Paraarticular tissues: variants of disease and their treatment (part 2)
Khitrov N.A. 

Central Clinical Hospital and policlinic of the Facilities and Property Management Office under the RF President, Moscow

Periarthritis are the lesions of paraarticular tissues (LPAT) of the joints. Paraarticular tissues are represented by a set of periarticular structures and tissues remoted from the joints. This article describes the most frequent diseases of periarticular tissues of the low extremities: enthesitis, tenosynovitis, ligamentity, fasciitis, bursitis. The problems of their etiology, pathogenesis, clinical manifestations, diagnosis and differential diagnosis are discussed. Diagnosis of LPAT is based on the presence of local changes: soreness, compaction, edema, hyperthermia, hyperemia. LPAT are haracterized by a local mild or severe pain, sometimes with the irradiation along the involved tendon-ligament, muscle and nerve structures. The pathogenetic therapy of these diseases is presented. In the treatment of LPAT it is highly important to exclude the provoking factors, first of all mechanical overloads. Good clinical results can be achieved by local administration of glucocorticoids (GC), taking into account the anatomo-morphological features of LPAT, indications, contraindications, the right dose, number and frequency of injections. Anti-inflammatory therapy of LPAT includes first of all nonsteroidal anti-inflammatory drugs (NSAIDs) of local (dermal) and systemic use. Analgetics, mild opioids, muscle relaxants, sedatives drugs are also used.
Earlier in our journal we published an article in which the LPAT of the upper extremities and back were considered in detail [Khitrov N.A. Paraarticular tissues: variants of lesion and their treatment / / RMJ. 2017. No. 3. P. 177-184].

Key words: periarthritis, enthesitis, tenosynovitis, ligamentit, fasciitis, bursitis, Amelotex.
For citation: Khitrov N.A. Paraarticular tissues: variants of disease and their treatment (part 2) // RMJ. 2017. № 7. P. 462–468.