, a technique such as arthroscopy, which provides the opportunity to carry out visual inspection and relatively clear photographing of the structure of the synovial membrane.

It should be remembered that with arthritis, shifts in the performance of many laboratory studies (leukocytosis, accelerated ROE, the presence of C-reactive protein, increased seromucoid rates, DPA reactions, etc.) are nonspecific for these diseases, since they are characteristic of virtually any internal inflammation process. Along with this, there is a whole series of serological tests, which in combination with a specific clinic allow you to make a nosological diagnosis. Among them, one can distinguish the reactions of Wasserman, Borde-Zhangu, Wright, Valera-Rose, Huddlesson and latex test.

X-ray diagnosis

As the basic technical method of x-ray examination for arthritis roentgenography. As a rule, it is carried out in 2 standard projections, however, if there are indications, they can take pictures in additional perspectives that demonstrate in more detail local metamorphoses of the affected articular surfaces. For the same purpose, especially when examining small finger joints, radiography with direct enlargement of the image is used.

In some cases, to specify the nature of the changes occurring in deeply localized areas of the pineal glands, poorly distinguishable or even invisible during conventional radiography due to the imposition (superposition) of shadow elements, the patient may be shown tomography (CT or MRI). In order to detect inflammatory changes in the articular soft tissues, consonant “soft” contrast radiological examinations are carried out, sometimes without the use of image intensifying screens.

Good results in the accurate diagnosis of arthritis can be obtained with roentgenography problem joints, which helps the diagnostician to clearly recognize the smallest details in pathological articular surfaces and soft tissues.

The most constant and primary radiological sign of the fact of the existence of arthritis, especially in the subacute period of the course of the disease, is present osteoporosis. In this regard, it is very important to accurately determine its variety (local, uneven, diffuse, spotted, etc.) and the dynamics of development, usually corresponding to the degree of joint disorders of a functional and neurotrophic nature.

In this case, significant assistance is provided X-ray densitometry, the purpose of which is extremely advisable in a dynamic comparative study of the joints of the same name, especially in case of unilateral lesion. Besides, X-ray densitometry It can be practiced not only for diagnostic purposes, but also for monitoring the effectiveness of the therapy, since it accurately reflects the course of bone demineralization in case of actively progressing arthritis, as well as reparative processes in the reverse formation of inflammatory changes.

The x-ray picture of arthritis itself is quite diverse and may include such visual signs:

  • almost all varieties osteoporosis;
  • partial or total thinning of the joint gap or, in some cases, its expansion associated with destructive damage to the bone-cartilage tissue of the joint;
  • the presence of bone pattern (edge ​​defects by the type of erosion) on the corresponding surfaces of problem joints as a result of degenerative processes taking place in them;
  • the existence of foci of active destruction in the periarticular bone region;
  • education sequestration (tissue necrosis), often observed with specific types of arthritis (for example, with tuberculosis);
  • the formation of periosteal layers near bone metaphysesas well as the occurrence of reactive osteosclerosis;
  • transformation of the relief of the bone surfaces of pathological joints and marginal growths on them;
  • subluxations and dislocationsformed in response to articular deformation (typical of some arthritis, including rheumatoid).

Despite the fact that the radiological conjuncture observed for different types of arthritis adequately reflects the nature of the pathological changes in the structure of the bone-cartilaginous tissues of the joint, differential diagnosis of the entire variety of existing forms of arthritis and the stages of their development is difficult due to the frequent inconsistency of the visual data of radiography and the actual clinical picture. For example, with rheumatoid arthritis in the subacute or acute period, when pathological processes still affect only the synovial membrane, radiological images are usually negative, despite the characteristic and intense clinical symptoms.

Explicit radiological manifestations, in particular osteoporosis, are noted in that period of the disease, when making a clinical diagnosis for a specialist is no longer difficult. However, radiography is useful even in the simplest cases, since the discrepancy in the radiological and clinical data is of considerable importance in the differential diagnostic plan.

Speaking of a constant radiological sign of arthritis - osteoporosis, it is worth noting that when diagnosing a disease, not only the fact of its presence is important, but also the distinguishing characteristic of this symptom. In particular, spotted osteoporosis, as a rule, detected in rapidly progressing arthritis. Diffuse osteoporosis it is found with a prolonged increase in clinical symptoms with neurotrophic changes and the rapid development of mobility restrictions on problem joints. Availability hypertrophic osteoporosis, even in the absence of destructive bone-cartilaginous changes, proves the fact of a long-running inflammatory process, in the past characterized by an acute clinical course.

