Examination of the knee joint for knee pain: how and where to go. Methods for diagnosing joint diseases: purpose and features of procedures How to check joints of the whole body yourself

Many people know what pain in the knee joint is - this phenomenon is quite unpleasant and reduces a person’s quality of life, since pain leads to limited mobility.

Trying to avoid pain, the patient begins to move less, resulting in physical inactivity.

As is known, prolonged immobility in the joints leads to the development of diseases of the musculoskeletal system, the treatment of which requires regular medication and is not always successful.

The knee, hip and ankle joints are among the most complex in structure. The knee connects the femur and tibia, and is assisted in this by menisci, tendons and ligaments. Since the knee joints are located on the lower extremities, they experience the load of the weight of the entire human body.

If the knee joints are in satisfactory condition, moderate loads on them are not only harmless, but also beneficial, and they do not cause pain. To effectively treat pain in the knee joint, it is necessary to know exactly the reasons that provoked this condition.

The difficulty of diagnosing the pathology lies in the fact that there are many diseases of the knee joint. Therefore, to clarify the diagnosis, a complete examination of the knee joint is required. In each individual case, an individual approach is required, since the symptoms of various joint diseases are very similar.

Only a comprehensive examination can guarantee the correct identification of the disease and the prescription of adequate treatment.

Diagnostic methods

To correctly diagnose the disease and identify the causes that led to it, the doctor refers the patient to undergo a comprehensive examination. Treatment can be prescribed only after confirmation of the diagnosis.

Modern diagnostic measures include the following procedures:

X-ray examination;
computed tomography of the knee joint, thanks to which doctors have the opportunity to thoroughly study human organs;
magnetic resonance imaging (MRI);
– this procedure is akin to surgery, but when it is performed, minimal trauma occurs. The method is carried out using an arthroscope, with which the doctor can examine the joint cavity from the inside;
general blood analysis;
a biochemical blood test is an additional research method for suspected joint diseases;
rheumatic tests.

A person must realize that an advanced disease is much more difficult to treat than its primary form. Often, in case of complications, conservative therapeutic measures do not bring the desired result, and the patient requires surgery.

Most people trust the effectiveness of modern pharmaceuticals, which are widely advertised on television and on the Internet. Many medications can indeed provide recovery, but we must remember that the reaction to certain medications is individual for each person, so only a doctor can prescribe them.

Therefore, if you suspect that you have a joint disease, a person should not go to the pharmacy, but to see a doctor. Self-medication can not only delay the recovery process, but also complicate the course of the pathology.

It is likely that self-medication can lead to temporary relief, but this does not mean that the disease has completely disappeared. In the patient's future, most likely, arthritis, contracture and loss of motor function of the knee joint await.

If a tendon or meniscus ruptures, only surgery can relieve the patient of pain.

Test one:

the patient lies on his back;
the limb is bent 30 degrees at the knee joint;
the doctor holds the patient’s thigh with one hand and moves the lower leg forward with the other;
The knee flexors and quadriceps muscles should be completely relaxed.

Assessment: If there is movement of the lower leg relative to the hip, then the anterior cruciate ligament is damaged. In this case, the end point of the displacement should not be clear and have a hard stop. If the stopping point is clear, this is evidence of the stability of the anterior cruciate ligament.

A tight stop at 3 mm of displacement indicates absolute stability of the anterior cruciate ligament. A displacement of 5 mm or more only confirms the relative stability of the anterior cruciate ligament; this condition is typical for a sprain.

Suspicion of damage to the anterior cruciate ligament arises when the end point of displacement is completely absent or weakly expressed. If the range of motion of the drawer is greater than 5 mm, congenital weakness of the knee ligaments is suspected. To exclude such a pathology, a comparison should be made with another knee joint.

Non-contact Lachman test - if positive, anterior cruciate ligament dysfunction is confirmed. Test procedure:

the patient lies on his back and with both hands holds the thigh (next to the knee joint) of the injured leg, bent at the knee.
the patient should try to raise the shin above the table, while bending the leg at the knee should be maintained;
When a patient performs this test, the doctor observes the tibial tuberosity.

With a healthy ligament, no change in the contour of the tuberosity is observed. There may be a slight forward displacement of the tuberosity. If there is an acute injury to the ligamentous apparatus, in which the medial collateral and anterior cruciate ligaments are damaged, there is a significant forward displacement of the tibial tuberosity (articular subluxation).

This test allows the doctor to exclude complex limb injury in a non-contact manner.

Functional testing of the posterior cruciate ligament

Posterior Lachman test (drawer with knee flexion 90). This test is performed with the knee joint flexed and approximately extended. It is similar to the anterior drawer test, but evaluates posterior displacement in internal, external, and neutral rotation.

Grade. Maximum posterior displacement when the knee is close to extension indicates isolated posteromedial instability. Minimum posterior drawer and maximum posterolateral rotation are observed when the knee is flexed to 90 degrees.

If there is an isolated rupture of the posterior cruciate ligament, maximum posterior displacement is observed during flexion. Posterolateral displacement is not observed in any of these positions.

With combined damage to the posterolateral structures and the posterior cruciate ligament, at any degree of flexion, a lateral opening of the joint space and an increase in posterior displacement are observed.

Houston test to determine recurvation (excessive extension) of the knee joint and external rotation.

Methodology:

the patient lies on his back, both of his quadriceps muscles of the lower extremities are relaxed;
The doctor lifts each leg by the foot one by one.

If posterolateral instability is present, this action may cause the knee to recurve into varus with parallel external rotation of the tibia.

To clearly demonstrate recurvation and external rotation of the knee joint, the test should be performed alternately on both limbs. This is done like this: the leg is moved from a state of slight flexion at the knee to a position of full extension. The physician places one hand on the posterior surface of the knee joint to palpate the posterior droop and external rotation of the proximal tibia.

Meniscus testing

Grinding test (Apley distraction and compression determination):

the patient lies on his stomach, the tested leg is bent at the knee at an angle of 90;
The doctor fixes the patient’s hip with his knee;
in this position, the doctor rotates the limb with alternate use of axial compression and distraction of the leg.

If the patient experiences pain during rotation, this indicates ligamentous injury (positive distraction test). Compression pain indicates meniscal damage (positive rotation testing).

With a meniscal cyst or discoid meniscus, a characteristic clicking sound may occur. Pain during internal rotation is typical of damage to the lateral capsule or lateral meniscus.

Pain during external rotation confirms injury to the ligaments, medial capsule, or medial meniscus.

If the posterior horns of the external meniscus are damaged and the capsule ligaments are tense, this symptom does not appear.

Fouche Sign (McMurray Test)

Methodology:

the patient lies on his back, the injured leg is bent as much as possible at the hip and knee joints;
with one hand the doctor clasps the knee joint, and with the other hand - the foot;
first, in the position of extreme external, then internal rotation, the doctor performs passive extension of the patient’s knee joint up to 90

Situation assessment:

If the patient experiences pain during extension in a state of external rotation and abduction of the leg, it is evidence of damage to the internal meniscus.
Pain during internal rotation indicates damage to the lateral meniscus.
A click in the position of maximum flexion is characteristic of a rupture of the posterior horn, in which the torn piece is pinched.
Crepitation that occurs at 90 flexion is typical for damage to the meniscus in the middle part.

A slip test performed to diagnose patellar instability.

Methodology:

the patient is in the supine position;
the doctor stands on the side opposite to the diseased joint;
The doctor clasps the proximal part of the patella with the first and second fingers of the hand, and its distal part with the other hand;
then, with the first fingers, the doctor tries to move the patella outward above the femoral condyle, at the same time, with the second fingers, he supports the kneecap - this is how the lateral test is performed;
When performing the medial test, the doctor uses his second fingers to try to move the kneecap in the opposite direction.

If excessive lateral displacement of the patella is suspected, stability can be achieved with this test. In this case, the test should be performed with the quadriceps muscle contracted. The patient must raise his straightened leg above the table, while the doctor evaluates the movement of the patella.

In most cases, a person suffering from joint diseases cannot indicate the exact time and cause of the onset of symptoms of the disease. For quite a long time, the disease, even in the presence of changes in the tissues of the joint and radiographic signs, is asymptomatic. Therefore, it is advisable to dwell on those methods by which the disease can be recognized.

First- this is a survey, in the language of the aesculapians, a collection of anamnesis. The main symptom for diseases of the joints of the upper and lower extremities is pain. The joint, along with mechanical functions, performs the function of a receptor field, that is, it contains receptors that perceive and transmit “distress signals” to our brain.

Therefore, joint pain is of a reflex nature, which means that joint pain should be considered not only based on the biomechanical characteristics of the musculoskeletal system, but also from the position of the reflex nature of pain.

Pain receptors are located in the fibrous and synovial layers of the capsule; their irritation can be caused by functional overload of the joint or the reaction of the synovial membrane to inflammation and injury.

Nature of the pain syndrome- one of the differential diagnostic signs - helps to distinguish one disease from another. Rheumatoid arthritis or an inflammatory process in a joint is characterized by an “inflammatory” nature of pain - it arises or increases at rest, at night, and subsides with movements in the joint.

Osteoarthritis is characterized by “mechanical pain,” that is, pain that occurs or intensifies during load on the joint and subsides with rest. The pain usually appears some time (minutes or hours) after exercise, and continues for several hours or days even after the exercise has stopped.

The diagnostic value of studying synovial fluid increases significantly when determining its total protein and immunological indicators (rheumatoid factor, compliment, beta-2-microglobulin).

With the simultaneous study of immunological and some other parameters (free radical oxidation activity, fatty acid spectrum of lipids) in the blood flowing to the limb (arterial) and flowing from it (venous) it is possible to obtain additional information about the activity and severity of the pathological process in the joint.

The most complete answers to questions on the topic: “how to check the joints of the whole body in women?”

X-rays of the hip joint may be prescribed if walking or supporting function is impaired, as well as if there is pain in this area.

Indications and cost...

Using computed tomography of the joints, you can obtain detailed images in different projections.

Read more…

Magnetic resonance imaging of joints with contrast can be used if there are contraindications to x-rays.

Indications and cost...

X-ray densitometry is aimed at studying the mineral density of bone tissue.

Where can I get the service?

In modern commercial laboratories, medical services are provided taking into account the individual characteristics of the patient, and the results can be recorded on a CD.

Read more…

Joint diseases do not begin overnight - pain that appears indicates that the disease has already reached a certain stage. How to monitor the condition of the joints in order to detect deviations from the norm in time and immediately begin treatment? Let's figure this out.

Correct diagnosis of joint diseases is the key to effective treatment

Joint pain can be a signal of arthritis, including rheumatoid arthritis, arthrosis, osteoarthritis, bursitis, chondrocalcinosis, ankylosing spondylitis and other diseases. The following symptoms usually indicate problems that have arisen.

Knee pain when going up or down stairs may indicate osteoarthritis. This disease sometimes affects the fingers - in this case, the upper phalanges become denser. Sudden sharp pain in the big toe is a typical sign of arthritis. This disease often affects the hip joints and makes itself felt by severe pain in the upper leg. Rheumatoid arthritis can manifest itself in impaired fine motor skills of the hands, when it becomes difficult to insert a key into a lock or thread into a needle.

Unfortunately, today 30% of the world's population suffers from joint diseases, and this includes not only older people. Joint diseases develop rapidly, so it is very important to diagnose them in time and begin to treat them. This will help maintain mobility, ease of movement and relieve severe pain.

For reference
What functions do joints perform?

Movement in space - it is the joints that allow us to walk, run, and jump.
Mobility - with the help of joints we cross our legs, squat, raise and lower our arms, clench our fists.
Maintaining body position - the joints allow you to squat or sit on a chair, lean forward, or stand leaning on something.

General examination and palpation method

The first visit to the doctor begins with a general examination, which allows you to see external deviations from the norm. This could be, for example, swelling in the joint area. During a general examination, the doctor may ask the patient to make certain movements in order to understand the nature of the pain and the area of its distribution. Posture and gait may also indicate joint diseases.

Another most common and simplest examination method is palpation. Using touch, the doctor detects external signs of joint diseases. For example, you can find rheumatic and rheumatoid nodules, detect the place where discomfort occurs during movements, determine the condition of the joint capsule, changes in temperature and humidity of the skin in the joint area.

General examination and palpation are the most accessible examination methods, but they occur without the use of technical means, and therefore do not provide a complete picture of the clinical picture of the disease.

Goniometry

This is a method of examination using a goniometer - a device that allows you to determine the amplitude of joint mobility. The goniometer resembles a protractor and allows you to determine the angle of mobility. The patient makes a number of necessary movements (flexion, extension, raising and lowering the limbs), and the doctor takes measurements, records the indicators and correlates them with the norm.

Laboratory diagnostic methods

More accurate information about the patient’s condition and his disease can be obtained by learning the test results.

Blood analysis

Many blood test indicators indicate joint disease. So, during a biochemical analysis, the doctor will definitely pay attention to the content of C-reactive protein in the blood serum, the content of total protein, the dephenylamine reaction and other indicators. An increase in ESR (erythrocyte sedimentation reaction) should be considered an alarming signal, since this reflects the level of the inflammatory process. In rheumatic inflammatory pathologies, an immunological blood test shows antinuclear antibodies (ANA). With arthritis and other joint diseases, the level of uric acid in the blood serum sharply increases. In addition, in patients suffering from rheumatism, psoriatic polyarthritis, ankylosing spondylitis and other joint diseases, there is a change in the content of lysosomal enzymes (acid proteinase, acid phosphatase, deoxyribonuclease, cathepsins) in the blood serum and synovial fluid.

Analysis of urine

It is worth noting that significant deviations from the norm in urine analysis are observed only in severe forms of joint diseases. However, it should be remembered that in healthy people, protein and blood should not be present in the urine. Their appearance indicates the presence of diseases.

Radiation diagnostics of joints

Radiation diagnostic methods allow us to study the condition of joints and their structure in detail. These procedures do not require preliminary preparation.

X-ray examination. Indications for its implementation may include pain in the joint area, difficult mobility, swelling and discoloration of the skin in the joint area. During the examination, an image of the joints is projected onto a special film using X-rays. A special apparatus directs rays to the examined area; for safety reasons, all vital human organs are covered with a protective lead apron. The patient either sits or lies down. X-rays allow you to see joint deformation and pathology. The procedure takes no more than three minutes, the results can be presented in about 15 minutes in the form of an image. Even when using the most modern equipment, minimal radiation occurs, so X-rays, like other radiation methods, are not recommended for pregnant women.

Arthrography– a more accurate method compared to conventional x-rays. It is used for damage to the meniscus, ligaments, and suspected rupture of the joint capsule. Before arthrography, the joints are artificially contrasted. To do this, a special substance is injected into the joint cavity, then the patient is asked to make several movements and the image is recorded with targeted radiography. The result, depending on the equipment, can be obtained on a monitor or on film. The procedure lasts about 10 minutes and is not dangerous. However, if the patient has an allergic reaction to iodinated contrast agents, this is a contraindication for this examination.

Trying to avoid pain, the patient begins to move less, resulting in physical inactivity.

As is known, prolonged immobility in the joints leads to the development of diseases of the musculoskeletal system, the treatment of which requires regular medication and is not always successful.

Why does knee pain occur?

Only a comprehensive examination can guarantee the correct identification of the disease and the prescription of adequate treatment.

Diagnostic methods

Modern diagnostic measures include the following procedures:

X-ray examination;
computed tomography of the knee joint, thanks to which doctors have the opportunity to thoroughly study human organs;
magnetic resonance imaging (MRI);
arthroscopy of the knee joint - this procedure is similar to surgery, but during its implementation there is minimal trauma. The method is carried out using an arthroscope, with which the doctor can examine the joint cavity from the inside;
general blood analysis;
a biochemical blood test is an additional research method for suspected joint diseases;
rheumatic tests.

If a tendon or meniscus ruptures, only surgery can relieve the patient of pain.

