Joint painFingers are an indispensable sign of any joint pathology in which the structural components of these joints are damaged.First of all, pain in the area of these joints can be associated with various autoimmune diseases (systemic red luster, rheumatoid arthritis, psoriatic arthritis, etc.) in which immune factors cause damage to their own articular tissues.
The next main reason that can initiatepainin the joints of the fingers, there may be injuries (bruises, dislocations, bone fractures, ligaments).Soreness in these joints can also be provoked by degenerative changes occurring in their articular tissues.This can often be observed with osteoarthritis.
Anatomy of the joints of the hand
All joints of the hand is customary to be divided into the following groups:
- wrist joint;
- joints of the wrist;
- carpal-pattern joints;
- interpencial joints;
- Parlemonal-phalanx joints;
- Interphalanx joints.
The wrist joint
The wrist joint is formed by the bones of the proximal bones (upper) a number of wrists (trihedral, semi -moon, scaphoid bones) and distal areas of radiation and elbow bones.The elbow bone is not directly connected to the bones of the wrist, but with the help of distal (Lower) the articular disk.This structure separates the cavity of the wrist joint from the distal cavity (Lower) The tile joint.
Joints of the wrist
The joints of the wrist are represented by three types of joints.The first form includes those joints that are located between the bones of the upper (scaphoid, semi -moon, trihedral, pea -shaped) or the lower row (hook-shaped, head-headed, trapezoidal, bone-trapping).These joints are called interchangena joints.By the second type, the so -called mid -wrist joint is ranked.This joint has a S-shaped shape and is formed due to the connection of the bones of the upper and lower row of the wrist.The third type includes the joint of the pea bone.Through this joint, the trihedral bone is connected to the pea bone.
Capacen-Penal joints
The carpal-panel joints connect the bones of the wrists and metacarpal bones.These joints are formed by the contact of the proximal ends (grounds) the metacarpal bones and distal sections of carpal bones belonging to the second row.The carpal-pattern joints include two main joints.The first is the carpal-playing joint of the thumb.It is formed by the connection of the first metacarpal bone with bone-trapping.
The second joint is the common carpal-paths joint for the rest of the carpal-prypyna compounds between the second, third, fourth, fifth metacarpal bones and trapezoidal, head bones and, partially, a section of bone-trapping.The carpal-pattern joint of the thumb is separated from the total carpal-pattern joint.Due to which more active movements are possible in it, compared to the rest of the carpal-paths (which are included in the general carpal-pathway joint) that are considered sedentary.The carpal-panel joints are strengthened by strong articular capsules, as well as ligaments (back and palmar-handbaging ligaments).
Interpretan joints
The lateral surfaces of the second, third, fourth and fifth metacarpal bones, when contacted by each other, form interprex joints.These joints have separate articular capsules, which are approaching the carpal-paths joint capsules, are connected with them.In addition to the capsules, these joints have a ligamentous apparatus represented by inter -scenery metacarpal ligaments, as well as the rear and palmar pairled ligaments.The interpener joints are attributed to the sedentary joints of the hand, since the articular surfaces of the bones that form these joints have a flat shape.
Parleen-phalanx joints
Parleus-phalanx joints are compounds between distal (lower) with the ends of the metacarpal bones and proximal (upper) areas of the first phalanges of the fingers of the hand.Each finger of the upper limb has its own metacarponal joint joint.Thus, there are five metacarpal phalancing joints on each hand.
Interphalanx joints
Interpophalanx joints are formed by the combination of neighboring phalanges of each of the fingers.Big (first) the finger has only one interfalanced joint, since this finger has only two phalanxes (proximal and distal).The rest of the fingers of each of the hands have two interfalancing joints.
The first of them is localized between the first (proximal) and the second (average) fingers and called proximal phalanges (upper) Interphalang joint.The second forms the connection between the average (second) and the last (distal) Finger phalanges.The second interphalangeal joints are called distal interfalanced joints.The inter -phalanx joints are strengthened with collateral and palmar ligaments.These joints belong to the block joints, the movements of which are possible only around the frontal plane (Fighting and bending).
What structures can become inflamed in the joints of the hands?
Inflammation is a typical pathological process characteristic of those tissues and organs that were damaged for any reason.It is worth remembering that, in most cases, every disease (For example, gout, rheumatoid arthritis, etc.) or trauma that damage the joints of the hands to one degree or another, affect not only the articular, but also the perioster (nerves, muscles, tendons, subcutaneous fat, skin) structures.
The following articular structures can become inflamed in the joints of the hands:
- joint cartilage;
- Squeezing bone tissue;
- joint capsule;
- Joint ligaments.
