Rheumatism – what is it, causes, signs,symptoms, treatment and diagnosis

Rheumatism is an inflammatory connective disease.
tissues, mainly in the cardiovascular and musculoskeletal
systems. The main danger of rheumatism is that
in the absence of appropriate treatment and supervision by a specialist,
possible development of serious pathologies affecting the central
nervous system and disturbing cardiovascular activity that
can lead not only to a deterioration in the quality of life in general, but also
disability and disability.

Rheumatism: what is it?

Ревматизм

Rheumatism is a systemic inflammatory disease that
localized mainly in the lining of the heart. At risk
there are people with a genetic predisposition to this
diseases and age from 7 to 15 years. Rheumatism usually suffer
adolescents and young people, rarely – older and weakened
Patients.

Rheumatism (synonyms: rheumatic fever, illness
Sokolsky – Buyo) proceeds chronically, with a tendency to
relapses, exacerbations occur in spring and autumn. On долю
rheumatic heart and blood vessels accounts for up to 80%
acquired heart defects.

The rheumatic process often involves joints,
serous membranes, skin, central nervous system. Frequency
The incidence of rheumatism ranges from 0.3% to 3%.

Great value is played by hereditary predisposition to
this disease. In the so-called rheumatic families
the incidence is three times higher than in the normal population. Disease
inherited by polygenic type.

Classification

Allocate:

Acute rheumatism

Rheumatism in the acute phase is most often seen in young people.
up to 20 years. The causative agent is streptococcus. Conjunction of the disease with
postponed upper respiratory tract infections lies in
delayed symptoms (14-21 days).

Onчальные проявления ревматизма имеют много общего с клиникой
colds, however, after a short time, to
symptoms of a cold are joined by manifestations of carditis, skin
rashes and polyarthritis.

The total duration of the acute form of the disease ranges from 3 to 6
months. Acute rheumatism may lead to serious
complications. In the absence of timely treatment, rheumatic
carditis develops into heart defects.

Chronic rheumatism

Chronic rheumatism is characterized by frequent relapses.
болезни, особенно при переохлаждениях организма. Amazed
most often the heart and joints, with typical pain in these organs.
The course of the disease can last for several years.

Rheumatism is divided into forms according to the criterion of the affected system.
or body:

  • Rheumatism of the heart. Heart failure at first rheumatic
    attack is observed in 90-95% of all patients. It can
    all three walls of the heart are affected – endocardium, myocardium and pericardium. AT
    20-25% of cases rheumatic carditis ends formed
    heart disease. The main feature of heart disease in rheumatism
    in children and adults – extreme scarcity of manifestations. Patients complain
    unpleasant sensations in the heart, shortness of breath and cough after
    physical exertion, pain and disruption of the heart. Usually,
    children keep silent about these complaints, without giving them serious
    values. Therefore, damage to the heart is most often possible to identify
    with physical and instrumental examination.
  • Ревматизм суставов (ревматический полиarthritis). More often,
    pathological changes affect the ulna, knee and
    ankle joints. In a person with rheumatic arthritis
    body temperature increases to 39 degrees, weakness increases,
    episodes of nasal bleeding may occur as well
    sweating increases;
  • Pulmonary form. Manifested in conjunction with a lesion.
    joints and heart, however, is extremely rare (about 1-3%
    total number of clinical cases). Develops in
    форме плеврита или бронхита;
  • Skin form. It manifests itself as a skin rash, or
    rheumatic nodules. ATстречается не более чем в 5%
    cases;
  • Eye rheumatism. It is an integral part of common manifestations.
    rheumatism of other organs. It is characterized by lesions of the retina.
    (retinitis) or other parts of the eye (iritis, iridocyclitis, etc.).
    Complicationsми может стать частичная или полная потеря зрения.

Bacteriological and serological studies have shown that
rheumatism is a particular allergic reaction to infection by one
из бета гемолитических стрептококков группы А.

First signs

ATыявление ревматизма на ранних стадиях, особенно при наличии
predisposition to this disease is very important for
the effectiveness of its further treatment. However, as a rule
diagnosis is made in the presence of reliable
symptoms indicative of the development of rheumatism. Required
pay attention to both individual signs and
their totality.

Signs that need to pay attention:

  • AT типичных случаях первые признаки ревматизма в виде лихорадки,
    signs of intoxication (fatigue, weakness, headache pain),
    joint pain and other manifestations of the disease are detected through
    2–3 недели после ангины или pharyngitis
  • One of the earliest signs of rheumatism are pain in
    joints detected in 60-100% of cases (rheumatoid
    arthritis).
  • The signs of heart damage are determined in 70-85% of cases. Complaints
    heart character (pain in the heart, palpitations, shortness of breath)
    marked with marked cardiac disorders.
  • More often, especially at the beginning of the disease, a variety of
    asthenic manifestations (lethargy, malaise, increased
    fatigue).