Functional testing of the anterior cruciate ligament

the patient lies on his back;
the limb is bent 30 degrees at the knee joint;
the doctor holds the patient’s thigh with one hand and moves the lower leg forward with the other;
The knee flexors and quadriceps muscles should be completely relaxed.

Non-contact Lachman test - if positive, anterior cruciate ligament dysfunction is confirmed. Test procedure:

the patient lies on his back and with both hands holds the thigh (next to the knee joint) of the injured leg, bent at the knee.
the patient should try to raise the shin above the table, while bending the leg at the knee should be maintained;
When a patient performs this test, the doctor observes the tibial tuberosity.

This test allows the doctor to exclude complex limb injury in a non-contact manner.

Functional testing of the posterior cruciate ligament

If there is an isolated rupture of the posterior cruciate ligament, maximum posterior displacement is observed during flexion. Posterolateral displacement is not observed in any of these positions.

Houston test to determine recurvation (excessive extension) of the knee joint and external rotation.

the patient lies on his back, both of his quadriceps muscles of the lower extremities are relaxed;
The doctor lifts each leg by the foot one by one.

If posterolateral instability is present, this action may cause the knee to recurve into varus with parallel external rotation of the tibia.

Meniscus testing

Grinding test (Apley distraction and compression determination):

the patient lies on his stomach, the tested leg is bent at the knee at an angle of 90;
The doctor fixes the patient’s hip with his knee;
in this position, the doctor rotates the limb with alternate use of axial compression and distraction of the leg.

If the patient experiences pain during rotation, this indicates ligamentous injury (positive distraction test). Compression pain indicates meniscal damage (positive rotation testing).

With a meniscal cyst or discoid meniscus, a characteristic clicking sound may occur. Pain during internal rotation is typical of damage to the lateral capsule or lateral meniscus.

Pain during external rotation confirms injury to the ligaments, medial capsule, or medial meniscus.

If the posterior horns of the external meniscus are damaged and the capsule ligaments are tense, this symptom does not appear.

Fouche Sign (McMurray Test)

the patient lies on his back, the injured leg is bent as much as possible at the hip and knee joints;
with one hand the doctor clasps the knee joint, and with the other hand - the foot;
first, in the position of extreme external, then internal rotation, the doctor performs passive extension of the patient’s knee joint up to 90

If the patient experiences pain during extension in a state of external rotation and abduction of the leg, it is evidence of damage to the internal meniscus.
Pain during internal rotation indicates damage to the lateral meniscus.
A click in the position of maximum flexion is characteristic of a rupture of the posterior horn, in which the torn piece is pinched.
Crepitation that occurs at 90 flexion is typical for damage to the meniscus in the middle part.

A slip test performed to diagnose patellar instability.

the patient is in the supine position;
the doctor stands on the side opposite to the diseased joint;
The doctor clasps the proximal part of the patella with the first and second fingers of the hand, and its distal part with the other hand;
then, with the first fingers, the doctor tries to move the patella outward above the femoral condyle, at the same time, with the second fingers, he supports the kneecap - this is how the lateral test is performed;
When performing the medial test, the doctor uses his second fingers to try to move the kneecap in the opposite direction.

Lateral and medial glide tests allow physicians to assess the degree of tension in the lateral and medial retinaculum. For comparison, such testing is performed simultaneously on both knees. The doctor, without changing the position of the hands, can assess the degree of anterior displacement of the patella.

If the condition of the knee joint is normal, the patellas move symmetrically without the characteristic crunch and tendency to dislocate. An increase in lateral or medial displacement indicates weakness of the ligamentous apparatus of the knee joint, congenital subluxation or dislocation of the patella.

Crepitation or crunching during movement of the patella indicates the presence of chondropathy or retropatellar osteoarthritis. The physician can extend this test without changing the position of the hands by moving the patella distally. A decrease in distal mobility indicates a high position of the patella or pathological shortening of the rectus femoris muscle.

How to check the knee joint

In case of damage to the knee joint, the mechanism and circumstances of the injury are clarified.

First of all, they find out the nature of the complaints - pain, lameness, instability (instability) of the joint, crunching, clicking, local changes in skin color and temperature, joint shape, the appearance of joint swelling or effusion, limitation of movements (contracture or ankylosis), and much more.

When examining, pay attention to the configuration of the knee joint, the axis of the lower limb, the condition of the soft tissues, especially the muscles of the thigh and lower leg. The supportability of the limb and the nature of the gait disturbance are determined.

During palpation, the localization of pain and the presence of effusion in the joint (fluctuation, or symptom of patellar balloting) are clarified.

Normal range of motion in the knee joint is °, in most cases it can be increased passively through hyperextension (15°) and flexion (20°).

The rotation of the tibia relative to the thigh in the position of flexion of the knee joint to 120° is equal to°.

To assess the condition of the capsular-ligamentous apparatus of the joint, a number of diagnostic techniques are used:

To clarify the nature of the pathology of K. s. use a number of instrumental research methods:

To determine the nature of movement disorders, biomechanical (for example, podography) and electrophysiological research methods are used.

The most common methods of instrumental research K. s. are MRI, X-ray.

Indications for MRI examination of the knee joints:

chronic arthritis;
knee pain of unknown cause;
household, sports, knee injuries;
bone tumors;
cartilage damage;
ruptures of the knee joint ligaments and joint capsule;
compression, pinching of the tendons and nerves of the knee joint.

Radiography

X-ray of K. s. usually carried out in direct and lateral projections.

For comparison, a simultaneous direct photograph of both knee joints is taken on one film.

In the lateral projection (different phases of its flexion), they allow us to assess the function of the knee joint.
With maximum extension of the lower leg, it is possible to determine the ratio of the axes of the thigh and lower leg. The angle formed by them, open anteriorly and exceeding physiological limits, indicates hyperextension of the knee joint.
An axial photograph of the knee joint (with the knee maximally bent, or less often half-bent) makes it possible to more accurately study the patella.

Due to the fact that the patella is formed by the fusion of several ossification nuclei, in children it consists of several shadows, and in adults, if complete fusion of the nuclei does not occur, structural variants in the form of a double, triple and multiple patella are observed.

In some cases (for example, with effusion in the joint), a diagnostic puncture (medical manipulation) is performed, and the joint fluid is subjected to laboratory testing (bacteriological, cytological, immunological, biochemical, etc.).

If a tumor process is suspected in K. s. a puncture biopsy is performed. In all cases of diagnostic difficulties, arthroscopy is recommended. If the information obtained is not enough, then arthrotomy is indicated to clarify the diagnosis.

The choice of the most informative research method and further treatment should be prescribed to you by your doctor.

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Evaluation of Patients with Knee Pain (Part I)

Family doctors often encounter patients who suffer from knee pain. An accurate diagnosis requires knowledge of the anatomy of knee pain, the types of pain associated with knee injuries, the most common causes of knee pain, as well as specific physical examination skills. The history should include a description of the pain the patient is suffering from, mechanics of symptoms (locking, pushing, sparing), joint effusion (time, number of recurrences), and mechanisms of injury.

The physical examination should include a thorough examination of the knee, palpation for tender points, recording of effusions, testing of range of motion, examination of ligaments for damage and laxity, and examination of the meniscus. X-rays should be performed in patients with isolated tenderness in the knee and head of the fibula, inability to bear weight, and inability to flex the joint to 90 degrees in those over 55 years of age.

Knee pain accounts for approximately one-third of all musculoskeletal pathologies seen at primary care physician visits. This complaint predominates mainly in physically active patients, among whom 54 percent of athletes experience some degree of knee pain annually. Knee pain can cause serious disability, limiting the ability to work and carry out daily activities.

The knee is a complex structure, the examination of which poses a challenge for the family physician (see figure).

The differential diagnosis of knee pain is broad but can be narrowed significantly through a detailed history, focused physical examination, and, if necessary, selective use of appropriate imaging and laboratory tests. Part One of this two-part article presents a systematic approach to knee evaluation, and Part II3 discusses the differential diagnosis of knee pain.

The patient's description of the nature of the pain is helpful in making a differential diagnosis. It is important to clarify the characteristics of the pain, including its onset (quick or gradual), location (anterior, medial, lateral, or posterior knee), duration, severity, and characteristics (eg, dull sharp, penetrating). Aggravation or, conversely, dissimulation must also be excluded. If knee pain is caused by an acute injury, the doctor needs to know whether the patient is able to continue activities and bear loads after the injury or whether he is forced to immediately stop his activities.

The patient should be assessed for mechanical symptoms such as locking, deviation, or sparing of the knee. Complaints of “locking” may indicate a meniscus tear. A sensation of deviation during injury may indicate ligament damage, possibly complete ligament rupture (third degree ligament rupture). Sensations of deviation may be associated with some degree of instability and indicate some degree of knee instability and ligament tearing.

The timing and amount of joint effusion is an important clue to diagnosis. A rapid onset (within two hours) large amount of tense effusion indicates anterior cruciate ligament rupture and tibial plateau fracture with subsequent hemarthrosis. If there is a slower onset (24 to 36 hours), a small to moderate amount of effusion is characteristic of a meniscus injury and sprain. Recurrent knee effusion after physical activity is associated with a meniscal injury.

Data on the phenomenon of “locking” indicate a meniscus tear, while the sensation of protrusion during injury indicates damage to the ligamentous apparatus.

The patient should be asked about specific details of the injury. It is very important whether the patient suffered a prolonged direct impact on the knee, whether the leg was in a state of support at the time of the injury, whether the patient at that moment slowed down or suddenly stopped, whether he was landing after a jump, whether there was a twisting moment at the time of the injury, or whether hyperextension occurred.

A direct blow to the knee area can cause serious injury. An anterior impact applied to the proximal tibia while the knees are flexed (eg, being struck by a dashboard during a car accident) can result in injury to the posterior cruciate ligament. The medial collateral ligament is usually injured as a result of direct lateral impact to the knee (eg, a tackle in football); this impact creates a valgus load on the knee joint area and leads to rupture of the medial collateral ligament. Conversely, a medial blow that creates a varus load can cause injury to the medial collateral ligament.

The figure shows the quadriceps angle (Q angle). Non-contact injuries are also an important cause of injury to the knee area. Stopping quickly and cutting or turning sharply creates severe braking forces that can cause anterior cruciate ligament rupture.

Hyperextension can cause damage to the anterior or posterior cruciate ligament. Unexpected twisting and turning movements can damage the meniscus. The simultaneous combination of various influences can cause damage to several structures.

A history of injury or surgery to the knee is important. The patient should be asked about previous attempts to treat knee pain, including medications, braces, and physical therapy. The doctor should ask about the presence of gout, pseudogout, rheumatoid arthritis, and degenerative joint diseases.

INSPECTION AND PALPATION

The doctor should begin the study by comparing the diseased and healthy knees, examining the knee for erythema, swelling, contusion and dislocation. The muscles should be bilaterally symmetrical. This is especially true for the "vastus medialis obliquus" of the quadriceps, which should be examined for signs of atrophy.

The knee should then be palpated and checked for pain, fever, and effusion. There should be pinpoint tenderness in the knee, tibial tubercle, patellar tendon, quadriceps tendon, anteriolateral and anteriomedial joint line, and medial and lateral joint line. Movement of the knee joint in a short arc helps to identify joint lines. Range of motion can be examined by extending and flexing the knee as far as possible (normal range of motion: zero degrees extension; degrees flexion).

KNEE AND HIP EXAMINATION

The examination of effusion should be carried out with the patient lying on his back with the injured knee extended. In order to determine the presence of effusion, the suprapatelar bursa must be identified.

Patellofemoral movements are examined by observing the uniform movements during contraction of the patient's quadriceps. During palpation of the kneecap, crepitus may be detected.

The quadriceps angle (Q angle) is determined by drawing a line spina iliaca fnterior superior through the center of the patella and a second line from the center of the patella through the tibial tuberosity (Figure 2). A Q angle greater than 15 degrees is a predisposing factor for patella subluxation (eg, if the Q angle increases, forceful contraction of the quadriceps muscle may cause patella subluxation laterally).

Then a patellar apprehension test is performed. The fingers are placed on the medial aspect of the patella and the examiner attempts to subluxate the patella laterally. If this test causes pain or tenderness in the patient, a subluxated patella may be the cause of the patient's complaint. As the kneecap moves medially and laterally, the upper and lower parts of the patella are palpated.

Anterior cruciate ligament. To perform the test (anterior drawer test), the patient lies down with the injured knee bent 90 degrees. The physician places the patient's leg in slight external rotation (sitting on the leg) and then places the thumb on the tibial tuberosity and the fingers on the back of the shin. While the patient keeps the muscles relaxed, the physician applies pressure anteriorly and examines the anterior displacement of the tibia.

The Lachman test is another way to test the integrity of the anterior cruciate ligament. This test is performed with the patient in the supine position and the injured knee flexed to 30 degrees. The examiner stabilizes the distal femur with one hand while grasping the proximal tibia with the other hand, and then attempts to sublux the tibia anteriorly. No clear endpoint – positive Lachman test.

Posterior cruciate ligament. For this posterior drawer test, the patient lies down with legs bent at a 90-degree angle. Standing to the side of the examination table, the physician observes the posterior displacement of the tibia (posterior sag sign). The physician then moves the patient's leg to a neutral position (sitting on his leg), placing his thumbs on the tibial tuberosity and fingers on the back of the thigh. The physician then pushes posteriorly and observes the posterior displacement of the tibia.

Varus and valgus stress tests. These movements should be performed with the knee not bent and with the knee in a state of flexion at an angle of 30 degrees.

Valgus stress - the test is performed with the patient's leg slightly abducted. The physician places one hand on the lateral aspect of the knee joint and the other hand on the medial aspect of the distal tibia. The valgus force is then applied to the knee in zero position (full extension) and at 30 degrees of flexion.

With the knee in zero position (that is, in full extension), the posterior cruciate ligament and the articulation of the femoral condyle with the tibial plateau should stabilize the knee; With the knee in 30 degrees of flexion, the application of valgus stress makes it possible to feel the weakness or integrity of the medial collateral ligament.

Lateral Collateral Ligament. To perform a varus stress test, the physician places one hand on the medial aspect of the patient's knee and the other hand on the lateral aspect of the distal tibia. Varus stress is then applied to the knee, first in full extension (i.e., zero degrees), then the knee is flexed to 30 degrees. A hard end point indicates that the collateral ligament is intact, whereas a soft or absent end point indicates complete rupture (third degree rupture) of the ligament.

Patients with meniscal injuries typically present with joint line tenderness. The McMurray test is performed on a patient in a supine position 9. The test is described in various ways in the literature, but the author adheres to the following technique.

McMurray test for examining the medial meniscus. (Top) The test is performed with the patient lying down with the knee flexed 90 degrees. To examine the medial meniscus, the examiner grasps the patient's heel with one hand, holding the tibia in external rotation, with the thumb on the lateral joint line and the fingers on the medal joint line (Middle). The examiner flexes the patient's knee, bringing the posterior horn of the meniscus against the medial femoral condyle. (Bottom) Varus stress is applied during knee extension.

The patient grasps the patient's heel with one hand and the knee with the other hand. The patient's thumb is on the lateral articular line and the fingers are on the medial articular line. The doctor then bends the patient's knee as far as possible. To test the lateral meniscus, the tibia is internally rotated and the knee is extended from maximum flexion to approximately 90 degrees; Additional compression on the lateral meniscus can be applied by using valgus stress across the knee while the knee is in extension.

To test the medial meniscus, the tibia is externally rotated and the knee is extended from maximum flexion to approximately 90 degrees; Additional compression on the medial meniscus can be produced by applying varus stress through the knee joint while the knee is in extension. A positive test produces a dull thud or click that causes pain in the restored portion of the range of motion.

Since most patients with knee pain have soft tissue injuries, a plain radiograph is not indicated. The Ottawa knee rules provide a useful guide to determining the indications for knee X-rays.

