Not joint rheumatism

Description:

Rheumatic processes in circumarticular fabrics belong to the extraarticular diseases of soft tissues of the musculoskeletal device which are often combined under the general name "extra articulate rheumatism". Various on the origin and clinic of pathological processes diseases as the fabrics located in close proximity to joints i.e. circumarticular fabrics (sinews of muscles, their vaginas, mucous bags, sheaves, a fascia and aponeuroses), and the fabrics which are on some distance from joints enter into this big group (muscles, nervnososudisty educations, a hypodermic fatty tissue).

Symptoms of Not joint rheumatism:

At defeats of the tendinous device clinical manifestations - pain and restriction of movements - are observed only after inclusion in pathological process of synovial educations - a tendinous vagina and serous bags. Primary isolated damage of the sinew usually is not shown by any clinical symptoms. Clinical displays of a disease of soft periartikulyarny tissues have some features allowing to carry out differential diagnosis with diseases of joints that sometimes presents difficulties in view of close topography, and sometimes and close contact of joint and extraarticular fabrics (for example, insertion of muscular sinews and a periosteum of an epiphysis). The pains arising at damage of sinews, vopervy arise or amplify only at the movements connected with the affected sinew whereas all other movements in view of an intaktnost of the joint and other sinews remain free and painless. Vovtorykh, they appear only at the active movements when tension of the affected sinew takes place. The passive movements of Izz of lack of reduction of this sinew are painless.

At a palpation of the struck area not diffusion morbidity or morbidity is determined by the course of a joint crack; as it is observed at a disease of joints, and the local painful points corresponding to places of an attachment to a bone of an insertion of a sinew or an anatomic arrangement of the sinew. The small and quite accurately outlined swelling in the affected sinew or a serous bag (contrary to diffusion comes to light at arthritis).

Localization of defeats of circumarticular fabrics is defined by intensity of their functional load. Mainly sinews of hands are surprised that it is connected with the set and a variety of function of upper extremities leading to almost constant tension of these sinews. Degenerative diseases of joints are localized, on the contrary, most often in joints of the legs which are basic, therefore, bearing a big functional load.

The most frequent localization of a periarthritis on an upper extremity is the area of a shoulder where short rotators of a shoulder and sinew of a biceps are constantly subject to a big functional load, and in difficult conditions (passing of sinews in narrow space). It serves as the reason of frequent emergence of a tsndoperiostit of supraspinal and podostny muscles, a subacromial tendobursit and a tenosinovit of a long head of a biceps.

In an elbow joint a periarthritis arises less often. Usually develops tendoperiostit in the field of an attachment of extensor tendons and an instep support of a forearm to an outside condyle of a shoulder (an outside epicondylitis). Meets tendobursit the sinews which are attached to a shoulder entocondyle (an internal epicondylitis) less often and tendoperiostit sinews of the biceps which is attached to an akromion (akromialgiya).

Frequent localization of degenerative process on upper extremities are long and thin sinews of a wrist and a brush which pass in narrow fibroznokostny channels. Various painful syndromes - a tendovaginitis of sinews of the muscles which are taking away and unbending a thumb (de Querven's disease), a tendovaginitis of an elbow razgibatel of a brush (an elbow styloiditis), a tendovaginitis of sgibatel of fingers (a syndrome of a carpal tunnel), etc. develop. Defeat of a palmar aponeurosis with development of a flexion contracture of fingers is much less often observed.

On the lower extremities defeat of the tendinous device and sheaves meets much less often. In the field of a hip joint can develop tendobursit sinews of gluteuses in the place of their attachment to a big hillock (trochanteritisis) and a podvzdoshnopoyasnichny muscle in the place of its attachment to a small hillock.

In a knee develops tendobursit the sinews which are attached to the internal surface of a knee and to tuberosity of a tibial bone.

