When talking about arthritis, we usually mean a specific condition, e.g. rheumatism, arthritis, lupus, Bechterew’s disease, juvenile idiopathic arthritis, degenerative disease or reactive arthritis. Despite the different course and causes, diseases involving joints cause similar symptoms and require similar treatment. Of course, there are complaints characteristic of a given disease, which facilitates diagnosis and detailed targeting of the therapeutic process. However, regardless of the diagnosis, in patients suffering from arthritis symptoms always include pain, swelling and limitation of mobility.
The emergence of inflammation in the joint may have a very diverse etiology – from injuries and overloads of the musculoskeletal system, infection with microorganisms (bacteria, viruses, fungi, and even parasites), to the defective functioning of the immune system and genetic burden. The autoimmune base shows most of the rheumatic diseases, but the primary cause of autoimmunity has still not been established.
The inflammatory process usually begins in the synovium, which begins to grow and constrict adjacent elements of joint connections. An overgrown synovial membrane leads to damage to cartilage, ligaments, tendons and finally bones, which causes gradual degeneration of the musculoskeletal system.
Inflammation of the joints may be acute, subacute or chronic, and some diseases (eg RA, ankylosing spondylitis) remain permanently with humans. In the course of the inflammatory process, permanent joint damage occurs, which can result in severe limitation of fitness or even disability. The extent of the damage depends on the stage at which the arthritis was diagnosed – the symptoms are quite characteristic, but you can easily overlook them or downplay them. Patients often go to a specialist only when the disease begins to impede their normal functioning at home and work or doing sports.
It happens that young people already have problems with moving or precise motor skills (writing, tying laces, repairing devices, using cutlery and tools, etc.). Early diagnosis of arthritis is certainly hampered by the myth that rheumatism is the domain of mature and elderly people – for example, JIA children get 16 years of age, and ankylosing spondylitis (Bechterew’s disease) affects mostly young people aged 17-35.
Unfortunately, in some people with arthritis, the symptoms also include other organs and systems. Increased inflammation may attack, among others skin, nervous system, heart, kidneys, lungs, eyes – we are talking about systemic connective tissue disease. It happens that patients treated for rheumatism die due to a heart attack, heart disease or kidney failure.
Fever or low-grade fever, weakness, “break”, muscle aches, worsening of appetite – usually these symptoms are accompanied by a cold, flu or other infection of the autumn and winter season. However, inflammation of the joints may appear in the same way – the initial symptoms are so unspecific that sometimes it passes several months from the disease to the diagnosis of the right condition. Meanwhile, the sooner the doctor makes a diagnosis and plans the appropriate treatment, the greater the chances of stopping the process of degeneration of the joint and avoiding disability. Unfortunately, the course of many rheumatic diseases can not be stopped completely – despite the early diagnosis and use of the drug, the patient is still at risk of disability, although much later than in the absence of treatment.
Sometimes, however, the patient notices the characteristic symptoms of arthritis from the very beginning, i.e .:
The above-mentioned changes may occur symmetrically or asymmetrically (i.e. only on one side of the body) and include both individual joints and joint groups. Over time, chronic rheumatic disease (especially RA) leads to joint deformity, which makes it difficult to perform even ordinary activities, such as dressing, body care or eating meals.
In patients with systemic arthritis, the symptoms depend on the duration and severity of the disease. Patients with RA relatively often report dry eye problems and a cosmetic defect in the form of subcutaneous rheumatoid nodules. More rarely, there are serious complications in the circulatory system, i.e. atherosclerosis, cardiomyopathy, pericarditis or damage to the valves. As a result of chronic inflammation, hematological disorders also occur, i.e. anemia, enlargement of the lymph nodes, thrombocythaemia and lymphomas.
Joint diseases can also affect the nerves, leading to carpal tunnel syndrome, sensory disturbances and even limb paralysis. Arthritis in the course of lupus causes symptoms of psychiatric disorders (psychotic behavior, convulsions, and even mental retardation), while patients suffering from ankylosing spondylitis due to the ossification of the chest, breathing disorders occur.
In rare cases, the result of rheumatism may be vasculitis and, consequently, ischemia of important organs. Systemic symptoms of arthritis also occur in children with JIA – the disease may be accompanied by rash, inflammation of the eyeball, pericarditis, muscle contractures, growth disorders (acceleration or slowing of the development of the skeleton). In addition, chronic diseases of the joints are conducive to pneumonia, kidney damage (also due to medication) and osteoporosis.