Paraarticular tissues: variants of lesions and their treatment
Khitrov N.A.

Central Clinical Hospital of the Presidential Administration of the Russian Federation, 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. Appeals regarding LPAT may account for up to 59% of primary visits to a rheumatologist. Diagnosis of LPAT is based on the presence of local changes: soreness, compaction, edema, hyperthermia, hyperemia. LPAT are characterized by a local weak or severe pain, sometimes with irradiation along the involved tendon-ligament, muscle and nerve structures. Passive movements in the patient’s joint performed by a doctor are less painful than active movements, which are performed by the patient himself. In the treatment of LPAT, the main role is played by the exclusion of 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 multiplicity of injections. Anti-inflammatory therapy of LPAT includes first of all non-steroidal anti-inflammatory drugs (NSAIDs) of local (cutaneous) and systemic (oral) use. Analgesics, weak opioids, muscle relaxants, sedatives, drugs from the groups of antidepressants and anticonvulsants are also used. The article considers the diseases of pararticular tissues of the upper limbs and back.

Key words: periarthritis, enthesitis, tenosynovitis, ligamentitis, fasciitis, bursitis, Amelotex.
For citation: Khitrov N.A. Paraarticular tissues: variants of lesions and their treatment // RMJ. 2017. № 3. P.177 –184.