Synonyms in a broader sense
- Arthritis
- Arthralgia
- Pain joint
Joint inflammation (arthritis) is an inflammatory and usually painful disease of one or more joints, which can be acute or chronic and can have many different triggers. In principle, joint inflammation can be divided into two large groups: those caused by infections (with bacteria or fungi) and those that are non-infectious (for example, rheumatoid arthritis or joint inflammation caused by other diseases such as gout or psoriasis). However, the symptoms of the different types are similar in that they are all associated with the five typical signs of inflammation: In contrast to the acute forms, however, chronic joint inflammation is intermittent and can flare up again and again, even if there has been a longer symptom-free interval.
Long-term joint inflammation can ultimately destroy the joint and thus lead to malpositions or even disabilities.
- Overheating
- Redness
- Swelling
- Pain
- And limited functionality.
The most common are bacterial joint inflammations. There are two ways in which the bacteria can get to the joints: either through open wounds following an accident or during surgery, but also via the bloodstream, which means that bacteria from another source of infection in the body are “washed up” on the joint and cause a corresponding reaction there.
In otherwise healthy adults, the triggering bacteria are from the genus Staphylococcus aureus in over half of the cases. In the context of a bacterial infection, an inflammation of the joint is typically purulent (this is also called joint empyema). In this form, all symptoms are classically very pronounced, and usually there is also a joint effusion.
This clinical picture is always a medical emergency. Within a few hours or days, the affected joint can be destroyed and/or germs can be carried away, leading to blood poisoning. For this reason, a surgical intervention is performed as soon as possible.
Normally, the joint is opened and a joint endoscopy (arthroscopy) is performed, during which the inflamed joint is rinsed out and infected material can be removed from the joint. At the same time, treatment with antibiotics should always be carried out, which can initially be calculated even without pathogen detection. At the latest when a pathogen has been identified (usually from the material of a puncture of the articular effusion), this should then be adjusted if necessary.
Rheumatoid arthritis (RA, also known primarily as chronic polyarthritis or PCP) is the main cause of non-infectious joint inflammation. This belongs to the group of rheumatic diseases and is an autoimmune disease. This means that the body, for a reason not yet finally known, incorrectly classifies endogenous elements as foreign and initiates an inflammatory reaction against them.
In rheumatoid arthritis, this inflammatory reaction is directed, among other things, against components of the articular cartilage, whereby the bone surface is exposed more and more and finally rubs bone on bone. The affected joints are typically the small joints of the hands and fingers and they are symmetrically located on both sides of the body. Initially, rheumatoid arthritis often simply makes itself felt by a morning stiffness of the joints.
However, this disease is chronically progressive and in its final stage, if not treated appropriately, can lead to pronounced malpositioning, especially of the hands, severe pain and severely limited mobility of the affected joints. To diagnose rheumatoid arthritis, various parameters from the blood (especially certain antibodies and rheumatoid factors) and X-rays are used to identify typical changes in the joints. The most important therapeutic options for rheumatoid arthritis include Some metabolic diseases such as gout can also lead to joint inflammation.
In this particular case, the arthritis is triggered by increased accumulation of uric acid in the joint (acute, very painful attack of gout). This type of joint inflammation usually occurs in the metatarsophalangeal joint of the big toe. In about 5% of patients suffering from psoriasis, an inflammation of the joint also develops as an accompanying symptom of this disease.In contrast to rheumatoid arthritis, the infestation pattern here is not symmetrical, but classically all joints of a finger or toe are affected “in the beam”.
The diagnosis of this disease is often made more difficult by the fact that the joint complaints can occur long before the trend-setting skin changes.
- Painkillers from the antirheumatic group (NSAIDs, for example ibuprofen)
- Anti-inflammatory medicines like cortisone
- Specific rheumatism drugs
- If necessary, immunosuppressive drugs to weaken the body’s overreacting defence system.
