OSTEOARTICULAR INFLAMMATORY DISEASES

What awaits you at Centrokinetic?

Centrokinetic welcomes patients, having a complete rheumatology department, a medical branch that deals with the diagnosis, treatment, and recovery of patients with non-surgical musculoskeletal disorders. These conditions are usually painful, acute, or, most often, chronic, preventing the proper functioning of the musculoskeletal system. They are generally called rheumatism or rheumatic and musculoskeletal diseases.

Most of the times, the patient's evaluation is complex, multidisciplinary, considering the systemic, generalized character of most rheumatological diseases, that is why Centrokinetic has experienced doctors:

• Rheumatologists: Dr. Alizzi Khalid and Dr. Oana Olteanu.
• Medical rehabilitation doctors: Dr. Tache Georgiana, Dr. Edis Mustafa, Dr. Matei Adina, Dr. Czego Renata.
• Orthopedic doctors: Dr. Andrei Bogdan, Dr. Vlad Gican and Dr. Crintea Alexandru
• Radiologists: Dr. Pantu Cosmin and Dr. Ghiea Sorin 
• Neurologists: Dr. Rotaru Bogdan, Dr. Simona Man and Dr. Simion Laurentiu
• Doctor of nutrition and metabolism diseases: Dr. Elian Viviana

How do inflammatory osteoarticular diseases manifest themselves?

One of the main symptoms in rheumatic diseases is swelling of the joints, which is due to the increase of fluid amount in the tissues surrounding the joints. This symptom is common in arthritis and infections.

Osteoarthritis or osteoarthritis of wear usually occurs with age, being influenced by genetic factors, biomechanics, weight, performance sports, or joint trajectory fractures. In this case, the cartilage that covers the extremities of the bones of a joint erodes. The most affected joints are the ones we put the most pressure on - knees, hips, ankles, spine. The patient complains of pain, stiffness after rest, especially in the morning, and decreased mobility.

Rheumatoid arthritis is an inflammatory process that can occur at any age, even in children. It is characterized by painful, stiff, and swollen joints. Usually, the hands, feet, and knees are affected.

Gouty arthritis often occurs unexpectedly, with pain, swelling, heat, and redness around the joint, affecting the hallux in 50% of cases. Usually, only one joint is affected. Uric acid forms crystals that deposit in the joints, leading to inflammation and pain. These crystals can settle in other areas of the body, forming nodules under the skin or kidney stones. 

Ankylosing spondylitis affects the sacroiliac joint, where the spine articulates with the pelvis.

Infectious arthritis is caused by bacteria, viruses, or fungi, affecting the tissues and fluids of the joint. It usually occurs after an infection in the body. The mechanism of transmission is through blood flow from another area of ​​the body - skin, nose, throat, ears, or from a pre-existing wound. The symptoms are pain, inflammation, and fever. Affected joints are much more vulnerable to infections. Staphylococcus aureus and Neisseria gonorrhoeae are among the most common bacteria.

Symptoms

The most common symptoms of affected joints are:

• Deep and stinging pain
• Heat to the touch
• Stiffness
• Lack of mobility

Our medical team will come in addition to the investigations to establish a correct diagnosis, with imaging investigations (musculoskeletal ultrasound, joint MRI), functional tests (electromyography), and arthrocentesis. Discover the open MRI imaging center in our clinic. Centrokinetic has a state-of-the-art MRI machine, dedicated to musculoskeletal conditions, in the upper and lower limbs. The MRI machine is open so that people suffering from claustrophobia can do this investigation. The examination duration is, on average, 20 minutes.

Treatment

Treatment depends on the cause and diagnosis and differs depending on the type of arthritis. Treatment methods are complex and include: drug treatment and careful follow-up by a rheumatologist (steroidal and non-steroidal anti-inflammatory drugs, analgesics, muscle relaxants, immunological modulating therapies, bone antiresorptive treatment in osteoporosis).

Non-steroidal anti-inflammatory drugs are used successfully in osteoarthritis. Hot packs and ice can help reduce swelling and pain.

Oral steroid medication has the effect of reducing pain and swelling, these drugs blocking the inflammatory process.