If radiographs are required, three views are usually sufficient: anteroposterior view, lateral view, and Merchant view (patellofemoral joint). Adolescent patients who complain of chronic joint pain and recurrent knee effusions require a marked and tunnel view (anterior-posterior view of the flexed knee). This projection allows us to determine the radiolucency of the femoral condyles (more often the medial femoral condyle), which is a sign of osteochondritis dissecans.

The radiograph should be carefully examined for evidence of fracture, particularly involving the patella, tibial plateau, tibial columns, proximal fibula, and femoral condyle. If osoarthritis is suspected, radiographs should be taken in the standing position under weight bearing.

The presence of increased body temperature, tenderness, tender effusion and severe pain in combination with mild impairment of mobility in the knee joint can be observed in septic arthritis and acute inflammatory arthropathy. In addition to a complete blood cell count and erythrocyte sedimentation rate (ESR), arthrocentesis should be performed. The joint fluid should be sent to the laboratory for cell counts and differential testing for glucose, protein, culture and sensitivity, and polarized light microscopy for detection of crystals. .

Due to tension, a painful and swollen knee may present an unclear clinical picture. Arthrocentesis may be necessary to differentiate between a conventional effusion due to hemarthrosis and an occult osteochondrosis fracture.4 A common joint effusion contains clear, straw-colored transudate from knee trauma and chronic meniscal injury.

Hemarthrosis can be caused by a torn anterior cruciate ligament, fracture, or sudden tear of the outer portion of the meniscus. An osteochondrosis fracture causes hemarthrosis, in which globules of fat are found in the aspirate. Rheumatoid arthritis can also affect the knee joint. Therefore, ESR and rheumatoid factor testing may be required in selected patients.

How to check the knee joint

The knee joint is considered large. It has a complex structure. Pain in the knee joint may indicate a malfunction in the body or be the result of a banal overload.

Causes and symptoms of pain in the knee joint

There can be quite a few reasons. The pain can be localized in different areas of the knee and be of a completely different nature. In order to carry out proper therapy, you need to accurately understand the symptoms and understand which doctor you need. Knee pain is a sign of chronic illness.

The presence of chronic diseases in bone tissue is a common cause of pain in the knee joint.

Arthrosis

Arthrosis is localized in both knee joints.

This condition is provoked by the following factors:

changes in the knees caused by age;
disorders in the bones and cartilage of the knee;
presence of a tumor in the knee.

The disease occurs in a latent form. Pain in the knee joint occurs occasionally. Over time, symptoms such as:

crunch in the knee joint;
morning stiffness;
inability to move the leg.

The pain also occurs when walking up stairs and when getting up from a chair. Ultimately, gradual deformation occurs in the joint. At rest, the pain does not make itself felt. Therefore, patients sleep peacefully at night.

Arthritis

Arthritis is characterized by swelling and pain as the inflammatory process occurs in the knee joint. The most common form of this disease is osteoarthritis. It is caused by the friction of joints against each other when walking. The main factor in the development of the disease is a decrease in the amount of intra-articular fluid.

Frequent injuries, as well as excessive stress on the knees, provoke the development of osteoarthritis.

In addition to pain, the patient notes swelling of the knee and the inability to move the leg, which is characteristic of the late stage of the disease. Symptoms do not appear immediately. Sometimes the disease develops over many years.

Rheumatoid arthritis usually occurs when there is a problem with the immune system. But scientists have not yet identified the exact reason. This disease also causes pain in the joints of the hands. In the acute form of the disease, the pain is so severe that the patient cannot even be touched.

Pain in the knee joint: symptoms, causes, diagnosis

Gout

Gout is caused by high levels of uric acid in the body. With this disease, the knees become red and hot. Touching them causes pain.

Without proper therapy, this condition lasts up to a month. Timely treatment stops this disease at the earliest stages.

Knee pain during exercise

Pain in the knee joint can be triggered by physical activity. They are inherent in any age category.

Dislocation

Dislocations are the lot of professional athletes and dancers. This injury causes swelling and deformation of the knee.

intense pain;
impossibility of any movement of the leg.

The dislocation is successfully treated, but in its complicated form, damage to the ligaments is noted, and surgical intervention cannot be avoided.

Stretching

Stretching can also cause pain.

Most often, provoking factors are:

blow to the knee area;
incorrect rotation of the leg (more common among athletes);
fall on the knee area.

When the knee is sprained, it swells and walking becomes impossible due to severe pain. After some time, hemorrhages may appear.

Meniscus injury

Sometimes the meniscus can be damaged just by an unsuccessful squat or turn. Swelling is observed, the patient's movement is limited. It is recommended to immediately consult a specialist, as this injury is considered complex.

Vascular pain

Vascular pain is caused by insufficient blood flow to the knee. This disease accounts for one tenth of all painful manifestations in the knees. In this case, joint mobility is not affected in any way. Swelling is also not noted.

Knee pain occurs when:

colds;
sudden change in weather;
physical activity;
hypothermia.

This condition is often diagnosed in adolescence with non-simultaneous development of bone tissue and blood vessels. This condition goes away by the age of 20.

Becker's cyst

With this disease, the ligaments in the fossa under the knee become inflamed. A noticeable compaction forms in this area - a cyst, which can be seen visually only when the knee is extended.

This disease is provoked by:

meniscus injury;
joint injury;
the presence of osteoarthritis;
cartilage injury.

Initially, a Becker's cyst does not appear. But as it progresses, the pain increases. Patients report tingling and numbness in the foot. There is also difficulty bending the toes in the injured leg.

Examination for pain in the knee joint

The doctor should listen carefully to the patient's complaints and conduct a thorough examination of the knee. The specialist may find it necessary to conduct additional examinations.

You may need to:

take an x-ray;
donate blood for a general analysis;
perform a bone biopsy;
undergo an ultrasound procedure;
do an MRI.

Treatment of knee pain

It is necessary to clearly establish the cause of the painful phenomena. After this, effective therapy can be prescribed. Each specific disease requires an individual approach.

Use hot compresses or ointments with a warming effect.
Wear a brace or tie an elastic bandage around your knee.
Take anti-inflammatory medications.
Do warm-up exercises.

Comprehensive diagnosis of arthrosis of the knee joint

Early diagnosis of arthrosis of the knee joint is one of the factors influencing the prevention of the development of the disease and improving the patient’s well-being. Research allows us to determine the causes of the development of pathology, as well as select the optimal course of therapy. Since in the early stages the disease does not have a pronounced clinical picture, the diagnosis is made through MRI, ultrasound and x-rays of the injured knee.

MRI of the knee joint for arthrosis

This method has no analogues with regard to the information content of the survey results. The uniqueness of MRI diagnostics is that after examination it is possible to recognize the disease in the early stages. Examination of arthrosis of the knee joint using a magnetic resonance imaging scanner allows us to identify microdamages at the cellular level, which are undoubted signs of the development of pathology. What can be seen thanks to the diagnostic procedure on MRI?

Any damage and degenerative changes.

Suspicion of the development of pathology during examination of the patient.

Ultrasound of arthrosis of the knee joint

Unlike tomography, the ultrasound method does not provide such an accurate and clear picture of changes and is effective after the clinical manifestations of the pathology have become noticeable. But provided that the ultrasound examination is carried out by a competent specialist, fairly reliable results can be obtained. Diagnosis of arthrosis of the knee joint using ultrasound helps to identify:

Thinning of cartilage tissue. One of the most obvious clinical manifestations of the disease.

X-ray of knee joints with arthrosis

Modern methods for diagnosing arthrosis of the knee joint may include several different diagnostic procedures, but radiography continues to be one of the most important functions in accurately determining the disease and its development. Using the photo you can see the following:

The inability to repeat the diagnosis and monitor the general trends in the development of pathology.

When should you see a doctor?

Patients over 50 years of age and those who have recently suffered a serious knee injury are at risk and should be alert to any warning signs. Knee crunching, fatigue with light loads, incomplete clench and unclench of the knee may be an indication to see a doctor. In most cases, an x-ray diagnosis of arthrosis of the knee joint will be prescribed, if clinical manifestations of the disease have already begun and deformations of the bone tissue will be noticeable. After receiving the results, a course of therapy will be prescribed or additional examinations will be recommended.

What is arthrosis of the knee joint and how to treat it?

Knee arthrosis is so common that it has a separate name - gonarthrosis. Another name for this disease is deforming osteoarthritis.

Arthrosis of the knee joint worries 20% of the population, its ICD-10 code is M17. Half of knee pathologies are due to arthrosis. This is a disease in which the tissue of cartilage and articular surface degenerates - they disintegrate. The joint is poorly supplied with nutrients and oxygen, its function deteriorates, and inflammation occurs. He becomes inactive and hurts, the patient’s quality of life decreases. Complications of arthrosis lead to a wheelchair.

Let's figure out what arthrosis of the knee joint is and how to treat it. How can the disease be prevented and how dangerous it is.

Causes and classification

The causes of arthrosis of the knee joint are different - mechanical damage, hereditary predisposition, metabolic disorders.

The occurrence of the disease is associated with excessive stress on the knees. This is an occupational injury in many sports. People with a high degree of obesity, over 60 years of age, almost always have arthrosis of one degree or another due to constant microtrauma. Arthrosis refers to occupational diseases in areas where a person has to stand or lift heavy objects for a long time. The disease can begin after rheumatoid arthritis.

The most common cause of knee arthrosis is injury. The second most common is dysplasia in childhood. Inflammation due to autoimmune pathologies is the third source of arthrosis. Usually there are several reasons, one complements the other.

Types of arthrosis of the knee joint are divided depending on the causes into primary and secondary. If the etiology is unknown, primary arthrosis is diagnosed; if the cause is determined, secondary arthrosis is diagnosed.

Development mechanism

Cartilage is nourished due to constant changes in osmotic pressure. When the joint is loaded, the viscosity of the intra-articular fluid decreases and its quantity increases. In a calm state, the intraarticular fluid becomes viscous and the amount decreases. Normally, these processes alternate. The cartilage plate, acting as a pump, pushes fluid out of the joint when loaded, and when relaxed, sucks it in. This is how the joint tissues are nourished. The pathological process manifests itself if the joint is subjected to destructive influences:

If the load is great and the joint does not have time to recover, nutrition is disrupted. The cartilage becomes thin, cracks and ulcers appear on it;
The structure of collagen fibers is disrupted, they absorb worse. The cartilage and patella soften, become inelastic, and perform their functions worse;
Bone growths appear in the joint. The membrane of the joint capsule becomes irritated and inflamed;
Since a person begins to take care of his knee and moves little, less intra-articular fluid is produced. The surface of the cartilage becomes dry and rough;
The knee receives even less nutrition, atrophies, and its destruction accelerates.

Signs of arthrosis of the knee joint appear: it becomes inactive and pain occurs. The pain is especially severe in the morning and after prolonged immobility.

Stages of arthrosis

There are three degrees of arthrosis:

Initial stage. The tissues have not yet been destroyed. So far, only the function of the synovial membrane is deteriorating. The composition of the intra-articular fluid has changed. The knee can no longer withstand normal load;
Articular cartilage and menisci begin to deteriorate. Osteophytes—bone formations—grow into the bones. Inflammation and pain appear;
Difficult stage. The supporting platform of the knee joint is deformed, the axis of the leg changes. The ligaments shorten, the joint capsule becomes rigid. The joint is pathologically mobile, but it is impossible to completely bend or straighten it. Inflammation and pain are pronounced.

At the very beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movement is severely limited. Due to a change in the axis of movement, the muscle attachment sites change. The muscles are deformed - they contract or stretch, they can no longer contract normally. The nutrition of all leg tissues suffers.

Symptoms

Symptoms of arthrosis of the knee joint at the beginning of the disease do not manifest themselves in any way and do not force the patient to see a doctor. The patient notices fatigue and pain, but does not attach serious importance to them.

The classic sign of knee arthrosis is immobility and stiffness in the joint, a pulling sensation in the popliteal region, pain after exercise. It is difficult to move in the morning or after a long period of immobility. Relief comes after the patient stretches his knee, massages it, and walks around.

After some time, the intensity and duration of the pain increases. A crunch appears in the joint, it completely stops bending and unbending. A person begins to limp when walking - most patients come to the doctor with this complaint. Treatment of arthrosis of the knee joint usually begins only at the second stage.

If nothing is done, movement becomes possible only with outside help. When the patient lies down, the knee hurts less, but the pain often bothers you at night.

At the second and third stages, the knee joint is deformed - the contours of the bones are sharply outlined, the lower leg is curved. If you put your hand on your knee, you hear a crunching sound when bending and straightening. When the kneecap moves, it also crunches. Fluid collects in the cavity, the joint is swollen, and the tissues bulge.

As the disease progresses, all symptoms become more pronounced.

Irina Aleksandrovna Zaitseva

Knee pain. How to restore joint mobility

Bursitis, arthritis, arthrosis - all these diagnoses are associated with old age. But, unfortunately, everything is different. Today, even young people are increasingly paying attention to crunching in the joints and discomfort in the knees after prolonged walking, driving or exercising on an exercise bike. The knee joints are the most susceptible to damage, because together with the hip and ankle joints they support the weight of our body.

Joint pathologies may not make themselves felt for a long time. Symptoms, as a rule, appear when there is an already formed disease that requires treatment.

It is important to remember that any injury or excessive stress on the legs causes inflammation of the joints (arthritis) or joint capsule (bursitis). If proper treatment is not carried out, then over time bone tissue grows in the joint (arthrosis). Such diseases are most difficult for older people, since bones become more fragile with age, and the likelihood of damage increases.

It should be noted that women are more susceptible to pathologies than men. The fact is that female ligaments are weaker, and the loads on them are quite high. Shoes with heels, too active exercise in the gym, a sedentary lifestyle, injuries - all this sooner or later leads to diseases of the knee joints.

Everyone knows that a disease is easier to prevent than to cure. Prevention of joint pathologies includes a healthy lifestyle, proper nutrition, wearing comfortable shoes and regular but moderate physical activity.

By adhering to these simple rules, you can significantly reduce the risk of developing the disease, as well as improve the condition of joints with existing pathology. In addition, it is important to know the signs of the most common diseases of the knee joints in order to immediately pay attention to them and not put off visiting a doctor.

How the knee joints structure and function, possible pathologies and methods of treating them will be discussed in this book. In it you will also find useful recommendations on how to restore joint mobility without medications.

Structure and functions of the knee joint

A joint is where bones connect. Between them there is cartilage tissue, or meniscus, which is necessary to ensure that the joints do not wear out in these places and that movements are smooth. In order for the bones to hold together and perform their functions, there is a joint capsule, which consists of ligaments that envelop the joint and hold it in one place.

The knee joint, which provides flexion, extension and slight lateral rotation, is a hinge type synovial joint. Movement occurs between the joints of the bones, which include the kneecap, tibia and femur.

During the process of flexion and extension of the joint, movement occurs between the flattened upper part of the tibia and the heads of the femur. The condyles of the latter are distinguished by their small height; they can easily be palpated as the bone structures of the lateral and inner sides of the knee joint.

Like other synovial joints, the knee joint is surrounded by a synovial membrane, from which a lubricating substance is secreted. It ensures smooth sliding of cartilage enveloping the rubbing surfaces of bones.

In the case of arthrosis, the surfaces of the joints may not be smooth enough, which is accompanied by painful sensations when putting stress on the legs. However, even smooth knee joints are not strong and stable enough.

The stability of the knee joint is determined by the ligaments surrounding it, which fix the bones in the desired position when the knee flexes and extends. Knee joints, unlike stable hip joints, do not have the deep “capacity” necessary for the bones to “sit” securely in them. That is why they are quite fragile and vulnerable.

The ligaments that attach to the bones and form the knee joint bear a heavy burden of preventing one bone from sliding onto another.

The upper, middle and lateral surfaces of the tibia have two flattened surfaces connected to the femur. They are called tibial plateaus, and each of them corresponds to one of the two femoral condyles. There is a narrow intercondylar space between the tibial plateaus.