Foot and talocrural area are the place of the most frequent localization of degenerative process in sinews which, as well as on a brush, pass in narrow copular channels, and also in the place of an attachment of an Achilles tendon to a calcaneal hillock (akhillodiniya) and in the place of an attachment to a calcaneus of bottom muscles and a bottom aponeurosis (with development of a calcaneal bursitis).

The listed damages of sinews, sheaves and aponeuroses which are complicated by reaction of serous bags and tendinous vaginas can be observed as separately, and in various combinations.

Calcificats on the course of the affected sinew are found in 30-40% of patients on the roentgenogram, and also periosteal reaction - consolidation and small osteophytes in the place of an attachment of a sinew to a bone (tendoperiostit).

Reasons of Not joint rheumatism:

The etiology of independent diseases of circumarticular fabrics is very similar to an etiology of arthroses. Microtraumatization professional, household or sports is the main origin of these painful syndromes that is explained by a superficial arrangement of soft circumarticular tissues and their big functional load. It is established that it is long the repeating stereotypic movements lead to development of degenerative process in sinews, collagenic fibers and sheaves with the subsequent small reactive inflammation in nearby well vaskulyarizirovanny educations - vaginas and serous bags. Frequent development of a periarthritis, a tendovaginitis, a bursitis in athletes, dancers, painters, violinists, typists testifies to it. The strong physical overstrain and a direct injury can also cause a periarthritis and other defeats of soft tissues.

Treatment of Not joint rheumatism:

At any other disease there is no such wide choice of remedies - from grindings with antirheumatic drugs, ointments on the basis of medicinal plants, ointments with various components irritating skin, use of heat and cold in the most different look, massage, an electrotherapy up to acupuncture and other methods of treatment.

Reception of antirheumatic medicines has auxiliary value - the nonsteroid antirheumatic means suppressing pain and inflammatory process are widely applied here. It does not belong to a rheumatic polimialgiya at which as we noted above, reception of antiinflammatory adrenal hormones - corticosteroids is quite characteristic (Prednisolonum). Similarly treat also pains at diseases of sinews - by an injection of these hormones directly to places where pain is felt.

Medical ointments and solutions (even Shveyk in chapter 1 of the book of Gashek smeared to himself knees opodeldoky - the solution containing camphor and mint), that is the substances causing irritation of skin and reflex strengthening of supply of fabrics with blood that gives good medical effect belong to the most popular drugs at extraarticular rheumatism. Ointments (more dense, than solutions) contain various nonsteroid antirheumatic means and are rubbed in skin until they are not absorbed.

Excellent remedy is local or general use of heat. Can act as sources of heat a lamp соллюкс, a hot bathtub with medical additives (сольфатан, peat), an electric hot-water bottle, the warm compress or wax imposed on skin, therapeutic muds, including from Piyeshtyan, imposed in the form of a fabric compress which should be "heated" houses as it is written to instructions. Sometimes the patient gives preference to cold compresses.

Doctors often appoint electromedical procedures, such as an ionophoresis (administration of medicinal substances in skin by means of influence of electric current), a diathermy (works by means of electric waves, most often short which are similar to radio waves), ultrasound (the ultrasonic device generates certain so high-pitched sound that the human ear does not distinguish it, but body tissues feel its fluctuations and by that their blood supply increases).

Methods of treatment at a sore shoulder are a little more difficult. First of all it is necessary that the doctor defined a cause of illness. Here the patience is required, and it is necessary to realize that in a final stage improvement though sometimes it is necessary to wait also for several months will always be result of treatment. At treatment at first it is necessary to give preference to rest, not to be engaged in too active development of a shoulder. The shoulder should be spared, and sometimes using a sling for a hand. After that, as there will pass the first attack of a disease, the shoulder can be developed the swing movements or by means of a healthy hand. These exercises suit also for other types of rheumatic diseases. It is desirable to pass introduction occupations under the leadership of the rehabilitation specialist in the beginning.