• Anti-inflammatory solutions or corticosteroids: are usually used for several types of musculoskeletal problems, such as tendinitis, tenosynovitis, bursitis, fasciitis, osteoarthritis, muscle injuries, ligament injuries. Corticosteroids are natural hormones made from cholesterol in the adrenal glands. In clinical practice, steroids are used for their powerful anti-inflammatory effects. Corticosteroids should not be confused with anabolic steroids, which are known to be used by athletes to increase muscle mass and strength. Corticosteroids used in resentment are injected all over the world, the administration doses are minimal, on average 0.4mg, and the side effects are similar in elderly patients, by temporarily increasing (2-3 days) blood pressure and blood sugar.
• Sterile viscoelastic solutions (hyaluronic acid): are performed mainly intraarticularly, both in the large joints (knee, shoulder, hip, ankle) and in the small ones (fist, elbow, metatarsophalangeal, or interphalangeal). The role of these infiltrations is multiple: protector of the articular cartilage through the viscous properties of the injection - the molecules of Hyaluronic Acid in the synovial fluid, act as a lubricant, protecting the articular surfaces from mechanical damage, by elastic properties - under the pressure generated by the joint load (bodyweight), hyaluronic acid in a synovial fluid acts as a shock absorber, protecting cartilage from compressive trauma, a nutrient for joint cartilage, synovial tissue protector: Hyaluronic acid is a protective barrier for the synovial membrane and masks the receptors for inflammation in the knee, reducing inflammation.
• Infiltrations with PRP (platelet hyperconcentrate): have been used since 1978 in the USA, in the treatment of musculoskeletal disorders, with extraordinary results. The infiltration lasts on average 40 minutes, is painless, and consists of collecting peripheral blood (from the vein) of the patient, on average between 60 and 180 ml, centrifugation 20-25 minutes to separate platelets from other blood cells, and injection into the same stage in the affected area. Centrokinetic offers patients treatments with the best PRP kits in the world, brought from the USA, from Arthrex and Magellan. The rationale for using this type of infiltration is to initiate and accelerate the natural process of tissue healing and regeneration by releasing platelet-derived growth factors directly into the affected tissue. According to current studies, soft tissue lesions and cartilage lesions are receptive to this treatment. Some of these include the following: tendinitis (epicondylitis, plantar tendonitis, Achilles, patellar, etc.), tendinosis, tendon ruptures, tendon degenerative lesions, muscle ruptures, cartilage lesions (arthrosis). The therapy also has a postoperative indication in meniscus suture, ligamentoplasty, sutures/tendon reinsertions (rotator cuff, Bankard, Achilles tendon, patellar tendon, quadrigeminal, etc.).
• Autologous growth factor therapy:  is a therapy used in Germany for 15 years, and consists of harvesting the body's growth factors, multiplying them by incubation, and reinjecting them into the affected area. The duration of the treatment is 3 hours, performing 3-5 procedures, at 1-week intervals. The major indications are chronic tendinitis (epicondylitis, plantar tendonitis, Achilles, patellar), and articular cartilage lesions (arthrosis). It also has excellent results in the treatment of joint and periarticular pain. Autologous growth factor therapy is a treatment with a cytokine-rich autologous serum (ACRS), derived from the patient's blood. To ensure high tolerability, this technology completely avoids the use of any artificial additives. This special serum, rich in autologous cytokines, can activate the body's ability to heal itself by producing positive interleukins and growth factors. These are crucial to intervene in the cascade of pain, causing it to stop and the subsequent onset of the healing process.

Centrokinetic clinic has a very experienced team, specialized in sports traumatology, accredited in: Tecar therapy, dynamic taping, massage, Graston technique, Kinesio Tape, ERGON, flossing band. Our team has attended numerous overspecialized courses with trainers from the country and abroad, being certified to perform therapies at the highest level.

About Centrokinetic

Centrokinetic clinic offers all services necessary for a complete rehabilitation process, from the first consultation to the medical specialist to establish the correct diagnosis, to treatment and recovery.

Centrokinetic is the place where you will find clear answers and solutions for your motricity problems. The clinic is dedicated to osteoarticular conditions and is divided into the following departments:

• Orthopedics, a department composed of an extremely experienced team of orthopedic doctors, led by Dr. Andrei Ioan Bogdan, primary care physician in orthopedics-traumatology, with surgical activity at Medlife Orthopedic Hospital, specialized in sports traumatology and ankle and foot surgery.
• Pediatric orthopedics, where children's sports conditions are treated (ligament and meniscus injuries), spinal deformities (scoliosis, kyphosis, hyperlordosis) and those of the feet (hallux valgus, hallux rigidus, equine larynx, flat valgus, hollow foot).
• Neurology, which has an ultra-performing department, where consultations, electroencephalograms (EEG) and electromyography (EMG) are performed. 
• Medical recovery  for adults and  children, department specialized in the recovery of performance athletes, in spinal disorders, in the recovery of children with neurological and traumatic diseases. Our experience is extremely rich, treating over 5000 performance athletes.
• Medical imaging, the clinic being equipped with ultrasound and MRI, high-performance devices dedicated to musculoskeletal disorders, and complemented by an experienced team of radiologists: Dr. Sorin Ghiea and Dr. Cosmin Pantu, specialized in musculoskeletal imaging.

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