The knee joint is formed from two tubular bones - the femur (top) and the tibia (bottom). In addition, in the front of the joint there is a round bone - the patella, or kneecap. The two ball-shaped projections located at the bottom of the femur are called the femoral condyles.

The kneecap slides along the patellofemoral recess, which is formed by the femoral condyles. The ends of the bones in the joints are covered by articular cartilage, which is usually 5–6 mm thick. It is a shiny white fabric with a smooth surface. Articular cartilage reduces the frictional force in the joint during movement. In the knee joint, it is present at the ends of the femur and tibia, as well as on the back of the kneecap.

They run along the sides of the knee joint, prevent the femur and tibia from sliding in and out, and are called the tibial and fibular collateral ligaments. This name refers to the shin bone to which they are attached.

When the knee bends, the collateral ligaments become tense, and when the knee extends, they weaken. The fibula (the thinnest bone located on the side of the leg) is not part of the knee joint, but plays an important role as it anchors the fibular collateral ligament, which surrounds it and attaches to the thigh.

The peroneal collateral ligament is extremely rarely torn, since the main load falls on the inside of the knee joint. However, when the inside of the knee is overextended, the tibia or femur can become displaced to the side, often leading to a tear.

The tibial collateral ligament is located on the inside and runs along the knee between the femur and the tibia. It is attached to the medial meniscus, so if it is damaged, the latter and medial collateral ligament are torn.

Injuries that result in damage to the tibial collateral ligaments are usually the same ones that result in a tear of the anterior cruciate ligament. They are often seen in football players when the femur is displaced towards the middle as a result of a blow to the side of the knee.

If the tibial collateral ligaments are not torn, but only stretched, the femoral or tibial joints of these ligaments soften, which causes the development of a tumor in the inner part of the knee.

These knee ligaments can be compared to a rope. They connect the femur and tibia and are located between the lateral and internal condyles of the femur and the tibial plateaus. The name of these ligaments justifies itself: when they intersect, they form the letter “X”.

The anterior cruciate ligament is attached to the front of the tibia and the posterior cruciate ligament is attached to the back of the tibia of the knee joint. When the knee bends, the anterior cruciate ligament weakens, and when it straightens, it tightens. The stability of the knee when moving forward and backward is determined by the condition of the cruciate ligaments, especially if the knee joint is tense.

Anterior cruciate ligament

This ligament is the weaker of the two intersecting ligaments. It is approximately 38 mm long and 10 mm wide. It consists of many collagen bundles. Collagen is the main structural protein of most connective tissues, including ligaments and tendons.

The origin of the anterior cruciate ligament is the anterior part of the intercondylar space of the tibia. It is located behind the middle meniscus. The anterior cruciate ligament runs upward, forward, and slightly to the side and attaches the dorsal and medial sides of the lateral condyles of the femur.

When the knee joint flexes, there is a gap on either side of the femoral and tibial condyles. This is when the knee is most susceptible to injury. The reason this space forms is that when the knee bends, the anterior cruciate ligament is not stretched. Its main function is to protect the tibia from moving forward (relative to the femur).

This ligament also prevents the knee joint from hyperextending. When it is flexed 90°, the tibia cannot move backward because it is held in place by the anterior cruciate ligament (assuming it is in a normal, healthy state).

Posterior cruciate ligament

From the posterior part of the intercondylar space of the tibia, it runs superior and anterior to the middle part of the anterior cruciate ligament and attaches to the anterior part of the middle femoral condyle.

When a surgeon opens up the knee joint during surgery, this ligament is the first thing he sees. When the knee bends, tension is observed. One of the functions of the posterior cruciate ligament is to prevent the tibia from moving backward relative to the femur. Thanks to the joint fluid and cartilage, there is little friction on the surface of the joint when the knee bends.

The posterior cruciate ligament is more vertical when the knee is extended and more horizontal when it is flexed. It prevents excessive flexion of the joint.

When the knee is flexed, it is the main stabilizer of the femur. This applies when the knee is bent under resistance (such as deep leg presses, squats, and walking down stairs).

The posterior cruciate ligament is most vulnerable to injury when the knee is bent. For example, it can be damaged in a traffic accident when another vehicle hits the car from behind.

The extensor muscles are located on the front surface of the thigh. As a result of their contraction, the leg straightens at the knee joint, allowing us to walk. The main muscle of this group is the quadriceps muscle.

The patella, which is located in the thickness of the tendon, provides additional support and makes it possible to change the direction of action and increases the force of the quadriceps muscle applied in the process of straightening the leg.

The calf flexor muscles are located on the back of the thigh in the knee area. Their contraction, accordingly, is accompanied by flexion of the leg at the joint.

The main nerve in the knee area is the popliteal nerve, which is located on the back of the knee joint. It is a component of the sciatic nerve, passes through the lower leg and foot and provides sensation and movement to these areas. The popliteal nerve is located slightly above the knee joint and divides into the tibial and peroneal nerves. The first is located on the back surface of the tibia, and the second runs around the head of the fibula and runs along the anterior and outer lateral surfaces of the tibia.

Blood vessels are located on the back of the knee joint near the popliteal nerve. The popliteal vein and artery provide blood circulation to the lower leg and foot. The popliteal artery carries blood to the foot, and the vein carries blood back to the heart.

What does joint pain mean?

Causes of pain in the knee joint

The most common causes of knee pain are injuries from an impact, bending the knee, twisting it too hard, or falling on it. Unpleasant sensations can occur as a result of stretching of the tendon that supports this part of the body and helps it perform its functions.

Other possible causes include knee fracture, meniscus tear, dislocated patella, and joint dislocation. In all these cases, immediate surgical intervention is required.

Often, pain in the knee joint occurs when there is increased load on the knee or prolonged pressure on it. It can appear after a long ride on a bicycle (an exercise bike), jogging, jumping, or climbing stairs. The fact is that repeated loads on a joint can cause inflammation, as well as lead to thickening of its ligaments and the formation of “folds” in them.

At the same time, pain in the knee joint can occur for no apparent reason. There are a number of diseases in which there is a high probability of unpleasant and even painful sensations in this area.

For example, with osteoarthritis, discomfort appears in the morning and then gradually decreases. Stiffness and swelling in the knee area are observed in pathologies such as gout, lupus and rheumatoid arthritis. In teenage boys, swelling of the knee joints is often associated with Osgood-Schlatter disease. The same symptom is observed with Baker's popliteal cyst.

Knee problems may be symptoms of a disease in another organ, such as a nerve or hip. Pain and limited mobility are often caused by an infection of the bone, joint or skin.

Types of knee pain

Pain when walking

Pain in the knee joints when walking is not uncommon. Many people experience minor discomfort from time to time. Ideally, the usual movements of our body should not cause discomfort, but the appearance of symptoms is not surprising if the joints are under increased stress or an injury has occurred. The latter happens not only to athletes. You can injure your knee joint while doing normal activities, such as cleaning.

So, in what cases does knee pain occur when walking?

Most often, pain indicates inflammation of various structures of the knee (tendons, cartilage, periarticular bursae, etc.). Moreover, it is often accompanied by a decrease in joint mobility (stiffness of movement) and difficulty bending the knee. The described symptoms may also be accompanied by redness in the joint area, swelling and increased temperature in this area. These signs indicate arthritis of the knee joint.

As noted above, injuries are the most common cause of pain in the knee joints. Discomfort may increase over several minutes, hours, and sometimes even days after the injury. If nerves or blood vessels are compressed, a person may feel numbness and tingling in the knee or lower leg area. In addition, pale or blue discoloration of the skin is noted.

Acute knee injuries include:

Sprains, dislocations and other injuries to the tendons and ligaments connecting and supporting the kneecap;

Meniscus tears (elastic cartilaginous discs of the knee joints);

Fracture of the patella, lower femur, upper tibia, or fibula;

Displacement of the patella, which is most often observed in girls during adolescence;

A knee dislocation is a rare but serious injury that requires immediate evaluation and treatment.

Other causes of pain in the knee joint are injuries resulting from overuse (inflammation of the joint capsule and tendon, formation of folds or thickening of the joint ligaments, irritation of fibrous tissue, etc.) and osteochondritis dissecans (a disease in which a small section of cartilage separates from the adjacent bone and is displaced into the knee joint). joint cavity).

Pain when squatting

People who squat with a barbell during training often complain of knee pain. The causes of discomfort can be associated with both joint disease and incorrect technique for performing the exercise. One of the pathologies that causes pain during such exercises is gonarthrosis. With this disease, the cartilage of the knee joint wears out prematurely.

Other causes of knee discomfort may include a viral infection, poor diet, lack of physical activity, or overuse of the joint.

If you feel pain in your knee after performing 2-3 squats, stop the exercise immediately. If it does not go away within a few hours, you should consult a doctor who will prescribe an examination. Even if you have been exercising for many years, you cannot ignore the pain and hope that it will go away on its own.

Pain when bending

In most cases, pain in the knee when bending indicates Osgut-Schlatter disease, which is osteochondropathy of the tibia (in the area where the kneecap attaches). As noted above, this pathology is most often observed in boys during adolescence. The cause of its development may be damage to the knee joint, but often it appears without visible preconditions.

Patients complain of discomfort, which increases when going down stairs, walking and bending the leg at the knee. The disease lasts up to 3 weeks and ends with complete recovery, but in some cases it becomes chronic.

Another common cause of pain when bending the knee is inflammation of the joint capsules, or bursitis. In this case, discomfort is accompanied by swelling in the joint area and limited movement.

Arthrosis of the knee joint is indicated by crunching and pain when moving, squatting and bending the leg at the knee. At the initial stage, the discomfort disappears after a good warm-up, but as the disease progresses, the pain increases and appears more often. As a result, it becomes permanent, and the patient cannot move normally and even simply bend his leg at the knee.

In some cases, limited movement and pain when bending are caused by pathology of the patella cartilage. In this case, unpleasant sensations are localized in the front of the knee when walking down stairs and sitting for a long time. In addition, patients complain of a cracking sound when bending and straightening the knee.

Sciatica (inflammation of the sciatic nerve) also often causes discomfort when bending the knee. And sometimes the pain appears as a result of pinching of the subcutaneous branches of the nerves due to wearing narrow boots.

Crunching in the knees is very serious!

As a rule, we do not notice any sounds when the joints move, which indicates the smoothness of the hyaline cartilage that is located in the joint cavity and the presence of a sufficient amount of synovial fluid, which serves as a lubricant. If you notice a crunching sound in your joints when walking, bending your leg at the knee, doing exercises or other usual activities, this is a signal that something is wrong with the joint.

If the crunch is not accompanied by swelling, pain and stiffness of movement, there is little cause for concern, but it is still worth visiting a doctor. For some people, cracking joints when starting to move is normal, but such cases are rare. This is usually due to the presence of gas bubbles in the synovial fluid. When the joint capsule is stretched, they burst, as a result of which we can hear a sound similar to a crunch.

However, cracking is often the first sign of a serious disease such as osteoarthritis. It is characterized by a slow flow. As osteoarthritis develops, articular cartilage is destroyed and the articular ends of the bones become deformed. Due to this, the friction force in the joint increases during movement, and then a crunch occurs.

The danger of this pathology is that it does not produce any symptoms for a long time. The effectiveness of treatment depends on the stage at which the disease was diagnosed. If destructive processes in the joint are minimal, then the prognosis is favorable. That is why, even if the crunch is not accompanied by pain, it is necessary to undergo an examination to rule out osteoarthritis.

For a long time it was believed that the development of this disease is promoted by the consumption of nightshade vegetables and large amounts of salt. However, statistics refuted this opinion.

It should be noted that the prevention of this disease is to control the amount of food consumed. The greater the weight, the higher the load on the joint-ligamentous apparatus and the risk of developing osteoarthritis.

Physical therapy is of great importance in the treatment of this disease. If the correct set of exercises is selected, patients achieve improved blood circulation in the joint tissues, which speeds up the process of cartilage regeneration.

To treat this pathology, special medications (chondroprotectors) are prescribed. The composition of drugs in this group includes glucosamine, hyaluronic acid and chondroitin sulfate. However, they can only be taken after consulting an arthrologist or orthopedist.

Diseases, injuries of the knee joint and pain associated with them

Knee diseases, diagnosis and treatment

Arthrosis of the knee joint (gonarthrosis)

This pathology most often occurs in overweight women and varicose veins in the legs. As a rule, arthrosis affects both knees, but it also happens that pain appears in only one of them for a long time.

The first sign of gonarthrosis is slight pain when walking, going up and down stairs. It can also occur if a person has to stand for a long time. In the case of synovitis (swelling of the knee), the outflow of blood is disrupted, pain appears in the calf area, usually worsening at night.

As gonarthrosis develops, the joint becomes deformed, and the discomfort intensifies; it becomes difficult to bend the leg normally, as acute pain and crunching occur in the joint. At stage III of the disease, it is no longer possible to fully straighten the leg. In this regard, those who suffer from this form of arthrosis walk on slightly bent legs. Quite often, X- and O-shaped curvatures of the lower extremities develop.

At an advanced stage, the disease can be diagnosed even by the appearance of the joints, but it is no longer possible to restore them. Treatment should begin as early as possible, when the first signs appear. Gonarthrosis is often accompanied by other lesions of the knee joint, as a result of which one disease is superimposed on another, which makes it difficult to make a correct diagnosis.

Most often, this disease is combined with meniscopathy of the knee joints, the characteristic signs of which are tears and pinched menisci. Often, meniscopathy is one of the factors in the development of arthrosis; more details about it will be discussed in the section “Injuries of the knee joint, diagnosis and treatment.”

Treatment

Nonsteroidal anti-inflammatory drugs

Diclofenac, indomethacin, ibuprofen, piroxicam, flexen, etc.

The therapy is aimed at relieving inflammation and swelling in the joint area. The drugs themselves cannot cure arthrosis, but they can significantly reduce pain and stiffness during exacerbation. After this, you can move on to therapeutic exercises, massage and physiotherapy.

Important: drugs in this group cannot be used for a long time due to possible side effects.

The active ingredients of these medications are glucosamine and chondroitin sulfate, which promote the restoration of cartilage tissue. Chondroprotectors eliminate the symptoms of gonarthrosis and take part in the biosynthesis of connective tissue, preventing degenerative processes in cartilage.

It should be noted that drugs of this group are ineffective at stage III of arthrosis, when the cartilage is almost completely destroyed. In other words, they are not able to eliminate bone deformations and grow new cartilage tissue.

At stages I and II, chondroprotectors act slowly, so improvements are noticeable only after long-term treatment. To obtain tangible results, 2-3 courses are required, which usually takes from 6 months to 1 year.

Xanthinol nicotinate, nicoshpan, pentoxifylline.

In most cases, gonarthrosis is accompanied by stagnation of blood in the joint area, which leads to “bursting” pain at night. To eliminate this symptom, vasodilators are prescribed, which relieve spasm of small vessels of the lower extremities and restore blood supply to the joint.

Drugs of this group have a pronounced positive effect in combination with chondroprotectors, since the nutrients of the latter penetrate into the joint in greater quantities and are more actively absorbed into the tissues.

Intra-articular injections of corticosteroid hormones (diprospan, flosteron, kenalog, etc.) are used to relieve inflammation in the joint, which is expressed in edema and swelling of the knee. For severe pain, this method brings quick relief, but such injections can be done no more than once every 2 weeks. It is also important to remember that the effect of the first injection will be more noticeable than subsequent ones. If it did not give the desired result, then it is unlikely to appear after repeated use of the drug.

Hormonal drugs have side effects, so to avoid them, it is not recommended to inject corticosteroids into one joint more than 3 times. This treatment method is not prescribed to patients with severe bone deformation and curvature of the legs, that is, in all cases where pain is associated not with inflammation, but with anatomical changes in the joint.