With arthritis of an allergic or infectious origin, as well as with mixed polyarthritis, for which the acute onset of the pathological process and its further rapid progression are typical, the characteristic clinical symptoms at the beginning of the formation of the disease are not confirmed on x-ray images. Conversely, with specific arthritis of an infectious nature, radiography can significantly contribute to both making the correct diagnosis and identifying the phase of development of arthritis. In addition, a dynamic analysis of X-ray data in this case will help the doctor evaluate the effectiveness of the prescribed therapy and more clearly determine the prognosis of the course of the disease for the patient.

In the differential diagnosis of arthritis and arthrosis through x-ray studies, it is necessary to pay attention to the likelihood of secondary arthrosis against the background of primary arthritis.

Finger Arthritis Treatment

Before curing the inflammatory process directly and initiating rehabilitation therapy for the problematic joints of the hand, the patient needs to learn and implicitly follow some general rules of everyday behavior that will contribute to a more effective treatment of arthritis, namely:

  • in no case do self-medication and always coordinate with your doctor the use of any even alternative medicine;
  • in the acute period, to reduce the load on the arthritic joints of the finger joints to the maximum (delegate responsibilities to the household to relatives, take a vacation or sick leave, cancel workouts, etc.);
  • by all possible means to protect hands from injury, hypothermia and other adverse external influences;
  • comply with absolutely all the instructions of the attending physician regarding medication, the use of physiotherapy techniques and other recommendations;
  • practice a full night's rest, which should last at least 8 hours in a row;
  • during the period of remission, clearly carry out the exercises of physiotherapy exercises recommended by the doctor, without increasing the load on the fingers independently and without supplementing the lessons with your own workouts;
  • without fail adhere to the diet type appropriate to the type of arthritis, not allowing breaks in it even on holidays, as well as drinking regimen;
  • completely abandon all previously practiced harmful habits (alcohol, tobacco smoking, etc.);
  • if necessary, purchase for personal use special devices that facilitate the life of people with arthritis and / or help to alleviate the negative symptoms of the disease (for example, electrical stimulants).

The use in the treatment of arthritis of etiotropic therapy (aimed only at the primary disease) is possible only with specific infectious types of the disease (for example, brucellosis arthritis, gonorrhea arthritis etc.). In other cases, resort to complex pathogenetic treatment aimed at the following aspects:

  • normalization of the immunological and general reactivity of the patient's body (the use of immunosuppressive, desensitizing drugs, medication on a chronic infectious focus, activation of metabolic processes, mineral and vitamin balance, etc.);
  • reduction of local and, if necessary, general manifestation of inflammation (the use of hormonal, anti-inflammatory drugs, physiotherapeutic methods, spa treatment, etc.);
  • restoration of the functionality of the joint in violation of its mobility (medical gymnastics, occupational therapy, massage, physiotherapy, etc.);
  • therapy of the primary pathological process (suitable for arthritis caused by other diseases).

The key principle in the treatment of arthritic inflammation of the joints of the fingers, especially in the chronic course, is a stepwise continuous therapy according to a linear scheme: hospital - clinic - resort. The medications and treatment methods used in this case may vary slightly depending on the type of arthritis diagnosed, the stage of its development, and other features of a particular type of disease. For example, treat rheumatoid arthritis hands need to be consistent with the general rules of therapy for this group of pathologies, but nevertheless choosing the drugs and methods that are most suitable for this particular type of disease.

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specialization: Arthrologist / Rheumatologist

Elshansky Igor Vitalievich

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Medication

DiclofenacIndomethacinChondroitinFastum gelMetipredAceclofenacKetoprofenIbuprofenDonTeraflexAlflutopTrentalActoveginBerlitionDialiponPrednisoneSolu-MedrolDiprospanBetamethasoneTizanidineBaclofenLongVoltaren EmulgelDeep reefDiclacFinalgon

Thus, in the main drug treatment of arthritis of the finger joints of the hands, depending on the nature of the pathology and the severity of its course, the following medications can be used.

