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Swollen Joints What Should Need to Know

Swollen Joints What Should Need to Know

Swollen joints happen when there’s an increase of fluid in the tissues that surround the joints. Joint swelling is common with different types of arthritis, infections, and injuries

Joint swelling can make it difficult to perform ordinary tasks at work or at home, such as using a computer mouse and climbing stairs. Chronic (long-term) swelling and discomfort can affect your work, social or family life.

There are things you can try to reduce the swelling on your own. However, you should see your doctor if you think your joint may be infected, or if swelling hasn’t gone down after a few days.

welling around the joints – also known as joint effusion – occurs whenever there’s an increase in the amount of fluid inthe tissues that surround the joint(s) in question. Joint swelling can be seen with various types of arthritis (such as rheumatoid arthritis, osteoarthritis, and gout/gouty arthritis) as well as with infections andinjuries.

Osteoarthritis is the “wear and tear” type of arthritis that often accompanies aging or injuries. With osteoarthritis, the cartilage that cushions the ends of the bones wears down – the accompanying joint swelling typically causes swelling in the weight bearing joints like the hips, knees, feet, and spine.

Rheumatoid arthritis, on the other hand, is an autoimmune disease and can occur at any age, be it during your adult years or in childhood. This type of arthritis causes joints to become painful, stiff, and swollen, and typically strikes in the feet, knees, and hands BUT can affect other parts of the body as well.

What Is Swollen Joints?

Joint swelling, or joint effusion, is the enlargement of one or more of your joints due to an increase in the amount of fluid in the joint. Joint swelling may be caused by injury, such as a broken bone, or by an underlying medical condition or disease, such as arthritis or an infection. The fluid can be blood, pus, or a clear exudate.

Besides injury, arthritis is a common cause of joint swelling. Arthritis most commonly affects joints that undergo constant repetitive movements, such as the hips, knees or fingers, though it may be present in any joint. Osteoarthritis and rheumatoid arthritis are the two most common forms of arthritis, but there are many different types of arthritis. Approximately 50 million adults in the United States have some form of arthritis (Source: CDC).

Anyone may experience joint swelling, although older people are more prone to developing joint swelling due to an increased likelihood of arthritis and a general deterioration of the tendons and ligaments around the joints. Additionally, persons who are overweight, repetitively use their joints in strenuous activities, or have previously experienced a joint injury are more likely to develop joint swelling.

While you should always consult with a health care professional when you experience joint swelling, swollen joints that result from minor injuries, such as overuse or sprains, may be effectively treated with rest and the application of ice to the swollen joint.

Joint swelling may be an indication of a serious injury or an underlying medical condition and you should always consult with a medical professional if you experience joint swelling. However, if you experience joint swelling with other serious symptoms, including a fever, unexplained swelling or pain, persistent pain, loss of mobility in your joint, redness or warmth around the joint, or unexplained weight loss, seek prompt medical care.

A swollen joint is a symptom of the following health conditions:

Osteoarthritis (OA). OA is the “wear-and-tear” arthritis that usually happens with aging or after injury. With OA, there’s a wearing down of the cartilage that cushions the ends of the bones. OA may cause joint swelling in those joints that bear weight over a lifetime, such as knees, hips, feet, and spine. Except for the pain in the affected swollen joint, you usually do not feel sick or tired.

Rheumatoid arthritis (RA). RA is an inflammatory arthritis that can happen at any age — even in young children. RA causes painful, stiff, and swollen joints. Usually, RA affects hands, feet, and knees, but it can also affect most joints and other parts of the body. RA symptoms can interfere with daily activities.

Gout. Gouty arthritis usually strikes suddenly, with severe joint pain, swelling, warmth, and redness, often in the big toe (about 50% of cases). Gout causes a painful, swollen joint that’s so severe that the weight of bed sheets can cause distress. It usually involves one joint when it strikes, but occasionally gout can affect more than one joint.

With gout, uric acid — a normal chemical in the body — forms crystals that deposit in the joints, causing inflammation and pain. The crystals may also deposit in other areas to become nodules under the skin or stones in the kidney.

Ankylosing spondylitis. The key feature of this is the involvement of the joints at the base of the spine where the spine joins the pelvis, called the sacroiliac joints.

Psoriatic arthritis. Psoriatic arthritis is an inflammatory joint disease that’s linked with psoriasis, a skin condition. Up to 30% of people with psoriasis will develop psoriatic arthritis.

Infectious arthritis. Infectious arthritis or septic arthritis is the result of a bacterial, viral, or fungal infection in the tissues and fluid of a joint. Joint infection usually occurs after a previous infection in the body. The infection travels to the joint via the bloodstream from another part of the body, such as a person’s skin, nose, throat, ears, or an existing wound. Within hours to days, pain, inflammation, swollen joints, and fever develop. The joints most commonly affected with infectious arthritis are the knee, hip, shoulder, ankle, and wrists. Damaged joints are more vulnerable to infection.

