Arthritis of the fingers is one of the most common forms of peripheral arthritis in which the inflammatory process involves metacarpal-phalangem and interphalangeal joints. First inflamed inner synovial membrane of the joint, then the pathological process extends to the joint capsule, cartilage, tendons, ligaments, muscles, and bones.
The primary inflammatory process usually develops on the background of the infection, rheumatic or pathology, at least – on the basis of the trauma or surgical intervention. In the case of rheumatoid arthritis a role played by hereditary predisposition.
Secondary arthritis of small joints, is a complication of allergic, atopic and autoimmune conditions, common infectious or primary somatic diseases, such as gout, diabetes or psoriasis. In the pathogenesis of reactive arthritis the leading role played by a history of tuberculosis, dysentery, hepatitis, granulomatosis', influenza, measles, mumps, scarlet fever, quinsy and chronic tonsillitis, Lyme disease, Reiter's syndrome and sexually transmitted diseases. In children, the role of a provoking factor can play a vaccination.
Exacerbation of chronic arthritis of the fingers can irritandum hypothermia, humidity or weather changes, vibration, stress and changes in hormonal status of the organism. Because of variations in hormonal levels more typical of women, the incidence of arthritis of the fingers among them is 3-5 times higher than among men. Hypertension, advanced age, poor nutrition, bad habits and diseases of the excretory system also increases the likelihood of arthritis.
Arthritis of the fingers has a variety of manifestations that influence the choice of therapeutic strategies and medicines. Depending on the nature of the disease distinguish acute and chronic forms of arthritis and the identification of key etiological factors differencebut primary arthritis of the fingers as an independent nosological form and secondary arthritis of the fingers as a symptom in clinic related infectious, rheumatic and metabolic diseases. It should be noted that secondary arthritis of the fingers is much more common, independent of the disease.
Based on the number of affected joints, distinguish between polyarthritis and oligoarthritis of the fingers: in the first case the inflammatory process involved four and smaller joint, the second – from two to four. Extremely rare monoarthritis; of these, the most common resortit – inflammation of the first metacarpal-carpal joint.
Arthritis of the fingers is one of the most common forms of peripheral arthritis in which the inflammatory process involves metacarpal-phalangem and interphalangeal joints.
Arthritis of the fingers is among the rapidly progressing disease. Depending on the degree of destruction of joints there are four stages of the pathological process.
The clinical picture of arthritis of the fingers is characterized by great variability and depends on etiologic forms and stages of the disease. Early stages of rheumatoid arthritis tend stiffness of the joints in the morning and after prolonged rest. Thus there is a distinctive feeling of tight gloves that restrict the movement of the brush. In some cases, the patient may not be complaints, and the only manifestations of the disease as an early radiographic signs of arthritis fingers:
The characteristic signs of inflammation of the joints, usually observed in the II stage of the disease, starting with the appearance of painful swelling, erythema and crepitations in the affected joints, and radiological signs added multiple narrowing of the inter-articular slits, cystic enlightenment of bone tissue and regional deformation of the epiphyses of bones. Sprains, subluxations, and ankylosis of the joints detected predominantly in the terminal stages of the disease.
The most dangerous complications of arthritis of the fingers include osteomyelitis, osteolysis and necrosis of the bone tissue, which is often followed by generalized sepsis.
In the case of reactive and psoriatic arthritis affects joints asymmetrically. Psoriatic form is characterized by thickening of the joints and farciminis light of the shape of the fingers. Morning stiffness of movements, as a rule, is not observed; limited mainly exion.
When a reactive form of arthritis joint inflammation fingers occurs on the background of fever, chills, headache, conjunctivitis and symptoms of an infectious inflammation of the urinary tract.
When gouty arthritis affects mainly metacarpal-phalangem the big toe joint, in which are formed the elastic subcutaneous nodules-are referred to as tophi filled with urate crystals.
In children often diagnose infectious and reactive arthritis, most often developing on the background of streptococcal infection. The clinical picture of arthritis in fingers in children is more pronounced than in adults: severe pain and pronounced deformation of the joints accompanied by severe fever and General intoxication of the organism.
Rheumatoid form of arthritis in children is characterized by pertinax course and poor response to therapy. Inflammation of the joints of the fingers usually develops on the background of the defeat of the large joints and internal organs. If you locate the etiological factor of inflammation of the joints of the fingers the child is not possible, the diagnosis of juvenile idiopathic arthritis.