Intra-articular injections of chondroprotectors and enzymes are contraindicated in case of edema. They produce a pronounced effect in the initial stages of gonarthrosis, not accompanied by synovitis, and partially restore cartilage tissue. The disadvantages of this treatment method are the need for a course of treatment (from 5 to 10 injections) and minor trauma to the joint tissue during the procedure.

Intra-articular injections of hyaluronic acid (Ostenil, Fermatron, etc.) are a relatively new and very effective method of treating gonarthrosis. This substance serves as a lubricant for the joint, as it is close in composition to it. Once injected into the affected joint, it reduces surface friction and increases the degree of mobility of the knee.

Injections of hyaluronic acid are effective in stages I and II of gonarthrosis. At stage III, the drug can alleviate the patient’s condition, but only for a while. Treatment is carried out in a course (3-4 injections into each affected joint) and is repeated once a year.

Ointments and compresses

In complex treatment, it is also permissible to use local agents, the action of which is aimed at improving blood circulation in the joint and eliminating pain. For these purposes, dimexide is often used, a liquid with anti-inflammatory properties. However, this drug should be used with caution, as it often causes allergic reactions. Before use, a sensitivity test is carried out: a few drops of the product are applied to the skin, after which the reaction to it is checked. If redness or burning occurs, it is not recommended to use dimexide.

Medical bile and bischofite give a positive result. It should be noted that they also require a preliminary sensitivity test. If they are well tolerated, a course of treatment of 15 compresses every other day is prescribed.

As for ointments (“Fastum-gel”, “Dolgit”, “Voltarengel”, etc.), they have a less pronounced effect.

It includes laser therapy, cryotherapy (cold treatment), electrophoresis and massage. The effects of these procedures are aimed at improving the condition of the tissues and blood supply to the joint, as well as relieving inflammation. Contraindications to their implementation are hypertension, diseases of the cardiovascular system and infectious lesions of the joints.

Traction (stretching the joint)

Traction of the knee is carried out using manual therapy methods or using a traction apparatus. The goals of traction are to separate the bones and increase the distance between them to reduce stress on the joint.

The complexity of this method lies in the fact that it is necessary to affect four bones in contact. There are three joints in the knee joint, and it is necessary to act on the weakest of them, which requires pinpoint precision.

Even if traction is performed by an experienced specialist, a positive result can be achieved only in 80% of cases. This method is recommended to be combined with physiotherapy and medication.

For grade III and IV arthrosis, surgery is prescribed for complete or partial joint replacement. After it, the person becomes able to work again. However, such an operation requires a long recovery period, so doctors try to either avoid surgery or delay it as much as possible.

Arthritis of the knee joint

This is an inflammatory process that can be primary or secondary. In the first case, the infection enters the joint cavity from the environment (for example, as a result of injury), and in the second, it is brought into the joint cavity from another organ through the blood and lymph flow.

Depending on the causes of the disease, arthritis is:

Specific (caused by pathogens of syphilis, gonorrhea or tuberculosis);

Nonspecific (purulent or rheumatoid arthritis);

Infectious-allergic (developing against the background of infectious diseases: tuberculosis, brucellosis and viral infections);

Aseptic (rheumatoid arthritis, ankylosing spondylitis).

The most common rheumatoid arthritis (gonitis) of the knee joint. Its course can be either acute or chronic. A sign of the acute form is the accumulation of exudate in the joint cavity, which can be serous, fibrous or purulent. The latter depends on the cause and stage of the disease.

Patients complain of redness, severe pain and swelling in the area of the affected joint. In addition, limited movement and a half-bent position of the leg are noted. The latter helps reduce pain, so patients use it unconsciously.

Purulent damage to the knee joint is characterized by an acute onset, a sharp increase in body temperature, general intoxication and chills. In addition, swelling of the joint is noted. Purulent inflammation of the joint capsule is dangerous because it often leads to its perforation and penetration of pus into the tissues of the thigh and lower leg, followed by the formation of phlegmon. It is also possible for infection to enter the blood.

In chronic cases of arthritis of the knee joint, the patient complains of pain, swelling and impaired motor function. It should be noted that the listed symptoms are less pronounced than in the acute form.

The cause of chronic gonitis can be an acute inflammatory process with weakened immunity and improper (or insufficient) treatment. The disease can immediately take a long (sluggish) course. The result of chronic arthritis is persistent ankylosis of the knee joint. This is a disease that is characterized by a complete lack of movement and pain in the knee and muscle atrophy.

If at least one of the signs of arthritis appears, you should consult a doctor. After the examination, he may order an x-ray of the knee joint. Puncture and arthroscopy are also used to diagnose this pathology. These procedures make it possible to collect exudate for bacteriological analysis. This is how the type of pathogen and its sensitivity to antibiotics are determined, which allows you to prescribe the correct treatment.

In addition, when puncturing the knee joint, medications can be injected into the infection.

Treatment

Treatment of acute gonitis is carried out in a hospital. Using a plaster cast, joint mobility is limited, and antibiotics and medications are prescribed to enhance immunity. In addition, physical therapy and blood transfusions may be indicated.

In case of purulent inflammation, an operation is prescribed to open and drain the joint capsule.

Knee joint injuries, diagnosis and treatment

Anterior cruciate ligament rupture

The anterior cruciate ligament of the knee joint is injured much more often than others. The injuries are mainly associated with sports training.

When a blow hits the side of the leg (while the foot is anchored to the ground), the anterior cruciate ligament ruptures along with the tibial collateral ligament.

A rupture of the anterior cruciate ligament is possible when the knee joint is significantly strained. The cause of damage can also be a sharp push when performing certain strength exercises (for example, when bending over with a barbell on your shoulders).

Athletes test the stability and condition of the anterior cruciate ligament using the “drawer” method. Its essence is as follows. The subject assumes a sitting position on a chair with knees bent at right angles and relaxed. The trainer places both hands on the back of the upper calf (just below the knee joint) and gently pulls the shin forward. In this case, the athlete should not strain his knee. When the tibia moves forward (relative to the femur), we can talk about a rupture of the anterior cruciate ligament.

So, what are the dangers of such a knee injury? In most cases, this injury results in joint instability. Although sometimes, thanks to the strength of the muscles and other ligaments, it remains relatively stable.

The injury is diagnosed without opening the knee or other radical measures using magnetic resonance scanning. However, due to the relatively high cost of this procedure, many insurance companies resort to knee arthroscopy. This procedure involves making 2-3 holes around the knee joint. A special device is placed in one of them so that the joint can be checked for damage and, if necessary, repaired.

Treatment

If the damage is minor, the ligaments are treated arthroscopically. This is what the remaining holes around the knee are made for.

If a torn anterior cruciate ligament is not treated promptly, arthritis of the knee joint develops. In case of severe instability of the latter, surgery to reconstruct the damaged ligament is indicated. Within a few months after it, a person can return to their previous lifestyle and play sports.

Posterior cruciate ligament rupture

A characteristic symptom of a torn posterior cruciate ligament is knee instability. This can be checked using the test used to diagnose anterior cruciate ligament rupture. The difference is that you need to place your hands on the front surface of the tibia just below the knee joint and apply pressure to it. Posterior displacement of the tibia (relative to the femur) indicates damage to the posterior cruciate ligament.

In some cases, this test is not suitable for checking a severe ligament tear, and then other methods (for example, magnetic resonance scanning) are used.

Treatment

Timely treatment of the injury is of great importance, since an advanced form can lead to chronic arthritis of the patella and femur.

Previously, doctors did not recommend surgery unless the patient was over 60 years old and had little physical activity. For small ruptures, surgery was not performed, hoping for a favorable outcome.

Today, the view on this issue has been revised, because to maintain joint health, a person must move as much as possible. Surgical repair of the damaged ligament is recommended for young people and athletes, as well as in cases where a severe tear begins at the anterior border of the tibia and ends in the area of the posterior femoral condyles.

Removal of this ligament leads to instability of the joint in the posterior and lateral directions, as well as the need to wear a knee brace when playing sports, outdoor games, running and cycling.

Recently, surgeons tried to save part of a torn ligament by using the curvature of the bone to attach the damaged segment to it. This is a very difficult job that requires precision and experience from the doctor. Nevertheless, such operations give good results.

In some cases, the knee needs to be restricted for some time after surgery. This promotes better recovery of the ligament, but is harmful to the muscles that surround the knee. The stretched position of the joint reduces the stretch of the quadriceps, which causes muscle loss and atrophy.

If the operation is successful, the joint will function well and not cause pain. However, it is important to remember that an injured knee will always be prone to injury, and to take care of it. In addition, gentle muscle strengthening is recommended to increase joint stability.

People of different age groups and especially professional athletes are most susceptible to this disease. At a young age, the pathology manifests itself in an acute form. As a result of an awkward movement, step or jump, the meniscus is damaged, manifested by acute pain.

Painful sensations are associated with knee blockade. Between the articular surfaces, the meniscus or a broken piece of cartilage occurs. First, a click is heard, and then a sharp pain occurs, which forces the victim to pay attention to the injury. After a few minutes, the leg adapts to the pinching, and the discomfort decreases. However, if you do not consult a doctor in time and take the necessary measures, the pain will reappear and will be accompanied by swelling of the injured knee. The latter is a protective reaction of the body, which tries to separate the articular surfaces by increasing the production of intra-articular fluid and increasing pressure in the joint.

When advanced, the injury becomes chronic. The pain in the knee sometimes increases and decreases (depending on loads, weather conditions, etc.), and slight swelling also appears periodically.

Elderly people usually experience chronic meniscopathy. Injuries occur more often, but do not produce such severe symptoms as in the acute course of the disease. In addition, in most cases, meniscopathy in older people does not cause arthrosis, but, on the contrary, appears as a result of age-related changes in the joint.

Treatment

With timely reposition (putting the meniscus in place using manual techniques), there is a high probability that the injury will pass without consequences. However, in most cases it is treated not with manual methods, but with physical therapy and medications.

As a result, there is only a decrease in swelling and pain, and the pinched meniscus becomes chronic. This means that the articular surfaces of the knee are not “fitted” to each other properly, which first leads to a redistribution of the load on the joint, and then to arthrosis. In some cases (if the infringement of the same meniscus is repeated many times), with meniscopathy, an operation is performed, the purpose of which is to remove the damaged meniscus. But usually this disease is treated with therapeutic methods. Despite the fact that as a result of surgery, the tissue and functions of the damaged joint are quickly restored, the absence of a meniscus eventually leads to arthrosis of the knee.

In addition, the absence of menisci, which stabilize the joint during movement, is accompanied by increased stress on some joint structures, which causes cartilage destruction.

The most common cause of this injury is a fall on a bent knee. Sometimes this is due to a direct blow to the patella or too much traction on the tendon. In the latter case, the lower part of the patella is torn off.

Mostly horizontal fractures are observed. The quadriceps tendon attaches to the top of the patella. It pulls it upward, so a gap forms between the bone fragments - this is a displaced fracture.

When the lower edge of the kneecap is torn off, the fracture line runs at its lowest part (that is, in the place where there is no cartilage). If there is a blow of significant force and at high speed, then there is a high probability of a comminuted fracture, which can be with or without displacement of the fragments.

In the case of a vertical fracture, its line runs from top to bottom. As a rule, there is no displacement, since the muscle pull is directed along the fracture line. However, in clinical practice there have been rare cases of displacement in such fractures. They occur with dysplasia of the femoral condyles and displacement of the patella to the side.

Osteochondral fractures also occur, in which part of the articular surface is torn off.

A patella fracture can be suspected when the following signs appear:

Acute pain that intensifies when trying to lean on the injured leg or stretch it;

Edema. Since the patella fracture is intra-articular, its line runs along the sliding articular surfaces. Like other fractures, it causes bleeding, and since the fracture line is in contact with the joint cavity, it fills with blood and swells. This condition is called hemarthrosis and is characterized by a feeling of fullness and limited movement;

Difficulty in straightening the leg or lifting it in a straightened state (this symptom is not always observed and depends on the nature of the fracture);

Deformation of the kneecap that can be felt (sinking).

Some time after the fracture, a bruise appears on the skin - a consequence of the tissue being soaked in blood. It gradually descends to the level of the foot. This is a normal process with a fracture of the patella, which should not be alarming.

Alarming symptoms are a rapid increase in size of the bruise, loss of sensitivity and increased swelling.

First aid for a fractured patella involves applying ice and immobilizing the limb in a straight position. After this, you need to contact a specialist.

For an accurate diagnosis, radiography is used, which is performed in frontal and lateral projections. In case of a vertical fracture, an axial projection is also made. In some cases, computed tomography and magnetic resonance imaging are additionally performed.

Treatment

Treatment depends on the nature of the fracture and displacement of the fragments. By nature, stable and unstable fractures are distinguished. With stable fractures there is no displacement (this includes vertical ones). Unstable fractures are characterized by displacement or a predisposition to it. The nature of the fracture can only be determined by a specialist.

The kneecap slides with its back surface along the condyles of the femur, so it is important that this surface remains flat and nothing impedes movement. Otherwise, unevenness of the patella can lead to the development of post-traumatic arthrosis (the cartilage will be worn away and the joint will begin to hurt).

Stable, non-displaced fractures are treated conservatively. The leg is immobilized in a straight position using a cast for 1–1.5 months. During this time, control radiographs are taken. After the cast is removed, the joint is redeveloped to restore range of motion and muscle strength.

If the fragments are displaced by more than 3 mm and there are steps on the surface of the joint of more than 2 mm, an operation is performed, the goals of which are to compare the fragments, restore the surface of the joint and fix the patella (osteosynthesis).

If a significant displacement occurs as a result of a fracture, then the fragments may not heal because their surfaces do not touch each other. Surgery is necessary because the kneecap may not heal at all if the displacement is not corrected. In this case, the patient will not be able to bend and straighten the leg at the knee, or arthrosis of the patellofemoral joint will develop. It should also be noted that conservative treatment involves long-term immobilization of the joint, which is subsequently quite difficult to develop. The operation allows you to achieve reliable fixation of the fragments and begin to use the injured leg earlier.

The choice of method for fixing the patella depends on the type of fracture. The optimal solution for a transverse fracture is the use of a special medical cerclage (wire) and wires. This operation received the name of its inventor, Weber.

In some cases, fragments can be well secured with screws or screws and wire. A comminuted fracture requires the latter option. If the lower edge of the kneecap has been torn off, and the fracture line does not pass along the articular surface, then a small fragment is simply removed, after which the patellar ligament is sutured. This operation is called a patellectomy. After the operation, a plaster cast is applied to the injured limb for the period determined by the doctor.

Unfortunately, even with the correct comparison of fragments, arthrosis can develop, which will periodically cause pain in the anterior part of the joint.

Excess weight is the enemy of the knee joint

Cars, elevators, TV remote controls and other home appliances have minimized the need to move. A direct consequence of this is a significant reduction in energy expenditure and obesity.

It is not difficult to guess that joint diseases are directly related to excess weight. Among people suffering from arthrosis deformans, most are obese to one degree or another. The fact is that an obese person significantly increases the load on the joints of the lower extremities and spine, as well as on the ligamentous apparatus.

As an example, here is a simple calculation. The condyles of the femur in the knee joint are supported by menisci, the area of each of which is 14.5 cm 2. If a person’s weight does not exceed 70 kg, then the load per 1 cm 2 of his meniscus will be no more than 4.5 kg. However, the impact on the supporting surface of the joints increases in proportion to the increase in weight. With a body weight of 100 kg, the pressure increases by 7 kg, and with 120 kg - by 8 kg, etc.

The greater the daily load placed on a joint, the faster it wears out. It can be compared to a bearing, which is also designed to withstand a certain external influence.

In addition, obesity adversely affects lymph and blood circulation, which causes congestion in joint tissues that do not receive the necessary nutrients. In addition, obese people are more likely to develop flat feet.

