Diagnosis and treatment of arthropathy in congenital disorders of lipid metabolism

Basic principles of diagnosis of congenital arthropathies with dyslipidemia.Treatment and prognosis of diseases of the joints in disorders of fat metabolism.

Besides the usual amount of research needed to identify hypercholesterolemia patients to clarify the nature of arthritis additionally conducted:

  • X-ray and ultrasound examination of the affected joints, while noting the presence of effusion with shifting slurry into the joint cavity, the manifestations of synovitis with numerous protrusions of the synovial membrane, edema and hyperemia in the periarticular tissues;
  • study synovial fluid obtained by the puncture or arthroscopy, reveals the presence of cholesterol crystal compounds;
  • biopsy of synovium taken during arthroscopy reveals its proliferation with excessive deposition of lipids in it, and the phenomena of inflammation (chronic synovitis).

At the same time, clearly visible when viewed from the outer skin of the patient changes (ksantelomy and xanthelasma) and cornea can be suspected di

slipoproteinemia, and the presence of the family nature of the disease, phenotypic study of blood serum lipids, and the results of genetic studies allow an accurate (genetic) nature of this disease.

Beyond acute diagnosis of the patients joints is carried out in the same way as conventional deforming osteoarthritis.

Basic principles of treatment of arthropathy when disliroproteinemii

Since the disease is caused by genetic, and preventive treatment is symptomatic.Typically, such patients are prescribed a diet low calories (primarily due to limitations in its animal fats).In addition, they are constantly forced to take drugs, correcting disorders of lipid metabolism, and in severe cases, resort to methods of artificial blood purification (plasmapheresis, extracorporeal blood correction methods, krioferezu and cascade filtration of plasma and others.).

In acute arthritis prescribed analgesics, non-steroidal anti-inflammatory drugs, physiotherapy and reflexology, local therapy.Corticosteroids such patients is not shown.Also symptomatic therapy and treatment of opportunistic diseases.

outside the period of exacerbation need to follow a diet for life, take chondroprotectors and drugs that lower cholesterol levels, to engage in physical therapy.In the presence of manifestations of gout further correction is carried out exchange of purine compounds, followed by preventive treatment of gout.

In addition, such patients should be for life in the dispensary with the planned holding of regular treatment and preventive measures, as well as be seen by an endocrinologist (in such patients on the background of obesity often develops diabetes of the second type) and on the testimony - a cardiologist.

prognosis of dyslipidemia with arthropathy

When hereditary dyslipidemia relatively favorable prognosis when the disease is detected early and promptly started the correction of metabolic disorders.

In late diagnosis and / or started late and inadequate correction state, non-diet, and medical appointments often unfavorable prognosis.In these patients, against the backdrop of disorders of lipid metabolism is always affected carbohydrate metabolism, develops diabetes with severe vascular disorders, and often - lethal complications.

forecast in hypercholesterolemia and other dyslipidemias acquired nature is largely dependent on the flow of the main process that caused the violations, and the presence of comorbidities, as well as the ability and willingness of the patient systematically, meticulously deal with the correction of these states.

When all running types of dyslipidemia observed the progression of osteoarthritis deforming, in some cases even require surgical treatment with prosthetic joints.

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