Bright clinical picture of the inflammatory process in the joints of the fingers allows with a high degree of confidence to diagnose arthritis, but to clarify the etiological forms and stages of the disease will need to undergo a series of additional diagnostic procedures.
In the course of medical history, the doctor draws attention to the relationship of the manifestations of arthritis previously transferred infectious diseases, metabolic and somatic pathology, and exposure to damaging factors. The physical examination is a valuable source of diagnostic information be the size, shape and temperature of the joints, color of skin, character of pain, functional test, the presence of extra-articular manifestations, etc. are Sometimes necessary to see other specialists – orthopedist-traumatologist, dermatologist, and allergist-immunologist. The identification of characteristic changes in the joints of the fingers requires the use of instrumental techniques – x-ray, MRI and CT brushes, ultrasound of the small joints.
Laboratory diagnostics plays a crucial role to determine the cause of the inflammatory response. Common blood test reliably detects signs of inflammation. During biochemical analysis of blood can determine the level of uric and sialic acids, allowing to confirm or exclude the diagnosis of gouty arthritis. High rates of rheumatoid factor and C-reactive protein, fibrinogen, seromucoid, cryoglobulins, etc. indicate rheumatoid pathology. In some cases, shown a laboratory study of the punctate of synovial fluid.
Arthritis of the fingers is common among tailors, seamstresses, shoemakers, watchmakers and jewelers.
Medical strategy for arthritis of the fingers is based on a combination of pathogenetic and symptomatic approaches. During the acute phase of the disease the main goal is the elimination of inflammation and pain. In the early stages is usually enough of a course of analgesics, muscle relaxants, non-steroidal anti-inflammatory drugs, and in some cases it is possible to do external application of ointments containing blockers of cyclooxygenase-1 (COX-1), painkillers and vasodilators. Infectious and reactive arthritis in the scheme of treatment include antibiotics; if there is an allergic component, antihistamines, and rheumatoid arthritis – immunosuppressants and immunomodulators.
Treatment for arthritis fingers good effect is given physiotherapy the following:
When strains resistant joints conservative treatment is ineffective. In order to prevent patient disability recommended arthroplasty or joint replacement.
Diet for arthritis of the fingers contributes to prolongation of remission. During exacerbations it is necessary to refrain from the protein foods – meat products and legumes, as well as salty, fried, fatty and spicy food, chocolate, muffins, tea, coffee, cocoa and spirits. After inflammation food restrictions becomes less enough to avoid alcohol and limit the consumption of meat, smoked meat and heavy dishes, rich in saturated fats and quick-liquefaciens carbohydrates.
When gouty arthritis is also strongly contraindicated red meat, offal and smoked meats. The preferred dairy-vegetarian diet, except for fruit and vegetables that contain solanine. Eggplant, tomatoes, squash, green onions, sorrel, rhubarb and hot pepper should be consumed as rarely as possible.
Arthritis of the fingers has a variety of manifestations that influence the choice of therapeutic strategies and medicines.
The diet of the patient should include foods with a high content of polyunsaturated fatty acids, easily digestible protein and vitamin C:
Acute infectious arthritis of the fingers, in the absence of adequate treatment increases the risk of septic complications that threaten the patient's life. Prolonged disease threatens to become an irreversible deformation of the joints of the fingers that lead to patient disability. The most dangerous complications of arthritis of the fingers include osteomyelitis, osteolysis and necrosis of the bone tissue, which is often followed by generalized sepsis.
It is also reported about the severe side effects of prolonged use of nonsteroidal anti-inflammatory drugs. Some patients treated with inhibitors of COX-1 in injectable and oral form for a long time, there have been cases of gastroduodenitis, enterocolitis, and peptic ulcer disease due to regular irritation of the mucous membranes of the gastrointestinal tract; more rarely met nephropathy.
The result of arthritis of the fingers depends on the nature of the primary manifestations and etiological forms, response to therapy, patient's age at the time of disease onset, and the presence and severity of comorbidities. Early diagnosis and timely treatment increases chances of recovery.
In order to prevent arthritis of the fingers is necessary to monitor the state of health in General and to promptly contact their physician if signs of infection, metabolic disorders and other pathologies. It is particularly important to prevent the formation of chronic foci of infection, abstain from alcohol and to control the power. Moderation in food, with enough vitamins and minerals in the diet reduces the chance of arthritis and gout, in particular, should not be abused meat heavy and fatty foods. Active lifestyle, physical exercises and tempering improve the condition of joints, however, you should avoid injuries and hypothermia of the hands. With frequent training manual labor it is recommended to pause after every 2-3 hours and perform finger gymnastics.