idiopathic arthralgia syndrome
Introduction
Introduction to idiopathic arthralgia syndrome Idiopathic arthral syndrome (IAS) is unclear. Wind, cold, wet environmental factors and physical load are the main risk factors. The main clinical manifestations of knee and lumbar vertebrae are physical examination, physical examination and laboratory. A benign rheumatic syndrome seen without abnormalities is also referred to as rheumatic pain or benign joint pain, or unexplained joint pain. basic knowledge Sickness ratio: 0.001%-0.002% Susceptible people: no specific population Mode of infection: non-infectious complication:
Cause
The cause of idiopathic arthralgia syndrome
(1) Causes of the disease
Idiopathic joint pain syndrome, the current cause is not very clear, according to epidemiological data: IAS north more than the south, in the cold, wet season, warm season relief; outdoor operators more than indoor operators; physical labor More people than mental workers, it is believed that the cause of IAS may be related to environmental factors such as wind, cold, wetness and labor intensity. As early as two thousand years ago, "Su Wen·Paradox" has "wind, cold, and wet three gas, Meteorological data also confirmed that wind, cold, wet and other factors can cause joint pain.
(two) pathogenesis
Pathogenesis, pathology is not very clear, in order to confirm the pathogenic effects of wind, cold, wet, physical load factors, some people have carried out animal modeling experiments, Shanghai Wang Xuhui found that animals after wind, cold, wet, tissue Pathological features have changed, that is, platelet exudation and aggregation promotes phosphatidic acid hydrolysis, causing corresponding changes in microvessels and platelets, releasing low molecular cationic proteins, promoting multinucleated cell infiltration, and releasing dense particles and small particles, making local 5-HT , fibrinogen, potassium ion, permeable ions, increased chemokine content, causing local focal inflammation, tissue blood metabolism imbalance, energy metabolism disorders, resulting in tissue pH, cAMP content and neuro-muscle conduction capacity decreased, muscle The contraction ability is weakened and joint pain occurs. It has been reported that the animals are given wind, cold and wet stimulation, and physical load is added. It is also found that the blood condensing protein (CIP) increases with the action of pathogenic factors, and then glutathione peroxide Enzyme reduction, metabolites of lipid peroxides (LPO) and proteoglycans - monosaccharides: alpha-mannose (-Man), beta-acetyl The galactose (-GalNAC) and -galactose (-Gal) increase, it is speculated that wind, cold, wet, physical load can cause degradation and release of proteoglycan, and cause joint pain, the mechanism may be: 1 wind , cold, wet, physical load synergy, can cause increased plasma CIP, affect blood rheological properties, and can stimulate peripheral vasoconstriction, relaxation, leading to the formation of ischemia-reperfusion injury in peripheral tissues; 2 ischemia-reperfusion injury formation Produces free radicals, inhibits free radical scavenging system, and causes lipid peroxidation in the body; 3 free radicals can promote the degradation and release of proteoglycans in joint synovial membrane and cartilage matrix, leading to joint pain and dysfunction.
Prevention
Idiopathic joint pain syndrome prevention
1. Improve the living and working environment, using "thin-shaped infrared, far-infrared radiation parts" to make offices, chairs, beds and even walls, etc., using the far-infrared high permeability to treat and protect the human body.
2. Strengthen labor protection measures for outdoor workers.
Complication
Idiopathic joint pain syndrome complications Complication
Symptom
Symptoms of idiopathic arthralgia syndrome Common symptoms Joint pain Morning stiffness Chin joint pain
Age and gender
IAS occurs mostly in young workers aged 20-50 years old. The gender difference is not obvious. According to the analysis of 2341 cases of clinical data in Zhang Fengshan of Harbin, the incidence of adult males in the IAS is 93.55%. 38.81% and 37.53% of women, there is no difference between men and women; while the survey of males in the mining area is 3l%, females are 16.68%, male>female, most of the miners engaged in underground operations are male, while women are mostly engaged in light physical strength in the well. Or mental work, the difference between the environment and the physical load is large, not the gender difference. The investigation of the IAS rate in Zhaoguang Farm is 11.77% for men and 16.36% for women, mainly because the rural winter is the slack season, outdoor physical labor. In the forest area, the mining area is greatly reduced. Therefore, the IAS rate of agricultural workers is significantly lower than that of forest workers and miners. In the farm survey, IAS women are more women than men. They may be more labor-intensive than men in rural areas, have weak postpartum health, and are exposed to cold water. Or related to the cold environment.
Clinical symptoms
Knee joint, lumbar joint pain is the main symptom, often showing multiple joint pain, may be associated with short morning stiffness, painful joints without redness, annual joint pain lasts for 2 to 4 months, accounting for 60.57%; duration of 2 to 20 years accounted for 88.4%, often in winter or autumn and winter, cold weather or indoor cold and humid, indoor and outdoor temperature difference.
1. For more than 2 months, more than 2 joint pains, objective examination without abnormal findings:
(1) Repeated more than 2 joint pains, with heavy load on the knee, lumbar joints are the most common, followed by sputum, shoulder, elbow, hip joint, joint pain, but no redness, no deformity.
(2) Joint pain lasts for more than 2 months in 1 year, or 2 years of joint pain, lasting more than 1 month per year.
(3) Cold, damp can cause joint pain to occur or worsen.
(4) Laboratory examination of erythrocyte sedimentation rate, anti-O, rheumatoid factor, C-reactive protein, anti-nuclear antibody, etc.
(5) X-ray radiographs of pain joints are normal, and a few may have mild bone hyperplasia.
.2. Exclude other rheumatism that can cause joint pain.
Examine
Examination of idiopathic arthralgia syndrome
More than 1.96% of patients with blood routine, urine routine, erythrocyte sedimentation rate, anti-"O" and other tests are normal.
2. Immunological examination More than 95% of patients with RF, CRP, ANA, anti-ds-DNA antibodies, anti-ENA antibodies were detected in the normal range.
X-ray examination of pain joints: no abnormalities were found in more than 84%, and mild bone hyperplasia was seen in only 16% of cases.
Diagnosis
Diagnosis and diagnosis of idiopathic arthralgia syndrome
diagnosis
Diagnosis is based on clinical performance and examination.
Differential diagnosis
1. Rheumatoid arthritis invades the joints and IAS, mostly large joints, but it has a clear history of upper respiratory tract infection, joints often have redness, skin of the limbs with nodular erythema, and carditis, test and anti-test "O" (AsO) is usually 1:600 U or more.
2. Rheumatoid arthritis infringes joints mostly with small joints, and is symmetrical. There may be deformities in the middle and late stages, rheumatoid factors are often positive, and X-ray films may have bone destruction.
3. Osteoarthrosis This disease is mainly caused by weight-bearing joints. X-ray has bone hyperplasia, similar to IAS chronic disease, but it is generally 45 years old and above, and has nothing to do with cold stimulation.
