The causes of psoriasis and psoriatic arthritis

Psoriasis is considered to be an autoimmune disease, the main causes of which are currently not well understood. It is believed that the characteristics of the immune system, promoting disease, inherited, they cause allergic processes in relation to the own tissues of the skin, joints and so on.

As a result, the immune system attacks cells of skin tissue and joint them inflammation occurs, damaging these tissues. Particularly "get" of cartilage and bone joints, which leads to gradual limitation of movements.

As shown

Psoriatic arthritis often develops in patients who already have skin manifestations of psoriasis, usually several years after their occurrence. But sometimes initially affects the joints, and then there are rashes on the skin.

Peculiarities of this type of joint disease lies in the fact that almost always affects the joints of the fingers while the defeat of nails. Psoriatic arthritis patients skin over the joint becomes purple-bluish color, it is painful and swollen. Often affects the big toe, pain in the heels. One finger is sometimes inflamed several joints, causing the fingers acquire a kind of sausage.

At the same time a small number of joints becomes inflamed, while defeat is an unbalanced character. In severe cases, changes in the joints can be multiple.

Often, the process involved the intervertebral joints of the lumbar region and sacroiliac joints, which can develop adhesions that entail limited mobility of the spine.

Psoriatic arthritis Arthritis - a variety of forms and complications   usually occurs with sudden exacerbations, interspersed with inflammation subsided. It is noted line of skin and joint manifestations of the disease. As the progression of developing major dysfunction of the joints.

In some patients, changes in the joints occur quickly, which is very dangerous, because it leads to the correct diagnosis later, when changes in the joints become irreversible and restrict movement.

Drugs for treatment

Treatment of psoriatic arthritis consists of suppressing the unpleasant symptoms of the disease such as pain, swelling, Prevention and treatment of edema - it is important to understand the root cause   and stiffness (symptomatic treatment) and suppression of the immune destruction of its own tissues.

To relieve pain, signs of inflammation and stiffness of movement used nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin, diclofenac Diclofenac - relieve inflammation and pain   and so on. If these drugs are not sufficient to alleviate the condition of the patient, then join paracetamol and means of relaxing the muscles (muscle relaxants), for example, Mydocalmum Mydocalm: drug from muscle spasms .

In severe forms of the disease are appointed by glucocorticoid hormones (including locally within the joint), but they are dangerous to use in psoriasis: lowered immunity caused by these drugs may contribute to severe suppurative complications of the skin.

To suppress the immune processes used drugs such as methotrexate, sulfasalazine, and so on. The effects of taking these drugs turns out not once, but after a month or two of treatment.

Recently, for the treatment of psoriatic arthritis began to use specific antibodies produced by the disease with biologically active substances. Antibodies bind to the substance (antigen) and outputting it from the body. For drugs of this type include, for example, infliximab.

Cure psoriatic arthritis completely impossible, but if properly selected treatment of the patient may be in a satisfactory condition without loss of joint function.

Galina Romanenko

Surgical treatment of coxarthrosis

Surgical treatment of coxarthrosis is necessary only when other means can not permanently alleviate the pain and other symptoms of this disorder. After surgery restores mobility of the joints, the pain goes away, and significantly improved quality of life.

On the other hand, an artificial joint, of course, can not be absolutely identical to the present, and after hip replacement, the patient should comply with certain constraints. For example, it is not recommended to squat, as it increases the risk of displacement of the joint. Moreover, one out of ten patients, even after the operation remains slight or moderate pain, which have to cope with the help of analgesics, compresses, and other means. Unfortunately, not always possible to understand why the pain persists after surgery. However, the majority of patients after surgery begins improving.

Possible problems

Sometimes after hip replacement becomes one leg slightly longer than the other, but the difference can be corrected using special insoles for shoes.

The most commonly used artificial joints of metal and plastic - metal ball and a plastic socket (hip joint is classified as spherical joints in which one surface has a spherical shape, and the other, which is sometimes called jack - concave). Younger and more active patients may be implanted into the joints of ceramic and plastic (ceramic balloon, plastic socket), only ceramic or rare in most cases only of metal.

Preparation for surgery

The question of what exactly should be the joint implant is decided before the operation. In addition, for two or three weeks before the operation the patient should undergo a thorough examination. In particular, the analysis of blood Blood tests: a mirror of health , X-ray of the hip, urinalysis, electrocardiography. It is also recommended to be examined by a dentist and, if necessary, carry out dental treatment. Some dental problems are associated with an increased risk of infection after surgery. In some clinics, patients are also given the opportunity to advance to speak with a physical therapist about how they should dress, bathe and perform normal household chores in the first days after surgery. The specialist also can recommend to the patient before the operation to purchase tools that will help him move and perform simple daily tasks.

Since the operation is usually performed under general anesthesia, the morning of the surgery patients should not eat or drink.

After operation

After surgery, most patients remain in the hospital for 4-8 days. During this time they begin to walk and tend to learn on their own to climb stairs, and perform simple exercises that will speed up the recovery process. After 6-12 weeks after surgery, the patient will have to come to the examination, the doctor can make sure that the recovery is going well.

Possible side effects of surgery for hip replacement:

• Deep vein thrombosis. The risk of thrombosis Thrombosis - the cause of heart attack and stroke   can be reduced by compression bangs blood-thinning medications, and other means;
• Pulmonary embolism - a disorder in which blood clots formed in the veins, blood vessels are moved into the lungs. Fortunately, this complication is rare, and can be overcome with the help of anticoagulants;
• Offset artificial joint occurs less than one out of twenty. These patients required further surgery to put the joint in place;
• Infection. Despite the measures taken to ensure that the operation took place in a clean, safe environment, about one in a hundred patients after hip replacement infection develops. Infectious diseases respond well to treatment, but the artificial joints usually have to be removed, and then implanted only after the infection is cured;
• The weakening of the artificial joint. This most often occurs within 10-15 years after surgery. Weakening of the new joint is usually associated with thinning of the bone around the implant, resulting in increased likelihood of fractures;
• Bleeding and hematoma. As a rule, the bleeding stops after a couple of days after surgery, but sometimes it lasts longer, and blood accumulates under the skin. In some cases, a simple operation to remove the accumulated blood. Aspirin Aspirin - NSAIDs   and antibiotics Antibiotics - whether they will help you in the foreseeable future?   increases the risk of hematoma formation following surgery.

In the first two to three months after surgery, the patient has to move with extreme caution to avoid displacement of the new joint. However, this does not mean that we should move as little as possible - on the contrary, it is necessary to strengthen the muscles to do more joints as flexible as possible. Within 4-6 weeks after joint replacement patients usually walk, leaning on a stick or crutches. In the first few months after surgery, patients are not recommended to ride a bike, run on hard surfaces, as well as to engage in sports that require sharp turns and slopes - such as tennis or squash. Those who are hip replacement should be lifelong refrain from sports associated with an increased risk of falling - for example, from skiing.

In general, the new joint people can live active, full lives for many years without thinking about the pain. Approximately 80% of patients, artificial joints serve well as a minimum of twenty years. If necessary, can be repeated hip joint replacement - this operation is complicated and is associated with a longer recovery period, but usually it leads to good results.