Medication groupMedicinesMechanism of action
NSAIDs (injections and oral forms)
  • Indomethacin;
  • Aceclofenac;
  • Ketoprofen;
  • Diclofenac;
  • Ibuprofen;
  • Naproxen etc.
In the acute period of arthritic lesions, they contribute to the removal of the inflammatory picture of the disease and the relief of pain. Apply the course until the neutralization or a significant reduction in the severity of these symptoms.
Chondoprotectors (injections and oral forms)
  • Don;
  • Teraflex;
  • Alflutop;
  • Gialgan;
  • Chondroitin;
  • Protekon etc.
They improve the general condition of joint tissues, restore their damaged structure to some extent, and have a lubricating effect on joints. Mandatory course application for a long period of time (at least 3 months).
Metabolic and vasodilators (injection)
  • Trental;
  • Actovegin;
  • Theonicol;
  • Berlition;
  • Dialipon etc.
Normalize blood circulation in the area of ​​problem joints, improve the nutrition of damaged tissues and stabilize metabolic processes in them.
Glucocorticosteroids (injection)
  • Metipred;
  • Prednisone;
  • Celeston;
  • Solu-Medrol;
  • Diprospan;
  • Betamethasone etc.
They exhibit a more pronounced anti-inflammatory effect in comparison with NSAIDs and are prescribed for severe inflammatory processes. As a rule, they are applied locally for a short time.
Muscle relaxants (oral form)
  • Tizanidine;
  • Baclofen;
  • Tizalud etc.
They are used to level muscle cramps caused by the disease, if necessary.
Local NSAIDs (ointments, gels, creams)
  • Fastum gel;
  • Long;
  • Voltaren Emulsifier;
  • Indomethacin ointment;
  • Deep reef;
  • Diclac;
  • Finalgon etc.
They help locally reduce the manifestations of inflammation and pain. They can be used in any period of the disease and even after the main treatment.
Vitamin and Mineral Complexes (oral form)
  • vitamins BUT, FROM, E;
  • vitamins IN 1, IN 3, AT 6, AT 12;
  • molybdenum;
  • manganese;
  • calcium;
  • selenium;
  • copper;
  • zinc etc.
They have a general strengthening effect and directed beneficial effect in relation to pathologically altered articular tissues.

In addition to medications for symptomatic treatment of arthritic lesions directly, the doctor may prescribe another concomitant treatment of inflammation of the joints of the fingers, aimed at the root cause of this pathology. For example, with the infectious nature of diagnosed arthritis, systemic antibiotics (mostly macrolides or penicillins), with autoimmune processes - immunosuppressants (azathioprine, methotrexate, cyclosporin) etc.

Procedures and operations

Physiotherapy

The treatment regimen for any arthritis involves a complex effect on the affected joints of therapeutic agents and physiotherapeutic techniques, which in this case are quite a lot. So, depending on the type of arthritic inflammation of the fingers, the patient may be recommended: electrophoresis, UHF, thermal baths, massage, magnetotherapy, laser therapy and many other procedures at the disposal of a clinic. In general, all these methods of physiotherapy are aimed at enhancing drug treatment in terms of leveling the observed negative symptoms of the disease and improving the functionality of problem joints.

A set of physiotherapeutic procedures is selected for each patient individually, in accordance with his physiological capabilities and preferences. Basic physiotherapy, as a rule, is carried out in specialized rooms of a medical institution, however, the patient can practice some methods at home (Exercise therapy, massage etc.). In this case, it is important to find out in advance from the attending physician all the nuances and principles of performing such procedures so that they do not aggravate the existing situation, but bring benefits.

Exercise therapy at home

For people with arthritis of the hands, a number of special exercises have been developed that help them develop affected finger joints, thereby improving the overall quality of life. You can resort to the help of such physical education only at the stage of remission of the disease, since in the acute period, such loads, on the contrary, can be harmful. On the recommendation of a physician, the patient may include the following exercises described below in their hand training.

