Joint Turning Blue and Swollen for No Reason

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12 causes of swollen joints

One evening after work, my left shoulder became achy. By bedtime, it was really painful and difficult to raise. I took some pain killers and tried to sleep but my shoulder burned inside. No matter what position I tried, I couldn t move away from the pain. The doctor diagnosed bursitis and prescribed a steroid pack plus antibiotics. Both of us were baffled why I had it, since bursitis in the shoulder is typically a sports injury and I hadn t done anything. The bursitis cleared in a few days, but six months later, I awoke with the tops of both hands from the base joints of my middle, ring, and pinky fingers to the wrists puffy, red, and tender to touch. The inflammation disappeared from my hands after a couple days but appeared across the base joints of my toes on both feet. When the redness and swelling left my feet and returned to my hands, I returned to the doctor. Blood test results were positive for Rheumatoid Arthritis. - Dee s story.

Gordon's problem surfaced shortly after he and his wife, Christine, returned from a hike in the steep canyons around Sedona. After they returned home, Gordonnoticed that his left knee was swollen. He assumed he had twisted it on the hike. Several weeks later, when his knee failed to improve, he consulted an orthopedist, who recommended physical therapy, but within weeks it was clear that PT sessions were not helping. The pain worsened. Six months later doctors told Gordon he had a partially torn meniscus, a cartilage injury. The surgeon repaired the cartilage.

No better after several months, still in pain and unable to walk easily, Gordon consulted a new doctor. The doctor's first thought was that the heat and swelling might indicate an infection. A second MRI pointed to a condition called pigmented villonodularsynovitis, which causes an overgrowth of tissue for no apparent reason and is treated with surgery. Three surgeries later, Gordon s condition was no better. One doctor suspected the possibility of sarcoma, a type of cancer. Another one suggested it might be a deadly fungal infection. After a year of various treatments, Gordon s condition was finally diagnosed Lyme s disease.

Why are swollen joints so difficult to diagnose? What causes swollen and painful joints?

Swelling of the joint occurs when there is a build-up of fluid in the soft tissue surrounding the joints. It makes the joints look larger or abnormally shaped. According to the medical fraternity, there are 128 causes of swollen joints, which are broadly speaking, different types of arthritis, infections, and injuries. Arthritis can cause swelling, redness, and warmth around the joint. An infection generally causes swelling and pain in the joints along with fever. Injuries too cause swelling of the joint when there is a fracture in the bone or a tear in the tendon or ligament.

Let s check out some of the diseases / disorders that cause swollen joints.

1. Ankylosing spondylitis: It is a type of arthritis caused by chronic inflammation of the spine. The inflammation causes the vertebrae to fuse together (ankylosis) resulting in stiffness and loss of mobility of the spine. Pain and stiffness in the spine region including the neck and back are the main symptoms of the disease. The condition is generally inherited affecting all age groups and occurring in both men and women, though it is more common in men.

2. Rheumatoid arthritis (RA): This autoimmune disease causes inflammation of the joints. Symptoms include swollen and painful joints, fatigue, fever, loss of joint function, joint stiffness, redness, warmth, and even deformity. Unfortunately there is no cure for RA.

3. Osteoarthritis :Also called degenerative arthritis, this is a type of arthritis which causes joint inflammation due to wearing down of cartilage. The wear and tear of cartilage can occur because of aging or injury. You can suspect osteoarthritis if you experience pain after repetitive use of the affected joint. Although it has no known cause, it has generally been found to affect men over 45 years of age and women over 55 years of age.

4. Gout: Gout is an inflammation that begins suddenly and usually affects one joint. It occurs when there is a buildup of uric acid in the joint. Uric acid is normal byproduct of purine (protein) break down. A gout attack can be triggered by red meat, seafood, sweetened beverages and alcohol as they are high in purines. A recent study published in the American Journal of Medicine suggested that episodic alcohol consumption, whether beer, liquor, or wine, was associated with an increased risk of recurrent gout attacks even with moderate amounts. Even vegetables like mushroom, pea, spinach, cauliflower and lentils and kidney beans are moderately rich in purines. Dehydration is also a big trigger for gout. (Read: 5 warning symptoms of gout that you should know)

5. Psoriatic arthritis: It is a chronic disease characterized by inflammation of the skin (psoriasis) followed by inflammation of the joints (inflammatory arthritis). Psoriatic arthritis usually affects people with psoriasis in the age group of 40 to 50 years. Sometimes arthritis can occur earlier and psoriasis develops later, which makes it difficult to make a diagnosis.