The causes of pain in the joints of the hand and fingers
The main share among the reasons causing pain in the joints of the hand and fingers is occupied by mechanical injuries (Fractures, dislocations, bruises, etc.) and systemic autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, psoriasis, etc.).In addition to these causes, soreness in the joints of the hands can cause diseases associated with metabolic disorders (For example, gout, osteoarthrosis).
There are the following main causes that cause pain in the joints of the hand and fingers:
- bruise of the hand and fingers;
- fracture of the bones of the brush;
- dislocations of the brush;
- lesion of ligaments of the hand;
- rheumatoid arthritis;
- Kinbek disease;
- reactive arthritis;
- gout;
- psoriatic arthritis;
- synovitis;
- osteoarthrosis;
- System red lupus.
Bruise of brush and fingers
A bruise is one of the types of closed injuries, in which there is a damage to soft tissues (muscles, tendons, nerves, skin) And there are no wounds in the place where the main action of the traumatic factor was directed.Bruises of soft tissues of the hand and fingers are very rarely found in isolation (separately) from bruises of the joints of the hand and fingers.Therefore, with this type of injuries, mixed symptoms are found, indicating both damage to the joints of the hand, and the lesion of the periarticular (peri -human) fabrics.The bruises of the brush and fingers are usually found when falling on the hand, damage it with a blunt object, with its compression or pinching.
Quite often, bruises of the cystic zone lead to damage to the main trunks of median, radial, elbow nerves (which innervate the area of the hand and fingers), which is immediately manifested by the loss of skin sensitivity, and in some cases even the disappearance of the motor functions of the fingers.
Inflammatory edema of the articular and peri -human structures develops as a result of the expansion of numerous vessels that they are blood supply.This edema is one of the reactions of inflammation, which occurs in response to damage to tissues during bruises.
A fracture of the bones of the brush
Quite often, the cause of pain in the joints of the hand can be various fractures of its bones, since these bones directly register in the formation of articular surfaces.Depending on the anatomical position of the damaged bone, all fractures are divided into three main groups.The first group includes fractures of the wrist bones.The second includes fractures of tubular metacarpal bones.The third group includes fractures of bones of the phalanges of the fingers.
The most frequent places of damage in the carpal zone of the brush are semi -moon and scaphoid bones.A fracture of these bones occurs during falls on the brush and is accompanied by pain in the area of the wrist and medium wrist joints.Pain syndrome can also be observed in places of anatomical localization of these bones.
The most frequent fracture of the ends of the metacarpal bones is a fracture of the base of the first metacarpal bone (the one that is attached to the phalanges of the bones of the thumb).With this injury, edema and soreness appear in the zone of the base of the first metatarsal bone, as well as in that part of the carpal-pattern joint, which directly adjacent to it.The thumb with such a fracture is shortened, bent and led to the palm of your hand.His movements are limited.
Fractures of the phalanx of the brush are accompanied by deformation, a decrease in the length of the fingers, the loss of their function, sharp pain and swelling in their inter -phalanx joints and peri -human tissues.With fractures of phalanges of the fingers with a displacement of bone fragments, palpation (on palpation) You can identify their bulging on the palmar surface of the brush, and on the back, on the contrary, a hole or isolation.These fragments are usually mobile, near them you can often detect subcutaneous bleeding (hematomas).
Dislocation of the brush
Dislocation is a pathological condition in which the areas of bones that form any joint go beyond its anatomical boundaries, which, thus, is manifested by a complete or partial loss of the function of this joint.In addition to impaired joint function during dislocations, severe pains in the affected joint, swelling, and a local increase in temperature are also found.During dislocations of the brush, the appearance of swelling is explained not only by the presence of inflammation in damaged peri -human tissues, as well as the structures of the joint, but also with a protrusion of the emanated bone joint.