  • The exercise "Fist". Warm up for the entire hand (or two), consisting in a strong compression of the fingers into a fist. The thumb is obliged, so to speak, to cover the other four, that is, to be on top of them, carrying additional pressure. In this position, hold your hand for at least 30 seconds, then unclench your fist and spread your fingers to the sides as wide as possible. For bilateral arthritis, this exercise should be done simultaneously with both hands. In general, 4 consecutive approaches are carried out with a possible repetition in a few hours. Contraindication to this exercise is the occurrence of sharp painful sensations or severe discomfort of a different nature in the area of ​​problem joints.
  • The exercise "Ball". A small ball, approximately the size of a tennis ball, must be placed on a horizontal surface, put the palm of the problematic hand on top of it and roll it with your fingers back and forth. You can also diversify this exercise by rolling the ball in a circle. It is best to purchase a special so-called massage ball that has a ribbed surface or small rounded spikes. In a similar way, the effect of local massage can be achieved, thereby improving blood supply to all tissues of the hand.
  • The exercise "Beads". In this case, alternately with the tips of the four opposite fingers of the hand, touch the small pillow of the thumb, creating the appearance of sorting out the rosary. You need to start the exercise with the little finger, reach the index finger and come back, repeating this manipulation for about a minute for each hand.
  • The exercise "Pencil". This exercise is performed using a hexagonal pencil, which must be placed on a horizontal surface, pressed down with the palm of your hand and rolled from its base to your fingertips. You can also practice vertical rolling of a pencil using two palms holding it. Another way to use this item for arthritis is its consistent rotation between the fingers.
  • The exercise "Fan". For this exercise, any flat surface (horizontal or vertical) is suitable. Holding both palms firmly against it, without resting on your body, you should try to maximize strain on the hands and spread your fingers as wide as possible in different directions, holding them in this position for several seconds. Perform this procedure as if the fingers are tightened by a tight elastic band and its resistance must be overcome without fail. Once in a few hours you can do 5-6 such approaches.
  • The exercise "Pendulum". In this situation, both hands should be on the table, and fingers alternately rise up and divorced into groans (first in one, then in the other) like a pendulum. Exercise is done synchronously with the same fingers on two hands, starting from the little finger and ending with the index finger.
  • The exercise "Piano". Modification of the previous exercise with alternately lifting your fingers up and then lowering it down (as if you were pressing the piano key). It is important that the adjacent fingers remain pressed to the table surface, and the working finger does not bend at the joints. For each finger, at least 3 lifts / lowerings must be made.
  • The exercise Claws. Hands should be in an already familiar position - on the table, and all fingers should be bent and unbent, trying to touch their pads on the inside of the palm. The exercise is done with two hands at the same time, for about one minute.

Surgical intervention

Surgery in the tissue of damaged joints of the fingers with arthritis is practiced only with insufficient effectiveness of the previously conducted complex therapy and only after a complete relief of the inflammatory process. It is contraindicated for children under 5 years of age and adults whose general health status is assessed as severe (serious diseases of internal organs and systems, complex infections, intensive course of chronic pathologies, etc.). The nature and tactics of the surgery as a whole are determined by the doctor depending on the type of arthritis, the existing functionality of the joint and the stage of the local pathological process.

In the initial stages of the disease, when there is a pronounced synovitis, but there is still no bone and / or cartilage destruction, they can carry out the so-called preventive surgery of the type synovectomy. The meaning of this operation is to maximize excision of the hyperplastic and pathologically altered synovial membrane, which in itself has a beneficial effect on both the problem joint and the overall course of the disease.

In the late stages of arthritis, when in addition to the synovial membrane, the ligament capsule is also affected, as well as the formation of contractures and destruction of bone-cartilaginous tissues, a more radical operation called - extended synovial. In its course, together with the synovial membrane, the articular capsule, granulation tissue, small osteophytes, fibrous commissures, and even sometimes sections of bones are often removed.

In some cases, especially with the development of the pathological process on only one finger of the hand, such surgical technique as arthrodesiswhose general idea is to fix the joint in a constant position. Sometimes such an operation, although it actually immobilizes one finger, positively affects the functionality of the arm as a whole.

Reconstructive surgery performed with the installation of silicone (interphalangeal, metacarpophalangeal) occupy a special place in the surgical treatment of arthritis of the fingers endoprostheses. In the absence of contraindications (bone tuberculosis, osteomyelitis, skin pathology, severe systemic diseases, neuropsychiatric abnormalities etc.) and after conducting comprehensive studies, individual prostheses are made for the patient, which replace the damaged cartilage and / or bone tissue during the operation. Main purpose arthroplasty in this case, the maximum replacement of parts of the diseased joint with artificial implants, returning the arm to its former mobility and full working capacity, is. The only relative disadvantage of this procedure for the patient is its rather significant cost and a long rehabilitation period.