Metabolic disorders can be attributed to both the causes and consequences of obesity. It causes many non-inflammatory diseases of the lower extremities and spine. It should be noted that the latter are much more common than inflammatory ones. Many of them relate to degenerative-dystrophic changes. The most common pathologies of this type are arthrosis deformans, osteochondrosis and spondylosis.

In these diseases, the pathological process affects the intervertebral discs and cartilage tissue that covers the articular ends of the bones. The cartilage softens, cracks appear in it, and in some areas it collapses. In this case, the articular ends come closer together, and during movement, the friction between them increases. As a defensive reaction, the body tries to redistribute the load and smooth out defects in the cartilage cover in every possible way, which leads to the growth of bone tissue along the edges of the articular surfaces and the formation of spines. The latter injure nearby ligaments and the joint capsule. The most severe damage is typical for the knee, hip and ankle joints.

In the initial stages, the disease shows almost no symptoms. Fatigue and slight crunching in the affected joints may occur. After some time, pain occurs when starting to move (after a state of rest), walking for a long time, working out in the gym, cycling, etc. Progressive pathology is indicated by pain that intensifies at the beginning of movement, then decreases, and increases again in the evening . Quite often this does not allow a person to sleep normally.

With constantly increasing pain, the muscles reflexively contract, which increases the load on the articular surfaces of the bones and cartilage, which is gradually destroyed. Patients note a feeling of stiffness and tightness in the joints, difficulty in flexion, extension and walking. These symptoms together not only cause constant discomfort to a person, but also force him to change his usual lifestyle. As a rule, patients stop playing sports and try to avoid physical activity altogether, which leads to even greater weight gain.

In most cases, doctors prescribe such patients a variety of medications to relieve inflammation and reduce pain, as well as physical therapy, but many of them forget that all of these measures will not give the desired result until the weight is lost.

Of great importance is a review of the diet, the introduction of foods containing calcium into the diet, limiting chocolate, sugar, confectionery, etc. It is imperative to eat vegetables and fruits that are rich in nutrients and give a feeling of satiety. Another very important condition is to reduce food portions by at least half.

Relieving knee pain using traditional methods

Why is rest important during periods of exacerbation of joint pain?

The inflamed joint must be provided with rest, otherwise the risk of damage to the membrane covering its surface increases. The inflammatory process can spread to the bone and cause its deformation. Joints can become twisted and distorted, causing dysfunction.

But how can you limit the load on a sore joint if you need to go to work and do everyday activities? In case of severe inflammation, it is necessary to maintain bed rest if possible and reduce movements to a minimum. If you can walk and the pain is not severe, you should pay attention to what movements and body positions cause discomfort and, if possible, abandon them.

In specialized stores you can purchase devices that ease various types of stress on the joints and strengthen the muscles around them. If your job involves heavy physical labor, carrying heavy objects, or being in a forced position for a long time, then it needs to be changed. A special regimen is necessary in the early stages of arthritis to ensure the prevention of joint deformation.

As inflammation develops, you need to monitor your movements so that the joint does not experience repeated pressure, leading to arthritis. During the period of remission, it is also necessary to provide the joints with a gentle regime and avoid overload. Moderate physical activity is recommended, primarily therapeutic exercises.

Painkillers for the knee joint

In the treatment of inflammation of the knee joint, painkillers are necessarily used, the purpose of which is to relieve pain. These are non-steroidal anti-inflammatory analgesics and other similar drugs.

Doctors most often prescribe drugs on an individual basis that slow down the activity of the enzyme that forms foci of inflammation. Their use not only helps relieve pain, but also effectively reduces the activity of the inflammatory syndrome.

What not to do for pain in the knee joint

With diseases of the knee joint, there are certain limitations that must be remembered by everyone who has ever encountered pain in it.

You should not overcool, especially during an exacerbation. In this regard, summer is quite dangerous. A long stay in a body of cool water, the use of a fan and air conditioning - all this can provoke an exacerbation of the disease of the knee joint.

When playing sports, make sure that the level of physical activity is sufficient, but not excessive. The diseased joint must be spared. If discomfort appears in this area, you must immediately stop exercising and provide rest to the joint. Do not exercise if it is red or swollen. From the complexes of therapeutic exercises, choose only those that were designed specifically to improve the condition of sore knee joints.

Do not overeat, avoid foods rich in “empty” carbohydrates and contribute to obesity. Eat food rich in ballast substances - it normalizes intestinal function and has a positive effect on metabolic processes in the body. Remember: the diet must be balanced and contain sufficient amounts of calcium.

How to restore joint mobility without pills

Nutrition for joint health

As noted above, a balanced diet is one of the important conditions for maintaining healthy joints. This is very important both for existing diseases and in terms of their prevention. What does it mean to diet? Special (in this case, therapeutic and prophylactic) nutrition involves a variety of diet, limitation (or complete exclusion) of some foods and the mandatory use of others.

When planning your menu, take care to reduce the amount of animal fats. They must be replaced with fatty sea fish rich in omega-3 acids (sardine, mackerel, tuna, pink salmon, salmon, etc.). Numerous studies have shown that these acids reduce the activity of enzymes that break down cartilage and also reduce inflammation. With age, joints become more fragile, so you need to eat more fish and seafood. It is very important that fish does not contain omega-6 acids, as they increase inflammatory processes in the body.

People suffering from joint diseases are recommended to drink 800 ml of milk (medium fat, not low fat) and eat 2 oranges or tangerines per day. Citrus fruits contain a lot of ascorbic acid, which prevents pathological changes in the joints.

Freshly squeezed fruit and vegetable juices, as well as salads made from raw fruits and vegetables, are very healthy. It is advisable to season the latter with vegetable oil, lemon juice or low-fat unsweetened yogurt without dyes. The most useful fruits for joints are apricots, apples, raspberries, chokeberries, plums, etc. In the cold season, they can be partially replaced with dried fruits.

Instead of chocolate and buns with tea, it is better to eat honey, which enhances the production of synovial fluid. It is very important to drink enough water, as without it the cartilage pads will crack. For joint health, you need to consume at least 2.5 liters of it per day. In addition, green tea, birch sap and infusions of medicinal herbs are recommended. Black tea and alcoholic drinks are harmful to joints, so it is better to avoid them.

To keep joints in good condition, they need foods high in calcium: cheese, cottage cheese and lentils.

Physical activity - how not to harm your knee

For people involved in sports, the first pain in the joint usually makes itself felt during training. A feeling of pinching and discomfort can also appear in a healthy leg, because an additional load falls on it, because when walking and exercising a person spares the sore limb.

Is it possible to play sports if you have joint diseases? It is possible and even necessary, but very moderately and only after consulting a doctor. Prohibited and permitted loads depend on the nature of the pathology and the stage of its development.

The condition of affected joints can be improved with the help of therapeutic exercises. Specially selected exercises have a beneficial effect on the nutrition of joint tissues and strengthen the muscles of the thigh and lower leg, preventing their atrophy.

At the initial stage of arthrosis, you can perform various exercises for the legs, with the exception of strength training, squats and variations performed on the knees. Remember: exercising from time to time will only harm an already weak joint. If loads are rare, then a joint that is not prepared for them will react with increased pain and inflammation. Therefore, an important condition for achieving a positive result is regularity of exercise. Plan your time and choose 20-30 minutes that you can spend on studying every day.

Gymnastics to improve joint mobility

In addition to a general strengthening set of physical therapy exercises, you can perform special exercises for the knee joints. If there is limited mobility, atrophy of the hip muscles and pain (both when walking and at rest), do not proceed with exercise 5 and those options that require standing. Gymnastics is performed at a slow pace. The number of repetitions during the first 2 weeks is 4–5. If you are feeling well, this number can be gradually increased to 10. If you are not able to do all the exercises, choose a few of them.

Many people place a small pillow under their knee when pain occurs, but this is wrong. You should also not rest with your knee bent, because prolonged stay in this position causes flexion contracture, which is difficult to correct. Rest lying on your back with your straightened legs spread to the sides. The muscles should be relaxed.

Take a sitting position on the bed, lower your legs down. Alternately bend and straighten your knees.

Take a sitting position on the bed, lower your legs down. Using your hands, pull your knee toward your stomach and then straighten your leg. Repeat with the other leg.

Take a sitting position on the bed, lower your legs down. Straighten your legs and pull your feet towards you.

Take a sitting position on the couch, straighten your right leg, lower your left leg down.

Perform a half turn to the right, placing your hands on the knee of your right leg.

As you inhale, make three spring bends, lightly pressing on the knee joint. Then repeat with the other leg.

Take a sitting position on the bed, straighten your legs. Leaning on your hands, tense your thigh muscles and then relax them. During the exercise, the popliteal fossa should be pressed to the surface of the bed.

Take a lying position on your back, stretch your arms along your body. Then lift them up, take them back and stretch, pulling your feet towards you. Relax and then repeat the exercise.

Take a lying position on your back, bend your knees. Straighten your right leg, lifting it up, and then smoothly lower it. Repeat the exercise with the other leg.

Take a lying position on your back, straighten your legs. Move one leg to the side and then return to the starting position. Repeat with the other leg.

Take a lying position on your back, stretch your arms along your body. Raise your legs up and perform movements as if riding a bicycle.

Take a standing position, rest your hands on the back of the chair. Move one or the other leg to the side.

Take a standing position with your side to the chair, with one hand resting on its back. Swing your leg forward and backward. Repeat the exercise with the other leg.

Self-massage of the knee joint

Self-massage should be performed after therapeutic exercises and before bedtime. If you exercise once a day, the duration of the procedure should be 15 minutes, and if 2-3 times, then 10 minutes will be enough. When performing massage techniques, be careful: do not put strong pressure on the joint or twist it. If you experience any discomfort, stop the procedure immediately and give your sore leg rest. Both limbs need to be massaged, even if only one of them is bothering you.

Rub the lateral surfaces of the joints with back and forth movements.

Massage your left knee with your right hand, and your right knee with your left. The number of repetitions is 5–7.

Place your right hand on your right leg just above the knee and stroke in different directions. Do the same with the other leg. Number of repetitions - 8.

Press your palms and thumbs tightly against the lateral surfaces of the knee joint and move them back and forth. Then do the same with the other leg. Number of repetitions - 5.

Place your thumbs lightly on the top of your knee. Use the pads of the remaining fingers to perform circular movements along the lateral surfaces of the joint. Number of repetitions - 10.

Use your palm to stroke the outer side of first the right and then the left knee joint. Number of repetitions - 6.

Bend your right leg at the knee joint, turning it outward. Use both hands to stroke the inner surface of the joint. Do the same with the other leg.

Clench the fingers of both hands into a fist and lightly rub the joint of the right leg with the protrusions of the phalanges. Do the same with the other leg. The number of repetitions is 6–7.

Place your hands on top of each other, clasp your fingers and use the base of your palm and the tubercle of your thumb to move from the knee joint to the hip joint. Do the same with the other leg. The number of repetitions is 6–7.

Stretch your right leg out on the bed and lower your left leg down. Rotate your torso slightly to the right and relax your thigh muscles. Place the hands of both hands across the muscles being massaged. The distance between them should be 8 cm. Use your fingers to tightly grasp the muscles and pull them up. Movements should be smooth. Do the same with the other leg. The number of repetitions is 6–8.

Relax the thigh muscles of your right leg, grab them with the thumb and little finger of your right hand and perform oscillatory movements in the transverse direction (relative to the axis of the thigh). Do the same with the other leg. The number of repetitions is 6–8.

Place the hands of both hands on the muscles of the left leg just above the knee and perform tapping with the edge of the palms. The movements should not be intense and the muscles should not be tense. Do the same with the other leg. The number of repetitions is 6–8.

Take a sitting position on a chair, take your right leg to the side and, slightly bending the knee, place it on your toes. Using the heel of the palm of your right hand, stroke from the popliteal fossa to the buttock. Straighten your toes, tightly grasp the massaged muscles and make rotational movements. Do the same with the other leg. The number of repetitions is 6–8.

If there is atrophy of the muscles of the anterior surface of the thigh, you need to massage the points located along the nerve trunks.

The first is on the outer surface of the thigh just above the kneecap, the second is on the outer surface of the thigh just below the kneecap. Perform rotational movements in the area of these points with the pads of your thumb, index and middle fingers folded together. The number of repetitions is 6–8.

Sand is an effective means of preventing and treating inflammatory joint diseases. It is used for both general and local procedures. The convenience of this method of heat therapy is that it can be practiced, for example, while relaxing on a sandy beach. To achieve the desired effect, the sand must be sufficiently heated.

To use this method at home, collect enough sand, sift through a fine sieve, rinse and dry thoroughly. Use only clean river or sea sand, free from gravel and clay. In most cases, it is applied to the affected joint, that is, it is used locally. To do this, you need to heat it in the oven to a temperature of 50–60 °C, then pour it into a bag made of natural fabric, tie it and apply it to the sore joint for a while.

In summer, in hot weather, you can take general and local sand baths. To do this, you need to lie down on heated sand (its layer should be at least 10 cm), and then cover your body up to the chin (or only the limb with the affected joint). Important: the heart area should be free of sand. With local exposure, the temperature of the sand may be higher and the duration of the procedure may be longer.

The duration of one sand bath is 20–30 minutes, and the course of treatment is 15–20 procedures. After each session you need to take a warm shower.

Treatment with sand is contraindicated for diseases and injuries of the skin, acute inflammatory diseases, active form of tuberculosis, heart pathologies, anemia, tendency to bleeding, tumors and exhaustion.

Clay has an anti-inflammatory effect, restores damaged tissue and helps relieve pain. Due to these properties, it is often used for joint diseases.

Clay is no less effective than anti-inflammatory ointments. However, unlike them, it has no side effects, does not cause allergic reactions and promotes wound healing.

Clay wrap to relieve swelling

Dissolve 20 g of honey and 20 ml of lemon juice in water, pour it over the clay and stir until a homogeneous mass is formed. Apply the resulting product in a thick layer on gauze, wrap it around the sore joint and cover with a woolen or flannel cloth for 1–2 hours. Then rinse off the residue with warm water. The course of treatment is 10 procedures.

Clay compress to relieve swelling and redness

Dilute 30 g of clay with water to the consistency of a viscous slurry, apply it to the sore joint and wrap it with plastic wrap. After 30–40 minutes, rinse off any remaining product with warm water. The course of treatment is 10 procedures.

Clay compress with herbal decoction to relieve pain and inflammation

Combine 5 g of oregano herb, 5 g of wild rosemary herb and 5 g of crushed rosemary hop cones, pour in 300 ml of water, bring to a boil and keep on low heat for 10 minutes, then cool and strain. Combine the broth with clay diluted in water and mix well. Soak gauze folded in several layers in the resulting product, apply it to the affected joint, wrap it in plastic wrap and woolen cloth and leave for 1 hour. The course of treatment is 10–15 procedures.

Clay compress with honey and aloe to relieve pain

Dilute the clay with water to a liquid consistency, add a little honey and aloe juice and mix thoroughly. Soak a gauze bandage in the resulting product, apply it to the sore joint, wrap it in plastic wrap, woolen cloth and leave for 30–40 minutes. The course of treatment is 10–20 procedures.

Clay bath for pain relief

Dilute the raw clay with warm water and add a little lemon juice. Place your foot in the mixture so that it covers the sore joint for 30 minutes. The course of treatment is 10–20 procedures.

Clay bath with herbal infusion to relieve inflammation and pain

Combine dried wild rosemary, oregano, calendula and birch buds in equal proportions, add water and leave for 30 minutes, then strain. Dilute the clay in the resulting mixture and make a bath for the knee joint. The course of treatment is 10 procedures.

Clay bath with herbal decoction to relieve pain, redness and inflammation

Combine St. John's wort, chamomile, hemlock and burdock root (taken in equal proportions), add water, bring to a boil and keep on low heat for 10-15 minutes, then strain and cool. Dilute the clay with the resulting decoction and make a bath for the sore joint. The course of treatment is 10–15 procedures.

