December 28, 2012
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Reactive arthritis - This is the nature of purulent inflammation in the joints, the development of which takes place as a consequence genitourinary or intestinal infection .
If we consider all the rheumatic diseases, it is reactive arthritis, also called Reiter's disease It is considered to be the most common disease in this category. The name "reactive arthritis" appeared in 1969, and represents a response to the development of infection in the body, which is manifested by inflammation of the joints.
Most often, this diagnosis occurs in boys during adolescence and in young men. According to medical statistics, reactive arthritis occurs in 86, 9 patients per 100 thousand people.
Causes of reactive arthritis
Most often the development of reactive arthritis occurs against Chlamydia infection . Reiter's disease in children due to infection Chlamydia It develops in about 80% of cases. Chlamydia infection occurs through direct contact with carriers of the infection. Chlamydia also can be transmitted from animals. Modes of transmission - airborne, sexual, airborne dust, and everyday contact. Zzarazhenie occurs during the passage of the fetus through the birth canal of the infected mother. If chlamydia infection is usually a person does not manifest visible symptoms. Sometimes there is discomfort and pain when urinating, the presence of secretions from the genitals.
Another pathogen Reiter - intestinal microorganisms. It Salmonella . Yersinia . Campylobacter . Shigella , Which can be infected with the contracts with infected people, faeces, when receiving tainted food. In these lesions in humans there is a very heavy diarrhea .
However, manifestations of reactive arthritis is marked by no means all people who have had such an infection. According to some studies, the disease occurs only in people who have a special gene - HLA B 27. Therefore, the cause of reactive arthritis is still being studied.
Symptoms
With the defeat of rheumatoid arthritis in men indicated a more severe course of the disease than women. It is noted that after undergoing a sex infection reactive arthritis man sick nine times more often than women. But after an intestinal infection occurs in about the same incidence.
The symptoms of reactive arthritis observed in humans after about 2-4 weeks after he suffered sexual or intestinal infection. Reactive arthritis in children and adults is most often symptoms urethritis Later developed conjunctivitis And last notes arthritis joints. Usually, conjunctivitis manifested neobilnye department. Some patients (approximately one out of four) are present on the skin changes. Lesions predominantly occur on the skin rash, mucosal lesions of the oral cavity.
The symptoms of reactive arthritis are stored in a human patient a different time period. It lasts from three months to one year. Generally at this time are stored mild signs urethritis and conjunctivitis and inflammation affects one or two joints. For example, inflammation may be a hip joint, knee joint. Sometimes, however, reactive arthritis goes very hard, and significantly limits physical activity, moving in chronic arthritis . In this case, the patient is actively looking for an opportunity to get rid of the disease by practicing treatment of folk remedies. Initially, however, it should be carried out a qualitative diagnosis of the disease and be assigned a doctor's prescription.
Starting reactive arthritis usually acute: sharply increased body temperature, general condition significantly deteriorated. There is a loss of large joints of the legs: mainly suffer from the disease ankle, knee, heel, interphalangeal, metatarsophalangeal joints, joint damage occurs less frequently hands.
The most commonly affected toes, which develops swelling, which gradually covers the entire finger. The skin on the finger becomes purplish-blue. Besides arthritis in patients with the disease develop Reiter enthesopathies. So called inflammation of the tendons that occur in places where tendons attach to bones. Most often this phenomenon is observed in the heel area. Sometimes patients complain of pain in the spine.
If treatment Reiter's syndrome occurs in a timely manner, the symptoms disappear in a relatively short period of time. However, it happens that reactive arthritis becomes chronic.
Complications
When the disease reactive arthritis doctors say the favorable prognosis for a normal life and save functions. However, there are some unfavorable factors that worsen the prognosis. In this case, we are talking about too frequent exacerbations articular syndrome, the presence of hereditary predisposition to rheumatic diseases, carriers of HLA-B27 gene , No effect of therapy. Lethal outcomes in this disease is very rare. The main causes of death are complications, provoking the defeat of the human heart. To prevent the development of such complications, it is necessary to take care of timely and proper treatment of the disease and the regular monitoring by a specialist rheumatologist.
Diagnostics
In the process of diagnosis of reactive arthritis doctor initially conducting a survey of the patient. To establish the diagnosis in cases of Reiter's disease in humans can be based on evidence of infection, which occurred in a patient in the near future. Also, the doctor examines the clinical manifestations, using laboratory and instrumental methods of examination. The study should focus on the presence of lesions in human eyes, urinary tract, skin, and joints. Wires and analysis for the presence of the pathogen in the body of the patient. During laboratory testing using blood, stool, discharge from the genital tract. In some cases, practiced conducting X-ray examination of the affected joint.
In this case it is important not only confirm the diagnosis of reactive arthritis, but also to exclude the presence of other causes that triggered the development of arthritis.
Treatment
Starting treatment of reactive arthritis, the doctor puts a goal to eradicate the infection, cure the disease or to reach a state of stable remission. Reiter's disease should be treated in a hospital. Reiter's disease treatment is conducted using conservative methods. In this treatment of disease in both men and women suggests the use of antibiotics Non-steroidal anti-inflammatory drugs, glucocorticoids are also sometimes used. When the inflammatory symptoms subside, practitioners of physical therapy, massage course. Features of how to treat the disease, on an individual basis points physician.
Antibiotics - one of the main methods of treatment, their choice should be based on characteristics of life chlamydia or other microorganisms that triggered the infection. In general in the treatment of this disease are applied tetracyclines . macrolides . fluoroquinolones . However, considering the toxicity of certain antibacterial drugs in the treatment of disease caused by chlamydiae, children apply only macrolides. Note, however, that antibiotic treatment is effective in the acute course of the disease. If reactive arthritis becomes chronic, the antibacterial agents do not have the desired effect.
At the same time in the treatment of chronic chlamydial arthritis used a variety of immunomodulatory drugs. These treatments may be carried out only under constant medical supervision. Drugs in this group help to increase the overall resistance of the organism and its protective properties.
But not only getting rid of Chlamydia is the only condition for healing. Antigens Microorganisms are stored in the body for a longer time than the driver. Therefore it is very important to carry out a check-up at regular intervals. Sometimes you need to repeat courses of treatment with antibacterial drugs and immunomodulators .
Furthermore, if necessary symptomatic treatment of patients assigned. NSAIDs prescribed to relieve pain in the acute period. Doses of such drugs depends on the age of the patient.
Steroidal antiinflammatory drugs have strong anti-inflammatory effects, are assigned so that if the need to quickly stop the pain, or complications of the disease activity. When reactive arthritis corticosteroids are administered intra-articularly.
Unless articular syndrome exacerbated, and thus holds Enthesopathy limited mobility of the spine, the practice of accepting mmunopodavlyayuschih drugs. They were also assigned if the standard treatment is ineffective. Treatment of such drugs may last for several years, but require constant medical supervision.
If joint pain persists for a long time, they must be protected from stress. But later, after the inflammation is healed, it should gradually restore physical activity. Treatment of the disease usually lasts about 4-6 months.
Prevention
Primary prevention methods of reactive arthritis exists. It is necessary to take all measures to prevent the onset of disease. Therefore, special attention should be paid to a healthy lifestyle, hygiene, treatment of chlamydia, as well as prevention of contracting sexually transmitted infections. Acute and chronic foci of infection should be treated promptly.
Secondary prevention measures involve the prevention of recurrence of the disease. It is important to avoid self-medication and the time to contact a specialist.
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