With diagnosed specific arthritis (gonorrhea, tuberculosis, syphilitic, brucellosis, etc.), characteristic therapy is carried out, the scheme of which often includes surgical operations, such as: synovectomy, arthrodesis, excision of necrotic foci, removal of articular ends, bone grafting, arthroplasty and so forth

Treatment of arthritis of the fingers with folk remedies

To some extent, it is quite possible to alleviate the course of arthritis by folk remedies, of which there are currently a huge number. However, in this case, the choice of prescription or methodology for influencing diseased joints should be approached very carefully. The thing is that the same non-traditional methods of treatment for different types of arthritic lesions can have different effects, both positive and negative. As a result of this, before embarking on such therapy, it is necessary to thoroughly find out from the attending physician all the details of his illness and acceptable methods of influencing it. Do not hesitate to ask him any questions you are interested in, in particular: is it possible to soar hands with arthritis of joints, is it permissible to use warming compresses and rubbing, is it possible to use herbal infusions inside, etc.

In the general variety of folk recipes for treating arthritis of the hands, the following popular remedies can be distinguished.

Honey and Cinnamon

A good medicine for problem joints is a mixture of natural honey and cinnamon, which should be taken orally. To prepare one serving of such a product, you need to mix 1 tbsp. l fresh honey with 0.5 tsp ground cinnamon and continue to use it every morning (on an empty stomach) for 20 days.

Honey and mustard

It is also advisable to use honey for external treatment of arthritis pain syndrome. To this end, honey, vegetable oil and mustard powder are mixed in equal proportions (1 tsp each), heated and whipped until a homogeneous mass is formed and, by means of a gauze cut, they are applied as a compress to the injured brush. A similar procedure is done once a day, and the compress itself is held on the hand for about 60 minutes.

Sea salt

To remove the negative manifestations of arthritis in some cases, it is useful to make warming baths for the hands. For their conduct should be 4 tbsp. l completely dissolve sea salt in 2 l of warm water, bring it to a temperature of 50 ° C and already soak your hands in it for 15 minutes. For an additional warming effect after the end of this procedure, it is recommended to wear woolen mittens or gloves. You can use salt baths daily for 3 weeks, making them before going to bed.

Elecampane

Useful for problem joints is alcohol grind made from the roots of elecampane, which is prepared by two-week infusion of crushed raw materials in 200 ml of high-quality vodka. After this time, tincture is filtered and twice a day (morning and evening) for a month used to rub the fingers affected by arthritis. Elecampane rubbing can not be used with damaged skin in this area.

Cereals

To some extent, a compress with oatmeal will help relieve inflammation and pain. To make it, you need to boil the flakes in water in a ratio of 1: 2 until ready, apply them warm to the diseased brush, wrap it with a bandage and wrap it with woolen cloth on top (you can put on a mitten). You can practice this procedure for 3 weeks, doing compresses three times a day and leaving them on your arm for about 60 minutes.

Egg Turpentine Ointment

Egg-turpentine ointment proved to be good in the treatment of finger arthritis, for the preparation of which it is necessary to mix 1 yolk of (raw) chicken egg with 1 tsp. turpentine and a similar volume of apple cider vinegar. This mixture is subsequently rubbed into the skin over painful joints 2 times a day with a course of 20 days.

Onion applications

In order to quickly remove the inflammatory process, some people with arthritis will use onion applications. Such a peculiar medicine is made by grinding one large onion in a meat grinder and then mixing the resulting mass with 1 pinch of salt. Next, the finished product is applied in a thin layer on problem joints and wrapped with a bandage. A single application should last 30 minutes, and it is permissible to do it a maximum of twice a day.

Henbane

As another grind for patients with a joint, use a mixture of 2 tbsp. l bleached oils with the same amount of vegetable oil (olive or sunflower). After thoroughly mixing these ingredients, they rub the skin over the inflamed joints overnight, up to a decrease in the severity of pain.

Sagebrush

Wormwood compresses are also valued among patients with arthritis, as they have anti-inflammatory effects. To get them take 1 tbsp. l dry chopped wormwood, pour 200 ml of almost boiling water and boil for several minutes. Such a decoction is left for 2 hours for infusion, after which it is carefully filtered and applied in the form of night compresses for 20 days.

