Diagnosis
The diagnosis of joint inflammation begins with an anamnesis, followed by a physical examination. The physician attempts to obtain more precise information about the type of symptoms, localization and severity as well as the resulting limitations by asking specific questions. It is also important for the doctor to know how long the complaints have existed, when and in what context they first appeared and how they have developed since then.
During the physical examination, the examiner palpates the joint and looks for swelling, pain from pressure and overheating. He will also carefully test the mobility. Afterwards, an x-ray is often taken to obtain indications of possible damage to the joint.
Special blood tests can confirm an inflammation of the joint. Important values here are the so-called inflammation parameters. These include the white blood cells (leukocytes), the C-reactive protein (CRP) and the blood sedimentation rate (BSG). In rheumatoid arthritis, so-called rheumatoid factors are frequently found and in gout, elevated uric acid levels in the blood can be detected.If these examinations are not sufficient for a diagnosis, a joint puncture, i.e. the removal of fluid or tissue material from the joint, or arthroscopy may be necessary. In about 20% of cases, no pathogen can be detected despite special methods.
Therapy
An inflammation of the joint can have many different causes. The therapy therefore depends on the cause of the inflammation. In general, relief of the symptoms of acute arthritis can already be achieved by immobilizing, elevating and cooling the affected joint.
In addition, various drug, physical and surgical measures are used. Painkillers and anti-inflammatory drugs often form the basis of drug therapy. These include, for example, glucocorticoids (cortisone) and the so-called non-steroidal anti-inflammatory drugs (NSAIDs).
If the inflammation of the joint is caused by bacterial colonization, antibiotics are used. In rheumatoid arthritis, special rheumatic drugs, the so-called basic therapeutics or DMARDs (=Disease Modifying Antirheumatic Drugs), are used. These include Methotrexate, a cytostatic drug, Rituximab, a monoclonal antibody, and Ciclospoprin A, an immunosuppressive drug.
With regard to physical therapy, there are several options. The joint can be relieved by a joint puncture. During this procedure, excess fluid is removed from the joint, thereby relieving a feeling of tension, movement restrictions and pain.
The complaints can also be improved with cold therapy as well as with movement exercises and physiotherapy. If bacterial joint inflammation persists for longer than six to nine months despite therapy, surgical repair of the joint can be considered. Before deciding on a surgical measure, however, a second opinion from an expert should be obtained. In the course of an operation, either a minimally invasive or open procedure is then performed to clean up the joint, so to speak, and the bacteria are eliminated as far as possible.