Causes

A rheumatic attack is usually preceded by streptococcal
infection caused by β-hemolytic streptococcus group A:

  • scarlet fever,
  • tonsillitis,
  • puerperal fever,
  • acute otitis media
  • pharyngitis,
  • mug

97% of patients who have had streptococcal infection
formed a strong immune response. The rest of the persistent
immunity is not produced, and when re-infection
β-hemolytic streptococcus develops complex autoimmune
inflammatory reaction.

Factors contributing to the emergence and development of rheumatism,
are:

  • reduced immunity;
  • populous groups (boarding schools, schools, dormitories);
  • young age;
  • poor social and living conditions (food,
    housing);
  • prolonged hypothermia;
  • unfavorable family history.

Symptoms of rheumatism in an adult

Rheumatism is a multi-symptom disease for which, along with
with general changes in condition, signs of damage are characteristic
heart, joint, nervous and respiratory system, as well as other
organic structures. Most often the disease makes itself felt in 1-3
weeks after an infectious disease caused by β-hemolytic
Streptococcus group A.

The patient has the following symptoms:

  • increase in body temperature to high numbers;
  • tachycardia;
  • headaches;
  • increased sweating;
  • weakness;
  • swelling and soreness in the joints.

They are very similar to the common cold, but are caused
streptococcal, not viral infection. Characteristic difference
soreness and swelling of large joint arises
articulations: elbow, ankle, knee, shoulder or
wrist band.

Типичными симптомами ревматизма are:

  • высокая температура, 38-40 градусов, колебания которой в
    during the day are 1-2 C, excessive sweating, chills, as
    rule not;
  • on this background, there is muscle weakness, increased
    fatigue: pain in the joints;
  • swelling of soft tissue.

Most often, the disease manifests itself in a few weeks due to
previous infectious diseases, for example, after a sore throat and
pharyngitis

As rheumatism progresses, others may appear.
specific symptoms – not always, on average they are recorded in 10%
cases:

  1. vascular fragility increases – manifested in regular nasal
    bleeding that occurs suddenly;
  2. Annular rashes appear – look like rounded, with
    jagged edges, small pink rash;
  3. rheumatic nodes are formed – localized in places
    anatomical location of the affected joints, have the form
    subcutaneous dense formations and completely painless;
  4. affected abdominal organs – characterized by pain in
    areas of the right hypochondrium, indicate the need
    immediate hospitalization of the patient.
  5. The muscle of the heart (myocardium) and the inner lining of the chambers are affected.
    heart (endocardium) – as a result of this shortness of breath appears, rapid
    heartbeat, arrhythmias, chest pain, cardiac develops
    failure.
  6. Rheumatic inflammation of the heart wall (rheumatic heart disease) is often
    recurs, heart defects are gradually formed.
  7. With rheumatism of the joints in one or several joints at once
    there is a sudden pain. Joints become red, swollen
    and hot. Most often affects the knee, ankle, elbow
    joints, wrists. Sometimes hip, shoulder
    joints and small joints of the feet and hands.
  8. Along with the appearance of pain in the joints begins to rise
    Body temperature. Body temperature in rheumatism of the joints
    decreases, then rises again. Symptoms of rheumatism usually disappear
    in two weeks.

Complications

The development of rheumatism complications is determined by the severity
protracted and continuously recurrent nature of the flow. In active
circulatory disorders may develop in the rheumatism phase and
atrial fibrillation.

If the symptoms of rheumatism are not paid due attention, and
during a visit to the doctor, this disease can cause
The following complications:

  • go into the chronic form, the treatment of which may take up
    several years;
  • develop heart defects;
  • cause heart failure;
  • as a result of heart failure
    кровеносной системы, что в свою очередь может спровоцировать
    инсульты, варикозы, заболевания почек, печени, органов
    respiration, organs of vision, etc.
  • during exacerbation of all the above symptoms and diseases
    be fatal.

Diagnostics

Instrumental research methods include:

  • ECG (on the cardiogram rarely violations are detected
    heart rate);
  • Ultrasound of the heart;
  • X-ray examination (allows you to determine
    an increase in the size of the heart, a change in its configuration, and
    decrease in myocardial contractile function);

Laboratory diagnosis of rheumatism:

  • In general, a blood test shows an increase in ESR, a shift
    leukocyte left, anemia.
  • In the immunological analysis increases the titers of ASH, increases
    the number of immunoglobulins class A, G, M, is detected
    C-reactive protein, anti-cardiac antibodies and circulating
    immune complexes.