Clay lotions to relieve swelling

Dilute the clay with water to a liquid consistency, add a few drops of lemon juice, apply to gauze folded in several layers and apply to the affected joint for 25–30 minutes, and then rinse with warm water. The course of treatment is 4–5 procedures.

Clay application to relieve pain and inflammation

Dilute the clay with water to a thick consistency, add a little ground table salt and mix. Apply the resulting mass in a thick layer to the injured joint, wrap it in cotton cloth and leave for 20 minutes, then rinse with warm water. The course of treatment is 10 procedures.

Rubbing with clay water to relieve pain

Dilute the clay with water to a liquid consistency, add a little lemon juice and mix well.

Soak a cotton swab in the resulting liquid and rub it on the sore joint. The course of treatment is 10–15 procedures.

Rubbing with clay and garlic to relieve inflammation

Dilute the clay with water to a semi-liquid consistency, add a small amount of garlic, passed through a garlic press, and mix thoroughly. Dip a cotton swab into the resulting pulp and rub it on the sore joint. The course of treatment is 10–12 procedures.

Rubbing with clay water and mint to relieve redness and pain

Dilute the clay with boiling water to a liquid consistency, add finely chopped mint and a little honey melted in a water bath and mix thoroughly. Soak a cotton swab in the resulting liquid and rub the sore joint.

The course of treatment is 10 procedures.

Ice - first aid for a sore joint

If you are bothered by joint pain that appears immediately after an injury or for other reasons, use cold exposure.

The sooner you apply ice to the area of pain, the better. For this purpose, you can use both ready-made ice and frozen vegetables, meat, etc. The duration of the procedure is 20 minutes.

The ice should be wrapped in a towel. Apply it 4-5 times a day until the swelling subsides. After this, the sore spot will need to be warmed in accordance with the recommendations of the attending physician.

Compresses for the knee joint

A compress is a bandage applied to a sore spot to relieve inflammation, pain and redness. To achieve the best effect, the compress area should be wrapped in wool or flannel cloth. The used bandage should be thrown away and the joint should be covered. In between procedures, it is recommended to rub fir oil into the affected area, which reduces pain.

Hot steam compress

Fold a linen or waffle towel 2-3 times, soak it in boiling water, wring it out lightly and place it between two pieces of flannel fabric on the sore joint. To enhance the effect of the compress, you can place a heating pad with warm water on top. The course of treatment is 10–14 days.

Compress with fresh coltsfoot leaves

Wrap the sore joint with fresh coltsfoot leaves, wrap a woolen cloth on top and leave overnight. The course of treatment is 10–12 days.

Radish compress

Grate the radish on a fine grater. Place the resulting pulp in an even layer on gauze, wrap it around the sore joint and cover with flannel cloth. Leave the compress overnight. The course of treatment is 5–7 days.

Turnip compress

Boil the turnips and mash with a spoon. Place the resulting mass on a towel and wrap it around the affected joint, cover with flannel or woolen cloth on top. Leave the compress on for 2 hours and then rinse with warm water. The course of treatment is 1–2 weeks.

Compress with wormwood infusion

Pour 20 g of wormwood into 250 ml of boiling water and leave for 30 minutes, then strain, soak gauze folded in several layers in the resulting product, wrap it around the sore joint, cover with a cloth and leave for 30 minutes. The course of treatment is 2–3 weeks.

Compress with steamed linden flowers

Hold the linden flowers over the steam for 20–25 minutes, then place them in an even layer on a napkin and wrap them around the sore joint. Cover the compress with a flannel or woolen cloth and leave for 1-2 hours, then rinse with warm water. The course of treatment is 3 weeks.

Compress with a decoction of birch leaves

Pour water over fresh birch leaves, bring to a boil and keep on low heat for 20 minutes, then drain the water. Place the leaves in an even layer on a gauze bandage, wrap it around the sore joint and cover with flannel cloth.

Leave the compress for 6–8 hours. The course of treatment is 1–2 weeks.

Applesauce compress

Grate the apples on a coarse grater. Place the resulting mass in an even layer on gauze folded in several layers and wrap it around the affected joint, and cover it with a woolen cloth on top. Leave the compress on for 6 hours. The course of treatment is 21–30 days.

Compress with infusion of hop cones

Grind a few hop cones, pour 300 ml of boiling water and leave for 1 hour in a thermos. Then strain, soak a gauze bandage in the resulting solution, wrap it around the sore joint, cover with a warm natural cloth and leave for 1-2 hours. The course of treatment is 1–2 weeks.

Compress with vodka, honey and aloe juice

Combine 50 ml of vodka, 100 g of honey and 150 ml of aloe juice and leave for 3 days. Soak a gauze bandage in the resulting product, wrap it around the sore joint and leave for 20 minutes. The course of treatment is 3–4 days.

Compress with woodlice herb

Wash the woodlice grass, steam it, apply it to the sore joint and wrap it in plastic wrap and flannel cloth. Leave the compress overnight. The course of treatment is 1–2 weeks.

Compress with honey, mustard and vegetable oil

Combine 20 g of honey, 10 g of dry mustard and 20 ml of vegetable oil and heat over low heat. Place the resulting mass on gauze folded in half, wrap it around the sore joint, cover with plastic wrap and flannel cloth. Leave the compress for 1.5 hours. The course of treatment is 1 week.

Compress with alder leaves

Soak alder leaves in hot water, apply to the sore joint and wrap with a towel. Leave the compress on for 2 hours. The course of treatment is 2–3 weeks.

Compress with chamomile and black elderberry flowers

Steam chamomile and elderberry flowers, place in a gauze bag, apply it tightly to the sore joint and secure with flannel cloth. Leave the compress on for 1 hour. The course of treatment is 10–14 days.

Compress with sweet clover herb

Chop the sweet clover herb, pour boiling water over it and drain in a colander. As soon as the water has drained, spread the resulting mass in an even layer on a towel and wrap it around the affected joint. Leave the compress on for 2 hours. The course of treatment is 1–2 weeks.

Baths for the knee joint

During exacerbations of joint diseases, baths will help relieve inflammation and reduce pain.

Bath with vegetable oil and garlic

Add 50 g of chopped garlic to 1 liter of hot water, mix well and soak your feet in it for 15 minutes. After this, wipe your feet dry and lubricate the sore joints with vegetable oil. The course of treatment is 2 weeks.

Bath with fir cones

Add 200 g of fir cones to 1 liter of boiling water and leave in a thermos for 1 hour. Add the resulting product to a container of hot water and make a foot bath. The duration of the procedure is 30 minutes. The course of treatment is 2–3 weeks.

Bath with oak and willow bark

Pour boiling water over 50 g of oak bark and 50 g of willow bark and leave for 30 minutes, then strain, add to a container of hot water and soak your feet in it for 25-30 minutes. The course of treatment is 10–15 days.

Bay leaf bath

Pour 50 g of chopped bay leaf into 40 ml of vegetable oil and keep in a water bath for 30 minutes.

Strain the resulting mass, add to hot water and soak your feet in it for 25 minutes. The course of treatment is 2 weeks.

Beetroot juice bath

Add 200 ml of beet juice to 1 liter of water and pour into the bath. The duration of the procedure is 20 minutes. After this, wipe your feet dry and lubricate with emollient cream. The course of treatment is 3 weeks.

Bath with lilac flowers

Combine 120 ml of vegetable oil with 50 g of crushed lilac flowers and heat in a water bath. Strain the resulting mass, add to the bath and keep the leg with the affected joint in it for 25 minutes. The course of treatment is 2 weeks.

Bath with chamomile flowers

Pour 30 g of chamomile flowers, pour 1 liter of boiling water and leave for 30 minutes. Strain the resulting mixture, let it cool slightly and dip the leg with the sore joint into it. The duration of the procedure is 10–15 minutes. The course of treatment is 2–3 weeks.

Bath with bird cherry flowers

Combine 50 g of fresh bird cherry flowers and 120 ml of vegetable oil and keep in a water bath for 25 minutes. Strain the resulting mass and pour it into the bath. Place your foot with the sore joint in it for 20–30 minutes, then wipe it dry and apply cream to relieve inflammation. The course of treatment is 1–2 weeks.

Bath with sweet clover, hops and St. John's wort herbs

Crush 25 g of sweet clover herb, 30 g of hop herb and 15 g of St. John's wort herb, pour 1 liter of boiling water and leave for 30 minutes, then strain and pour into the bath. The duration of the procedure is 30 minutes. The course of treatment is 21 days.

Bath with parsley and wild garlic

Combine 30 g of wild garlic and 20 g of parsley, pour in 1 liter of water and leave for 20 minutes, then strain and add to the bath. Place your sore leg in it for 20 minutes. The course of treatment is 20 days.

Bath with white cabbage

Pour 50 g of white cabbage leaves into 1 liter of hot water and leave for 1 hour, then remove them and add the resulting liquid to the bath. The duration of the procedure is 25–30 minutes. The course of treatment is 14–20 days.

How to relieve joint pain with folk remedies

There are many traditional medicine recipes for treating joints. They can be used either in combination with traditional methods or independently. However, before being treated with such remedies, it is advisable to cleanse the body.

Bay leaf medicine to relieve inflammation and pain

Pour 500 ml of boiling water over 20–25 bay leaves and keep on fire for 5 minutes, then leave for 3–4 hours. Strain the resulting product and take in small portions throughout the day. The course of treatment is 3 days.

Medicine from rye grains to relieve inflammation and swelling

Pour 250 g of rye grains into 2 liters of water, bring to a boil and keep on low heat for 30 minutes, and then strain. Add 10 g of crushed barberry root, 30 g of honey and 500 ml of vodka to the resulting decoction and place in a dark place for 1.5–2 weeks. Take the finished product 60-100 ml 20 minutes before meals. The course of treatment is 2–3 weeks.

Horseradish medicine to relieve pain and inflammation

Pour 1 kg of chopped horseradish into 4 liters of water, bring to a boil and keep on low heat for 5 minutes. Strain the resulting broth, cool, add 500 g of honey and store in the refrigerator. Take the finished product 200 ml per day for 1–2 months. Carry out treatment once a year.

Horseradish juice remedy for pain relief

Extract the juice from 350 g of horseradish and take small amounts throughout the day. The course of treatment is 1–2 weeks.

Cottage cheese medicine with calcium chloride to strengthen joints

Heat 500 ml of milk, add 40–50 g of 10% calcium chloride. Once the milk has curdled, remove the container from the heat. Cool the resulting mass, drain in a colander, cover with gauze and leave overnight. Take 200 g once a day for 2 months.

Medicine from chestnuts to relieve inflammation and pain

Combine 500 ml of vodka and 300 g of finely chopped chestnut fruits and leave for 2 weeks. Rub the resulting product onto sore joints at night. The course of treatment is 4–6 months.

Rice medicine to relieve inflammation

Pour 50 g of rice with 250 ml of cold water and leave for 24 hours. Boil the resulting mass and eat it in the morning without salt or bread. Regular food can be eaten after 2-3 hours. The course of treatment is 1–2 weeks.

Medicine from dandelion flowers to relieve inflammation

Pour 20 g of dried dandelion flowers into 300 ml of boiling water and leave for 1 hour, then strain and cool. Take the resulting product 100–150 ml 2–3 times a day. The course of treatment is 2 weeks.

Medicine made from thyme and linden blossom to relieve inflammation and pain

Combine 10 g of thyme and 20 g of linden blossom, pour 350 ml of boiling water and leave for 30 minutes, then strain. Take the resulting product 200 ml 2-3 times a day. The course of treatment is 1–2 weeks.

Nettle medicine to relieve inflammation

Pour 10 g of dried nettle into 250 ml of boiling water and leave for 30 minutes, then strain and take 80-100 ml 2 times a day. The course of treatment is 1–2 weeks.

A medicine made from green tea and birch bark to relieve inflammation and pain

Combine 5 g of green tea and 5 g of crushed birch bark, pour 200 ml of boiling water and steep for 15 minutes, then strain and drink in one serving. The course of treatment is 3–4 months.

Onion medicine to relieve inflammation

Grind or mince 200 g of onion and apply the resulting mass to the sore joint for 20 minutes 2-3 times a day. The course of treatment is 2 months.

Medicine from elecampane roots to relieve pain and inflammation

Pour 20 g of crushed elecampane roots into 180 ml of vodka and leave for 12 days in a dark glass container. Use the prepared product for rubbing. The course of treatment is 2–3 months.

Medicine from celandine to relieve inflammation

Mash 50 g of crushed celandine, place in a dark glass container, pour in 1 liter of olive oil and leave for 2 weeks in a dark place. Strain the resulting product and use it for self-massage of the sore joint.

Medicine made from chalk and kefir to strengthen joints

Grind 100 g of chalk, combine with 200 ml of kefir and mix thoroughly. Place the resulting mass on a gauze bandage and apply to the sore joint for 30 minutes. The course of treatment is 6 months.

A medicine made from white cabbage and vegetable oil to improve the condition of joints

Combine 100 g of finely chopped white cabbage and 30 ml of vegetable oil and mix thoroughly. Take the resulting product 50 g 3-4 times a day. The course of treatment is 2–3 weeks.

A medicine made from white cabbage, honey and lard to relieve inflammation and improve the condition of joints

Finely chop 100 g of white cabbage, combine with 50 g of liquid honey and 50 g of lard and mix thoroughly. Store the resulting product in the refrigerator and take 50 g 2 times a day. The course of treatment is 1 month.

Medicine made from white cabbage and plums to improve joint health

Peel 200 g of plums, mash well with a spoon, combine with 100 g of finely chopped white cabbage and mix thoroughly.

Take the resulting product 50 g 2-3 times a day. The course of treatment is 2–3 weeks.

Medicine made from broccoli and sunflower seeds to improve joint health

Chop 200 g of broccoli, add 100 g of sunflower seeds, 100 g of liquid honey and mix thoroughly. Take the resulting product 50 g 1-2 times a day. The course of treatment is 1 month.

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Young people, and especially girls and women, may periodically notice clicking in the joint area.

Many people are indifferent to such sounds, not considering them a symptom of any disease.

Indeed, in most cases, clicking joints are quite normal, but it also happens that it is associated with a pathological process in the body.

Causes of Clicking

The most common causes of crunching when walking, flexing and extending joints are: the development of arthrosis, hereditary predisposition, increased joint mobility, sprained ligaments (typical for active athletes).

If the answer to the question: why do joints click is their excessive mobility, then this is explained by the fact that too much protein is produced in the connective tissues.

The joint ligaments begin to stretch and weaken, causing characteristic sounds. In addition, the phenomenon in question causes excessive stretching of nearby blood vessels. For this reason, women under 30 years of age complain of red and blue spider veins on their legs.

When ligaments weaken due to poor heredity, the only effective medical advice will be to reduce the load on the joints as much as possible. Joints crack not always without discomfort.

Often, when walking, the patient may experience pain of varying degrees of intensity due to injuries to the ligaments and joints. Clicking in the area of the spinal column requires special attention, especially when the lower back hurts.

The most unpleasant explanation for sounds in the joints is the beginning of the progression of arthrosis. This disease develops gradually. It slowly and unnoticed by the patient destroys cartilage and bone tissue.

Localization and development mechanism

Synovial fluid, necessary to lubricate cartilage tissue, contains carbon dioxide. If the position of the joint changes, the gas moves, causing a click. However, such a phenomenon should be rare. When making regular clicks, you should focus on the sensations in the other joints.

A person has a large number of points at which bone tissue harmoniously coexists with cartilage and forms joints. Most often, clicks occur in:

knee joints;
hands;
cervical spine.

The crunch in the shoulders is much less frequent, since in this place the load and deformation are minimal due to the low friction of the cartilage. Accordingly, the synovial fluid and cartilage tissue in the area of the shoulder joint wear out little.

In addition to painful sensations, weak ligaments will cause everyday problems. The patient simply will not be able to care for himself or carry out basic hygiene procedures. With age, innocent crunching and clicking can cause serious problems.

