Periarticular lesions as actual problem of general practice: modern possibilities of diagnosis and boosting effectiveness of treatment

Abstract

Background. Lesions of extra-articular soft tissues occupy a leading place in the structure of diseases of the musculoskeletal system in primary health care. At the same time, insuffcient attention is paid to this pathology, which leads to a decrease in the quality of care for patients with extra-articular pathology.Objective. Increasing the awareness of general practitioners about the clinical forms of extra-articular soft tissue diseases, current approaches to diagnosis and treatment.Basic provisions. The article presents the characteristics of the main forms of periarticular lesions: periarthritis, incl. painful shoulder, tendonitis, tenosynovitis, capsulitis, bursitis. The leading mechanisms of periarticular disorders are presented, the clinical picture and diagnostic signs of particular forms are described. The role of modern methods of visualization of periarticular lesions using ultrasound and MRI is noted. The main approaches to the drug therapy of periarticular disorders are presented, including use of slow-acting symptom-modifying drugs (SYSADOA). The authors present their own data demonstrating the connective tissue metabolism disturbance in periarticular disorders as well as the effectiveness of the drug Alflutop in the treatment of periarticular lesions of a ‘mechanical’ nature.Conclusions. Primary forms of periarticular disorders are a consequence of microtraumatization and can be attributed to ‘mechanical’ types of damage. The ultrasound is pivotal in the diagnosis and evaluation the severity of the lesion and its origin. Biomarkers of connective tissue damage can be detected in the blood of patients with periarticular disorders. The treatment results can be improved with drugs from the SYSADOA group.