Rheumatism treatment

The treatment of the considered disease is necessarily carried out under
контролем специалиста и чаще всего пациент  помещается в
medical institution. There are a number of drugs that
who are necessarily assigned to the patient as part of the treatment
in relation to rheumatism. These include:

  • Antibacterial drugs (penicillin with the subsequent transition
    on bitsillin5). In case of intolerance to penicillin,
    used erythromycin.
  • Corticosteroids for rendering a pronounced anti-inflammatory
    effects: Prednisolone. Since the use of corticosteroids
    affects the water-salt metabolism, in addition to the patient
    prescribe potassium drugs (Asparkam, Panangin).
  • nonsteroidal anti-inflammatory drugs: indomethacin,
    Ibuprofen, Xefocam, Revmoksikam, Dikloberl and others;
  • hyposensitizing drugs;
  • immunosuppressants: Azathioprine, Chlorbutin, Chloroquine,
    Hydroxychloroquine;
  • glucocorticosteroids: Triamcinolone, Prednisolone.
  • Aspirin. With rheumatism, this drug helps
    quickly save the patient from pain in the joints, remove
    swelling of the joints.

Hormone therapy is now rarely used, and such drugs
appointed only in certain clinical cases.

Лечение ревматизма проводится по специальной
scheme. It consists of three stages:

  1. Stage 1. Therapy is carried out in a hospital, different
    lasting from 4 to 6 weeks. The first stage is treatment.
    diseases at the peak of activity.
  2. Stage 2 This stage is restorative after
    intensive care. It involves treatment in special
    spas or resorts.
  3. Stage 3. This stage is preventive. is he
    implies annual preventive therapy, accounting for
    rheumatologist and constant supervision by a doctor.

An acute attack of rheumatism is treated in the hospital. To the patient
prescribe bed rest. Drug therapy depends on
clinical manifestations and forms of pathology and includes:

  • glucocorticoids,
  • anti-inflammatory drugs
  • antibiotics
  • means of stimulating the body’s immune response,
  • sedative dosage forms.

In the presence of cardiac lesions, cardiac glycosides are used and
diuretics.

The prognosis of rheumatism depends on the severity of damage to the tissues of the heart and
joints (i.e. the presence and extent of myocardiosclerosis, the nature
valvular heart disease). If eliminating rheumatic fever
was started on time, then the disease is amenable to treatment, and
life of the patient is not in danger. Most unfavorable
often recurrent rheumatism occurs.

Folk remedies

To use folk remedies for rheumatism is necessary only
after the consent of the attending physician.

  1. Broth from aconite. 10 g of aconite root put in a pan and
    Pour 500 g of water into it. Boil means for 2 hours on
    slow fire. Next cool the product, strain, and rub it.
    affected areas 3 times a day.
  2. Lemon. Citrus Tincture Stimulates Blood Circulation
    and relieves inflammatory manifestations. 2 large lemons cut
    together with the peel, pour 0.4 liters of vodka in a glass container or
    diluted alcohol, clog, insist in a shaded place
    three days. Use liquid externally, for rubbing with
    subsequent insulation with wool fabrics.
  3. Pour 10 g of Hypericum grass with 1 cup of hot water, boil 30
    minutes on low heat, cool and strain. Take when
    rheumatism 0.3 cups 3 times a day 30 minutes before meals. Keep
    no more than 3 days.
  4. Drink every day for 2-3 cups decoction of stigma of corn. On
    a glass of water to take a teaspoon of raw materials with the top, cook on slow
    fire 10 minutes. Drink for 6–8 weeks. It takes the most old
    muscle rheumatism.
  5. Air (root) for the bath. 2 tablespoons finely chopped
    calamus rhizomes pour 1 liter of boiling water, boil for 20 minutes, insist 30
    minutes and strain. Bath (35-36 ° C) to take a day or night at
    rheumatism and gout. The course of treatment: 10-12 baths.

Prevention

Among the measures aimed at preventing rheumatism,
include:

  • timely detection of streptococcal infection, rehabilitation
    infectious focus;
  • improving hygienic, social and living conditions of work and
    life;
  • hardening;
  • prophylactic antimicrobial and anti-inflammatory
    препаратов в осенние и  весенние периоды.

Secondary prevention of rheumatism includes the following plan.
action:

  1. If the illness is active, then you should always be on
    контроле у ревмокардиолога. First visit the doctor each
    month on протяжении 3 месяцев от начала развития недуга,
    а после 1 раз в квартал. Compulsory
    условием является обращение за консультацией к неврологу,
    ENT, oculist, dentist, gynecologist.
  2. Plasma testing should be carried out 6 times a year.
    and urine analysis should be taken up to 4 times a year.
  3. Prevention ревматизма
    основывается на обязательном проведении диагностических
    events. They should be conducted quarterly.
  4. Исследование крови на ревмопробы осуществляется 4
    times a year. If the process attenuation is observed and its transition into
    неактивную фазу, то посещать ревмокардиолога следует 2– 4
    times a year.

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