Rheumatoid arthritis is the most common inflammatory disease of the joints. This autoimmune disease typically affects small joints: the base and middle finger joint can be affected on the finger, while the end finger joint is never affected in rheumatoid arthritis.
In most cases of rheumatoid arthritis, several joint inflammations occur in parallel, often symmetrically distributed on both hands. The swollen joints are soft but still bulging and feel hot. A typical early symptom of rheumatoid arthritis is a long morning stiffness of the finger joints of over 30 minutes.
The joint inflammation in rheumatoid arthritis can be accompanied by strong general symptoms such as fever, weight loss and fatigue. In the course of the disease, the joint inflammations lead to deformities of the fingers (swan neck deformity or buttonhole deformity) due to malposition and stiffening of the joints. Treatment is given with painkillers, cortisone, special rheumatism medication and immunosuppression in severe cases.
Joint inflammation of the fingers can also occasionally be a symptom of Reactive Arthritis after bacterial infections, but generally the fingers are less frequently affected than larger joints. If the rheumatoid arthritis affects the wrist, bending towards the palm is particularly painful. The wrist is typically elastically swollen and overheated.
Psoriasis, an autoimmune disease of the skin, can also cause inflammation of various joints. It is typical here that all joints of a finger and the corresponding metacarpal are affected by the inflammation, which then appears as a single “sausage finger” and is medically called dactylitis. It is also possible for joint inflammation in the context of psoriasis to affect various joints, including the end joints of the fingers, whereby the joint inflammation is not symmetrically distributed as in rheumatoid arthritis.
Chronic inflammatory diseases of the intestine (Crohn’s disease, ulcerative colitis) can also manifest themselves in the joints of the hands and fingers in addition to the typical intestine-specific symptoms: This type of joint inflammation improves with treatment of the chronic bowel disease and rarely leads to permanent damage to the joint. The already mentioned autoimmune joint inflammations caused by rheumatoid arthritis or psoriasis can of course also affect the ankle or other joints of the foot. In addition to swelling, redness and overheating, the joint inflammation then manifests itself as pain when running or standing.
If psoriasis affects the foot, in many cases all joints of a toe and the associated metatarsal bones are affected by the inflammation, which is called dactylitis. Joint inflammation of the foot is often caused by Reactive Arthritis, which in many cases affects the knee joint, but also very often the ankle joint. About 2 to 6 weeks after infections of the gastrointestinal tract or the urogenital system, Reactive Arthritis may occur in hereditary predisposed patients.
Possible pathogens include Yersinia, gonococcus, streptococci and various viruses. It is interesting that the pathogens cannot be detected in the joint because the joint inflammation is triggered by a cross-reaction of the immune system. In most cases, Reactive Arthritis heals within a few months, but about 20-25% of patients have to be treated with medication on a permanent basis.
A special case of pathogen-induced joint inflammation is Lyme arthritis. Months to years after a tick bite, the Borrelia bacteria that may be transmitted can trigger an inflammation of the joints, which most frequently affects the large joints. Usually the knee is inflamed, but the ankle joint is also often affected.
The toes can also occasionally be affected by rheumatoid arthritis. An inflammation of the metatarsophalangeal joint of the big toe is typical of an acute attack of gout. Gout is a metabolic disease in which increased uric acid levels in the blood occur for various reasons.If uric acid levels are too high, uric acid is deposited in joints in the form of uric acid crystals.
The metatarsophalangeal joint of the big toe is affected in 60% of cases. The uric acid crystals cause swelling and joint inflammation, which occurs suddenly (often at night) and is very painful, so that, for example, the bedspread is already a painful irritant. The patients usually have a fever. Treatment in acute attacks is with anti-inflammatory painkillers, the high uric acid levels should be lowered prophylactically by a healthy diet and, if necessary, by drugs such as allopurinol. You may also be interested in the following topics: Inflammation in the big toe or pain in the big toe – These are the causes
