systemic lupus erythematosus arthritis
Introduction
Introduction to systemic lupus erythematosus Systemic lupus erythematosus is a manifestation of systemic lupus erythematosus, a systemic autoimmune disease characterized by multiple systemic damage. Mainly manifested as fever, rash, hair loss, joint pain or arthritis, nephritis, serositis, hemolytic anemia, leukopenia, thrombocytopenia and central nervous system damage. Patients with visceral (kidney, central nervous system) lesions have a poor prognosis, and are more common in women of childbearing age between the ages of 20 and 40. In recent years, the incidence of systemic lupus erythematosus in China has increased, and early diagnosis and comprehensive treatment can significantly improve the prognosis. basic knowledge The proportion of illness: 0.001% Susceptible population: women of childbearing age of 20 to 40 years old Mode of infection: non-infectious Complications: septic arthritis vasculitis arterial embolism
Cause
Systemic lupus erythematosus arthritis
Cause:
Systemic lupus erythematosus is a manifestation of systemic lupus erythematosus disease, and systemic lupus erythematosus is a chronic inflammatory disease that can affect many organ systems, such as the skin, nerves, and serosa. It is not clear, and may be related to genetic, environmental (sunshine or ultraviolet, drugs, microbial pathogens, etc.), immunity, estrogen and other factors that lead to immune dysfunction.
Prevention
Systemic lupus erythematosus prevention
Active treatment of systemic lupus erythematosus and prevention of joint involvement is the key to the prevention and treatment of this disease. In addition to the symptomatic treatment during the active period, the treatment of systemic lupus erythematosus is mainly due to the treatment, mainly the prevention of its possible causes.
Complication
Systemic lupus erythematosus complications Complications, septic arthritis, vasculitis, arterial embolism
This disease occurs in the femoral head, talus, and sacral skull necrosis. The incidence of osteonecrosis is increased in patients receiving steroid therapy. The most common one is concurrent idiopathic osteonecrosis: it has severe teratogenicity, and its etiology may include Vasculitis, vasospasm, abnormal blood coagulation mechanism, arterial embolism, abnormal bone metabolism and the use of glucocorticoids, often occur in weight-bearing joints, most commonly involving the femoral head, almost all patients with osteonecrosis have a history of glucocorticoid treatment.
In other cases, systemic lupus erythematosus may be associated with septic arthritis, fungal arthritis, viral arthritis, etc., and may be associated with the use of glucocorticoids and immunosuppressive agents.
Symptom
Systemic lupus erythematosus symptoms common symptoms joint collateral morning stiffness joint deformity osteoporosis asymmetry joint pain soft tissue swelling pathological nerve damage leukopenia hemolytic anemia thrombocytopenia
Systemic lupus erythematosus joint disease is one of the manifestations of disease activity, mainly characterized by joint pain, non-specific arthritis and idiopathic osteonecrosis.
1, joint pain and arthritis
Mild joint pain with morning stiffness is the most common initial manifestation of systemic lupus erythematosus. Most patients eventually develop symptoms of arthritis, some develop joint effusion, and the most commonly involved joint is the proximal interphalangeal. The joints of joints, wrist joints, knee joints and systemic lupus erythematosus are mostly symmetrical, insidious, gradually aggravated, and half of them are accompanied by morning stiffness, which may be migratory and dysfunctional.
2, joint deformity
Most of the systemic lupus erythematosus joint lesions do not cause joint deformity. A characteristic hand deformity of the systemic lupus erythematosus has been described (palap finger joint flexion, ulnar deviation and subluxation, excessive inter-throat joint extension). ), its inactive inflammation, is considered to be caused by para-articular tissues, ie, joint capsule, ligament and tendon involvement, ligament relaxation and tendon imbalance, rather than erosive deformity, "Swan neck"-like deformity can be seen in about 1 / 3 In patients with systemic lupus erythematosus, the involvement of the systemic lupus erythematosus and the involvement of the hand joints are parallel. Some people think that the most common abnormalities of lupus foot are the valgus of the foot, the widening of the anterior part of the foot and the hammer toe.
3, joint effusion
The joint effusion of this disease is rare, and the decrease of complement level is a specific change of systemic lupus erythematosus joint fluid.
4, radiation performance
Systemic lupus erythematosus arthritis has less imaging findings, early soft tissue swelling, osteoporosis around the joints and extensive osteoporosis; severe deformities can be seen in the late stage, but imaging evidence of bone erosion is often absent.
SLE can be confirmed by anti-nuclear antibody test: most of the anti-nuclear antibodies in the active phase of SLE are positive. If the anti-nuclear antibody is negative, the possibility of the disease is ruled out. The anti-nuclear antibody test sensitivity can replace the lupus cell test to diagnose the presence of SLE.
Examine
Systemic lupus erythematosus examination
In patients with systemic lupus erythematosus and arthritis, in addition to soft tissue swelling and signs of diffuse osteoporosis around the joints, articular cartilage or bone damage is rare, and a small number of patients may be similar to rheumatoid arthritis. The erosive joint disease, when combined with effusion, the amount of effusion is usually less, its appearance is clear, protein content and cell count are lower, the general white blood cell count is less than 3x109 / liter, mainly lymphocytes, in the effusion The total complement level is lower. Unlike rheumatoid arthritis, 7%-10% of patients have rheumatoid nodules, similar to the distribution of rheumatoid arthritis, and are common in the olecranon and metacarpophalangeal joints.
The disease can also be confirmed by anti-nuclear antibody test: most of the anti-nuclear antibodies in the active phase of SLE are positive. If the anti-nuclear antibody is negative, the possibility of the disease is ruled out. The anti-nuclear antibody test sensitivity can replace the lupus cell test to diagnose the presence of SLE, X-ray examination, There are many boneless joints.
Diagnosis
Diagnosis and diagnosis of systemic lupus erythematosus
1, systemic lupus erythematosus arthritis diagnosis
Systemic lupus erythematosus joint disease has no specific diagnostic conditions and no characteristic signs, but it is generally believed that non-erosive and non-deformed arthritis is a systemic lupus erythematosus arthritis different from rheumatoid arthritis, characterized by joints Face and joint gaps are often kept intact.
2, differential diagnosis
Systemic lupus erythematosus arthritis needs to be differentiated from rheumatoid arthritis. Early polyarticular pain and polyarthritis in systemic lupus erythematosus are easily misdiagnosed as rheumatoid arthritis. The latter's joint lesions are persistent and severe. The stalemate is long, the deformity is more common, the systemic damage is rare, and the X-ray shows erosive arthritis.