The most frequent types of dislocations of the brush
| The name of the dislocation | The mechanism of dislocation | Which joint is amazed? |
| True dislocation of the brush | The articular surfaces of the wrist bones are displaced relative to the joint surface of the radial bone towards the palm or in the back of the hand. |
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| Perilunar dislocation | The bones of the wrist and the rest of the brush are shifted relative to the midday and radial bone in the back of the brush. |
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| Dislocation of the bone | At the same time, the scaphoid bone displays the dislocation in the radiation side in parallel (in the same plane) to the nearby bones of the wrist.Sometimes it can shift in the palmar side, that is, to switch to the palm of the bone-trapping, less often on the same side of the trapezoidal bone. |
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| Dislocation of the semi -moon | There is a slipping of the half -moon in the direction of the palm, so that the space in the place of this bone remains not busy.It is gradually occupied by the head bone, penetrating here from the second row of the bones of the wrist.This dislocation is a complication of self -regulation of perilunar dislocation. |
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| Dislocation of the first metacarpal bone | The articular surface of the base of the first metacarpal bone is shifted relative to the articular surface of the bone-trapping in the radiation side, up (proximal) and in the same plane with the bones of the wrist.Thus, the thumb is pulled a little back and towards the wrist joint. |
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| Dislocation of the phalanges of the fingers | There are dislocations of the fingers in the metacarpophalangeal joints and inter-phalanx joints.At the first, the joint surface of the proximal phalanx of the fingers (Together with the whole finger) shifts relative to the articular surface of the metacarpal bones.With the second, there is a displacement between the bones of the phalanges of the finger itself.Usually there are back and palm dislocations of the phalanges of the fingers. |
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Damage to ligaments of the hand
The lesion of the ligaments along with bruises of the brush is attributed to closed traumatic damage.This pathology is mainly found with excessive extension of the hand, fingers in any direction.The main types of lesions of the bunch of brush are their stretching and rupture.With stretching in the damage zone, slight re -voltage and partial rupture of the connective tissue fibers are observed.With the rupture of the ligaments, the whole ligament is divided into two endless ends.
The following main types of ruptures of the ligaments of the brush are distinguished:
- rupture of the radial collateral ligament of the wrist;
- rupture of the elbow collateral ligament of the wrist;
- rupture of intercept ligaments;
- rupture of the side ligaments of the metacarpal phalancing joints;
- Rupture of the side ligaments of the interphalang joints.
Rheumatoid arthritis
Rheumatoid arthritis is a disease in which the human immune system damages the body's own tissues.In other words, rheumatoid arthritis is an autoimmune pathology.This disease is also systemic, since many tissues are affected with it (muscles, joints, vessels, etc.) and organs (Heart, kidneys, lungs, etc.) in the body.
Despite the fact that rheumatoid arthritis is a systemic disease under it, to a greater extent, the joints suffer, while the lesion of other tissues and organs is in the background.With this disease, almost all types of brush joints can be affected (wristwalls, carpal-paths, metacarpal-phalanx, inter-phalanx joints).The lesion is usually symmetrical (those.The same joints are affected) on both hands, accompanied by swelling, pain in damaged joints.In the morning, during lifting from bed, there is some stiffness in the affected joints, which can last about 1 hour and then disappear without a trace.
Quite often with rheumatic arthritis near the affected joints of the brush (more often the piano-phalanx, inter-phalanx joints) Rheumatoid nodules appear.They are a rounded formation located under the skin.On the brush, these formations arise most often on the back.On palpation, they are dense, inactive, painless.The number of them can vary.
Kinbek disease
Kinbek's disease is a pathology in which a semi -moon carpal bone of the brush is affected.The disease develops as a result of long -term physical overload of the palms of the hands.Usually it occurs in specialists of construction professions - plasters, mason, joiners, etc. Excessive physical activity of the palms of the palms most often this bone, since it occupies the central position in the wrist joint.Most often, during the disease of the kinbek, the brush of one hand is affected and, as a rule, the main one (The right -handed hand is damaged, the left -handed hand is damaged).
Reactive arthritis
Reactive arthritis is a pathology of immunopathological genesis, in which its own immune system attacks various joints in the body, which is why autoimmune inflammation develops in them.Unlike other autoimmune diseases (for example, rheumatoid arthritis, systemic lupus erythematosus, in the occurrence of which an infectious origin is assumed) In reactive arthritis, a clear relationship between the infection is traced (and, in particular, intestinal or urogenital) and the development of joint lesions.
Also, with this pathology, lymph nodes can increase and fever appear.When reactive arthritis transition to a chronic form, over time, patients may indicate signs of kidney disease, heart, and muscle atrophy, bursitis may occur (Inflammation of the periosemantal bags), tendovaginites (Inflammation of the vagina of tendons) and others.
Gout
Gout is a disease based on the development of the accumulation of uric acid in the body and its deposition in the form of salts in the joints.Uralgic acid is the final product of the metabolic of purine and pyrimidine bases.They serve as the basis for the construction of DNA and RNA molecules, some energy formations (adenosine trifosphate, adenosine monophosphate, etc.) and vitamins.
Pain with gout mainly occurs in the small joints of the lower and upper extremities.Moreover, in 50% of all clinical cases, the disease begins with the first plus joint of the legs.On the hands, as a rule, the interfalanced joints of the fingers are affected, less often - radiant joints.Gout usually damages one or more joints on one limbs, sometimes the joints of other limbs are involved in the inflammatory process.
Psoriatic arthritis
Psoriatic arthritis is a pathology in which various joints are inflamed against the background of psoriasis.The development of psoriasis is based on a violation of the interaction between immune cells and skin cells as a result of which in the body (and especially in the skin) there are autoimmune reactions that cause inflammation.