A common symptom of a sprained ligament is a crunching sound in the jaw while chewing food. The causes of the phenomenon are excessive load on the jaw muscles. Against this background, teeth grinding at night is noted - bruxism. Jaws crack after injury and joint displacement.

Almost every person has a crunch in their cervical spine.

This can be explained by a sedentary lifestyle, when the patient spends too much time at the computer or driving a car. At such times, the spine becomes severely curved and the back hurts.

How to get rid of the problem?

What should you do if a click occurs when you stand up (extend and flex) your limbs? If the reasons are not in the genetic characteristics of the body, then doctors recommend a number of measures. These include:

special tightening cuffs, bandages;
constant strict control of posture;
yoga classes;
the use of anti-inflammatory drugs in the form of tablets, ointments, gels;
walking up stairs;
increasing the duration of walks in the fresh air.

If the patient has had sports injuries with a characteristic sprain, then the bones also crunch. In such cases, the application of constricting bandages and cuffs is indicated to limit mobility and load on the diseased joints.

In addition to a fixative for pain (if the pain is severe), it is appropriate to treat a sprain with the help of painkillers. As soon as the symptoms of the pathology pass, you can continue to train.

The source of the clicking sounds may be bones rubbing against each other due to thinning cartilage. To get rid of the problem, it is good to use special anti-inflammatory drugs.

The patient should rest more and not put stress on the sore joint and bones.

If your child's bones crunch

When a child’s joint clicks and it doesn’t hurt, there is often nothing dangerous to health in the crunch. Usually we are talking about the baby growing up and the natural formation of his musculoskeletal system.

In cases where the crunching noise is too loud when walking, straightening and bending the limbs, the joint swells, and the child complains of discomfort or even pain, then you should consult an orthopedic doctor as soon as possible. You will need to undergo a full examination to rule out arthritis in your child.

If the doctor believes that the child has joint pain due to hypermobility due to dysplasia, then parents should do everything to ensure:

moderate physical movement (he may need to attend special physical therapy classes). At the same time, it would be reckless to completely abandon the load. The ideal activity for such a child is swimming and slow cycling;
strict drinking regime. In situations where bone crunching occurs when the amount of synovial fluid decreases, premature wear and injury of the joints should be prevented. By giving your child plenty to drink, water will begin to stimulate the secretion of fluid inside the joint and alleviate its condition;
dietary food. Children suffering from crunching sounds should eat foods rich in calcium, such as dairy products. It is good to give your child dishes containing collagen, for example, jelly, jellied meat, aspic (they can be made with gelatin or bone broth).

Parents should be wary if the child only cracks in a certain joint, the clicks are too loud, the crunch is accompanied by asymmetry in the folds of the skin on the legs, the knee clicks, and the hips move apart with particular difficulty, in this case it may be hip dysplasia.

You will need to find out why joints click in children and begin to treat the problem as quickly as possible.

Prevention of crunching

Prevention of clicking, in order not to treat arthrosis in the future, should be done from birth. To prevent crunching in the joints, you should include a large amount of fruits and vegetables in your diet. You should not abuse protein foods, namely meat and fish. It is important to drink at least 1.5 liters of pure still water (preferably mineral) per day. This will help replenish joint lubrication.

It is useful to eat cucumbers and vegetable oils:

sesame;
linen;
olive;
corn

They contain the necessary daily supply of microelements involved in the formation of cartilage.

Doctors also advise not to sit in one position for too long - you should change your body position every 40 minutes. If the patient has a sedentary job, then he should do gymnastic exercises (turns, stretching). You also need to monitor your weight and alternate the load on the joint.

Some people have a bad habit of cracking their knuckles, which is best avoided. There are no painful sensations, but the absence of harm from the exercise is questionable.

Every time joints are forced to deform unnecessarily, a person is forced to sprain the ligaments. As a result, the synovial fluid dries out. At a more mature age, a bad habit will cause a lot of trouble and the need to treat joints.

Relieves pain and swelling in joints due to arthritis and arthrosis
Restores joints and tissues, effective for osteochondrosis

To learn more…

Which doctor treats joints and spine

Osteoarthritis is increasingly occurring in fairly young people (20-25 years old). Experts blame poor ecology and an inappropriate lifestyle for the increased development of the disease.

Introduction

A large number of people do not attach any importance to the primary symptoms that directly indicate the onset of arthrosis, and do not even think about visiting a doctor. This is a big omission, because such a disease without treatment can lead to loss of ability to work and even disability.

But often the reason is not laziness, but a simple lack of information about which doctor treats joints. Treatment of joints is carried out by specialists of several categories: in each specific situation of the development of the disease, a doctor is required who deals with the treatment of specific pathologies.

Symptoms that indicate the need to see a doctor

Immediate consultation with a doctor requires the presence of certain symptoms:

Discomfort in the joint area, gradually turning into constant, quite severe pain.
Feeling of sharp attacks of pain, with the inability to move the affected parts of the body.
Swelling and redness of the skin, crunching in the joints of the legs, arms or fingers.
Changing shape.

Causes of pain:

inflammatory processes in the body;
infection through open wounds near the joint;
injuries;
metabolic disease.

Which specialist treats joints?

Joint diseases have two types of development:

Degenerative-dystrophic – active nutrition of cartilage tissue is disrupted.
Inflammatory - serious inflammatory processes develop, including synovial membranes, cartilage, and ligaments.

It is by the etiology and mechanism of the lesion that they determine which doctor should be consulted.

Rheumatologist

This is a therapeutic doctor who works exclusively with the initial stages of diseases against the background of viral infections. If you notice mild pain in the joints or increased fatigue due to stress, you should consult a rheumatologist. The specialist will prescribe all the necessary studies after he finds out the causes of pain in the joints of the arms and legs:

X-ray;
rheumatic tests.

It is important to determine the presence or absence of viruses in the body. After all diagnostic measures have been carried out, the doctor will make an accurate diagnosis and give recommendations for further treatment. Treatment by a rheumatologist is only conservative, using intra-articular injections, physiotherapy, massage or exercise therapy. In more complicated stages of the disease, he will refer you to the right specialist.

Orthopedist-traumatologist

When treatment with conservative methods does not bring results, the disease takes on a more complex form, then you need to contact an orthopedic traumatologist. The doctor deals with surgical methods to restore joint function. The main symptoms for contacting this specialist:

Complete or partial destruction of the joint.
Deformation, up to complete loss of motor ability.
Painful sensations are constantly present, even at night.

An orthopedic traumatologist performs several types of surgical interventions:

Organ-preserving operations (joint resection, arthroplasty, arthrodesis) - this type of intervention helps eliminate pain and restore natural functions, preserving as much of the patient’s own tissue as possible.
Endoprosthetics - this type of operation is performed for the most severe forms of arthrosis, with complete destruction of the joint. A complete replacement of the joint with a prosthesis occurs to ensure full motor activity.

Most often, prosthetics are performed on the knee and hip joints. The goal is to restore normal life and avoid disability.

Neuropathologist

Naturally, few people with joint pain will consult a neurologist, but the role of this specialist is quite large in the treatment of pain, including pain in the joints of the arms, legs and fingers. There is a possibility of neurological causes for the development of the disease - this is a pinched nerve in the spine or an inflammatory process of the nerve ending. It is with such lesions that a neurologist will help fight.

Endocrinologist

A doctor of this profile can help with arthritis associated with metabolic disorders: many diseases appear due to stress and poor nutrition. Due to impaired metabolism, there is an active accumulation of salts on the joints, which quickly lose elasticity and are at risk of impaired functionality. An endocrinologist will help restore metabolic processes in the body and prevent the development of arthritis.

Which doctor treats osteochondrosis?

To determine which doctor treats spinal joints, you need to know some features.

Osteochondrosis is a pathological change in the spine. The development of the disease has two factors:

Treatment of joints Read more >>

Changes in bone and cartilage tissue of the vertebrae.
Inflammation and pinching of the spinal roots.

Therefore, doctors of two specialties treat the disease:

Orthopedist – prescribes treatment to restore the elasticity of intervertebral discs, conducts therapy for osteoporosis of bone tissue;
Neurologist – treats osteochondrosis, the cause of which is pinched spinal roots. Determines the exact location of the disease.

When spinal lesions require surgical interventions, this task falls on the shoulders of neurosurgeons.

Some joint diseases and which doctor treats them

Some joint diseases, their types, symptoms, which doctor treats:

Bursitis is an inflammation of the joint sac with subsequent accumulation of fluid. Accompanied by severe pain, swelling, redness of the inflamed area. The most common types of bursitis are the knee and elbow joints. If you have bursitis, you should consult a rheumatologist or orthopedist.
Baker's cyst of the knee joint is a watery formation; the cyst is localized only under the kneecap. The disease was discovered by Dr. W. Baker and named after him. Baker's cyst is accompanied by pain in the knee area and swelling. The pathology is treated by a traumatologist and an orthopedist. In some cases, physicians and rheumatologists can diagnose this disease.
Synovitis is an inflammation process localized inside the synovium of the knee or elbow. It manifests itself as severe swelling, rarely painful. Synovitis most often affects the elbow and knee joints. Typically, a person is referred to a surgeon; sometimes the victim immediately goes to see a traumatologist.
Gonarthrosis of the knee joints is the complete decomposition of the cartilage tissue of the joints of a non-inflammatory nature. Gonarthrosis is accompanied by pain in the knee when walking. The patient can be referred to an orthopedic traumatologist, rheumatologist, and in milder cases of arthrosis - even to a therapist.

If you have the slightest suspicion of these diseases, consult a doctor immediately!

Rheumatism is an infectious-allergic disease that damages the connective tissue of the joints, cardiovascular system, internal organs, muscles and skin. The causative agent of this disease is considered to be hemolytic streptococcus, but the main role is played by allergies, which arise as a result of high sensitivity to the secondary introduction of streptococcus. Typically, rheumatism develops after acute inflammation of the upper respiratory tract, sore throat, and such a disease may occur with dental caries. Cooling the body also contributes to the development of this disease. Before you figure out how to treat rheumatism of the joints, legs, for example, you should understand what this disease is and what its symptoms are.

General information about rheumatism

In fact, rheumatism is not as common a disease as is commonly thought. In general, this disease is typical for children aged 6 to 15 years. This disease appears extremely rarely in older people. But even in that classic “children’s” group, which is most susceptible to this disease, no more than 1 child in a thousand is sick.

Many people wonder why we hear this word so often if this disease is so rare? In this case, it is reflected that the disease used to be more common, but after medicine became stronger and antibiotics became available, the number of cases of rheumatism decreased greatly.

The second reason is even simpler - previously the word “rheumatism” meant all diseases of the joints. Doctors simply did not distinguish between them, since there was no such need - the choice of treatment procedures was small, and accordingly, the treatment was almost always the same. But since the capabilities of medicine have increased, they have begun to distinguish between various joint diseases and select treatment appropriate for each of them. Therefore, now not a single doctor will confuse the symptoms of real rheumatism with manifestations of other diseases.

It is also worth noting that rheumatism is characterized by seasonal exacerbations, and the intervals between attacks are different for everyone and can range from a couple of months to several years. In addition, if the first attack of the disease passes without affecting the joints, then the disease may generally remain undetected for a long time. This latent form of the disease is revealed only after a while, when rheumatic heart disease forms. Repeated attacks of the disease in this case are much more severe.

How to identify the disease?

In general, the symptoms of this disease are very characteristic. As we have already said, mainly teenagers and children suffer from this disease. Most often, the disease develops several (1 to 3) weeks after the child has suffered a streptococcal infection of the upper respiratory tract. This could be a sore throat, pharyngitis, which is an inflammation of the pharynx, or tonsillitis, which is an inflammation of the tonsils.

The streptococcal infection itself does not always manifest itself clearly, often occurring in an atypical and secretive manner. In this case, you only have to deal with a slight sore throat and minimal fever. That is why doctors very often simply diagnose acute respiratory infections, simply not noticing the infection and not prescribing the treatment necessary in this case. As a result, an untreated infection, especially when it appears against the background of reduced immunity and reoccurs, often leads to articular rheumatism. As a result, some time after suffering from an illness (pharyngitis or tonsillitis), a person experiences inflammation of various large joints - shoulder, elbow, knee, ankle, wrist. But the small joints of the toes and hands are very rarely affected by this disease.

Another characteristic is the fact that the joints do not become inflamed simultaneously, but one at a time. For example, at first the knee joint may become inflamed, after a few days this inflammation goes away, but a new one appears, in another joint, then in a third, etc. It is this movement of inflammation through the joints that is a kind of “calling card” of rheumatism. Moreover, the inflammation of each specific joint is usually quite short-lived, it rarely lasts more than 10-12 days. the problem is that such inflammations usually occur several times in succession, and they cause harm not only to the joints, but also to the heart.

As a result of untreated or untreated rheumatism, rheumatic carditis appears, which is a rheumatic inflammation of the heart. This disease comes in three degrees of severity, and the process may involve the heart muscle, membranes and heart valves.

Forms of rheumatic carditis

There are three forms of this disease - mild, moderate and severe.

A mild form of rheumatic carditis affects only some local areas of the heart muscle. At the same time, the blood circulation of the heart is not disturbed, and there are simply no external manifestations of the disease, so it almost always goes unnoticed.

With a moderately severe disease, more severe damage to the heart muscle occurs, the heart itself increases slightly in size, unpleasant sensations appear behind the sternum, increased fatigue, shortness of breath, and a feeling of palpitations that occurs during habitual household activities.

Severe rheumatic carditis leads to even greater weakening of the heart, while its size increases significantly. Even at rest, the patient experiences pain in the heart, and swelling may appear in the legs. As a result of this particular form of the disease, heart defects (shrinkage of the heart valves) can develop.

Another consequence of rheumatism is chorea.

Rheumatic carditis is not the only possible consequence of rheumatism that was not cured in time. Children may also develop chorea, which is a disorder of the nervous system. As a result, the child's character changes somewhat; he becomes capricious, irritable, sloppy and absent-minded. Gait and handwriting change, memory and speech deteriorate, and sleep disturbances may appear. Moreover, in the early period of the disease, this is all explained as indiscipline and capriciousness, and no one even thinks about going to the doctor. Parents begin to get nervous much later, when the child begins to have involuntary twitching of the muscles of the arms, legs, torso and face.

Chorea, like rheumatic inflammation itself, goes away without a trace over time. So the most serious result of rheumatism that is not fully cured remains rheumatic carditis, which can lead to serious problems, including disability. That is why it is important to diagnose this disease as early as possible and begin treatment for this disease; fortunately, everyone knows which doctor treats rheumatism.

The main task of treating rheumatism

The main task set before the attending physician is to suppress streptococcal infection, which both causes the development of the disease itself and causes its complications. When it comes to how to treat rheumatism, one of the many antibacterial agents is usually chosen, most often penicillin. In this case, active antibiotic therapy lasts about two weeks, after which the patient receives intramuscular penicillin injections every few weeks for another five years to prevent possible heart complications.

In recent years, “broad-spectrum” antibiotics in the form of tablets have begun to be actively used to treat rheumatism. Such drugs (for example, erythromycin, ampicillin, oxacillin, etc.) have also shown to be highly effective.

During an exacerbation, various non-steroidal anti-inflammatory drugs are used to relieve pain. They act quite quickly and effectively eliminate pain and inflammation itself.

Rheumatism, despite its “secrecy” and danger, is perfectly treated with non-steroidal anti-inflammatory drugs and antibiotics, in most cases this is quite enough to completely eliminate the disease. But in rare cases, this treatment does not give the desired effect, then the doctor has to prescribe corticosteroid hormones. In combination with antibiotics, these drugs can relieve rheumatic inflammation in just a few days.

It is worth noting that painkillers are practically not used in the treatment of rheumatism, since their effect in this case is exclusively temporary, and they cannot suppress inflammation. If an anesthetic relieves pain, then the inflammation has not gone away, and a person, actively moving, causes additional harm to the diseased joint.