Gelenk-Klinik

Athritis
(right: Arthritis)

The Athritis is an inflammatory joint disease, the damage to the joints can lead to. You shall be delineated by the degenerative changes, the arthritis. While arthritis is a cold world, the joints wear, which are the arthritis by hyperthermia, marked swelling and redness. Moreover, they effusion. After the number of affected joints is between a Monoarthritis (joint ill), a Obligoarthritis (some joints) and polyarthritis (many joints) can be distinguished. This disease can have several causes: both hereditary factors, as well as acquired joint damage or injury may play a role. Because the cause is also the differentiation of these arthritis: The most common Athritis are forms of acute bacterial Athritis and rheumatoid Athritis. This meaning, which is activated osteoarthritis, which is a result of mechanical overload also contributes to joint inflammation comes.
In the case of a bacterial Athritis get germs in the joint. In this context, one speaks also of Gelenkempyem. The guiding of the bacterial Athritis is the joint pain. In about 90% of cases only one joint is affected. The most common sites are the knee (50%) and hips (25%). In about 10% are shoulder, elbow, ankle or wrist affected.
From the bacterial Athritis the Athritis for rheumatic diseases, the post-Athritis and Athritis with metabolic disorders (eg gout) can be distinguished. These inflammatory disorders are also under the term osteoarthritis summarized.

What is a Athritis?

Any inflammation in the body is following the same pattern: When there is damage in the affected area to a redness and warming. They are signals of increased blood flow. With the blood also increases the immune cells in the area of injury. The swelling is occurring signs of edema, which is leading to increased water retention in the tissue. This increases the pressure on the nerve endings to. Therefore in this area occur on pain.
This is true even when joint swelling to: The blood vessels in the joint inner skin (membrane Synovialis) expand and fill with blood. Due to the membranes of blood vessels filled blood enters the water in the cell interstices Synovialis (mucosal layer), which then swells. From there, the fluid in the joint cavity. At this stage it becomes Gelenkerguss which rich in white blood cells and is coagulants. These are a result of inflammatory processes with the blood in the inflammation area geschwemmt. Through the coagulants and the white blood cells formed on the Synovialis a fine Schorfschicht, resulting in a proliferation of Synovialis result. From arthroscopic view resemble those Gelenkschleimhautauswucherungen the Darmzotten. They also serve the same function: They provide a surface magnification, which one to increased absorption, but also to an increased secretion of synovia (joint fluid), that accumulates in the joints. The white blood cells accumulate in the joints and attract ever more defensive cells. Thus, the inflammatory process further. The proliferating mucous überwächst the cartilage and destroys him. This mechanism shows that the Athritis is a disease which itself operates. Depending on the type and form of the Athritis it may take up to a complete exposure of the bony surface of joints then rub bone to bone, resulting in significant joint pain.

What triggers a Athritis from?

In the case of rheumatoid Athritis the Synovialis responding to these fine Schorfschicht with the formation of rapidly proliferating cells. This access to the cartilage covering the joints above and eat in the cartilage inside. They also draw the cells of the bone at the edges of the cartilage at the base of the joint capsule is released. Although these cell proliferations are dying off, but a small part remains, and is transformed into fiber cells and to form a layer on the cartilage is destroyed. This fibrous layer is called pannus.
The pannus over larger areas of the articular cartilage, so that it no longer can be fed synovia. The cartilage is hungry. The white blood cells attempt to dissolve the dead Gewebsteile. In doing so, they are aggressive digestive substances, cytokines, free, the more cartilage damage. The cytokines also cause stimulation of bone-degrading cells, osteoclasts. This is also the bone attacked. The result is a more or less destroyed joint. Also, the tendons, ligaments and bursa can be affected.
In the case of the bacterial (infectious) Athritis get germs either through injuries, the interior open joints, or in the bloodstream (blood) in the joint. One of the most common causes of direct Keimeintritts Besides injuries, surgery or injections into a joint, in which bacteria are introduced.
The most common pathogens of infectious Athritis is Staphylococcus aureus, in which half of the patients, about 25% of Staphylococcus epidermidis and streptococci. Viruses can also cause arthritis. The most common pathogens are the rubella virus, mumps virus and the hepatitis B virus.

How can your doctor the diagnosis?

Diagnostic shows a Gelenkerguss. At the knee and elbow, it is palpable in other joints sonographically representable. Also using X-rays can be characteristic changes in the bone near the joints, arthritic Randsaumbildung, demonstrated. The blood test also found elevated inflammatory values. The investigation is the key to the analysis of Gelenkpunktion synovia (joint fluid). The diagnostic value of different parameters, namely the white blood cell does not affect the delimitation of the inflammatory nichtentzündlichen Gelenkerguss too. The appearance of Gelenkergusses serves to further differentiation. Moreover, a swab taken from a pathogen and to take evidence.

Which therapeutic measures are taken?

The therapy must be 4 goals to be achieved:

• the rapid elimination of the inflammatory process, infectious cause with the help of antibiotics.
• mechanical cleaning (removal of the inflammatory factors)
• pressure relief
• functional recovery
• the elimination of the joint überwuchernden mucosa.

An infectious Athritis requires prompt surgical intervention: primarily the Gelenkspieglung (arthroscopy). This involves the white blood cell and thus to reduce harmful cytokines to prevent joint destruction. Furthermore, even the complete flushing of the joint and subsequent drainage. At insufficient response may open or arthroscopic Synovektomie implemented. In parallel, a treatment with antibiotics, the first broad and must act upon receipt of specific pathogen detection is used. Antibiotic therapy is usually given intravenously for a period of 2-6 weeks.

Other links to Athritis on our website (Quick Links):

Arthritis of the hip, knee arthritis, ankle arthritis, big toe joint arthrosis, facet arthritis, shoulder arthritis