Synovitis
Synovitis is an inflammation of the synovial shell of the joints, accompanied by damage to its tissues and the accumulation of pathological fluid in the affected joints.Synovitis is not a separate disease, but rather serves as a complication of other diseases.It can occur with endocrine, allergic, infectious, autoimmune pathologies, brushes, etc.
Osteoarthrosis
Osteoarthritis is a disease in which there is a violation of the processes of formation of normal cartilage tissue in various joints.These processes are violated under the influence of certain external and internal predisposing factors.They can be constant joint injuries, prolonged physical activity (At work, in everyday life, during sports), heredity, other joint diseases, etc.
The joints of the fingers are sore with this pathology, because in the periarticular (peri -human) The tissues occur inflammation, nerves are affected.A characteristic feature of osteoarthritis is the connection of pain with physical activity.Soreness in the joints mainly appears at and/or after heavy physical overload and disappears at rest or after rest.
System red lupus
A systemic lupus erythematosus is an autoimmune pathology, in which in the human body there is a production of an immune system of autoimmune antibodies, attacking various structures of cells and tissues.In particular, with it, the production of the so -called anti -core antibodies that damage cell nuclei and DNA and RNA molecules is observed.With a red lupus, various fabrics and organs are affected - leather, vessels, heart, pleura, pericardium, kidneys, joints, etc.
System Red lupus is constantly associated with other extra -intact signs - weakness, weight loss, fever (Improving body temperature).However, special symptoms are of greatest importance, without which the diagnosis of red lupus is not made.These special signs are photodermatitis (skin inflammation under the influence of sunlight), discoid rash (The appearance on the skin of the neck, chest of red paples), lupoid butterfly (The appearance of red spots on the skin near the nose), erosion in the oral cavity, kidney damage (Glomerulonephritis), serosites (Inflammation of serous membranes) and others.
Diagnosis of the causes of pain pain
The hands of pain in the joints of the hand are engaged in the diagnosis and treatment of the causes of pain, mainly a traumatologist and a-breeding doctor.To diagnose such reasons, these doctors mainly use clinical (Anamnesis collection, external inspection, palpation, etc.), radial (radiography, computed tomography) and laboratory (General blood test, biochemical blood test, etc.) research methods.
Depending on the cause of pain in the joints of the hand, all diagnostics can be divided into the following sections:
- Diagnosis of traumatic injuries of the brush (bruises, dislocations, fractures, ligaments);
- diagnosis of rheumatoid arthritis;
- Diagnosis of Kinbek's disease;
- diagnosis of reactive arthritis;
- gout diagnostics;
- diagnosis of psoriatic arthritis;
- Diagnosis of synovitis;
- diagnosis of osteoarthrosis;
- Diagnosis of systemic lupus erythematosus.
Diagnosis of traumatic brush injuries
When injuries of the brush, you should consult a traumatologist.The main methods of diagnosis that are used in medical practice to identify traumatic damage to the brush (fractures, dislocations, ligaments, bruises), are an external examination, anamnesis, radiation methods of research (radiography, computed tomography).
The collection of anamnestic data allows the doctor to identify incidents that led or could lead to an injury to the brush.The history of the anamnesis is also used to clarify the symptoms that bothering the patient.During an external examination on the brush, it is possible to detect swelling, hematomas, its deformation, limitation of joint mobility.With the help of palpation, the doctor reveals the presence of pain, violation of the anatomical shape of the joint, damage to the ligaments.Radiation methods of research (radiography, computed tomography) They allow you to confirm the diagnosis, since during their use, mechanical damage to the anatomical formations of the brush is clearly visible.
Treatment of pathologies that cause inflammation of the joints of the hand
For the treatment of causes of pain in the joints of the hand and fingers, doctors, first of all, prescribe a variety of drugs (Anti -inflammatory, painkillers, anti -rhevetas drugs, etc.).In some cases, they combine the use of these products with physiotherapeutic procedures.The traumatic damage to the brush is most often treated surgically or applied to the affected upper limb of the gypsum bandage.
To relieve pain and relieve inflammation, the first help may be the use of an external NSAID.The drug selectively blocks the COO-2 and acts directly on the source of pain.It is quickly absorbed thanks to a special texture, leaves no traces of clothes, has a pleasant smell.
Depending on the pathology that causes inflammation in the joints of the hand, all treatment can be divided into the following parts:
- treatment of traumatic injuries of the brush (bruises, dislocations, fractures, ligaments);
- treatment of rheumatoid arthritis;
- treatment of Kinbek disease;
- treatment of reactive arthritis;
- gout treatment;
- treatment of psoriatic arthritis;
- synovitis treatment;
- treatment of osteoarthritis;
- Treatment of systemic lupus erythematosus.