Tramp

Joint inflammation can be tried to be removed with the help of such a product as a body gun, the powder of which (5 grams) should be combined with 1 tbsp. l butter. The resulting kind of ointment should be rubbed into the affected joints of the fingers, and put on a cotton glove on top. As a rule, ointment with a bodysuit is left on the arm all night, continuing the course of treatment until the inflammatory process disappears.

White cabbage

Treatment with cabbage leaf is practiced in various local inflammations, including arthritic manifestations. Having beaten off one fleshy leaf of cabbage a little, it is necessary to fix it with a bandage on a sick brush for 12 hours, performing such procedures every day for 2 weeks in a row.

Horseradish and honey

The well-known horseradish root in combination with floral honey will be useful in the fight against joint inflammation. A similar product is prepared by 5 minutes boiling 1 kg of finely grated horseradish root in 4 liters of water and further mixing the cooled and filtered mass with 0.5 kg of flower honey. Such a ready-made mixture for the next 20 days in a volume of 200 ml is taken orally once a day after a main meal.

Radish

According to some evidence, freshly squeezed black radish juice, due to its natural antibacterial effect and warming effectiveness, can significantly reduce inflammation in the area of ​​arthritic lesions. Use it by rubbing 4 times a day into the skin around the problem joints, giving such treatment a total of at least 20 days.

Radish and potato

In order to reduce not only inflammation, but also pain in arthritis, sometimes apply applications with radish and potatoes. To do this, thoroughly mix in equal proportions (1 tbsp. L.) Pre-ground black radish, potatoes and parsley, and then use the resulting mixture in compresses. This medicine is usually left on the damaged joints until the pain disappears and, if necessary, changed every 4 hours.

Bay leaf

The anti-inflammatory properties of bay leaf, among other herbal remedies, allow it to beneficially affect arthritic joints. In this case, only 2 tsp. steamed bay leaves for 12 hours, steamed in a thermos using 200 ml of boiling water and, after straining, take 50 milliliters of it on an empty stomach. The general course of such therapy lasts 2 weeks.

Dandelion

Dandelion flower infusion also helps reduce inflammation and pain in arthritis. To obtain this medicinal composition, it is necessary to fill the liter jar with fresh flowers of this plant up to half and fill it with medical alcohol to the brim. Then, for 3 weeks, the medicine must be infused in a dark place and shaken daily. After this time, the infusion is filtered and used for 20 days to rub the affected joints (up to 6 times a day).

Prevention

Absolutely protect your own hands from the development of such a pathology as arthritis today is impossible, however, everyone is able to significantly reduce the likelihood of its occurrence. In order to protect the joints of the fingers from their inflammation, it is only necessary to adhere to the certain rules below:

  • if possible, do not burden your fingers with excessive loads in relation to household and work activities;
  • try not to allow hypothermia and constant overstrain of the hands;
  • adhere to the principles of a healthy and nutritious diet with an additional seasonal intake of the missing vitamins and minerals;
  • control your own weight, preventing development obesity;
  • strengthen the muscle tissue of the hands with the help of proportionate sports exercises;
  • without fail, under the supervision of a specialist doctor, undergo complete treatment of all, without exception, infectious diseases and chronic pathologies;
  • protect yourself from stressful and other similar negative situations;
  • give up all bad habits (smoking, alcohol, etc.);
  • practice a full night's rest (at least 8 hours of sleep per day).

In children

In childhood, diagnosed arthritis in most cases is infectious and develops as a result of a focal or general infection present in the child's body. Somewhat less often, various injuries and disorders of internal metabolic processes act as the root cause of arthritic joint damage in children. The specificity of the reactivity of a growing organism outlines some pathogenetic characteristics of this group of diseases in relation to their formation at different age periods.

So, at a young age, as a rule, a bacterial-metastatic pathway for the development of infectious arthritis is observed, and the lesion affects only one or two and much less often several joints. In this case, the course of the disease is often severe with a high chance of an adverse outcome for the patient (for example, septic arthritis in infants). In the older children's age group, for the most part, cyclic toxic-allergic arthritis occurs, which proceeds benignly as synovitis with subsequent self-elimination of all negative symptoms.

The essence and methods of treating arthritis in children as a whole are no different from those in adults, given the continued growth of the body in the child, including its skeletal system. In the vast majority of cases, timely treatment leads to a complete recovery of the joints, however, it is impossible to launch such pathologies and self-medicate them.