6. Bursitis: Bursitis is the inflammation of bursa. Bursa is a fluid-filled sac that cushions the areas of friction between the two tissues, and reduces friction between the moving parts of the body for example, area around the joints of the shoulder, elbow, hip and knee. Bursitis can be caused by trauma to the affected area through repetitive motions, such as when you repetitively kneel on the hard surface to scrub the floor you may get pre-patellar bursitis or the bursitis of the knee. Infection or a pre-existing rheumatoid conditions can also cause bursitis.

7. Lupus: Lupus is another autoimmune disease where your body produces abnormal antibodies called autoantibodies in the blood. These tissues can attack different parts of the body such as skin, joints, heart, lungs, and kidneys. When it affects just the skin you may notice flare-ups or rashes. However, if the internal organs are involved lupus is called systemic lupus erythematosus (SLE) and it can cause serious trouble. Symptoms include fever, headache, swollen and painful joints, swelling in hands, feet, legs, or under the eyes, and extreme fatigue. (Read: Lupus 8 facts you ought to know about this autoimmune disease)

8. Lyme disease: Lyme disease is an infection caused by the bite of an infected deer tick. It can affect any organ of the body including the brain and the nervous system. Early symptoms include flu-like illness that could go away without treatment and a bulls-eye rash darker around the edges (only 10 percent of affected people show this rash). Later symptoms include headache, swollen and painful joints, light or sound sensitivity, cognitive impairment, fatigue, abdominal pain, nausea, shortness of breath, shooting pain, and depression or mood swings.
9. Synovial sarcoma: It is one of the most common soft tissue cancer in adolescents and young adults. The tumor occurs near a joint, not in the joint, especially in the knees and ankles. Usually there are no signs and symptoms in the early stages. Later symptoms include pain and swollen joints and a noticeable painful lump.
10. Torn meniscus: Meniscus is the cartilage within the knee joint that protects the knee from the stresses placed on it due to walking, running, climbing or bending. Sometimes a forceful twisting or rotation of the knee can cause the meniscus to tear. A torn meniscus causes a popping sensation, swelling or stiffness in the knee, a block in the movement of the affected knee.
11. Sprains and strains: A sprain is an injury to ligaments, for example, when you twist your ankle, whereas a strain is an injury to muscle or tendons as in hamstring injury in sports. Sprains and strains occur when your muscles and joints are forced to perform a movement for which they are not prepared, or occur after many repetitions of the motion. Pain and swelling of the joint in case of sprains and pain and swelling of the muscle in case of strains are the main symptoms. You may not think much of it but do see a doctor when you can t move the affected joint or have numbness in any part of the affected area.
12. Bone fracture: A bone fracture occurs when you exert a stronger force on the bone than it can bear. There are different types of bone fractures depending upon the person s age or health. For example, elderly people are more prone to hip fractures than say an adolescent. Fractures can also occur as a result of traumatic injury such as motor accidents, sporting injuries and falls. Osteoporosis and certain cancers also cause bones to break easily. A fracture in the bone is usually accompanied by injury to the surrounding tissue. This causes swelling of the affected joint near the fracture area. The swelling occurs within a few hours. (Read: A simple blood test can save you from fractures)

Swollen joints as such may not be life threatening. But do see a doctor if there is unexplained swelling of joints or if you have joint swelling after an injury.

Photo source: Getty images

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Reference:

John Gordon s story from The Washington Post, September 27, 2010

Neogi T, et al. Alcohol quantity and type on risk of recurrent gout attacks: an internet-based case-crossover study. American Journal of Medicine,2014 Apr;127(4):311-8.

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