Common bacterial causes of infectious arthritis include Neisseria gonorrhoeae and Staphylococcus aureus. Some joint infections may be caused by more than one organism.

Joint injuries. Joint injuries can result in painful, swollen joints, and stiffness. Sometimes, joint pain can be caused by injured or torn muscles, tendons, and ligaments surrounding the joint, bursitis, tendonitis, dislocations, strains, sprains, and fractures.

Symptoms & Signs

Swollen joints refers to the enlargement of the joints, usually as a result of an inflammatory process or injury to the joint or to surrounding structures. Joint swelling may be accompanied by other symptoms, including

  • stiffness,
  • pain,
  • redness,
  • warmth, and
  • apparent loss of range of motion of the joint.

Depending upon the exact cause, swollen joints may occur singly, or multiple joints in the body may be involved at one time. The many arthritis conditions are a common cause of swollen joints.

Causes of Swollen Joints

Swollen joints can happen when there’s more fluid than normal in the tissues around your joints. This is due to inflammation in these tissues, which is part of your body’s natural immune response to tissue damage or infection.

If one joint is swollen, it’s usually due to a joint injury, such as a sprain, dislocation or fracture. This is usually accompanied by pain.

Causes of pain and swelling in one joint

  • Baker’s cyst — a build-up of fluid at the back of your knee
  • Bursitis — swelling and tenderness usually in one joint caused by inflammation of the jelly-like sac that cushions your joints (bursa)
  • Bleeding into the knee joint — injury to the knee joint eg a torn ligament or knee fracture can cause bleeding into the joint spaces (haemarthrosis); this causes bruising, swelling, stiffness and warmth, and is more common if you are taking anticoagulants eg warfarin; you should go to A&E if you think you are bleeding into your joint
  • Damaged knee joint — this can cause knee pain but knee pain is not always caused by a joint problem
  • Damaged cartilage at the back of the kneecap
  • Gout or pseudogout — types of arthritis caused by a build-up of mineral crystals in your joints, leading to repeated attacks of pain, redness, swelling and warmth; gout usually affects the joints of your big toes first while pseudogout usually affects the knee joints first; it is important to see your GP if you’re concerned you have gout or pseudogout because if left untreated, your joints can become permanently damaged

Joint swelling may be caused by many events or conditions including:

  • Aging (general degeneration of the joints)
  • Autoimmune diseases
  • Broken bone
  • Bursitis (inflammation of a bursa sac that cushions a joint)
  • Gout (type of arthritis caused by a buildup of uric acid in the joints)
  • Joint dislocation
  • Joint injury
  • Joint surgery
  • Neuropathic arthropathy (progressive degenerative disease of the bones in the joint)
  • Osteoarthritis
  • Rheumatic fever (complication of strep throat)
  • Rheumatoid arthritis (chronic autoimmune disease characterized by joint inflammation)
  • Sprains

Differential Diagnosis

Infection:

  • Septic arthritis
  • Neisseria gonorrhoeae
  • Lyme disease

Rheumatoid arthritis.
Crystal arthropathies – gout and pseudogout.
Reactive arthritis.
Trauma.
Palindromic rheumatism (multiple and unpredictable episodes of arthritis which can be severe, affecting different joints at different times; joints tend to return to normal between attacks).
Psoriatic arthropathy

How Are Swollen Joints Treated?

Not all swollen joints are treated the same way. Treatment for swollen joints depends on the problem or diagnosis.

For instance, nonsteroidal anti-inflammatory drugs (NSAIDs) are used in treating swollen joints with OA. NSAIDs may also be used to treat swollen joints from an injury. Along with NSAIDs, applications of moist heat or ice can help ease swollen joints and pain.

Steroid medications taken orally for a short period of time may be effective in reducing painful, swollen joints. Steroids block the production of inflammatory chemicals in the body.

Injecting an anti-inflammatory drug such as a steroid into a joint is another treatment method. The injection goes directly into the swollen joint — the source of inflammation and pain. Injections usually give the patient temporary but rapid relief of joint swelling and pain. Fluid removal is part of this procedure in most circumstances.

For inflammatory types of arthritis such as RA, psoriatic arthritis, and ankylosing spondylitis, treatment may include NSAIDs, steroid medications, and the newer types of drugs that affect the immune system. These include the disease-modifying anti-rheumatic drugs (DMARDs), biologic agents such as tumor necrosis factor inhibitors, and enzyme inhibitors which can block the proteins that cause. Inflammation.

Acute gout can be treated with a medicine called colchicine. This prescription drug eases swollen joints, pain, and inflammation caused by the crystal deposits in the joint. NSAIDs may also help decrease pain and swelling. Sometimes, stronger painkillers are needed.

Swollen joints and pain from infectious arthritis are treated with antibiotics to stop the infection. Sometimes, surgery may be needed to allow drainage of infected material.

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