Diet for arthritis of the fingers

Arthritis Diet

  • Efficiency: The healing effect after 2-6 months
  • Dates: 2-6 months
  • Product Cost: 1780-1880 rubles a week

Diet for rheumatoid arthritis

  • Efficiency: therapeutic effect after 3-6 months
  • Dates: 2-6 months
  • Product Cost: 1700-1800 rubles a week

Diet for sore joints

  • Efficiency: therapeutic effect after 2-3 months
  • Dates: 2-6 months
  • Product Cost: 1700-1800 rub. in Week

Gout Diet

  • Efficiency: therapeutic effect after 20-30 days
  • Dates: 1 month or more
  • Product Cost: 1490-1610 rubles per week

Diet for rheumatism

  • Efficiency: therapeutic effect after 2-6 months
  • Dates: 2-6 months
  • Product Cost: 1800-1900 rub. in Week

Arthritis Diet should be assigned to the patient individually, while the doctor must take into account not only the manifestations of arthritic lesions, but also the root cause of its occurrence. Based on this, the patient may be recommended several excellent nutritious diets, nevertheless united by general gastronomic principles.

Food products such as oily sea fish (tuna, salmon, sardine, etc.), fresh fruits and vegetables, as they contain many vitamins and minerals (oranges, papaya, apples, kiwi, etc.), are considered useful for arthritis. ) This also includes seeds and nuts (primarily almonds), turmeric and ginger, characterized by anti-inflammatory effects, garlic, as well as various cereals (millet, rice, buckwheat, oatmeal).

Among the products harmful to the joints are: salt in any form, hot pepper, pumpkin, tomatoes, eggplant, fatty meat, all offal, pastries on margarine, cocoa, gingerbread cookies and other sweets. Scallions, rhubarb, spinach and other greens also fall into this category. A separate ban applies to alcoholic beverages, which do not benefit even healthy people.

In some cases, doctors may insist on the advisability of moving the patient to vegetarian diet, with minimal heat treatment of all fruits and vegetables consumed. As a rule, the patient should observe such nutrition only in the most acute phase of the disease, which most often lasts 7-14 days.

In addition, for people with arthritis, several nutritional rules have been developed, the observance of which will more likely contribute to recovery:

  • it is forbidden to starve or to consume a large amount of food;
  • the daily diet should be divided into 6 meals (3 main and 3 additional meals), which will normalize the plasma sugar level and purine acid content (the latter are largely responsible for articular deposits);
  • own body weight must be kept under control, and if its norm is significantly exceeded, it is imperative to lose extra pounds;
  • daily you need to practice drinking plenty of clean water, the minimum volume of which will help the dietitian to calculate based on the weight of the patient.

Consequences and Complications

If you ignore such a problem as arthritic damage to the joints on the fingers of the fingers or with inappropriate treatment of this pathology, it will, in the end, cause serious deformation of the hands and their complete disability. So, according to WHO statistics in the aggregate disability 3.1% of humanity accounts for exactly chronic arthritis.

Forecast

It is not possible to give an unambiguous positive or negative prognosis for the course of arthritis of the hand, since this pathology is very variable and is determined both by the characteristics of the underlying disease and the severity of local joint changes. In the case of early detection of arthritic lesions of the fingers, it is completely possible for the patient to fully recover while preserving absolutely all the functions of the previously affected hand. With advanced or severe arthritis, significant destruction of articular tissues can occur, followed by irreversible deformation of the hand and ankylosing (cessation of mobility) of the joints.

List of sources

  • Berdyaev, A.F. Diseases and injuries of joints and bones / A.F. Berdyaev. - M .: State publishing house of medical literature, 2010. - 244 c.
  • Diagnosis and treatment of degenerative-dystrophic lesions of the joints / ed. I.V. Shumada. - M.: Health, 2016 .-- 200 p.
  • Zabolotnykh, I.I. Joint diseases / I.I. Boggy. - M.: SpetsLit, 2009 .-- 256 p.
  • Velyaminov, N. A. The doctrine of joint diseases from a clinical point of view / N.A. Velyaminov. - M.: State Publishing House, 2011. - 434 c.
  • Sinyachenko, O. V. Diagnosis and treatment of joint diseases / O.V. Sinyachenko. - M.: ELBI-SPb, Publisher A. Yu. Zaslavsky, 2012 .-- 562 p.

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